SOME CLUES, SOME ANSWERS
Have you forgotten? I'm talking about the pains doctors can't see. Fibromyalgia, TMJ, Irritable Bowel Syndrome, and more. The problem appears to be in the nerve/brain signals, not in the part that hurts you. Signal intensity is off. Neuronal transmission needs fixing.
The Clues:
Lets go back to the gene variants involved in susceptible individuals. Serotonin Transmitter, Adrenergic Response Element, COMT. First of all, these genes have NOTHING to do with the parts of the brain that respond to Narcotics or NSAIDS, So no wonder these drugs just don't work. What do they process? Serotonin, Dopamine, Adrenaline. All three are neurotransmitters. Since it's the nerve transmission that's off, this makes sense. The last gene variant is different. I'm talking COMT here. COMT breaks down and inactivates neurotransmitters. And it also breaks down HORMONES, including estrogen.
Well, that's an interesting combination! Hormones and mood related? What a concept! Genetic variants in Depression, Reward, Anxiety, and SEX hormones set you up for the PAINS doctors can't see.
We're talking about your mood - too little serotonin and you get depressed, too much adrenaline and you get anxious. Not now, I have a headache! Stay away, I have PMS, my mood is terrible, and I hurt all over.
So Prozac is given for PMS. Savella is given for fibromyalgia. Immitrex is given for migraine. All of these drugs modulate your neurotransmitters. And they all should work better than codeine, percocet or advil.
Here's the thing. If you have a bad functional pain, you just can't help but reach for 3 Aleve or maybe some Norco. You're in PAIN. But did you know that while these drugs may give you relief now, they actually prolong your healing, increase rebound inflammation, stop your pain's resolution. You may feel good now but you'll suffer later and longer. Thus in the traditional medicine world, functional pains often become chronic, perpetuated by ever increasing polypharmacy.
I want you to understand these clues. I want you to understand the underpinning of your condition. It's the nerves and the brain that are tweaked. Now think about which antidepressant or anti-anxiety pill has helped you somewhat. It's a clue pointing to your genetic makeup. A clue, but not the answer. However it does point the way.
Better, we could use more natural substances which involve the same genes. We could nourish and promote nerve and brain health. We could nudge the brain into turning down the pain and turning up the "no pain" signals using it's own transmitters, not pharmaceuticals.
Next up. How do you spell Relief ?? My approach....
Until then. Sincerely yours. LHC MD
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