ALTERNATIVE TREATMENTS

Some people find that boosting brain levels of endorphins can provide natural pain suppression. This approach is not an effective way of dealing with acute (short-term severe) pain, but it is the safest method of alleviating chronic (long-lasting) pain.

Early in the 1970s, researchers at the Johns Hopkins University School of Medicine wrestled with a baffling puzzle. They had just proven that morphine, a powerful pain-killing drug, fits perfectly into special receptors in brain cells just as a key fits into a lock. The brain receptors were just the right size and shape for the morphine keys, suggesting that the human brain had been designed to work with morphine, allowing it to unlock, enter, and control parts of the brain.

Why would the human brain have evolved receptors specifically designed for morphine? After all, morphine is made by plants, not by the human body. Morphine is not supposed to be in humans and it rarely gets there. Most of us go through life without ever taking morphine.

Researchers theorized that if there were receptors for morphine in the brain, then there had to be morphine or a morphine-like substance somewhere in the body, but what was it, where was it, and what did it do?

The puzzle was solved when the first components of the human body's natural, morphine-like substances were discovered. They were called endorphins (endogenous morphine), and, like the drug, they are powerful painkillers that can alter mood. In fact, studies have proven that an endorphin called beta-endorphin is approximately 50 times more potent than morphine at quelling pain. Morphine was once the most powerful pain killer known

Endorphins are part of the natural pain-control net­work in the human body. They work by interfering with pain messages traveling through the nervous system. Endorphins cut off the pain message, stopping it dead in its tracks. Unfortunately, we cannot use endorphins themselves as painkillers. Taking endorphin pills or injecting endorphins into the body is inefficient, costly, impractical, and potentially dangerous..

Supplements That Fight Pain

Fortunately, we do not have to take endorphins to experience their pain-killing benefits. Instead, we can use natural substances that protect or boost the endor­phins in our bodies, allowing their levels to rise to higher, more powerful levels. A brief description will follow of some of the supplements to consider if you suffer from chronic pain.

Tyrosine

Tyrosine is a nonessential amino acid that is manufac­tured by the body or absorbed from food. The body uses tyrosine to make the neurotransmitters dopamine, norepinephrine, and epinephrine, all of which play a role in elevating mood and keeping us alert.

A suggested dose of tyrosine is 500 mg taken 2-3 times daily.

Phenylalanine

Phenylalanine, like other amino acids, comes in D and L (right and left) forms. The difference between the forms is like the difference between your hands. They are identical, but are opposite, mirror images of each other. The left-handed form is known as L-phenylalanine (LPA). This is the form in which phenylalanine is normally found in foods. The right-handed form is known as D-phenylalanine (DPA). DPA is the form that protects endorphins in our bodies and helps us to fight pain and depression. A mixture of the two forms, which has been used to fight pain since 1978, is known as DL-phenylalanine (DLPA).

Phenylalanine protects our endorphins. It has helped many people overcome pain, as well as the depression that often accompanies chronic pain. In the original study of the effects of phenylalanine on pain, three of 10 patients reported significant relief. Phenylalanine has also been proven to be effective against painful inflammation. Phenylalanine may work by up-regulating what is called the "endogenous analgesia system" (EAS), a neural pathway that occurs in a part of the spinal column. When stimulated by chronic pain or therapeutic measures such as opiates or acupuncture, the EAS suppresses activation of pain-receptive nerves in the spinal column and thereby alleviates pain .

Phenylalanine is not a drug, and it does not work directly against pain. Instead, it acts as an endorphin shield, battling pain indirectly by helping the body's built-in pain control system grow more powerful.

Phenylalanine was first tested against pain in a 1978 study at the Chicago Medical School. Researchers began by timing how long laboratory mice would remain on a hot plate before jumping off. Then they injected hundreds of mice with phenylalanine and again watched to see how long the mice would remain on the heated surface before scurrying off.

The amino acid blocked pain in 70% of the mice, allowing them to stay on the hot surface longer. The pain blocking action actually grew stronger with time. Standard medicines tend to become less effective over time as the body grows accustomed to them, but phenylalanine was actually more effective on the ninth day than it was on the first. Plus, there was more good news. Phenylalanine worked with other medicines, making them stronger, and did all this without any apparent side effects.

Excited by these surprisingly positive results, the Chicago scientists tested phenylalanine on humans. The results were astounding. All 10 patients studied who had been suffering from long-standing chronic pain (people who had not been helped by modern medicine) found pain relief with this simple amino acid. Phenylalanine relieved chronic pain that had not been helped by conventional methods. There were no harmful side effects, and no one became addicted (as can be the case with powerful pain medicines). Also, no one developed a tolerance to phenylalanine, requiring larger and larger doses to get the same effect, as is often the case with conventional pain drugs.

Additional research supported these early promising results. In one landmark study, 43 patients suffer­ing from various types of severe pain were given 250 mg of phenylalanine 4 times a day. Some of the patients reported marked relief within 1 week. But by the end of the fourth week, 75% of the patients reported that their pain had been relieved (Balagot et al. 1983).

In Great Britain, a double-blind, controlled study was undertaken to determine whether the amino acid really worked or whether the pain relief reported in other studies was caused by the so-called placebo effect. It is well-known that the power of belief can act as a medicine. Thus, when patients are given pills that contain no medicine but are told that the pills contain powerful drugs, many patients will get better. The participants in this study were adults suffering from long-standing, intractable pain of varied causes that had not been cured by conventional drugs or physical therapy. Despite the fact that lower doses of the substance were given and a 50% reduction in pain was required to qualify as improvement, more than 30% of the participants experienced significant relief. Phenylalanine outperformed the placebo, showing that it is, indeed, a powerful medicine .

There are some people, however, who cannot use phenyl­alanine. This includes those born with a genetic deficiency called phenylketonuria (PKU) that prevents them from metabolizing phenylalanine, those with preexisting high blood pressure (phenylalanine can elevate blood pressure in people who are already hypertensive), and peo­ple with cancer (phenylalanine can promote cancer cell division).

Although phenylalanine is a powerful painkiller, it does not begin to work as rapidly as aspirin and other pain medications. This is because the amino acid helps to increase the body's supply of endorphins, rather than attacking pain directly. Strengthening the body's natural pain-control mechanisms is a very effective strategy, but it takes time to begin working. For headaches and other acute pain, people naturally prefer the almost instant pain relief they get from aspirin and other conventional medications.

What about chronic pain that does not respond to stan­dard medicines, physical therapy, or surgery? Phenylalanine has ample time to begin working in such cases, so why is it not used more? The reason is because phenylalanine is not profitable for drug companies. It is a simple amino acid that cannot be patented. Thus, most physicians know that phenylalanine is an amino acid but have never heard about its powerful analgesic properties because no drug companies promote it.

The suggested dose of phenylalanine is 500 mg taken 2-3 times daily.

Glucosamine

Glucosamine is found in fish, meat, and other foods. This amino acid compound is particularly helpful in treating arthritis pain because it stimulates connective tissue, encouraging it to repair itself. Glucosamine is chondro-protective which means that it protects the chondrocytes that are found in large quantities in the joints.

Glucosamine is made in the body from glucose (sugar) and an amino acid called glutamine. Glucosamine serves as a building block of mucopolysaccharides (MPS) which are important for the development of cartilage, bone, liga­ments, nails, hair, and skin. We can also get glucosamine from supplements.

As we get older or when we are injured, the body produces less glucosamine. This is surprising. One would think that the body would produce more glu­cosamine in order to repair the injury. Unfortunately, even small injuries that are not repaired can lead to greater damage and pain. Taking glucosamine gives the body the material it needs to help repair damaged cartilage. It often works best when taken with the fatty acids GLA, DHA, and EPA; chondroitin sulfate; manganese; and vitamins C and E.

Many studies have shown glucosamine to be a potent natural remedy for osteoarthritis that seems to affect so many of us as we age. It also opposes degeneration of the substance of the joints that occurs in arthritis. Several studies conducted at research centers in Europe have shown that supple­mental glucosamine reduces joint pain, tenderness, and swelling, making joints that had been frozen with pain and inflammation usable again (Vajaradul 1981).

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Glucosamine does not work as fast as some standard pain medications, but it does so without the serious side effects associated with drugs. In fact, many Euro­pean physicians give glucosamine to their osteoarthri­tis patients as a firstline treatment, turning to drugs only in cases where the amino acid is not effective. Currently, over 5 million Americans take glucosamine or glucosamine and chondroitin combinations (Maher 2001).

Glucosamine appears to be even more effective in the form of glucosamine sulfate. Like glucosamine, sulfate is a component of joint cartilage. The sulfate also appears to strengthen the healing effects of glu­cosamine. Here are some of the studies on glu­cosamine sulfate.

A group of 20 patients with osteoarthritis of the knee was given either 500 mg of glucosamine sulfate 3 times a day, or a placebo. Within 6-8 weeks, subjects receiving glucosamine sulfate experienced significant reductions in pain, joint tenderness, and swelling. There were no reported side effects .

A randomized, placebo-controlled, double-blind study was carried out with 202 patients for 3 years. Some were given glucosamine sulfate, 1500 mg, once a day. The researchers wanted to see if long-term treatment with glucosamine could alter the progres­sion of osteoarthritis in the knee. Based on the various tests that were carried out, there was a significant improvement of 20-25% in the glucosamine group. The authors concluded that long-term use with glu­cosamine slowed progression of the disease, possibly determining disease modification. A group of 80 osteoarthritis patients experiencing pain, movement restriction, and swelling was given either glucosamine sulfate or a placebo: 73% of sub­jects receiving glucosamine sulfate experienced an improvement in symptoms within 3 weeks. What is more, when those who received glucosamine sulfate were biopsied and their cartilage was examined under an electron microscope, it looked much healthier than the cartilage taken from the placebo group.

Glucosamine sulfate was compared to ibuprofen in a double-blind study involving 40 patients with osteoarthritis of the knee. As expected, the ibuprofen worked faster. But, by the eighth week, subjects taking glucosamine sulfate were doing better than subjects taking ibuprofen, with significantly fewer complaints. In two other studies, one with 200 patients and another with 178, similar results were noted. The researchers in one of the studies noted that glucosamine was more effective because it curbed the pathogenic mechanisms of osteoarthritis. If taking glu­cosamine sulfate, follow the directions on the bottle.

Chondroitin Sulfate

Chondroitin sulfate provides building materials for cartilage that is so often damaged in arthritis. Chon­droitin sulfate slows the free radicals that attack the cartilage in joints. It also increases the flow of blood to joints, thus allowing antioxidants and other healing substances produced by the body to protect and repair body tissue. When arthritis patients were given injec­tions of chondroitin sulfate, joint pain diminished sig­nificantly, and mobility and function returned.

Chondroitin sulfate is found in shark cartilage. A summary of two studies in which shark cartilage was used on arthritis patients follows:

• Shark cartilage capsules were given to six osteoar­thritis patients who had not found relief with con­ventional anti-inflammatory medications. By the fourth week, the patients reported less pain and inflammation and greater joint mobility (Orcasita 1989).
• Either cartilage extracts or a placebo were given to 147 patients who had osteoarthritis in another long-term, double-blind study. After 5 years, aver­age pain scores had fallen by 85% in the cartilage group, compared with only 5% in those receiving the placebo. The cartilage group also had less joint deterioration and took significantly less time off from work (Rejholec 1987).

The suggested dosage of shark cartilage for arthritis patients is 2000-3000 mg daily. However, most people take a combination supplement that provides 400­500 mg each of both chondroitin and glucosamine sulfate. Typical daily doses are 2-8 capsules daily.

Melatonin

Melatonin is a hormone with potential as a therapy for treatment of diseases with pain and abnormal immune response. The effects and mechanisms of melatonin on inflammation and immuno-regulation have been studied systematically (Maestroni 2001). Melatonin showed significant analgesic effects in animal studies. Melatonin was also shown to enhance the pain-suppressing effects of analgesics.

Further studies showed that melatonin could enhance the functions of T and B lymphocytes and

macrophages in vitro and in adjuvant (assistive) arthritis treatment. In animal studies, melatonin was shown to inhibit swelling.

These factors suggest that melatonin possesses marked anti-inflammatory, immunoregulatory, and analgesic effects that may be related to the system of opiate modulation.

CAUTION Use melatonin cautiously when treating autoimmune diseases such as rheumatoid arthritis. Some sci­entists speculate that melatonin could worsen the severity of auto immune diseases. For nighttime pain relief, 3-10 mg of melatonin should be taken before bedtime. Melatonin should not be used during the day.

Vitamins That Fight Pain

Vitamins and antioxidants can help to reduce pain in many people. Just like many things in life, the oxygen we breathe is both good and bad. On the one hand, oxygen is a nutrient gobbled up by every cell in the body, and without it, we would quickly die. On the other hand, oxygen is a highly reactive substance that can do quite a bit of damage. We know what oxygen can do to metal: oxygen causes metal to rust. Uncon­trolled, oxygen can do something equally dangerous to our body cells and tissues.

Oxygen occurs in different packages. The oxygen we breathe is composed of two oxygen molecules attached to each other, but other highly toxic single oxygen molecules called singlet oxygen also occur in the body and can cause trouble. These oxidants (including all reactive oxygen species) are created as byproducts of bodily functions, but they may also be inhaled or taken in when we are exposed to drugs, pesticides, certain foods, cigarette smoke, and air pollution. If not carefully controlled by antioxidants, oxidants would travel through the body, "rusting" substances in cells and tissues.

As more and more "rust spots" appear, the body's ability to function, heal itself, and fend off disease begins to falter. Eventually the immune system, circu­latory system, and nervous system weaken.

Certain oxidants called free radicals are unstable molecules. Seeking to balance themselves, free radi­cals take electrons from other molecules. By setting up a chain reaction of electron stealing, free radicals can cause irreparable damage to the body.

There is much to learn about oxidants: we have not yet figured out all of the ways oxidants harm the body. But many researchers believe that oxidation is a major cause of many of the diseases associated with aging, including arthritis, and we know that oxidation can harm already damaged arthritic joints, as well as their surrounding tissue, making swelling and pain increas­ingly worse.

The body maintains its own antioxidant "police force" to control oxidants. SOD, catalase, and glu­tathione peroxidase are three of our natural "oxidant policemen." Unfortunately, our built-in antioxidant militia is not always proficient in protecting us, espe­cially as we age or are subjected to various chemical substances. That is when antioxidant supplements, including vitamins, can be helpful.

Plant antioxidants, the best antioxidants, occur natu­rally in plants. Potent antioxidants such as tocotrienols have to be extracted from palm oil, while others such as lycopene can be obtained from tomato paste or juice. People often consume supplements that are a variety of plant antioxidants including beta-carotene, alpha-carotene, zeaxanthin, and lutein.

Vitamin B1 (Thiamin)

Vitamin B1 (thiamin) is a vitamin that is an over­looked source of pain relief. Vitamin B1 is particularly helpful for patients with neuritis, shooting pains in the legs related to chronic liver disease or alcoholism, and diabetic neuropathy (nerve disease caused by diabetes), as well as nerve and joint pains associated with a B1 deficiency.

In a study of the efficacy of B1, the vitamin was given to 133 people who had headaches, joint pain, nerve pain, or neuritis (pain caused by inflammation of the nerves). None of the patients had found relief with conventional pain pills or physical therapy, but when given 1-2 grams of B1 once or twice daily, patients reported that 78% of headaches improved, 71% of spine or joint pain improved, and more than 62% of patients with neuralgia reported relief.

Start with 25 mg of B1 twice a day. Studies have shown that in order to get the best effect from water-soluble vitamins (for example, vitamins B and C), they should be taken at least twice a day. B1 can be found in almonds, whole-grain wheat and oats, nuts, and beans.

Vitamin B3

Vitamin 133 is nicotionic acid, a derivative is niacinamide. Vitamin B3 is a potent antiarthritis supplement. In certain people, it may reduce pain and increase mobility in arthritic joints within 3-6 weeks. The ability of B3 to make joints more mobile has been known for more than 40 years. Niacin (B3) is readily converted into niacinamide. As early as 1955, a study reported that 663 patients, when given niacinamide, showed improved ability to move their joints (compared with 842 controls who did not receive the vitamin.

CAUTION Niacin or niacinamide should not be taken by people with chronic liver diseases.

The suggested dose for arthritis is 500 mg taken 3 times a day.

Vitamin B6 (Pyridoxine)

Vitamin B6 (pyridoxine) is the most important of the B vitamins, among several other vitamins required for a fully functioning immune system. Vitamin B6 has a special role in treating chronic pain. Pain patients tend to have a lower pain threshold, which means that they feel pain sooner than other patients. In addi­tion, they often have a smaller supply of the neu­rotransmitter serotonin.

Our body cells have special receptors, "parking spaces," where medicines pull up and interact with cells, but with long-term use of pain-killing drugs, the number of receptor sites for these drugs seems to diminish. This means that the drugs are less effective. Patients must take more and more pills or their pain will increase, and if they stop taking their medicines, they may suffer from severe rebound pain.

However, if patients are given B6 as they are weaned from their medicines, they do much better. B6 is also helpful in reducing the inflammatory component of arthritis. (In animals, B6 deficiencies can even cause a version of human arthritis.) This vitamin has also been used successfully to treat the pain of carpal tunnel syndrome and unexplained cyclical breast pain.

Although doses vary from person to person, many people find it helpful to take 100-150 mg of B6, one time per day. The medical literature con­tains reports of neuritis or nerve damage caused by using large amounts (ranging from 1000-6000 mg per day) for long periods. There are also reports that certain susceptible people may develop neuritis from as little as 300-400 mg per day without other B vitamins present. Examine your vitamin and sup­plement combinations to ensure that you are not taking excessive doses. B6 is found in beans, Brus­sels sprouts, cantaloupe, cauliflower, lentils, whole wheat, and rice.

Vitamin B12

Vitamin B12 deficiency is normally associated with pernicious anemia. B12 has also shown powerful pain­killing abilities. In one study, 400 patients suffering from vertebral pain were given 5000 mcg of B12 a day. Within 6-16 days, 50% of the patients were experi­encing relief that they rated as "good" to "very good." Almost all of the remaining patients reported at least satisfactory results. Only 10 of the 400 said they felt no improvement at all. Larger doses of the vitamin have been successfully used to treat the pain of cancer and degenerative neuropathy.

For chronic pain, some authorities recommend 500 mcg of sublingual B12 2-3 times per day. The neurologically active form of vitamin B12 (methylcobalamin) is the recommended form to be taken sublingually in doses of 5 mg (5000 mcg) or higher a day.

Vitamin C

Vitamin C, a versatile immune system booster and antioxidant, is another natural shield against pain. When pain becomes too strong for victims of breast cancer, and their usual medications are not helping, giving vitamin C along with drugs sometimes quells the pain. Vitamin C has also been used to treat gum and muscle pain. Optimal doses of vitamin C range from 2500-6000 mg a day. Good food sources of vitamin C include broccoli, papaya, red peppers, oranges, cauli­flower, and asparagus. In special cases, larger doses are suggested.

Vitamin E

Vitamin E has two possible ways of blocking pain: by working with endorphins and by acting as an antioxi­dant. A study of women with dysmenorrhea (painful menstruation) found that vitamin E could reduce dis­comfort and that endorphin levels rose. However, when the women were given naloxone, a substance that blocks endorphins, vitamin E lost its pain-killing power. This suggests that vitamin E and the natural morphine within are linked.

Vitamin E was put to the test in a double-blind study involving 50 patients with primary degenerative osteoarthritis. The participants were given either vitamin E or a placebo (a sugar pill). After 6 weeks, the vitamin E group reported less pain while moving or at rest and less pain when their joints were subjected to pressure.

In another test of the efficacy of vitamin E against arthritis, 29 patients were given vitamin E for 10 days, and a placebo was given for another 10 days. (The patients did not know which one they were receiving at any given time.) When taking vitamin E, 52% reported relief from pain, compared to only 4% when taking the placebo (Machtey et al. 1978).

A suggested dose is 400 IU a day of D-alpha­tocopheryl succinate along with a separate supple­ment that provides at least 200 mg of gamma­tocopherol. This vitamin is also found in green leafy vegetables, green beans, seeds, broccoli, and nuts. Check all supplements you are taking to be certain that your total vitamin E intake does not exceed 1200 IU a day (unless otherwise directed by your physician).

Other Substances That Fight Pain Minerals

Studies demonstrate that a number of minerals also work to fight pain in many people. These include:

Selenium

Selenium, an antioxidant mineral, works with vitamin E and other substances to control free- radical damage. Selenium also has anti-inflammatory properties, which reduce pain. In combination with vitamin E, selenium works well against long-standing muscle pain, stiffness, and aching. Good sources of this mineral include whole grains, fish, and poultry. Selenium is also found in fruits and vegetables, but the amount varies depend­ing on how much of the mineral was present in the soil in which the food was grown.

A suggested dose of 200 mcg of supplemental selenium taken once per day can be helpful for con­trolling pain.

Magnesium. Magnesium, another mineral, has been used to treat many painful states with good results, especially headaches. When 3000 women who suffered from migraine pain were given 100-200 mg of magnesium, 80% reported a "good" response. The mineral is even more potent when mixed with B6 and ascorbate (a form of vitamin C). Intrave­nous injections of the triple combination can substan­tially reduce or eliminate the pain of acute migraines in most cases.

Magnesium deficiencies have been linked to a variety of ailments. For example, the blood of 26 women who experienced premenstrual tension had less magnesium in their red blood cells than was found in the blood of control women .

Consider taking 250-500 mg of elemental magnesium twice a day. Look for elemental magnesium on the label.

Boron

 Boron is a little-known mineral that plays an important role in bone health. We normally associate calcium with bones, and there is certainly more cal­cium in bones than boron. Boron acts as a stop sign, helping to keep calcium in the body and in the bones. Studies comparing large populations in various countries have found that where there are higher amounts of boron in the soil (and thus presumably more of the mineral in foods), there is less osteoarthritis. Some clinicians have reported good results with boron supplements, which appear to relieve the symptoms of osteoarthritis up to 90% of the time.

A suggested dose is 3 mg a day, but do not exceed 9-10 mg per day.

Herbs That Fight Pain

Sometimes the best place to look for treatment is nature's pharmacy. Many plants have remarkable pain-reducing qualities. The leaves of pain-fighting herbs may often be taken in a tea. Most herbs are complexed to be taken in supplement form as well. General dosage guidelines for teas and supplements are given below.

Ashwaganda. Ashwaganda has been used for many years to treat pain in Ayurvedic medicine. One to two cups of tea made from ashwaganda have been shown to reduce pain and inflammation. In a double-blind, crossover study, 42 patients with osteoarthritis who were given an herbal formula with ashwaganda and zinc showed a significant improvement in pain and stiffness.

CAUTION In large doses, ashwaganda can be harmful. Discuss the use of ashwaganda with your physician, and do not drink more than the recommended dose.

Capsaicin

Capsaicin, a chemical found in cayenne and other peppers, is a prime ingredient of over-the- counter and prescription analgesic ointments. Rubbing capsaicin on the skin produces an immediate sensation of warmth. Capsaicin works by interfering with sub­stance P, a chemical messenger that transmits pain sig­nals to the brain. Capsaicin can stop the pain of shingles, post-therpetic neuralgia, osteoarthritis, and diabetic nerve pain. Although mostly used as an ointment, capsaicin can be made into a tea. Drink 1-2 cups of tea daily. Capsaicin is also available in capsules of 400-500 mg.

Curcumin (from the spice turmeric)

Curcumin is a root that is used to add color and flavor to curry and other foods. Because it has anti-inflammatory proper­ties, curcumin has been used to combat the pain and swelling of arthritis. Some researchers think that curcumin is as powerful an anti- inflammatory as cortisone. Curcumin may also help to lower cholesterol, reduce the risk of heart disease and stroke by thinning the blood to prevent unnecessary blood clots, lower blood sugar in diabetics, and help the body to counteract carcinogens. Doctors of Orien­tal medicine also use the herb to treat colic, menstrual cramping, and shoulder pain.

The recommended dosage of curcumin is 900-1800 mg daily. A tea may be prepared from the turmeric root at a dose of 0.5-1 gram a cup.

Devil's claw

Devil's claw is from an African plant whose fruit bears a resemblance to a large, hooked claw. Several pharmacological studies using animal models of inflammation have found that devil's claw produces powerful anti-inflammatory effects. At least two components of the plant, harpogoside and beta-sitosterol, have anti-inflammatory properties. This makes devil's claw a pain­killer because reducing inflammation helps to relieve pain. Some studies in Germany and France have found that the herb's ability to alleviate pain and inflammation compares well with that of the drugs cortisone and phenylbutazone. Although there is no official dosage for this herb, these amounts are usually helpful: dried powdered root, 1 gram taken as a tea 3 times per day; tincture (1:5), 1 tsp 3 times per day; or dry solid extract (3:1), 300-400 mg 2-3 times per day.

Feverfew

Feverfew is an herb that sprang to prominence in the late 1970s when newspapers in England reported about a woman whose headaches were cured by the herb. A randomized, double-blind, placebo-controlled, crossover study using feverfew as a prophylaxis reported good results. There was a reduction in the severity and number of migraine attacks in each 2-month period. The visual analog scores showed significant improvement. There were no serious side effects. That report backed up an article in a 1985 issue of the British Medical Journal that described how eating feverfew leaves daily led to fewer and less severe migraine headaches in 70% of 270 cases. (Many of these were severe cases that had not responded to standard headache medications.) It is thought that feverfew counteracts headaches by inhibiting production of inflammation-causing substances (such as 5-lipooxygenase) in the body and by helping to keep blood vessels supplying the head from being vasoconstricted.

A suggested dose is 25 mg twice per day. Mygracare is a stabilized form of feverfew which contains 600 mcg of the active ingredient parthenolide.

Ginger

Ginger, commonly used as a spice in foods, has anti-inflammatory and analgesic effects. It has long been used to prevent and relieve migraine head­aches. Ginger is a versatile substance that has also been used to treat headache, nausea, and vomiting. It is thought to have antioxidant and antidepressant properties as well. Ginger may be added to foods, brewed in teas, or taken in capsules.

For pain and inflammation, 1-2 grams daily should be taken.

Proanthocyanidin

Proanthocyanidin possesses extraordinary antioxidant properties that may be of value in reducing the inflammation associated with pain. For chronic pain, start with 100 mg twice per day for 4-6 months and then reduce the dosage by half.