headache Archives

Apr

2020

Side Effects of the Birth Control Pill

By Ray Schilling | autoimmune disease, birth control pill, breast cancer, Cancer, Cardiovascular disease, cervical cancer, depression, headache, heart attack, Hormones, Menopause, Osteoporosis, Stroke

Dr. Jolene Brighten gave a lecture about side effects of the birth control pill. This was at the 27th Annual World Congress on Anti-Aging Medicine in Las Vegas from Dec. 13 to 15th, 2019. Her exact title was “Your Body on Birth Control- What Prescribers Should Know About the Effects of Birth Control on the Female Body”.

Most commonly the oral contraceptive pill is prescribed to prevent pregnancy. But the long-acting reversible contraceptives like the IUD and progestin implants are also popular. Depot Provera, the ring and the patch are the least popular ones.

Why women use the birth control pill

Women age 15 to 49 are often on some form of birth control method. 58% of women who use the birth control pill use it for reasons other than to prevent pregnancy. They use it to control symptoms of various conditions.

31% use it for menstrual cramps
28% want to regulate their periods
14% hope to improve their acne
4% use the pill for menstrual pains associated with endometriosis
11% for other reasons

What the birth control pill does

The birth control pill exerts a negative influence on the hypothalamus and the pituitary gland. This is called “functional hypothalamic amenorrhea”. The birth control pill is not suitable to treat polycystic ovarian syndrome. Symptoms of bleeding may improve for 3 months, but after that the original symptoms return. Thyroid disease that may be present needs separate investigations.

The hormones that are part of the birth control pill are synthetic hormones. They do not quite fit the body’s hormone receptors. For instance, the progestins, artificial analogues of progesterone behave like estrogens, not progesterone. This causes clotting problems cancers of the uterus, breasts and cervix. It can also cause heart attacks and strokes.

List of side effects of the birth control pill

From depression to liver health

The list of side effects of the birth control pill (BCP) is long. The BCP can worsen symptoms of depression and anxiety. The deeper the depression is, the higher is the risk for suicide. There is increased risk of hair loss. The BCP depletes nutrients in the body that the thyroid gland needs to produce thyroid hormones. This can result in hypothyroidism.

It also increases thyroid binding globulin, a protein in the blood that binds thyroid hormones. As a result, there are fewer thyroid hormones available to the body cells. Breasts may become tender and enlarged after the start of the BCP. In some women with fibrocystic disease of the breasts the BCP may improve her cyclical breast changes. The BCP changes the liver both structurally and genetically. As a result, there is a higher risk of developing benign liver tumors and liver cancer.

From gallstones to blood clots

Women with a history of gallstones may experience faster gallstone formation on the BCP. The pill also can elevate your blood pressure. You should have blood pressure checks from time to time to prevent a stroke. Weight gain is common on the BCP. However, some women experience weight loss. Usually the BCP is 99% effective for the prevention of pregnancy. Pain from heavy periods or menstrual cramps are often relieved by the BCP. There is an increased risk to develop diabetes, because insulin resistance is gets worse in patients on the BCP. In postmenopausal women on HRT there is an even higher risk of developing diabetes. Blot clots are a common side effect of the BCP. Being a smoker, having a heart or liver condition, a history of genetic risk of blood clots, having migraines with an aura or being overweight are all additional risk factors for developing blood clots.

From effects on the brain to cancer risks

The BCP can change brain function and structure. This may lead to a different mate selection and production of neurotoxins. Some women get relief from hormonal headaches; but others experience exacerbations of migraines and headaches. In some women acne improves on the BCP; in others acne gets worse. When it comes to stress, some women experience an altered hypothalamic-pituitary-adrenal gland response from the BCP. The BCP reduces some cancer risks, like the risk of ovarian, uterine and colorectal cancer. But the risk for breast cancer, brain cancer and liver cancer are higher. The BCP increases gut permeability, leads to leaky gut syndrome and the disruption of the microbiome. There is often overgrowth of yeast in the gut. In addition, people with a genetic predisposition for autoimmune disease of the gut can develop immune diseases. Multiple studies have shown malabsorption of vitamins, minerals and antioxidants when on the BCP.

From vaginal yeast infections to osteoporosis and autoimmune diseases

Many women develop vaginal yeast infections. Women on the BCP often complain about low or a lack of libido. There can be vaginal dryness and pain with sex.

Teenage women on the BCP often develop decreased bone density. Synthetic hormones lack the specificity to the natural hormone receptors, which leads to decreased bone density. On the other hand, bioidentical estrogen and bioidentical progesterone will indeed build up bone mass. In the past it was thought that hormones would be good for the bones and this is still true with the use of bioidentical hormones.

A number of autoimmune diseases have been identified to be directly related to the use of the BCP. These are Crohn’s disease, multiple sclerosis, lupus, interstitial cystitis and ulcerative colitis.

Synthetic hormones will always have side effects

The body is a complex organism with various hormone receptors built into its cells. In order to be able to cash in on patented modified hormones Big Pharma introduced progestins to replace natural progesterone and various synthetic estrogen products to replace natural estradiol. However, the Women’s Health Initiative has shown in 2002 that these artificial hormones produced heart attacks, strokes, blood clots, colorectal and endometrial cancer and hip fractures. There was an increase of mortality of 15% over 5.2 years compared to controls who did not take artificial hormones within the same timeframe.

Bioidentical hormones have a perfect fit to the natural hormone receptors

In contrast, when bioidentical hormones are given in menopause, there is a 10 to 15 year extension of life expectancy and researchers did not see any of the above mentioned side effects that were noted with synthetic hormones. Many people in Europe have elected to stick to bioidentical hormones for decades; they did not use the synthetic hormones. As a result, there are good data going back to the 1960’s about the safety of bioidentical hormones. In this study several thousand postmenopausal women were followed for 9 years or more and showed no increase in the rate of heart attacks or any cancer. Their postmenopausal symptoms were optimally controlled. I conclude from this that bioidentical hormone replacement in menopause will protect the women from missing hormones safely. There are no side effects and for this reason the bioidentical hormone replacement should become the standard of care.

Side Effects of the Birth Control Pill

Conclusion

Synthetic hormones have a long list of devastating side effects. Yet, Big Pharma managed to influence general practitioners and gynecologist to prescribe them to postmenopausal women. The Women’s Health Initiative has changed everything. The promise was that synthetic hormones would show heart-protective effects, cancer protective effects and healing effects for osteoporosis. These have been empty promises! None of this occurred with synthetic hormones- to the contrary! Many physicians are now prescribing bioidentical hormone replacement for women in menopause.

No good alternative for teenage girls

However, for teenage girls there is no good alternative for the traditional birth control pill, even though the catalogue of side effects is of serious concern. One compromise is to limit prescribing the birth control pill for up to 5 years only and then switch to several years of a copper T or other intrauterine device (IUD). Suicide in teenage girls on the BCP is of real concern. Despite the list of side effects many doctors continue to prescribe synthetic hormones for decades to the same patients, who trust that it will benefit them. In time patients will know about the side effects, and unfortunately many will experience them. As a result, it is only a matter of time, till this will be exposed as malpractice!

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Nov

2019

Non-Drug Treatment For Migraines In Women

By Ray Schilling | Drugs, headache, Hormones

In the following I am discussing the non-drug treatment for migraines in women. There are a number of different types of headaches: common headaches, tension type headaches, cluster headaches and migraine headaches. Here I am only zeroing in on migraine headaches.

Introduction

A migraine headache is the second most common headache and occurs with an average frequency of about 12% in the general population. Women outnumber men in the U.S. by a factor of 3 to 1 with migraines. There is a genetic factor as migraine sufferers’ family members are getting migraines about 3-fold more often than the general public. Newer insights into hormonal connections point to the fact that often migraine sufferers are in an estrogen dominant state (Ref. 4). With estrogen dominance there is a disbalance between estrogen production and progesterone production. For instance, many women who develop fibroids miss their ovulation and as a result can have fertility problems (no corpus luteum developed in the ovaries). The reason for infertility, fibroid development and the development of migraines in some migraine sufferers is the lack of progesterone in the second half of the cycle.

Xenoestrogens

Xenoestrogens (pesticides, artificial hormones like Provera, the birth control pill etc.) can also function as a contributor to the estrogen load as a woman’s estrogen receptors will have a partial fit with them. The resulting hormone disbalance can trigger migraines in migraine sufferers. The trigger is the relative lack of natural progesterone. This may also be the reason why migraines are much more common in woman than men. On the other hand Dr. S.A. Dugan has done hormone studies on both male and female patients with migraine. He found that both sexes are often also suffering from fibromyalgia, chronic fatigue syndrome, and lipid disorders including high cholesterol, sleep disorders, gastrointestinal problems and depression. When these patients had hormone tests were done on these patients the majority had what Dr. Dzugan called “steroidopenia” (low levels of estrogen, progesterone, testosterone and DHEA). This is discussed in more detail under Ref. 3.

Symptoms

Migraines present in 85% without an aura (formerly called “common migraines”) and in 15% with an aura (formerly called “classic migraines”). An aura consists of changed behaviors such as pacing, yawning, craving of certain foods, lethargy, depression or mild euphoria. These symptoms are separate from the migraine aura, which consists of neurological symptoms such as visual symptoms arise 1 or 2 hours before the migraine headache starts and disappear about 1 hour after the start of the migraine.

Types of migraine aura symptoms

These migraine aura symptoms are quite varied and can include numbness of the skin in a hand or a foot on the side where the migraine is and around the mouth area. Spotty eye field defects can also occur immediately prior to the onset of the headache and there may be deficits in language expression and pronunciation. Other such migraine aura symptoms can consist of double vision, ringing in the ears, balance problems, a gait abnormality and decreased levels of consciousness.

Typically a migraine is confined to one side of the head

The actual migraine headache is on one side of the head, can last 4 hours to 3 days, is throbbing in nature, moderately to severe in intensity and is made worse by physical activity, light or noise. The patient is complaining of nausea and might be vomiting with a severe migraine. In a small percentage of patients a more severe form of complicated migraine (or “migraine with prolonged aura”) can develop where the patient has prolonged symptoms of a migraine aura for more than 1 hour, but usually less than 1 week. These patients should be investigated thoroughly by a neurologist as a small percentage of these patients can develop persistent neurological symptoms including a “migraine stroke ” (=a stroke like clinical picture) (Ref. 1, p. 2067).

Conventional treatment of migraines

Medication that is used is quite different between attacks as compared to during an attack. During a migraine attack non-steroidal anti-inflammatory drugs (=NSAIDs) and dihydroergotamine or Sumatriptan, which stimulate serotonin receptors, are common medications. Drug dependency issues on narcotics have to be discussed frankly with the patient because of the danger of rebound migraines that are triggered by the continued use of narcotics. Sumatriptan can be given intranasally, but it is important for the physician to monitor overuse and dependency on this medication. In males there is a higher risk for heart attacks as a side effect of the medication. The patient can also receive Prochlorperazine (brand name: Stemetil or Compro) intravenously as a drip in an Emergency room setting. This can abort a migraine.

Preventatives of migraine attacks

Between migraine attacks there are a number of preventatives that are effective. They consist of beta-blockers such as propranolol, metoprolol, Timolol and others; NSAIDs such as ASA, naproxen or ketoprofen; calcium channel blockers such as Verapamil or Flunarizine, also antidepressants such as amitriptyline.

Gabapentin is the latest medication that research found to be useful in several smaller studies. Gabapentin (brand name: Neurontin) releases GABA in some parts of the brain and inhibits the NMDA pain receptors. Dr. Stephen Clarke, Clinical Assistant Professor in the Div. of Neurology of the University of BC/Vancouver/Canada, reviewed the use of gabapentin at a conference in Vancouver/BC in November 2004 (Ref. 2).

Other medication for headache prevention are the anticonvulsant gabapentin; the MAO inhibitor phenelzine and the serotonin stimulating drugs methysergide and cyproheptadine. Unfortunately many of these medications do not work 100% and there is a lack of good randomized studies to prove effectiveness.

Non-conventional, but effective treatment of migraines

Bioidentical progesterone treatment

In light of what I explained above with regard to a hormone disbalance in women migraine sufferers, it is logical that Dr. Lee suggested (Ref. 5) using 20 mg of a bioidentical progesterone cream applied to the skin during the second half of the cycle (day 12 to 26 of the cycle). After three months there is usually a significant improvement of the migraines. With only a partial response to this low dose of progesterone cream, the doctor can increase the progesterone dosage temporarily to 40 or 50 mg per day from day 12 to 26 of the cycle for several months. If there is a response, the doctor continues treatments with bioidentical progesterone cream until menopause. An alternative to bio-identical progesterone cream is Prometrium (micronized progesterone) by mouth, 100mg or 200mg at bedtime. Discuss this with your doctor. You will need a prescription from him/her for Prometrium.

Avoid migraine triggering factors

It is important to include in the regimen of anti-migraine measures non drug regimens such as avoidance of triggering factors like certain foods (chocolate, red wine, certain cheeses and strong smells) or bright lights and noises. It is important to pay attention to consistent sleeping patterns and meal times. When emotional factors play a role, counseling, relaxation techniques like yoga, self-hypnosis and biofeedback methods are all helpful as well. The doctor refers more complex migraine cases to a neurologist or a multidisciplinary headache clinic.

Dr. Dzugan’s “correction of steroidopenia” approach

Since Dr. Dzugan published the results of treating migraine sufferers with the Dzugan method, it is important to look at all of the hormones including steroid hormones as mentioned above. Any hormone deficiency is rectified using bio-identical hormones; then the doctor repeats hormone levels to verify hormone balance. Dr. Dzugan found that following “correction of steroidopenia” after 9 to 12 months at the latest almost all of his patients were migraine free and lost all of the other accompanying symptoms.

Non-Drug Treatment For Migraines In Women

Conclusion

Many women suffer needlessly from migraines because of estrogen dominance. Estrogen dominance occurs when they miss an ovulation (because of a lack of the corpus luteum that manufactures progesterone in the second part of the menstrual cycle). But taking the birth control pill or taking HRT with synthetic hormones in menopause can also cause estrogen dominance. This is when bioidentical progesterone replacement can help to rebalance progesterone and estrogen. Migraines often disappear in the process of this approach. If you have migraines, you should discuss the bioidentical progesterone approach with your doctor.

References

Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company
The 50th Annual St. Paul’s Hospital Continuing Medical Education Conference for Primary Physicians, Nov. 16 – 19, 2004, Vancouver,BC, Canada
http://www.ncbi.nlm.nih.gov/pubm…: Dzugan SA, Rozakis GW, Dzugan KS, Emhof L, Dzugan SS, Xydas C, Michaelides C, Chene J, Medvedovsky M.: “Correction of steroidopenia as a new method of hypercholesterolemia treatment.” Neuro Endocrinol Lett. 2011;32(1):77-81.
Dr. John R. Lee, David Zava and Virginia Hopkins: “What your doctor may not tell you about breast cancer – How hormone balance can help save your life”, Wellness Central, Hachette Book Group USA, 2005. On page 256 and 257 Dr. Lee describes how he uses progesterone as a cream to treat PMS.
Dr. John R. Lee: “Natural Progesterone- The remarkable roles of a remarkable hormone”, Jon Carpenter Publishing, 2nd edition, 1999, Bristol, England.

Dec

2017

Fasting Mimicking Diet

By Ray Schilling | autoimmune disease, Cancer, Diabetes, diet, headache, heart attack, High Blood Pressure, immune system, Inflammation, Multiple sclerosis, Stroke, telomeres

The fasting mimicking diet (FMD) was at the center of this year’s anti-aging conference in Las Vegas. This was the 25^th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017. Dr. Valter Longo, PhD reviewed some of the research he had done on longevity in yeast cells, worms and mice.

Fasting mimicking diet relevant in humans

Dr. Longo pointed out that this type of research has relevance in humans. If there was a cure for cancer, heart disease, stroke and diabetes, we would live 13 years longer. But if we stimulated longevity with this pulsed calorie restricted diet, we would live on average 30 years longer. There is a rare genetic abnormality where people are deficient for IGF-1, a growth factor produced in the liver. These genetically IGF-1 deficient people live longer and do not develop cancer. Observations like these and detailed mouse experiments inspired Dr. Longo to develop a new diet plan. Patients would receive a fasting mimicking diet on 5 days per month. The rest of the month would consist of a normal, balanced diet. 5 days of the month the person would consume a low 800-calorie diet. This is enough to ensure adherence to the diet, but low enough to lead to enormous metabolic changes including youth-preserving stem cell stimulation.

Clinical Application of fasting mimicking diet in cardiovascular health

Dr. Joel Kahn, Prof. of Medicine at the Wayne State University School of Medicine lectured later that day. He is also the Director at the Kahn Center for Cardiac Longevity. His talk was entitled “The Fast Track to Slow Cardiac Aging: Fasting &Targeted Nutrition”. He mentioned that a fasting mimicking diet was a powerful tool in cardiology to prevent heart attacks and hardening of arteries. He explained in detail the complex aging pathways that involve three components, IGF-1, mTOR and PKA. When lifestyle choices stimulate these genetic markers, accelerated aging is a consequence. But with the inhibition of those markers longevity can happen. He added that researchers looked at heart cells, where the same principles apply. Dr. Kahn pointed out that the basic research of Dr. Longo enables clinicians to see positive results in patients who follow caloric restriction for 5 days in a month on a regular basis.

How does the fasting mimicking diet work?

It is best to let one of the users of this diet explain how it works. Once per month you eat calorie-restricted food with only 800 calories per day and you follow this regimen for 5 days. Some patients receive 1100 calories for the first of these 5 days, if they have difficulties switching from normal food to the boxed food. Dt. Longo has developed boxed food, called ProLon (from L-Nutra). ProLon stands for “pro longevity”. Dr. Longo and Dr. LaValle mentioned at the conference that these prepared meals make it a lot easier for patients to stick to the low calorie diet. Three hundred dollars for the boxed food for 5 days are a stiff price, and this may well be out of reach for you.

Alternative way to make your own 800 calorie food at home

Nevertheless, this should not stop you. You can look at the ingredients online and copy the boxed food by creating your own balanced 800 calories per day food at home. It is true: you have to do some research! But counting calories and finding information about the caloric content of food on the Internet is not difficult. And preparing these very, basic, small and simple meals does not require a degree in nutrition. Here is another testimony from a user of the fasting mimicking diet.

Effect of the fasting mimicking diet on the metabolism

In the past it was thought that only ketogenic diets or periods of fasting would trigger longevity genes. But the basic research of Dr. Longo and others has shown that a low calorie diet for only 5 days can achieve the same thing. Longevity genes are activated; the negative aging pathways including IGF-1, mTOR and PKA are suppressed. The immune system gets activated from this. It also leads to lowering of LDL cholesterol, triglycerides, blood pressure, insulin resistance, and diabetes improves. With the fasting mimicking diet the stomach sees some food, but the cells are fasting. According to Dr. Kahn this combination down regulates the body’s key nutrient-sensing pathways, which activates cellular regeneration and rejuvenation.

Clinical observations

Dr. Khan observed a high compliance rate with 3 cycles of the fasting mimicking diet. 94% of a group of patients were compliant over 3 months. Mild fatigue, mild headaches and mild weakness were present, but improved with each cycle. In addition to the above findings Dr. Khan found that there was weight loss, abdominal fat loss and waist circumference loss. There was also a reduction in IGF-1 levels, a reduction of the C-reactive protein and stimulation of stem cells.

Inflammation reduced, autoimmune diseases improved

The reduction of the C-reactive protein proves that semi-fasting reduces inflammation. The finding of stimulation of stem cells explains that regenerative processes can take place. Pain disappears, people report more energy and are generally feeling better.

There are other clinical findings. The positive effects from following the fasting mimicking diet last for several months. Also, when patients are on chemotherapy for cancer, the FMD will protect the healthy cells from the side effects of chemotherapy.

Dr. Kahn and Dr. LaValle noted that autoimmune disease responded to FMD. This was shown in both animal experiments using mice and in clinical case reports. Dr. LaValle described a 46-year old former Olympic athlete swimmer who had multiple sclerosis. After FMD she lost all of her muscle aches and cured her optic neuritis. This was something conventional medicine could not do for her.

Clinical applications of fasting mimicking diet

Here are some of the conditions that will respond to it.

Obesity, because of the weight loss effect
Diabetes: insulin resistance becomes lower and blood sugar levels drop.
High blood pressure reduced: many patients were able to reduce their medications or discontinue them
Prevention of heart attacks and strokes
Pain conditions will improve as all kinds of pain disappears, an effect for which at this point is no explanation
Autoimmune diseases like MS and rheumatoid arthritis improve, likely because of the effect of increased stem cell circulation
Prevention of heart attacks because of reduction of LDL, triglycerides and CRP
Cancer cure rates improved by protecting normal cells and bone marrow
Longevity improved in mice with a 3-fold increase of their life span. Telomere length in humans was increased. Increased stem cells will find defective areas that need repair. This effect will open up a new chapter in medicine.

Maintaining the achievements of the fasting mimicking diet

At this point the implications of this new approach to weight loss and metabolic rejuvenation can only be estimated.

Limiting calories for 5 days triggers a metabolic change, which is permanent. You can experience the full effect of this rejuvenating low calorie treatment. You can do it every month without having to fear vitamin or mineral deficiencies.

Here is another link to the website of Dr. Axe where the fasting mimicking diet is also recommended.

Fasting Mimicking Diet

Conclusion

The 25^th Annual World Congress on Anti-Aging Medicine in Las Vegas, Dec. 14-16, 2017 had a new theme. Several talks dealt with the fasting mimicking diet (FMD). It is a calorie-reduced diet for 5 days in a month that will reset your metabolism. But it will also stimulate your stem cells and can heal autoimmune diseases. If you need chemotherapy for cancer, it protects your bone marrow and improves cancer cure rates. The interesting thing is that the effects of this low calorie treatment persist permanently for many months.

With the help of this diet longevity has been shown in mice; there has been a threefold life expectancy boost. Smaller trials in humans have shown telomere lengthening and stem cell stimulation. It is too early to say what the long-term effects will be for humans. But you can treat yourself with the FMD for 5 days of every month on an ongoing basis. The other days of the month you are eating a normal diet. This will ensure that your metabolism stays in top shape.

A healthier and longer life

Practical applications for the FMD are huge. Patients with obesity, diabetes and pain conditions all benefit from this. High blood pressure drops. There will be prevention of heart attacks, and there is improvement in patients with autoimmune diseases. There is better cancer survival when on the FMD. Finally there is a strong possibility that you will live longer, but also stay healthier on this intermittent calorie restricted diet.

As Dr. LaValle said: it is “fasting with food”, and Dr. Kahn added: “Eat less, live more!”

More info: Life extension through calorie restriction.

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May

2017

New Treatments For Premenstrual Syndrome

By Ray Schilling | coffee, exercise, headache, Hormones, low back pain, Pain, premenopause, Prevention, Stress management, thyroid disease, Vitamins and supplements, Women’s Diseases

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24^th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

Symptoms are varied; they can mimic various psychological problems like anxiety, depression, panic attacks and more. But physical symptoms like abdominal bloating, acne, back aches, and asthmatic attacks are also common. There are a myriad of more symptoms of PMS: constipation, cramps, clumsiness, dizziness, drowsiness, decreased sex drive, facial swelling, forgetfulness, fatigue, headaches, a herpes-like outbreak, hot flashes, sensitivity to light and noise, insomnia, joint pains, mood swings, palpitations, restlessness, poor memory, sore throat, tearfulness, vomiting and weight gain.

What do we know about PMS?

PMS is due to a hormone dysfunction

There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.

PMS due to estrogen dominance

PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which many hormone experts call estrogen dominance.

Several hormones need checking with PMS

But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.

Neurotransmitters of the brain can be involved in PMS

Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.

Women with PMS often have hypoglycemia

Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.

PMS after partial hysterectomy

A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.

Birth control pill can cause PMS

The birth control pill can bring on PMS due to the progestin component in it.

Tubal ligation may cause PMS

Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

Dr. Smith said that PMS has been divided into 4 subcategories depending on the main symptoms.

Anxiety: PMS A
Carbohydrate craving: PMS C
Depression: PMS D
Hyperhydration: PMS H

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS C is associated with sugar craving, hypoglycemia, headaches, heart palpitations and spontaneous sweating.

PMS D is leading to increased neurotransmitter degradation. Symptoms consist of depression, crying, despair, feeling hopeless, fatigue, low libido, apathy and insomnia.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

Estrogen and progesterone are on the rise around the time of ovulation
When a woman has hypoglycemia (due to hyperinsulinemia)
Estrogen levels are changing
When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Most PMS patients persistently lack one hormone, progesterone. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and can take the place of progesterone cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

Estrogen balancing Black Cohosh

Black Cohosh is said to balance estrogen and is anti-spasmodic.

Progesterone raising Chasteberry

Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.

Herbal supplement St. John’s Wort

St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.

Anti-inflammatory Ginkgo biloba

Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.

Nutrient-rich saffron

Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group. Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.

Lavender, Motherwort, and Dandelion

Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

Dec

2016

Magnesium Is Essential To Life

By Ray Schilling | Alzheimer’s disease, Cancer, Cardiovascular disease, Diabetes, headache, Health, heart attack, Heart Disease, High Blood Pressure, immune system, Inflammation, kidney disease, Mortality, Nutrition, Obesity, Osteoporosis, Prevention, Stroke

Magnesium is an important co-factor in many biochemical reactions, so magnesium is essential to life.

Many diverse diseases and cancers can develop from magnesium deficiency. The key is to supplement with magnesium regularly to get more than the government recommended daily allowance (RDA). The RDA for magnesium is 420 mg a day for males and 320 mg a day for females.

In the following I will review the diseases that occur without enough magnesium on board.

A lack of magnesium can cause heart disease

In this 2014 study 7216 men and women aged 55-80 with at high risk for heart attacks were followed for 4.8 years. The risk of death from a heart attack was found to be 34% lower in the high tertile magnesium group when compared to the lower magnesium tertile group.

The protective mechanism of magnesium was found to be as follows. Magnesium counteracts calcium and stabilizes heart rhythms. Magnesium helps to maintain regular heart beats and prevents irregular heart beats (arrhythmias). It also prevents the accumulation of calcium in the coronary artery walls. This in turn is known to lower the risk of heart attacks and strokes.

Another study, which was part of the Framingham Heart Study, examined calcification of the heart vessels and the aorta as a function of magnesium intake.

There were 2,695 participants in this study. For each increase of 50 mg of magnesium per day there was a 22% decrease in calcification of the coronary arteries. For the same increase of magnesium the calcification of the body’s main artery, the aorta, fell by 12%. Those with the highest magnesium intake were 58% less likely to have calcifications in their coronary arteries. At the same time they were 34% less likely to have calcifications of the aorta.

In a Korean study a group with low magnesium levels was at a 2.1-fold higher risk of developing coronary artery calcifications compared to a group with normal magnesium levels.

Low magnesium increases your stroke risk

In a 2015 study 4443 subjects, men and women aged 40-75 were followed along.

928 stroke cases developed. The researchers compared the group with the highest 30% of magnesium intake with the lowest 10% of magnesium intake. They had significantly lower blood pressure (7 mm mercury) and lower total cholesterol levels. They also had 41% less strokes than those with low magnesium intake.

In a 2015 study that lasted 24 years the authors investigated 43,000 men.

Those with the highest magnesium supplement had a 26% lower stroke risk. Those with the lowest magnesium intake served as a control.

Among women low magnesium levels were shown to cause 34% more ischemic strokes than in controls.

This study included 32,826 participants in the Nurses’ Health Study. Examiners followed them for 11 years.

It is clear from all these studies that supplementation with magnesium can prevent strokes.

Magnesium protects kidney function

This study examined 13,000 adults for 20 years to see how kidney function was dependent on magnesium levels. Those with the lowest magnesium levels had a 58% higher risk of developing chronic kidney disease. It makes sense when you consider that magnesium is necessary to keep arteries healthy, blood pressure low, and blood sugars stable. When diabetics do not control their blood sugars optimally their kidneys develop kidney disease. The term for this is diabetic nephropathy. In the presence of magnesium supplementation and a low sugar diet people are less likely to develop diabetes or kidney disease.

Magnesium helps blood sugar control

A metaanalysis showed that magnesium supplementation was able to improve blood sugar control. This occurred in both diabetics and borderline non-diabetics within 4 months of supplementing with magnesium.

An important factor in helping control blood sugar is magnesium. Here is an article as an example.

Magnesium good for bones and teeth

Magnesium is important for calcium metabolism and this is helping your bones and teeth to stay strong. The bones store half of the body’s magnesium. Another location for magnesium are in our teeth.

Low levels of magnesium lead to osteoporosis, because one of the two structural components of bone (calcium and magnesium) is missing. In addition low magnesium causes inflammatory cytokines to increase. These break down bones. The Women’s Health Initiative showed that when daily magnesium intake exceeded 422.5 mg their hip and whole-body bone mineral density was significantly greater than in those who consumed less than 206.6 mg daily.

With regard to healthy teeth magnesium is important as it prevents periodontal disease.

This study found that there was less tooth loss and there were healthier periodontal tissues in 4290 subjects between 20 and 80.

Those who took magnesium supplements had healthier teeth.

Migraine sufferers improve with magnesium

A double blind randomized study showed that magnesium supplementation can reduce migraines. The researchers in this trial used 600 mg of magnesium supplementation for 4 weeks.

This reduced migraines by 41.6% in the magnesium group compared to the non-supplemented control group.

Another study showed that both intravenous and oral magnesium are effective in reducing migraine headaches.

Intravenous magnesium showed effects on improving migraines within 15 – 45 minutes. The authors concluded that one could supplement other migraine treatments with both oral and intravenous magnesium.

Too little magnesium can cause cancer

It may surprise you to hear that magnesium can even prevent some cancers. Two cancers have been studied in detail. I will limit my discussion to these two.

Pancreatic cancer

One study found that pancreatic cancer was reduced. Researchers recruited 142,203 men and 334,999 women between 1992 and 2000 and included them in the study. After 11.3 years on average 396 men and 469 women came down with pancreatic cancer. On the male side they found that when the body mass index (BMI) was greater than 25.0 there was a 21% reduction of pancreatic cancer for every 100 mg of added magnesium per day. There were a lot of smokers on the female side, which interfered with the study as confounding factors undermined statistical validity.

In another study, the US male Health Professionals Follow-up Study was examined after 20 years of follow-up. Those with a BMI of above 25.0 on magnesium supplementation had a reduced risk of pancreatic cancer. The pancreatic cancer rate in the higher magnesium group was 33% lower than in the lower magnesium group. The higher group consumed 423 mg of magnesium daily, the lower group 281 mg per day. It is significant that in both studies it was the heavier patients who came down with pancreatic cancer. It is common knowledge that obesity is a pancreatic risk factor.

Colorectal cancer

A study done on Japanese men showed that magnesium could protect them significantly from colon cancer.

Men who consumed the highest amount of magnesium developed 52% less colon cancer over 7.9 years. Researchers compared them to the group with the lowest 20% intake of magnesium. The women in this study did not reach statistical significance.

A study from the Netherlands examined colon cancer in patients. They found that only in patients with a BMI of greater than 25.0 magnesium did have protective effects. For every 100 mg of magnesium per day increase there was a 19% reduction of colon polyps. And there was also a 12% reduction of colorectal cancer for every 100 mg increase of magnesium per day.

Magnesium plays an important role in genome stability, DNA maintenance and repair. It also prevents chronic inflammation and reduces insulin resistance, all factors contributing to cancer reduction.

Live longer with magnesium

Consider that magnesium is the fourth most common mineral in the body. Add to this that magnesium is a co-factor of more than 300 enzymes in the body. Magnesium is an important co-factor in the conversion of chemical energy from food that we ingest. Magnesium is regulating blood sugar, blood vessel health and our brain electrical activity. 50% of our stored magnesium is located in our bones, which helps the strength and integrity of them.

Because of the distribution of the enzymes to which magnesium is a co-factor, virtually every cell in the body depends on our regular intake of magnesium.

Magnesium deficiency develops in older age

Since the 1950’s soils have lost magnesium where farmers grow vegetables and raise fruit trees. We simply do not get enough magnesium from food.

But chelated magnesium is freely available in health food stores. Take 250 mg twice per day, and you will have enough.

Because our metabolism slows down, there is a critical age where magnesium deficiency becomes more obvious than when we are younger. By the age of 70 there are 80% of men and 70% of women who do not get the minimum of magnesium-required amount they should get (350 mg for men and 265 mg for women).

Proton pump inhibitors lowering magnesium levels

At this age many people are on multiple drugs. For many proton pump inhibitors (PPI) are used to suppress acid production in the stomach. PPI’s have been associated with low magnesium blood levels. This link explains that when a patient takes PPI’s the total time of taking the medication should not exceed 1 year.

Low magnesium levels accelerate the aging process on a cellular level. Low magnesium levels increase senescent cells that can no longer multiply. Some of them could cause the development of cancer. These senescent cells also can no longer contribute to the immune system. This causes more infections with an adverse outcome.

Remember to take chelated magnesium capsules or tablets 250 mg twice per day and you will be protected from low magnesium levels in your body.

Here is why we live longer with magnesium supplementation

Our blood vessels will not calcify as early; they keep elastic for longer, preventing high blood pressure. Our kidneys will function longer with magnesium, preventing end-stage kidney disease. We need our kidneys to detoxify our system! More than 300 enzymatic reactions all over our body help that we have more energy and also help to prevent cancer. When there are fewer strokes and less heart attacks this helps reduce mortality. Magnesium supplementation helps to lessen the risk for Alzheimer’s disease and also reduces insulin resistance. Researchers have shown that this prevents Alzheimer’s disease.

The bottom line is we live longer and healthier; that is the meaning of longevity.

Magnesium Is Essential To Life

Conclusion

Magnesium is a key essential mineral. It balances calcium in the body and participates in many enzymatic reactions in the body as a cofactor. As long as we have enough of this mineral we won’t notice anything. It is with magnesium deficiency that things go haywire. Heart disease or a stroke could affect you . You could get kidney disease. And you could even get pancreatic cancer or colorectal cancer. If this is not enough, magnesium deficiency can cause diabetes, osteoporosis and bad teeth. You may suddenly die with no obvious cause. But, if balance your your magnesium blood level by taking regular supplements, you will carry on living and eliminate a lot of health problems.

Nov

2016

Stress Drives Our Lives

By Ray Schilling | Alzheimer’s disease, Diabetes, headache, heart attack, Heart Disease, Infertility, sleep, Smoking, stress, Stress management, Substance abuse

Every year the American Psychological Association (APA) monitors the American public how stress drives our lives. This yearly report has been compiled since 2007. About 75% of the people questioned reported that they have experienced moderate to high stress over the past month.

Symptoms when stress drives our lives

What kind of symptoms can stress cause? It can cause sleep deprivation, anxiety, headaches and depression. But there can be more symptoms from any disease that stress may cause. The “Stress in America” report from February 2016 shows on page 5 that unhealthy life habits are used by low-income Americans to cope with stress. A bar graph shows that watching television or movies for more than 2 hours per day is common. Another way of coping is to surf the Internet more often, take more naps or sleep longer. Eating more, drinking alcoholic beverages and smoking more are other unhealthy ways to cope with stress.

As the stressed person gains extra weight and eventually becomes obese, there is a higher rate of diabetes that can develop with all of its complications.

Causes of stress in our lives

The “Stress in America” survey was based on 3,068 adults in the US who completed the survey during August 2015. 72% were stressed out about financial issues. 22% of these said that they were extremely stressed in the past month as a result of money concerns. Other common concerns were work, the economy, family responsibilities and concerns about personal health. Average stress levels among Americans decreased when compared to 2007. On a 10-point stress score respondents rated their stress at 4.9 in 2016 compared to 6.2 in 2007. But according to the American Psychological Association this is much higher than a stress rating of 3.7 considered to be a healthy level.

Stress affects people from all walks of life, workers, women, young adults, students and those with lower incomes.

“Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us” Stevan Hobfoll, PhD, a clinical psychologist from Rush University Medical Center said. “So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health…” is what causes stress.

Stress drives our lives causing disease

When stress is too much for our system, we are starting to see pathology develop. “Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease” professor Hobfoll says. The following are common diseases that can result from chronic stress.

Heart attacks and strokes

In a 2015 Lancet study 603,838 men and women who worked long hours were followed for a mean of about 8 years with respect to heart disease or strokes. All of the subjects were free of heart attacks and strokes when they entered into the study. There were a total of 13% more heart attacks in those who worked extra hours in comparison to those who worked 40 hours per week or less. With respect to strokes there were 33% more strokes in those who worked long hours. Researchers noted a dose-response curve for strokes in groups with various workloads. Compared to standard working hours there were 10% additional strokes for 41-48 working hours, 27% for 49-54 working hours and 33% for 55 or more working hours per week.

Stress drives our lives and causes substance abuse

In order to cope with stress many of us treat daily stress with alcohol. It makes you feel good subjectively, but it can raise your blood pressure causing heart attacks and strokes down the road. A low dose of alcohol may be healthy, but medium and high doses are detrimental to your health.

Next many people still smoke, although scientists have proven long time ago that it is bad for your health. It can cause heart attacks, various cancers and circulatory problems leading to leg amputations.

Overeating is another common problem. Comfort food relieves stress, but it puts on extra pounds. As you know it is easier to put weight on than get it off. Being overweight or being obese has its own problems: arthritis in the hips and knees makes walking more difficult. The metabolic syndrome sets in, which is a characteristic metabolic change causing diabetes, high blood pressure, heart attacks, strokes and certain cancers. The more weight you carry, the less likely you are to exercise. This deteriorates your health outlook.

Diabetes

Stress causes too much cortisol secretion from the adrenal glands. This raises blood sugar, and when chronic can cause diabetes. In addition unhealthy eating habits associated with stress can cause weight gain and high blood sugars leading to diabetes.

In a 2012 California study 148 adult Korean immigrants were examined. They all had elevated blood sugars confirming the diagnosis of type 2 diabetes. They had a elevated waist/hip ratio.

A high percentage of the study subjects had risk factors for type 2 diabetes. This included being overweight or obese and having high blood glucose readings. 66% of them said that they were feeling stressed, 51% reported feeling anxious, 38% said they were feeling restless, 30% felt nervous and 3% said they were feeling hopeless.

An Australian long-term follow-up study computed risk factors for developing type 2 diabetes. Stress was a major contributor to diabetes.

A 30-day episode of any anxiety disorder had a 1.53-fold risk to cause diabetes. A depressive disorder had a 1.37-fold risk to cause diabetes and posttraumatic stress disorder had a risk of 1.42-fold to cause diabetes.

Infertility

Stress changes hormones in women causing ovulation problems and infertility. 1 in 8 couples in America have problems getting pregnant. Physicians identified stress as at least a contributing factor. But in men stress can also reduce sperm count and semen quality as this study describes.

Alzheimer’s disease

A 2010 study from Gothenburg University, Sweden examined 1462 woman aged 38-60 and followed them for 35 years.

Psychologists assessed the stress score in 1968,1974 and 1980. 161 females developed dementia (105 Alzheimer’s disease, 40 vascular dementia and 16 other dementias). The risk of dementia was higher in those women who had frequent/constant stress in the past. Women who had stress on one, two or three examinations suffered from higher dementia rates later in life. Researchers compared this to women did not have any significant stress. Specifically, dementia rates were 10% higher after one stressful episode, 73% higher after two stressful episodes and 151% higher after three stressful episodes.

Remedies for stress

Before you can attempt to remedy stress, you must first detect that you are under stress. You can recognize this when you have problems sleeping, you suffer from fatigue, when overeating or undereating is a problem, and if you feel depressed. Others may feel angry or are irritable. Some bad lifestyle habits may also make you aware that you are under stress. You may smoke or drink more in an attempt to manage stress. Some people abuse drugs.

Here are some suggestions how to remedy stress:

Seek support from family, friends or religious organizations. If you engage in drugs or alcohol overuse or you feel suicidal, it is best to seek the advice from a psychiatrist or psychologist.
Engage in regular exercise. This produces endorphins, the natural “feel-good” brain hormone. This reduces symptoms of depression and improves sleep quality.
Do something that increases pleasure, such as having a meal with friends, starting a hobby or watching a good movie.
Positive self-talk: avoid negative thoughts like “I can’t do this”. Instead say to yourself “I will do the best I can”. Psychologists have developed a technique where they teach patients how to turn negatives into positives. Psychologists call this therapy “cognitive therapy”. You may want to seek the advice of a psychologist to have a few cognitive therapy sessions.
Daily relaxation: you may want to use self-hypnosis, tai-chi exercises or meditation to reduce your stress levels.

Stress Drives Our Lives

Conclusion

Stress is very common. Diverse diseases like heart attacks, strokes, diabetes and Alzheimer’s disease can all be caused by stress. It is important to minimize the impact of stress by seeking family support and support from friends. Engaging in regular exercise will release endorphins and make you feel better. Relaxation exercises and seeking counselling can all help you to manage stress. You cannot ignore or simply tolerate this force in your life. Stress is indeed there, but we can make a difference by managing it to avoid that stress manages us.

Aug

2016

Pain Treatment

By Ray Schilling | Drugs, headache, IMS, low back pain, osteoarthritis, Pain, trigger points

General practitioners see a lot of patients with various pain symptoms for which they seek pain treatment. The underlying conditions might be from an arthritic problem that suddenly becomes symptomatic, or an acute back injury may send pain from the lower back into one of the legs. Others may experience excruciating headaches like migraines or tension type headaches. Often these painful conditions require some immediate pain relievers to treat the pain, but this can turn into a nightmare of drug dependency and may even lead to the development of chronic pain. Here I like to review an article that I found in the June edition of ConsumersReports.org. In my review I included most of the content, but added a few newer pain treatment modalities.

Acute pain

Here I’m discussing back pain as an example. When a disc bursts in the lower back because the person was lifting an object too heavy to lift, acute pain develops in the lower back. This is often located at the lower lumbar spine level (L5/S1) causing radiating pain into one of the legs.

In a case like this it will often take several weeks before the body can heal this condition.

Chronic pain

It can happen in many cases that the pain will still be there 3 to 6 months down the road. If a disc fragment pushes on the nerve root in the nearby canal through which the nerve root travels, this will cause the muscles supplied by the nerve root to melt away in the leg of the affected side. If nothing is done about this, the acute pain turns into chronic pain, which is much more difficult to resolve. The initial physician may refer the patient to a neurosurgeon who will review the case together with the help of an MRI scan that shows the underlying pathology. The neurosurgeon may determine that a mini discectomy will reduce the pressure onto the nerve root.

Relief of pressure on nerve root from mini discectomy

This surgery may be able to prevent chronic pain from setting in. Once the pressure is relieved, the nerve can start the healing process. It is critical to not miss the point where acute pain crosses over into chronic pain. This happens at around 2 to 3 months into the pain condition. Chronic pain is much more difficult to treat as some of the neurological pain pathways that form after such injuries can persist within the spinal cord or even within the central nervous system, even after successful disc surgery that is done too late. With respect to the example given above, if the patient is operated on too late (1 to 2 years after the injury), the procedure may not be effective in relieving the pain. A chronic pain syndrome has started.

How pain treatment is done

Avoid bed rest

In the past (up to the late 1970’s to mid 1980’s bed rest was the accepted initial mode of treatment. Even though patients often felt some relief of pain initially, this led to muscle atrophy (literally a melting away of muscles) in the muscles that are supporting the spine. These structural changes destabilized the spine and often made the pain more chronic until physiotherapy treatments and active exercises rebuilt the supporting muscles again.

See a physiotherapist

Physiotherapists can use different treatment modalities like traction, a TENS machine, active exercises that all can help to alleviate back pain due to muscle spasm. If there is only a strain, this will often help to resolve your back pain within 4 weeks. But if there is an underlying disc herniation as previously explained, you need to be assessed by a physician in an urgent care center, primary care setting or by an emergency physician in the emergency department of a hospital. When the examination confirms an abnormal reflex from a nerve root compression, a referral to a neurosurgeon or orthopedic surgeon is usually made as previously explained.

Chiropractic treatment

Some people have their backs treated periodically to prevent back troubles. When they get an acute back pain they likely will see the chiropractor again. In cases of a back strain, where one or more muscles are pulled, this approach will be helpful together with some home exercises and swimming to build up muscle strength along the spine. However, in the case of a herniated disc chiropractic adjustments should not be done (physicians say they are “contra-indicated”). Instead the patient should be referred to either a neurosurgeon or an orthopedic surgeon.

Medication for pain

Often physicians prescribe Tylenol with codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) or morphine for pain relief. All narcotic medication have side-effects; they can cause constipation, can cause vomiting, make you feel dizzy and can lead to falls, particularly in elderly patients. These falls can cause hip fractures and other fractures that complicate the recovery from the original pain. Never exceed the dosage of pain medicine prescribed on the label, and if it does not relieve the pain, see your physician again for a reassessment to rule out any complications.

Depression with back pain

Often people with back pain also have depression. To address this issue your physician may prescribe an antidepressant like duloxetine (Cymbalta), which has been approved by the FDA for treatment of lower back pain. But there are two rare, but important side effects to know about. Cymbalta can cause lowering of blood pressure, which leads to dizziness. This can cause serious falls with the danger of fractures. The other complication is the risk of liver failure.

Side effects of pain treatment

Pain pills can be addicting

While there seems to be an urgency to treat a patient who is in pain with pain medication, the treating physician must not forget that pain medication is potentially addicting and patients often use higher doses than advisable. However, pain medication has a narrow therapeutic window meaning that the toxic levels are not much higher than the drug levels necessary to relieve pain.

Some medications are only marginally effective

There are medications that are only marginally effective, if at all. Glucosamine and chondroitin are used for relief of arthritic pain in osteoarthritis sufferers. They are eliminated by a liver enzyme system that also eliminates blood thinners. If a patient is on blood thinners, the addition of glucosamine and chondroitin can lead to dangerous bleeding. Instead of using glucosamine and chondroitin when you experience pain and inflammation in joints, reduce your activities, but stay as active as you can to avoid your symptoms from getting worse.

Tests for severe migraines

When a patient has a severe migraine headache it is tempting to want to rule out a brain tumor. But a CT scan exposes the patient to dangerously high radiation doses that over time could cause brain cancer or leukemia. There are physical examination methods to rule out a brain tumor. If the findings are positive, an MRI scan can be used to get much more detail of the brain than a CT study would reveal. MRI scans do not have undesirable side effects.

Use gentle movement to remobilize the painful joints

Before you rush into using anti-inflammatory drugs, use gentle movement to remobilize the painful joint, back or limb. Activities like swimming, walking or yoga can reduce pain and allow you to recover from a painful condition according to a Cochrane Library analysis of 61 studies.

Non steroidal anti inflammatory drugs (NSADs)

For more pain relief NSAID (non steroidal anti inflammatory drugs) pain relievers like ibuprofen (Advil) or naproxen (Aleve) for a brief period will also help. The problem with long-term use of NSAIDs is that it can cause kidney damage. With longer use of NSAIDs there is also a danger of stomach bleeding, heart attacks and strokes.

Toxicity with Tylenol

The pain drug acetaminophen (Tylenol) has a narrow therapeutic window and is less effective in pain relief than the NSAIDs. The FDA has recommended as the highest daily dose 4000 mg of acetaminophen. But if you are a heavy drinker or you have liver disease, your daily dose of acetaminophen should not exceed 3250 mg to avoid liver toxicity. Long-term use of acetaminophen can also damage your kidneys, therefore the recommendation to use acetaminophen only for a short period of time (a few days).

Side effects of triptan drugs for migraines

Migraine headache drugs: The newer migraine drugs, called triptans temporarily narrow widened blood vessels. This relieves severe migraines within about 2 hours. However, these medications are not recommended for those with high blood pressure, chest pain, heart disease or circulation problems in the legs, as blood vessel constriction could bring on heart attacks or worsen circulation problems.

Common sense approach to pain treatment

The key for any pain condition is to treat the pain right away to minimize the impact that pain has on you and to prevent developing chronic pain, which is more difficult to treat.

Here are some examples.

Migraine headaches

If you have a migraine headache, use an over-the-counter pain reliever like naproxen or ibuprofen to treat the migraine pain very early. A combination of acetaminophen, aspirin and caffeine (like Excedrin Migraine or a generic copy) will also do. This will stop the release of prostaglandins, which would send pain signals to the brain. Heat packs or cold packs on your head can also help in the treatment of a headache. A 2013 study from Germany has shown that migraine sufferers can get rid of their migraine headaches in 60% by having sex. It sounds like a nice idea, but what they have not considered may be the fact that somebody who has a splitting headache is not feeling like sex at all!

Triptan pills for migraines

If your home remedies did not help, see your physician for one of the triptan pills. Sumatriptan or a similar drug constricts blood vessels to the brain. The doctor will also look for common triggering factors that can bring on a migraine. Weak neck and shoulder muscles may respond to physiotherapy strengthening. In women a condition called estrogen dominance is associated with migraines and can be treated with bioidentical progesterone to balance estrogen and progesterone in the body by elevating progesterone concentration.

Acute lower back pain

Acute lower back pain usually follows an event where the person lifted something too heavy or injured the back from a fall. The important part is to rule out a fracture. Most of the time there is no underlying fracture, just a muscle strain. A muscle strain usually sorts itself out in time. Stay active as much as possible. But if the back pain does not resolve within a few days, see your physician for more tests. X-rays can delineate structural changes like a fracture. As explained earlier, an MRI scan can rule out a disc herniation. Instead of neurosurgery, further options nowadays are prolotherapy, stem cell therapy or a combination prolotherapy/stem cell therapy. This type of therapy will also work for knee injuries (meniscal or ligamentous tears).

Hip or knee pain

Conventional medicine usually treats osteoarthritis with NSAIDs, but may not warn you about the possibility of gastric erosions that can lead to massive stomach bleeding, heart attacks or strokes when using NSAIDs. It also can lead to kidney damage that can cause sudden kidney failure. The key is to use anti-inflammatory medication only for a few weeks. If arthritis persists, it is wiser to seek the advice of a naturopathic physician for prolotherapy treatment. One or two treatments of prolotherapy can give relief of pain. If prolotherapy does not succeed, it is best to move on to mixed stem cell therapy with bone marrow and mesenchymal stem cells (from fat cells) as well as PRP (platelet rich plasma). This usually leads to complete healing of osteoarthritis and eliminates the need of total knee or total hip replacement.

Neck and shoulder pain

This often develops because of poor posture, shoulder tendinitis or neck muscle spasm. Physiotherapy is often successful treating this. If not the physiotherapist can use intramuscular stimulation (IMS) with acupuncture needles. This may be more successful in interrupting the abnormal neuropathic pain pathways. Alternatively electro acupuncture with a TENS-like device can also be successful. The newest treatment modality is the Weber medical system using a low-dose laser applicator. Prolotherapy can also be used for shoulder and neck problems, if the ligaments are lax. It requires a lot of experience on behalf of the health professional to choose the right treatment protocol for the condition.

Tension headaches

Anxiety, stress and fatigue can all lead to tension headaches. Initially you may want to drink liquids, as dehydration is related to tension headaches. If your headache is still present after one hour, use naproxen or acetaminophen. Take a warm or cold shower and lie down with a cool cloth on your forehead. If you still have a headache, check with your doctor whether it is indeed a tension headache or a migraine. You may have jaw clenching or teeth grinding during your sleep. If your bite seems off, see a dentist. For stress control use relaxation techniques.

Other ways to treat tension headaches

Some suggestions sound mundane enough, but they can be effective: Get enough sleep, get enough exercise, and work on improving your posture. A physician trained in trigger point injections with local anesthetics (often anesthetists or general practitioners) can freeze your suboccipital and supraorbital nerves with lidocaine, which I have seen to work in 60% to 70% of cases in my former practice.

Pain Treatment

Conclusion

Pain treatment can be confusing as pain itself can be very multifaceted. The key is to search for the cause of the pain. Then treat pain very quickly. This way it has time within 2 to 3 months to turn into a chronic pain condition. Chronic pain is much more difficult to treat. The physician should treat acute pain successfully. Conventional medicine has to yet learn from naturopathic medicine and alternative medicine practitioners. They use prolotherapy, stem cell therapy, IMS and trigger point injections with local anesthetics. In addition low-dose laser therapy (Weber medical system) are valuable alternative methods to treat pain. These methods can successfully treat pain conditions. The physician can incorporate them into general medical practice.