Louise H Connolly MD
Integrated Help for your Nerve Pain
This pain is not primarily from the bones, cartilage, or ligaments, this is about pain from the nerve itself, and ultimately from it's basic cellular unit - the neuron. You need to understand it's building blocks, what protects the nerve and what drives it into a frenzy. Protection and growth is related to BDNF. Oxidative stress leading to abnormal pain amplification is NMDA. Throw those two words around and everyone will think you know more than you do. BDNF and NMDA.
Protection also comes from the fatty acids in the myelin sheath surrounding each nerve. So make sure you have plenty of omega 3's for myelin repair. (Protective supplements may do better if they are fat soluble, so they can penetrate that myelin.)
If you are experiencing neuropathic pain, please do all you can to shut down NMDA derived inflammation first. Then promote BDNF, a nerve growth factor, with exercise and B3.
Let's start from the ground up. What got those nerve cells all fired up to begin with? A trigger that hits an already compromised neuron: A surgical stitch kinks a nerve, a herpes zoster attack gives you post herpetic neuralgia, a bony constriction irritates a nerve exiting your spinal cord. All create inflammation and injury, but some people's nerves over react, and create a NMDA sponsored gift that keeps on giving. It may be necessary to cut the stitch, quell the virus, or shave the bony protrusion. That comes first. But sometimes the nerve just keeps hurting long after the injury is over. How do you calm it down? This involves understanding just what is abnormally revving this nerve up when the initial problem is gone. From thence comes correction of the problem.
Too much calcium. That's the mediator of ongoing inflammation and pain. Calcium influx through open NMDA channels. You've done all you can to reduce triggers and inflammation with lifestyle, diet, herbal anti-inflammatories, physical therapy. I'm now down to the elemental.
Calcium excites, inflames and amplifies pain signals. And it raises your blood pressure. Exactly how it works? A trigger like monosodium glutamate (MSG) sensitizes your NMDA receptors causing a rapid influx of calcium into your neurons, creating more inflammatory molecules and thus heightening your pain. Whoops! Here comes a migraine! We need something to close up those NMDA receptor channels! Big pharma knows this. There's a whole host of calcium channel blockers doctors use for blood pressure control and modulation of many different pain syndromes.
But I am talking about something much simpler and more basic. I am talking about Magnesium, the number one supplement to promote nerve health. So simple - so elemental, so profound. Magnesium blocks entry of calcium into your neurons at the level of the NMDA receptor. There you have it.
Magnesium calms things down, lowers blood pressure, helps you sleep, and soothes all your nerves, helping them to conduct signals properly. Magnesium is also the most common mineral deficiency in our population So I ask you, if you have nerve pain, what's your RBC magnesium level? Probably low, but if you don't know, come in and find out.
The problem is that it's hard to absorb and even harder to retain magnesium. You have to really work at it. You can't just drop into CVS and buy any cheap brand you see. The magnesium won't go in, at best it's just a natural laxative. Then coffee, tea, and alcohol make you flush out magnesium. It also comes out in sweat. You can try an Epsom salt bath (it's magnesium sulfate), add an essential oil like lavender. Magnesium readily goes in through the skin.. Magnesium oils can work, but they also can itch, it's better to use a lower percentage Mg+ lotion. Magnesium, so simple, so profound, and so tricky.
Alpha Lipoic Acid: (ALA) This is an important and potent antioxidant and detoxicant which decreases oxidative stress in a wide variety of tissues. It floats easily in the blood as it is water soluble. It penetrates myelin sheathes as it is fat soluble. It's also small enough to cross the blood brain barrier and squelch inflammation there. Specifically, it works on nerves by increasing blood flow to them, increases their glucose uptake, and enhances the flow down their axonal branches. Great stuff.
Acetyl-L-Carnitine: (ALCAR) Here again we are actually protecting our nerves! We are also supplying our mitochondria with the fuel they need to make energy. Acetyl-l-Carnitine also penetrates into the brain. It slows neuronal degeneration (as is found in brain fog and peripheral neuropathy) and decreases excessive neuronal excitability and firing. It feeds their mitochondria what they need to make our energy
Co-Q-10: Acetyl l carnitine supplies raw material to our mitochondrial powerhouses, Co-Q-10 is the backbone of energy production. Although not directly involved in healing nerve based pain, ALA/ALCAR/CoQ10 act synergistically here.
The B vitamins - I'm talking about the first three B's. (That's B1, B2, B3) Then, of course, there's B12. Below are some examples of supplement combinations for neuronal pain.
1) Benfotiamine, a fat soluble form of vitamin B1, penetrates nerves in and outside of the brain much better than it's water soluble cousin. Benfotiamine, ALA/ALCAR, and Magnesium protect nerves from damage. (All but ALCAR can be used during chemotherpy.) They also help with diabetic or idiopathic peripheral neuropathy.
2) Riboflavin (B2), Magnesium, and CoQ10 help prevent migraines. Who knows if migraines are all in your head. If so, why are there ocular and even abdominal migraines?
3) Niacin (B3) ALCAR gets the basic nutrients into neuronal mitochondria, B2 ,B3, magnesium and CoQ10 produce mitochondrial energy. So your poor nerves run out of energy w/o these.
4) B12. So important are B1 and B12 to neuronal health that deficiency in either one actually causes peripheral nerve damage by destroying myelin sheathes.
See the pattern? It's redundant. It's simple. Magnesium, ALA/ALCAR, Co-Q10, Pick the right B for you, or use all 4.
Next up: Central Sensitivity Syndromes