Pain is draining. And most people who are in chronic pain, also experience fatigue. They tend to go hand in hand. There are many approaches to both pain and fatigue, most which address one or the other. I’d like to review a few approaches for both that you likely have not considered, or even heard of. And don’t mistake not hearing about these for meaning that they are not tried and true therapies. They all are backed by years and years of research, and we have used these therapies in many, many patients to help them with the balance of pain and fatigue.
Low-Dose Naltrexone (LDN)
Firstly, let’s explore a medication that is non-toxic, safe and well-tolerated – Low-Dose Naltrexone (aka, LDN). In the early 1980’s, it was offered for relieving opioid addiction. It just inhibits the receptor, so there is no addictive potential or narcotic effect. LDN is pain-relieving, anti-inflammatory and increases our own levels of endorphins. Endorphins are the natural proteins which help to regulate cell growth and balance mood.
Conditions that respond well to LDN: Fibromyalgia, Moderate to Severe Degenerative Joint Disease, Chronic Osteoarthritis, Autoimmune Disease,
A typical daily dose of LDN is between 3-4.5mg, however, the dose may be increased up to 16mg in divided doses. The effect typically lasts for 4-6 hours.
Patient Story with LDN Treatment: April, an early 50’s entrepreneur and mother, came in with concerns of chronic joint pain and osteoarthritis which she was managing with advil, and the occasional Vicodin if pain was severe. The pain would breakthrough at night, often waking her and disturbing her ability to fall back asleep. She worked long hours, and would end the day in worse pain and feeling extremely fatigued. Then the cycle would repeat. We began to work on healing therapies which would start to work on increasing cartilage and connective tissue strength, reducing inflammatory aspects in her diet and correcting her nutrient deficiencies. These all take time however, and her pain was severe enough we began a trial of LDN. At 4.5mg she was almost completely free of pain for the day. We worked on the dose a little more and found 6mg to work well enough where she does not get any breakthrough pain at night, and is now sleeping throughout, waking feeling refreshed and ready for the day. She has more energy to work on shifting her diet, preparing meals, incorporating light exercise and also reports that her mood is feeling lighter and she is more hopeful about her health and ability to achieve long-term wellness and pain relief.
Adult Growth Hormone Deficiency
Adult Growth Hormone Deficiency is an often overlooked hormone deficiency in adults. Just as we see low hormone levels with the thyroid, or in adrenal fatigue, your levels of growth hormone can be lower and in need of support, without having the severe symptoms of pituitary glandular slowdown which would flag most endocrinologists to look for this condition. In other words, the symptoms can appear to be generalized, thereby being missed or appearing to be something else, such as a borderline functioning thyroid gland. Symptoms of lower growth hormone include: slow metabolism, difficulty with weight loss, fatigue, chronic pain, slow healing, less muscle mass, less strength and stamina. All of these make it more likely that a chronic pain condition will remain chronic as the body has difficulty with healing.
Conditions that respond well to growth hormone therapy: If you have a growth hormone deficiency and any form of chronic pain, there is a strong likelihood that you will experience benefits in healing and reduction of pain. (Note: There are certain situations where growth hormone therapy is not appropriate, for example during cancer therapy – this will need to be discussed with your primary care physician).
The best tests for determining if you have adult growth hormone deficiency are starting with growth hormone precursors (IGF-1, IGFBP-1, IGFBP-3, Growth hormone, and if severe: a Growth Hormone Stimulation test from an endocrinologist. Treatment for lower level growth hormone deficiency that may not warrant actual prescription Growth Hormone can be done with prescription Sermorelin (a growth hormone precursor), and other herbs which support the gland, such as Vitamin C, L-arginine, and ornithine alpha-ketoglutarate.
Patient story with Growth Hormone support: Debbie, a mid-40’s professional woman, was diagnosed with Fibromaylgia, in addition to arthritis in multiple joints which would flare on a weekly basis, interfering with sleep, and making her generally exhausted. She had done a trial of LDN for one year, and found it did not relieve her pain an appreciable amount. She had made improvements with changing her diet, IV nutrients and chiropractic care, and was feeling better, but could just not lose the extra weight she had put on due to exercise being painful all these years. Her level of pain also tended to be higher than she would have liked. Her growth hormone markers were on the lower end, and we began the growth hormone precursor, Sermorelin. Within 3 weeks, her pain level dropped significantly, “at least 50%” she reported. Her daily walking became easier, without the Fibro flare that often accompanied exercise. And she is starting to lose weight, without changing much else in her routine. A few months now into the treatment, her pain level is continuing to decrease, which is giving her more energy to make other changes, such as increasing her exercise and continuing to clean up her diet.
Oxygen Therapy (aka, Ozone Regenerative Therapy)
Ozone is an incredible medicine that has been used in medicine for over 35 years in the US, and in over 40 countries, with thousands of clinical trials. It’s incredibly safe, and has many uses. When ozone is introduced into the body, either via a technique called MAH (Major Autohemotherapy) or through insufflation (think an oxygen enema), it behaves like a prooxidant which then stimulates regeneration and healing in the body.
One of the top uses of ozone regenerative therapy is to reduce pain (and in some instances completely resolve pain) and stimulate healing.
Ozone therapy works by:
- Pain relief – Ozone has an analgesic effect when placed locally, such as directly into a joint or into the muscle with trigger point therapy
- Stimulating antioxidant production and growth factors – for example, we see this through repair of a joint space through ozone stimulating cartilage to regrow via stimulation of growth factors
- Increasing cellular energy and production of ATP – more energy in the cells equals a greater ability by the body to repair itself
Is there anyone who should not do ozone therapy? The top things we screen for are a low/abnormal G6PD, high iron and low platelets before beginning ozone therapy.
Conditions that respond well to LDN: Fibromyalgia, Moderate to Severe Degenerative Joint Disease, Chronic Osteoarthritis, Acute and Chronic Injury
Patient story with Ozone Regnerative Therapy treatment: Mike was a professional athlete in his 20’s, and as a consequence of multiple injuries over the years, and now being in his 50’s, his knee and shoulder joints were in constant pain. He was on 2 narcotics, with an extra narcotic for breakthrough pain, and he and his pain management doctor were discussing increasing his doses. We started with the strongest form of Ozone treatment, MAH (Major Autohemotherapy), which goes through the entire body and is therefore available to stimulate repair in all joints. We decided on 10 treatments, as this amount tends to work best on more severe chronic pain issues. After the first treatment, he felt some relief. By the 5th treatment, his pain had dropped so significantly, he worked with his pain doctor to cut his pain medications by 40%, and start reducing to NSAIDs (eg, advil) instead of narcotics. He noticed after each therapy, he also had more energy to accomplish work in his personal business, which he was finding was flourishing as well with his extra energy.
While approaching and healing the core issue that is causing pain can sometimes be difficult, all of these therapies can and should be considered in the approach to chronic pain. We specialize in these approaches, and would love to talk with you about how to best approach your particular situation!
Please reach out to us if you have questions, or would like a personalized medicine plan.
We are here for you!
Yours in health, Dr. Angila Jaeggli