Monday, July 29, 2019

Four Common Nutrient Deficiencies in Patients with Pain

Chronic pain can cause nutrient depletion in patients for many reasons, including increased inflammatory and oxidative stress, and changes in diet. One of the initial ways to approach chronic pain is to focus on nutrient optimization in areas of common deficiency. How can we, as healthcare providers, address this with patients and clients?

1. Vitamin D – especially beneficial in patients with musculoskeletal pain; A trial which added 4,000 iu/day of vitamin D reduced daily pain and need for analgesic rescue medication vs. placebo. In addition, several inflammatories decreased by 39.2% to 54.3% in the group treated with vitamin D (Gendelman, Itzhaki, & Amital, 2014).

2. Magnesium – known deficiency in American population; A trial evaluating the role of magnesium replacement in patients with chronic low back pain found those receiving magnesium over 6 weeks vs placebo noted reduced pain intensity and improvement in lumbar spine mobility during a 6-month follow up period (Yousef & Al-deeb, 2013). 

3. Omega 3s – U.S. adults do not have adequate intake of anti-inflammatory fatty acids including EPA and DHA; Several studies have noted that marine-derived n-3 polyunsaturated fatty acids supplementation provided significant reduction of inflammatory markers. (Li et al., 2014). 

4. B Vitamins – deficiencies in several of the B vitamins have been linked to pain; Studies show carnitine demonstrated benefit in treating fibromyalgia pain when compared to prescription medication (Leombruni et al., 2015). 

All four of these supplements also have secondary benefits for patients with pain.

Source: The Andrew Weil Center for Integrative Medicine


References

Gendelman, O., Itzhaki, D., & Amital, H. (2014). AB0873 A Randomized Double-Blind Placebo-Controlled Study Adding High Dose Vitamin D to Analgesic Regimens in Patients with Musculoskeletal Pain: Table 1. Annals of the Rheumatic Diseases, 73(Suppl 2). doi:10.1136/annrheumdis-2014-eular.2555

Yousef, A. A., & Al-deeb, A. E. (2013, March). A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia, 68(3), 260-266. doi: 10.1111/anae.12107

Li, K., Huang, T., Zheng, J., Wu, K., & Li, D. (2014). Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on C-Reactive Protein, Interleukin 6 and Tumor Necrosis Factor α: A Meta-Analysis. PLoS ONE, 9(2). doi:10.1371/journal.pone.0088103.

Leombruni, P., Miniotti, M., Colonna, F., Sica, C., Castelli, L., Bruzzone, M., Parisi, S., Fusaro, E., Sarzi-Puttini, P., Atzeni, F., & Torta, R. G. (2015). .A randomised controlled trial comparing duloxetine and acetyl L-carnitine in fibromyalgic patients: preliminary data. Clinical and Experimental Rheumatology, 33(1 Suppl 88), S82-S85. Epub 2015 Mar 18.

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