Scientific information for specialists, general practitioners and pharmacists
Palmitoylethanolamide, an analgesic Evidence Based Medicine (EBM) supplement available in the form of PeaPure®, a foodsupplement
Palmitoylethanolamide is available as a diet supplement PeaPure®: produced in the Netherlands, and as food for medical purposes, under the brandname Normast® In pharmacists in Italy.
Since 2012, palmitoylethanolamide (PEA) has become available worldwide in the form of the analgesic supplement PeaPure. PeaPure is produced in a GMP certified facility in the Netherlands. PEA has been tested on purity in an independent American laboratory. The analysis certificate can be viewed on the website of the supplier of PeaPure®, JP Russel Science Ltd: www.RS4supplements.com
PeaPure contains only palmitoylethanolamide, a pure and natural substance produced by the body, and comes in 400 mg capsules.
PeaPure can be purchased via the web shop of JP Russel Science (www.RS4supplements.com).
PeaPure is not known to have negative interactions or significant side-effects. Palmitoylethanolamide is produced in a simple way in every body cell from membrane lipids and enzymes and is easily broken down by the body through the cytoplasm. Therefore, no hepatic or renal clearance is necessary.
Several interaction studies have been carried out with other analgesics, such as pregabalin and oxycodone, which have repeatedly shown that palmitoylethanolamide strengthens the pain-relieving affect of other analgesics and that there is no problem with taking it together with other remedies.
A good starting dose is 400 mg PeaPure 3 times a day, perhaps 2 capsules in the morning and 1 capsule in the evening. Sometimes, PeaPure becomes effective slowly, because palmitoylethanolamide works via biological modulation of several intracellular and membrane targets. However, some patients notice the effects within several days, because PEA also works via several fast targets, ion channels and the TRPV1 receptor.
Advisably, let patients use palmitoylethanolamide over a period of 2 months and during that period evaluate with the patient whether it is worthwhile to continue usage, to adjust the doses or to discontinue. Usually, patients experience the pain-relieving effect within 1 to 3 weeks, but with some patients it takes longer before the pain-relieving effect is noticeable.
More about palmitoylethanolamide
Palmitoylethanolamide (PEA) is an anti-inflammatory natural substance produced by the body. The substance palmitoylethanolamide was first described in 1957. (1) In 1975, the first article about PEA as an analgesic appeared in The Lancet. In 1993, the mechanism of action of PEA became clear thanks to research conducted by Professor Rita Levi-Montalcini (Winner of the Nobel Prize in Medicine in 1986). (2)
Since the 1970s, dozens of clinical studies have been carried out among approximately 4000 patients about the safety and effectiveness of this substance, which is naturally produced by the body. Reports in English about many of these studies are limited because most of these studies were carried out by physicians who are not native English speakers. Most of these studies appeared in Italian or Spanish neurology or anaesthesiology journals. Since 2010, this has changed.
By now (mid 2013), more than 350 articles about PEA have been published in Pubmed, including dozens of articles about the clinical implications. The most extensive clinical placebo-controlled study was carried out among 636 patients with severe pain caused by hernia. (3)
The references below provide a clinical summary of these and all other studies that have been carried out about the analgesic effect of palmitoylethanolamide. (3) You will also find a report about the experiences of several Dutch patients, with various pain syndromes, with this substance. (4)
Palmitoylethanolamide is safe and is clearly effective in cases of chronic pain. The Numbers Needed to Treat (NNT) of palmitoylethanolamide is 1.5. As such, PEA is one of the best analgesics for neuropathic pain. These results were first presented in 2011 at the Italian neurologists and anaesthesiologists’ congress, SIAARTI. With such NNT, palmitoylethanolamide is an exceptional asset in the treatment of chronic and neuropathic pain.
Palmitoylethanolamide: extensive reviews and source articles available
The reviews in number 3 and 4 are available for free on the Internet in open source journals.
- Kuehl, F.A., Jacob, T.A., Ganley, O.H., Ormond, R.E., Meisinger, M.A.P. 1957. The identification of N-2-hydroxyethyl-palmitamide as a natural occurring antiinflammatory agent. Journal of the American Chemical Society 79:5577-5578
- Aloe,L., Leon, A., Levi-Montalcini, R. 1993 A proposed autacoid mechanism controlling mastocyte behaviour. Agents and actions 39:C145–C147.
- Keppel Hesselink,, J.M. 2012. New Targets in Pain, Non-Neuronal Cells, and the Role of Palmitoylethanolamide. Open Pain Journal 5: 12-23
- Keppel Hesselink, J.M., Hekker, T.A. 2012. Therapeutic utility of palmitoylethanolamide in the treatment of neuropathic pain associated with various pathological conditions: a case series Journal of Pain Research 5:437 – 442