The (pain) killer in your medicine cabinet

For as long as humans have existed, they’ve experienced pain…and turned to plants for relief. Which is only natural. After all, plants pre-dated animals—dinosaurs and humans alike. This is why animals are “pre-adapted” to use plants as a source of nutrition and medicine.

And through the millennia, the plants we’ve turned to are those that either reduce inflammation, or pain sensations. These sensations are felt by the nerves and perceived by the brain and central nervous system.

Plants pack a powerful punch

The most powerful pain relievers of all come from the opium poppy (Papaver somniferum). The poppy contains morphine and related plant alkaloids. These plant chemicals deaden the brain and the central nervous system’s perception of pain, and makes the patient indifferent to pain sensations.

Other plant chemicals such as cocaine (from the coca plant) are used as local anesthetics. These include related drugs procaine and novocaine. Cocaine was once used routinely as a local anesthetic for ear, nose and throat surgery. It even appeared in popular beverages and tonics for a quick “pick-me-up” during the 19th century.

Indeed cocaine can affect the body in many ways. Native Americans of the Andes chew the coca leaf to help digest complex carbohydrates, for energy. And probably to even help thin the blood. The blood can become thick and “sludgy” at their high altitude.

In comes the strong arm of the law

Of course morphine and the opiates (such as the synthetic opiate diacetyl-morphine, or heroin), as well as cocaine, are all either illegal or highly regulated as controlled substances by the federal Drug Enforcement Administration (DEA).

And in case you didn’t know, the power of the DEA far exceeds that of the Food and Drug Administration (FDA). And thanks to the government’s ineffective “war on drugs,” many physicians are outright restricted from prescribing the most effective drugs in many cases. Or, are intimidated by the DEA and afraid to prescribe what actually works. And laws on prescription narcotic pain relievers just keep getting tougher. (See the premier issue of Insiders’ Cures and back issues of my Daily Dispatches for more on the ineffective “war on drugs”—all searchable online at drmicozzi.com.)

In the meantime, an over-the- counter pain reliever—one that I can almost guarantee is in your medicine cabinet—has long been proven to cause liver failure. But it still gets the green light from the government!?! I’ll explain more on that shortly. But first…

Is inflammation the cause

Narcotics work by interfering with pain signals and perception. But many pain relievers work by controlling or reducing inflammation. Redness, heat and swelling are the cardinal signs of inflammation. But what causes these symptoms in the first place?

When a tissue, body cavity or joint space is inflamed, blood flow increases, fluids accumulate, swelling occurs, and immune cells rush into the area. The immune cells release histamines, enzymes and other biochemicals. All these effects aggravate sensitive pain fibers. These fibers send signals through the spinal cord to the brain…indicating all is not well. Those signals are discomfort, irritation and pain.

Steering away from steroids

The most potent (and dangerous) anti-inflammatory agents are corticosteroids. But here’s something you may not realize—steroid hormones are actually produced naturally by the body.

The center of the adrenal gland produces the “fight or flight” hormone adrenalin, or epinephrine. While the outer core produces steroid hormones.

The steroid hormones have a wide range of important physiologic effects. Including causing growth and “body-building,” reacting to stress, balancing fluids and electrolytes, playing a part in reproductive and other metabolic functions, as well as influencing inflammation and pain.

Problems can arise, however, when steroids are used as drugs. They can be given as injections directly into painful areas, applied topically to irritated skin or taken internally as prescription medication. And while they may work, steroid medications have serious side effects.

Steroid drugs circulating in the blood stop the normal metabolic production of steroid hormones. This means that when the course of drug treatment is finished, the patient must be slowly weaned off—cutting back on the dose a little each day to give the body a chance to restore normal metabolic function. Otherwise the consequences are dangerous…even deadly.

So you can probably see why I advise avoiding steroids if at all possible. 

Take two of these and call the doctor in the morning (for a liver transplant)

Fortunately, there are some over- the-counter drug and herbal remedies that are effective—and safe—anti- inflammatory agents. But you may be surprised to learn that Tylenol (acetaminophen) is not among them.

Also known as paracetamol, acetaminophen was originally an industrial chemical developed in Germany. Since then, it has caused more pain than it has cured. In fact, it has become the leading cause of acute liver failure in the United States.

Tylenol was actually one of the first drugs for which we developed protocols to monitor therapeutic and toxic blood levels when I worked with a technical team at McDonnell Douglas (now Boeing) on instrumentation from the manned space program.

Our job was to adapt analytical technology from the NASA space exploration program to everyday clinical use. We were also looking at other potent and potentially dangerous drugs, like anticonvulsants, amphetamines, barbiturates and psychoactive drugs. That’s right: All of these dangerous toxic potential killers were treated in the same category as a common household pain-reliever.

I have known otherwise intelligent people who kept taking more and more Tylenol until their knee pain went away…just so they could keep their appointments to play handball or basketball. They may have won the match, but at what cost? I guarantee you they won’t be thinking about those victories when they’re diagnosed with liver failure.

Don’t get a headache over aspirin

Aspirin has seen its share of controversy. But it still has its merits when used appropriately.

This remarkable product of nature (acetyl salicylic acid) originally came from the white willow tree (Salix alba). It was well known to Native Americans. They used it to reduce fevers among other things. Salicylates are prominent in nature, also occurring in wintergreen. They are also used in many digestive aids and in topical pain relievers.

Aspirin is indeed the “granddaddy” of all over-the-counter pain relievers. It was grandfathered into approved use by the FDA, since it was already in common use before the FDA was created in 1906.

But some argue that the gastrointestinal irritation and bleeding it causes (it is an acid, after all) would prevent it from being approved by the FDA today.

Taken in low doses long-term, aspirin has been found to lower the risk of heart disease (perhaps by inhibiting blood clots). And recent research shows it lowers the risk of cancer (see my August 21, 2012 Daily Dispatch).

People who are taking blood thinners or who have a certain type of age-related macular degeneration (of the eye) should consult with their doctors before taking aspirin (or other pain relievers).

Avoid “sugar” coating

There’s another debate surrounding aspirin related to a commonly used coating on the tablets. This is done to theoretically protect the stomach. However, some question whether or not these coatings make a difference. And they may in fact obscure the benefits, leading doctors to prescribe more expensive prescription drugs. This is according to a recent study published in the journal Circulation.1

The conclusion about coated aspirin was only one finding in the study. The main goal was to test the hotly disputed idea that aspirin does not really help prevent heart attacks or stroke in some people.

For more than a decade, cardiologists and drug researchers have speculated that anywhere from 5 to 40 percent of the population is “aspirin resistant.” But some prominent doctors say drug makers with a commercial interest in disproving aspirin’s benefits have exaggerated the prevalence of aspirin resistance.

In fact, the new study did not find a single case of true aspirin resistance among the 400 healthy people who were examined. They claim the coating on aspirin interfered with the way that the drug entered the body, making it appear that the drug was not working.

The study was partly financed by Bayer, the world’s largest manufacturer of brand-name aspirin, much of which is coated.

And, aside from whether coating aspirin conceals its heart benefits in some people, there is little evidence that it protects the stomach better than uncoated aspirin.

A rare modern therapeutic breakthrough

I had the opportunity to witness the development of a true breakthrough pain reliever when ibuprofen (Motrin) came on the market while I was still in training.

Many patients with a variety of conditions from arthritis to menstrual pains who could never find relief suddenly were swearing by Ibuprofen.

Initially, it was available only by prescription in 800 mg tablets, but later the generic form (Advil) became available in 200 mg tablets.

Ibuprofen is one of the original “non-steriodal anti-inflammatory agents” or NSAIDs. This approach to pain relief did represent a rare, therapeutic breakthrough. It provided pain relief with something other than aspirin. And without having to resort to potent and metabolically disruptive steroids. (Of course, effective narcotic pain relievers were already off the list due to government political agendas.)

Then, in the late 1990s and early 2000s, “cox-2” inhibitors became the new pain relievers du jour. They work by preventing formation of certain prostaglandin hormones (originally discovered in the prostate gland) that cause pain. There was a rush to market these new drugs, but their side effects have been so intense that one of them—Vioxx— was quickly taken off the market in 2004 because of its toxic effects on the heart.

So, in short, Ibuprofen is the only over-the-counter (OTC) pain reliever I would recommend, in addition to aspirin. Though, you may need to take the full 800 mg dose, since the OTC 200 mg dose may not be effective. I would steer clear of ALL other OTC pain relievers. And if aspirin and Ibuprofen don’t work, you need to talk to your doctor about other options, including natural approaches.

Effective natural remedies

Luckily there are a number of safe, effective anti-inflammatory compounds that appear to function as natural cox-2 inhibitors but without the dangers.

• Curcumin (Curcuma longa), or turmeric, is the spice that gives curry its bright yellow color. It is also an ancient Ayurvedic remedy that appears effective at a dose of 200 mg per day.
• Omega-3 fatty acids also appear to be cox-2 inhibitors and can reduce pain and inflammation, while providing a host of other health benefits.
• Capsaicin, an active ingredient in hot peppers, is also an effective pain reliever. It is generally used in topical creams and ointments. But it is also taken orally, including as a staple of several traditional cuisines worldwide.
• Resveratrol also appears to have these activities. It is a prominent constituent of red wine, among other natural sources. The moderate levels of alcohol in wine, of course, are also well known as an effective pain reliever.
• A traditional Chinese herbal remedy known as Thunder God vine also appears effective.
• A number of flavonoids and phenolic compounds, which are prominent components of many fruits and vegetables, are also being investigated for these effects.
• Boswellia (the ancient fragrant incense known as frankincense) is another traditional Ayurvedic remedy with potent anti- inflammatory and pain-relieving effects (400–500 mg per day).
• Winter cherry (Withania somnifera, 500 mg per day), also known as Ashwaganda root, is another

Ayurvedic remedy with potent anti- inflammatory and pain-relieving effects. It is also considered an “adaptogen” like Chinese ginseng, or South African Sutherlandia frutescens.

There are also many specific herbal remedies for headache (such as butterbur and feverfew), which affects the majority of Americans either acutely or chronically. Some have now been recognized by the American Academy of Neurology, as we have described in recent Daily Dispatches.

Beyond oral pain-relievers

Since pain has its origins in the body, many therapies that work directly on the body, or through “mind-body,” are also very effective for pain. For example, spinal manual therapy is the most effective and cost- effective remedy for back pain, which is the most common cause of pain and disability in working Americans.

Look to the article on irritable bowel syndrome in this issue for a discussion of several other mind-body therapies. But before you choose one that’s right for you, take my quiz at drmicozzi.com to find out which one is best suited.

In my book on the topic, Your Emotional Type, I go into even greater detail to help you find the best approach to start living pain-free— while reversing a number of other ailments as well.

The good news

As I’ve described, nature has provided us with countless ways to reduce inflammation and control pain. So there’s no reason at all you should need to turn to the dangerous pain killers on pharmacy shelves. And remember: Pain is a signal that something is wrong in the body. So rather than masking it, pay attention to the pain and allow time for your body to heal.

Sources:
1. “Drug Resistance and Pseudoresistance: An Unintended Consequence of Enteric Coating Aspirin”Circulation. 2012;CIRCULATIONAHA.112.117283 published online before print December 4 2012, doi:10.1161/CIRCULATIONAHA.112.117283