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Supplement Therapy

Supplementation is often necessary because so many foods have been processed or altered that they end up lacking the proper nutrients. Vitamins, minerals, amino acids, antioxidants, enzymes, and herbs (a separate entry) are all supplements, and all are beneficial for many conditions, but we are limiting the discussion here to those useful for chronic pain. You can buy supplements at health food stores, grocery stores, pharmacies, by mail, and on the Internet. They are available in many forms, including capsules, geltabs, liquids, powders, and tablets. Vitamins are substances derived from plant and animal food sources, or they may be synthetic. They are present in varying quantities in many different foods. Minerals are necessary to help your body assimilate vitamins. Soil contains minerals, which are absorbed by the fruits and vegetables you eat. Amino acids are components of protein and act as neurotransmitters that are needed by the brain to send and receive messages. Enzymes are complex proteins produced by living plant and animal cells that help digest and repair body tissue and aid most body functions. Antioxidants include those particular vitamins, minerals, and enzymes that protect your body from free radicals.

Supplements for Angina

Angina is a symptom of myocardial ischemia, which occurs when the heart muscle doesn't get enough blood to do its work. The myocardium is the heart muscle, and ischemia means lack of blood supply. Angina can be a warning sign that you are at risk for a heart attack. There are three types of angina: stable angina, unstable angina, and variant angina. Sometimes the pain is so mild that people think it is indigestion. For some, the pain is excruciating. If you are not sure, go to the nearest emergency room, especially if the attack lasts more than fifteen minutes.

Ginkgo biloba is an herb you can trust to improve your circulation, and that can be important if you experience angina. Angina is a mild to severe chest pain that occurs around the heart. It usually feels like you have pressure in your chest, and when it gets severe, the pressure can spread to your shoulders, back, and arms.

Angina is caused by poor blood circulation to the heart, and it can make you feel as if you are having a heart attack. The poor blood flow to the heart can be caused for a number of reasons including restricted arteries. Treatment focuses on improving circulation and that is where ginkgo biloba can be beneficial.

Ginkgo biloba can increase blood flow and decrease the viscosity of blood. When you regularly use a ginkgo biloba supplement, you know you are seriously working on decreasing your incidences of angina. Coupled with a low fat diet and regular exercise, ginkgo biloba supplements round out a natural approach to good heart health. Get Additional Information on Angina Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.

Supplements for Crohn’s Disease

Inflammatory bowel diseases (IBD) are disorders in which the bowel becomes inflamed, resulting in cramps and diarrhea. The IBD known as Crohn's Disease is named for Burrill Crohn, MD, a physician who wrote a paper in 1932 describing the condition. It is a chronic inflammation of the intestinal wall that usually occurs in the ileum (the lowest part of the small intestine) and in the large intestine. Sometimes referred to as ileitis when it is in the small intestine, it affects all layers of the intestinal wall. It is occasionally seen in other parts of the digestive tract, which extends from the mouth to the anus, and can also occur in the skin around the anus. Normal areas may be present between the affected places. Crohn's can occur in both sexes equally, and the condition can first appear anywhere between the relatively early age of fourteen and thirty years of age. It is most prevalent among Jewish people, is least seen among blacks and Asians, and tends to run in families. During flare-ups, inflammation may also occur elsewhere in the body, particularly in the joints, mouth, skin, and whites of the eyes. Get Additional Information on Crohn's Disease Here

Curcumin and Crohn's disease

Curcumin therapy in inflammatory bowel disease: a pilot study.

Dig Dis Sci. 2005 Nov;50(11):2191-3. Holt PR, Katz S, Kirshoff R. St. Luke's Roosevelt Hospital Center, Columbia University and Strang Cancer Center Research Laboratory, New York, New York.

Curcumin has been shown to have anti-inflammatory and antioxidant properties in cell culture and animal studies. A pure curcumin preparation was administered in an open label study to five patients with ulcerative proctitis and five with Crohn's disease. All proctitis patients improved, with reductions in concomitant medications in four, and four of five Crohn's disease patients had lowered CDAI ( crohn's disease activity index ) scores and sedimentation rates. This encouraging pilot study suggests the need for double-blind placebo-controlled follow-up studies.

Fish oil and Crohn's disease

Fish oil and antioxidants alter the composition and function of circulating mononuclear cells in Crohn's disease.

Am J Clin Nutr. 2004 Nov;80(5):1137-44.

Crohn's disease is associated with osteoporosis and other extraintestinal manifestations that might be mediated by cytokines from circulating (peripheral blood) mononuclear cells (PBMCs). Fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) reduces disease activity in patients with Crohn's disease. We investigated the effect of fish oil plus antioxidants on cytokine production by PBMCs from patients with Crohn's disease with raised C-reactive protein concentrations or erythrocyte sedimentation rates (>/=18 mm/h). A randomized placebo-controlled trial of fish oil (2.7 g EPA and DHA/d) or placebo (olive oil) for 24 weeks was conducted in patients with Crohn's disease. The fish-oil group additionally received an antioxidant preparation (vitamins A, C, and E and selenium). Exclusion criteria included corticosteroid use. Fish-oil plus antioxidant dietary supplementation was associated with higher EPA and DHA incorporation into PBMCs and lower arachidonic acid and lower production of IFN-gamma by mitogen-stimulated PBMCs and of PGE(2) by lipopolysaccharide-stimulated PBMCs. Dietary supplementation with fish oil plus antioxidants is associated with modified PBMC composition and lower production of PGE(2) and IFN-gamma by circulating monocytes or macrophages. The response of extraintestinal manifestations of Crohn's disease should be investigated in a randomized controlled trial.

Vitamin D and Crohn's disease

Vitamin D status in children and young adults with inflammatory bowel disease.

Pediatrics. 2006 Nov;118(5):1950-61. Pappa HM, Gordon CM, Saslowsky TM, Zholudev A, Horr B, Shih MC, Grand RJ. Center for Inflammatory Bowel Disease, Division of Gastroenterology and Nutrition, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.

Previous studies of vitamin D status in pediatric patients with inflammatory bowel disease have revealed conflicting results. We sought to report (1) the prevalence of vitamin D deficiency (serum 25-hydroxy-vitamin D concentration < or = 15 ng/mL) in a large population with inflammatory bowel disease, (2) factors predisposing to this problem, and (3) its relationship to bone health and serum parathyroid hormone concentration. Vitamin D deficiency is highly prevalent among pediatric patients with inflammatory bowel disease. Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohn's disease. The long-term significance of vitamin D deficiency for this population is unknown at present and merits additional study.

Prebiotics and probiotics for Crohn's disease

High dose probiotic and prebiotic cotherapy for remission induction of active Crohn's disease.

J Gastroenterol Hepatol. 2007 Aug;22(8):1199-204. Third Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

This study assessed the clinical usefulness of combined probiotic and prebiotic therapy in the treatment of active Crohn's disease. Ten active Crohn's disease outpatients without history of operation for Crohn's disease were enrolled. Their mean age was 27 years and the main symptoms presented were diarrhea and abdominal pain. Patients' initial therapeutic regimen of aminosalicylates and prednisolone failed to achieve remission. Patients were thus initiated on both probiotics (75 billion colony forming units [CFU] daily) and prebiotics (psyllium 10 g daily). Probiotics mainly comprised Bifidobacterium and Lactobacillus. Patients were free to adjust their intake of probiotics or prebiotics throughout the one year trial. Seven patients had improved clinical symptoms following combined probiotic and prebiotic therapy. Six patients had a complete response, one had a partial response, and three were non-responders. Two patients were able to discontinue their prednisolone therapy, while four patients decreased their intake. High-dose probiotic and prebiotic cotherapy can be safely and effectively used for the treatment of active Crohn's disease.

Crohn's disease diet

Although diet may affect the symptoms in patients with Crohn's disease, it is unlikely that diet is responsible for causing the disease. But it is possible that diet could influence the course of Crohn's disease. If you find a particular diet helps your Crohn's disease symptoms, stay with it. Get Additional Information on Crohn's Disease Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.

Supplements for Fibromyalgia

Fibromyalgia is a chronic pain disease of unknown origin. When people with this disorder seek help, they are often shunted from one specialist after another, only to be eventually informed it is all in their heads or they are suffering from depression. Although dismissively told that psychological distress is the cause of their pain, fibromyalgia is not a psychiatric illness. The opposite is, in fact, most probably the case—that their distressed psychological state is the result of attempting, unsuccessfully, to cope with the pain, not the cause of it. Prior to 1990, fibromyalgia was not even recognized by mainstream medicine as a medical musculoskeletal disorder. Even now, the person has had the condition for about five years on average before being accurately diagnosed with it, and has often undergone extensive testing and unnecessary surgery. It is a progressive illness that, in its early stages, appears for only a few days at a time, and, as with many conditions involving pain, it is usually worse in the morning, easing up somewhat in the early afternoon. It is estimated that up to 10 million people in the United States have the disease, which is known to strike four times as many women as men, usually those between the ages of twenty and forty-five.

Ribose for fibromyalgia treatment

The use of D-ribose in chronic fatigue syndrome and fibromyalgia: a pilot study.

J Altern Complement Med. 2006 Nov;12(9):857-62. Teitelbaum JE, Johnson C, St Cyr J. Fibromyalgia and Fatigue Centers, Dallas, TX, USA.

Fibromyalgia and chronic fatigue syndrome are debilitating syndromes that are often associated with impaired cellular energy metabolism. As D-ribose has been shown to increase cellular energy synthesis in heart and skeletal muscle, this open-label uncontrolled pilot study was done to evaluate if D-ribose could improve symptoms in fibromyalgia and/or chronic fatigue syndrome patients. Forty-one patients with a diagnosis of fibromyalgia and/or chronic fatigue syndrome were given D-ribose, a naturally occurring pentose carbohydrate, at a dose of 5 g t.i.d. for a total of 280 g. D-ribose, which was well-tolerated, resulted in a significant improvement in all five visual analog scale (VAS) categories: energy; sleep; mental clarity; pain intensity; and well-being, as well as an improvement in patients' global assessment. Approximately 66% of patients experienced significant improvement while on D-ribose, with an average increase in energy on the VAS of 45% and an average improvement in overall well-being of 30%. D-ribose significantly reduced clinical symptoms in patients suffering from fibromyalgia and chronic fatigue syndrome.

Acetyl L carnitine for fibromyalgia

Double-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patients.

Clin Exp Rheumatol. 2007 Mar-April. Rossini M, Di Munno O, Valentini G, Bianchi G, Biasi G, Cacace E, Malesci D, La Montagna G, Viapiana O, Adami S. Rheumatology Unit, University of Verona, Italy.

It has been recently suggested that fibromyalgia may be associated with metabolic alterations including a deficit of carnitine. One hundred and two patients meeting the American College of Rheumatology criteria for fibromyalgia syndrome were randomized. The treatment consisted of 2 capsules/day of 500 mg acetyl L carnitine or placebo plus one intramuscular injection of either 500 mg acetyl L carnitine or placebo for 2 weeks.  Results indicate that acetyl L carnitine may be of benefit in patients with fibromyalgia, providing improvement in pain as well as the general and mental health of these patients. Get Additional Information on Fibromyalgia Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.

Supplements for Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS), sometimes call spastic colon or mucous colitis, is a condition of abnormally increased movement of the small and large intestines, leading to pain and a change of bowel patterns, and causing excessive mucus and toxins to form in the bowels. IBS occurs most frequently in women, usually beginning between twenty to thirty-years-old. Up to 20 percent of the American population has symptoms of IBS, but very few people seek treatment. It is not a life-threatening condition, but is a frequent health-related reason for missing work. And, although it is unrelated to other problems of the digestive system, such as the inflammatory bowel diseases (Crohn's or ulcerative colitis), and does not cause inflammation, it is possible to have both irritable bowel syndrome and an inflammatory bowel disease at the same time.

Probioics and Irritable Bowel Syndrome

Probiotics, such as acidophilus, are live cultures, and are available as pills or in soy yogurt (avoid dairy yogurt - see dietary trigger foods to learn why). Probiotics occur naturally in fermented foods.

The cultures help normalize and maintain healthy gastrointestinal flora, which can minimize diarrhea, bloating, gas, and painful abdominal cramps. Probiotics are most effective when they're taken in conjunction with a prebiotic; a prebiotic (such as Tummy Fiber Acacia) is something that encourages the growth of probiotics. Soluble fibers often have a prebiotic effect, as their normal fermentation in the gut causes the production of beneficial short-chain fatty acids, which then lead to the growth of good gut flora. This in turn leads to a reduction (sometimes dramatic) in abdominal bloating and gas.

Probiotics are particularly effective when your gut is under assault from antibiotics, though they can also be helpful when taken for daily maintenance. Quite a few research studies have shown that probiotics can dramatically improve irritable bowel syndrome. The problem is that other studies have found that many retail brands of probiotics don't actually contain any live cultures at all, and are thus worthless. Though probiotic supplements are widely available at drug and health food stores, it can be difficult to know if the brand you're buying is high quality and really does contain live cultures. Probiotic supplements should be taken with food.

Calcium and Magnesium play critical and antagonistic roles in regulating muscle function. Together they provide the mechanism for muscle contraction and relaxation.

In terms of GI tract function, calcium has a constipating effect, whereas magnesium acts as a laxative. As a result, calcium supplements can be truly beneficial for people with diarrhea-predominant IBS, and magnesium supplements can work wonders for IBS-constipation. Remember that calcium can block iron absorption in the body and contribute to anemia, so women who take calcium supplements may want to take an iron supplement at a different time of day. Calcium and magnesium should both be taken with food.

To take a calcium/magnesium supplement that will keep your bowel function in balance, it's typically recommended to use a 2:1 ratio of calcium to magnesium, as many people absorb magnesium more easily than calcium. I wouldn't exceed the USRDA for calcium or magnesium, taken either singly or together, without an explicit recommendation from your physician.

Digestive Enzymes can be helpful when taken right before a meal, especially if there is more fat in that meal than is safe for IBS. Enzymes are available at all health food stores and may be of more benefit to older people, as natural digestive enzyme production declines with age.

For gassy foods such as beans, lentils, and many vegetables, there is Beano, a brand-name digestive enzyme. Beano contains the sugar-digesting enzyme that the body needs (and which some people lack) to digest the complex sugar raffinose. If you have trouble digesting raffinose the sugar will ferment in your colon, producing gas and intestinal distress. Beano breaks down raffinose into simple sugars that cause no GI discomfort. Beano is available at health food stores in either tablets or drops, and is simply taken at the beginning of a meal. There are no side effects unless you have a rare sensitivity or allergy, and the product can be used every day. Get Additional Information on Irritable Bowel Syndrome Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.

Supplements and Migraine Headaches

Headaches are symptoms of underlying conditions, not diseases in themselves, and are almost universal. Each year, more than 40 million Americans seek treatment for relief of their headache pain....If you have a headache accompanied by breathing problems, fever, or a stiff neck, or if it occurs after a head injury or respiratory infection, you should seek medical help immediately because it could be a symptom of a life-threatening condition. Medical help should also be sought if you have headaches that occur daily; do not respond to simple pain relievers; become progressively worse; are caused by exertion from coughing, sneezing, or exercise; or are accompanied by numbness, loss of consciousness, or hallucinations.

On the other hand, incorporating foods rich in omega-3 fatty acids, like flaxseed, walnuts (which contain alpha-linolenic acid [ALA], an important omega-3 fatty acid), and fish, into your diet may help stave off migraines. More research in this area would be helpful.

5-hydroxytryptophan (5-HTP) for Migraine Headaches

5-hydroxytryptophan for migraine prevention. 5-hydroxytryptophan (5-HTP) is an amino acid. The body makes 5-HTP from tryptophan (an amino acid that is obtained from the diet) and converts it to an important brain chemical known as serotonin. 5-HTP dietary supplements help raise serotonin levels in the brain, which may have a positive effect on sleep, mood, anxiety, aggression, appetite, temperature, sexual behavior, and pain sensation. Some studies suggest that 5-HTP supplements may be effective in children and adults with various types of headaches including migraines.

Magnesium for Migraine Headaches

Magnesium levels tend to be lower in those with migraine headaches, including children and teenagers, when compared to those who do not get headaches. A few studies suggest that taking a magnesium supplement may decrease the length of time that a migraine headache lasts and reduce the amount of medication you need to relieve the pain from a migraine.

Combining magnesium with the herb feverfew along with vitamin B2 (riboflavin) may be particularly helpful when you have a headache. This is a welcome alternative for many, especially if you have trouble taking medications because of side effects.

However, if you have 3 or more headaches per month, magnesium does not seem to work as well as prescription medications to prevent migraine headaches (that is, reduce their frequency by taking the medication or supplement every day). Unless, you are a woman and your migraines tend to happen around the time of your menstrual period; then, magnesium can be an effective way to prevent such headaches.

Magnesium sulfate may even be administered intravenously in the hospital if home remedies for the migraine symptoms are not working. The physician in the emergency room will determine if this or another therapy is most appropriate.

S-Adenosylmethionine (SAMe) for Migraine Headaches

In a preliminary study, SAMe decreased the frequency, intensity, and duration of migraines for most of the 124 people included in this evaluation. In addition, many reported an improved sense of well-being and use of fewer pain killers.

Vitamin B2 (Riboflavin) for Migraine Headaches

For many migraine sufferers, taking riboflavin regularly may help decrease the frequency and shorten the duration of migraine headaches. It is not clear how riboflavin compares to conventional medications used to prevent migraine headaches, however. As mentioned above, often the combination of riboflavin, magnesium, and feverfew is particularly helpful. Get Additional Information on Migraine Headaches Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.

Supplements and Rheumatoid Arthritis

Excerpts from the entry on Rheumatoid Arthritis in Relieving Pain Naturally by Dr. Sylvia Goldfarb and Roberta W. Waddell. For full entries on all 37 conditions and 27 treatments, order the book.

Arthritis is inflammation and pain in a joint. Its most common forms are rheumatoid arthritis and osteoarthritis and, of the two, rheumatoid arthritis is the more serious because it is more crippling. Considered an autoimmune disease, it is a chronic inflammatory condition that affects the entire body because it attacks the membranes surrounding the lubricating fluid in the joints. Scar tissue replaces this damaged membrane tissue, causing the joint space to narrow and eventually fuse together. Three times as many women as men are affected by this form of arthritis, which usually starts between the ages of twenty and forty-five.

Borage oil for Rheumatoid Arthritis

Borage oil comes from a plant and contains omega-6 fatty acids, which are thought to offer people with rheumatoid arthritis some relief from pain and joint stiffness. One recent study showed success in using borage oil to reduce pain and inflammation in people with rheumatoid arthritis. According to NCCAM, however, results of studies involving borage oil for rheumatoid arthritis have not been conclusive. And caution is in order: Borage oil and other oils that contain omega-6 fatty acids, such as evening primrose oil, can increase bleeding and bruising. NCCAM also warns that borage oil is made with an additive that may increase liver damage.

The appropriate dose of borage oil varies with each individual. Discuss what is appropriate for you with your rheumatologist. Borage oil supplements are available at many pharmacies and natural food stores.

Capsaicin Cream for Rheumatoid Arthritis

Capsaicin cream is a numbing agent that comes from cayenne peppers. The cream is rubbed onto joints that are sore and inflamed. Studies suggest that this cream is modestly effective in reducing joint pain if it is used daily. Side effects can include a burning sensation after application. This cream is available online and at some pharmacies and health food stores. Follow your doctor's recommendations for use.

Cod Liver Oil for Rheumatoid Arthritis

Cod liver oil, a rich source of omega-3 fatty acids, is the only dietary supplement that has been strongly associated with relieving symptoms such as inflammation and pain among people with rheumatoid arthritis. "It has [results] similar to non-steroidal drugs like ibuprofen and can be used safely," says Robert W. Hoffman, DO, professor and chief of the division of rheumatology and immunology in the department of medicine at the University of Miami Miller School of Medicine. "It also has cardiovascular protective benefits."

The risks of cod liver oil include increased bleeding and bruising and possible exposure to mercury from the original codfish. Research has shown 10 grams of cod liver oil daily to have a positive effect on joint pain, but there are no official recommendations about dosing. Cod liver oil is available in gel tablet forms at pharmacies, some grocery stores, and health food stores.

Flaxseed Oil for Rheumatoid Arthritis

Flaxseed oil, which comes from ground flax seeds, also contains omega-3 fatty acids. This oil is available in gel capsules and as in oil form for salad dressings or foods, but it must be kept refrigerated. Adults can take about 3,000 milligrams a day. It is available at pharmacies, health food stores, and some grocery stores.

Ginger for Rheumatoid Arthritis

Ginger is a spice that comes from the root of the ginger plant. It can be ground up to a powder, used fresh, boiled as a tea, or crystallized. Ginger has been used in Ayurvedic medicine (ancient medical practices native to India) for hundreds of years to fight inflammation. Data from scientific studies is scarce and inconclusive, but at least one study has shown ginger to help relieve some of the pain and swelling experienced by people with RA. Ginger can be bought at grocery stores as a spice, tea, crystallized candy, or a fresh root. It is available in capsule form as well. It can be used daily, but you should not use more than four grams each day.

Thunder God Vine for Rheumatoid Arthritis

Thunder god vine (TGV) is made from the root of a plant native to China, Japan, and Korea. It has been used in Chinese medicine to fight autoimmune diseases. Some studies in the United States suggest that taking TGV extract can help relieve RA symptoms. However, NCCAM notes that there is no safe product containing TGV available in the United States. It can be acquired through Chinese sources or Chinese medicine practitioners, who will make a recommendation about the appropriate dose.

Turmeric for Rheumatoid Arthritis

Turmeric is a spice that, like ginger, has played a role in ancient Ayurvedic practices as an inflammation fighter. Research into its effectiveness is ongoing. At least one study has shown that taking turmeric daily can help relieve morning stiffness and joint pain. Turmeric is available as a ground spice, in capsules, and as a cream. Curcumin is the active ingredient that addresses inflammation. Taking too much turmeric can cause stomach problems such as ulcers. About 1,200 milligrams a day is what is typically recommended. It can be bought at health food stores and grocery stores.

Rheumatoid Arthritis and a Healthy Diet

Although many supplements are available in pill form, it may be a healthier — and less expensive — to turn to your diet for pain relief.

A diet rich in fruit and vegetables is also a diet rich in antioxidants, which also play a role in fighting inflammation. "All RA patients should eat a healthy, balanced diet," says John M. Stuart, MD, professor of medicine and rheumatology at the University of Tennessee Health Science Center. "There is good evidence that diets rich in antioxidants may have at least modest long-term benefits." Get Additional Information on Rheumatoid Arthritis Here

If you decide to go the supplement route, talk to your doctor — together you can construct a "supplementary" plan that is right for you.




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