Circle of indications of palmitoylethanolamide (PeaPure, Normast)

Palmitoylethanolamide (PeaPure, Normast) is a natural compound, proven to be effective and safe in a great mumber of indications, related to chronic pain and inflammation. These disorders are all summerized in this figure.

Palmitoylethanolamide is a body’s own molecule, that is obtainable as the supplement PeaPure®. This natural anti-inflammatory agent has a painkilling effect and virtually no side effects. At this moment, over a 1000 patients have been treated with this supplement in the Netherlands. For many of them, who suffered from untreatable pains and conditions, the results were and are still very positive.

Palmitoylethanolamide: Natural Molecule: 300.000.000 years development time

The functionality of palmitoylethanolamide in our body is a very special one. The molecule had the opportunity to develop itself in a natural way for over 300 million years, inside the bodies of many different kinds of animals. That is why it can be so very helpful in treating severe pains in dogs, as well as neuropathic pains in people.

Palmitoylethanolamide works inside our cells on many different levels. It penetrates the nucleus of the cell and limits the activity of the so-called mast cells (certain inflammatory cells). It also influences the functioning of a specific important receptor that is located inside the nucleus. This receptor is called the PARR-receptor and by influencing it, palmitoylethanolamide fights inflammations and pain. This is why the agent can be helpful in cases of so many different diseases and conditions, that cause chronic pain and/or inflammations.

In the figure above you will find the ‘potential circle of indications’ for palmitoylethanolamide. This circle is based on pharmacological studies, preclinical studies on animals and on experience, gained at the Institute for Neuropathic Pain in the Netherlands and in the coalition for chronic pain. The circle of indications has been designed as a guideline for patients and professionals.

Circle of indications for palmitoylethanolamide

Because palmitoylethanolamide limits the activity of the so-called mast cells [1] and of the nerve- and glia cells that cause problems in cases of chronic pain, the following indications for this agent are understandable when you keep in mind their pathogenesis. The limitation of the distortion of the mast cells and other inflammatory cells, happens through the PARR-receptor. [2] [3] [4]

Chronic pain syndromes

• Chronic pain syndrome [5] [6] [7] [8] [9] [8] [11] [12] [13] [14] [15] [16] [17] [18]
• Bladder pain
• Diabetic neuropathic pain [19]
• Pain due to shingles (Herpes Zoster) [20] Deslo. P. Combination of pregabalin and palmitoylethanolamide (PEA) for neuropathic pain treatment.; Pathos, 2010, 17,4:9-14
• Neuropathic pain due to different kinds of neuropathy, CIAP, CIDP, etc. [12]
• Carpal Tunnel Syndrome (Assini A, Laricchia D, Pizzo R, Pandolfini L, Belletti M, Colucci M, Ratto S.; P1577: The carpal tunnel syndrome in diabetes: clinical and electrophysiological improvement after treatment with palmitoylethanolamide; http://onlinelibrary.wiley.com/doi/10.1111/ene.2010.17.issue-s3/issuetoc; Eur J Neurol; 2010: 17(S3):295.) [22]
• Regional Pain Syndrome, Sudeck [23]
• Pain and painful spasms due to multiple sclerosis [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34]
• Central neuropathic pain due to a stroke [35] [36] [37] [38] [39]
• Central neuropathic pain due to syringomyelia and paraplegics [24] [41]
• Migraine [42] [43] [44] [45]
• Fibromyalgia [46]
• Reumatism; Rheumatoid arthritis en pain due to Bechterew’s disease [47] [48] [49]
• Psoriatic arthritis [50]
• Costen’s Syndrome, Temporomandibular Joint Disorder (Bortolotti F,Russo M, Bartolucci ML, Alessandri Bonetti G, Gatto MR, Marini I.; Palmitoylethanolamide vs NSAID in the treatment of TMJD Pain; http://www.neuropathie.nu/documenten/wetenschappelijke-artikelen-engels/palmitoylethanolamide-bij-kaakpijn/details.html; Journal of Dental Research; 2010: 89(Special Issue B)
• Chronic pruritus (Itchy Bottom) [51]
• Pain and itching due to chemotherapy [52]

Urogenital Pain Syndromes (bladder, prostate, vagina)

When the urologist has excluded the possibility of cancer and when there are no bacteria causing the chronic infection, but there is a painful inflammation due to an unclear cause, than Normast® can be helpful. This agent regulates the overactivity of the inflammatory cells and it reduces the pain.

Chronic painful prostate complaints

• Chronic painful prostate complaints (prostatodynia) [53] [53] [55]
  If the gynaecologist or urologist has excluded any infections, and when there is an inflammation on the inside of the bladder, that is accompanied by pain, trouble urinating and urinating small amounts, than treatment with Normast® can have a successful result.

Interstitial cystitis and bladder pain

• Interstitial cystitis [56] [57]
• bladder pain [58] [59] [60] [61]

Pain, burning sensations and inflammations of the vagina and vulva, gynaecological problems

• Lichen planus accompanied by itching and pain [62]
• Vulvovestibulitis [63] [64] [65]
• Vulvodynia, vestibulodynia [66] [67]
• Perineodynia (pain in the pelvis due to an unclear cause) [68]
• Endometriosis [69]

Gastrointestinal indications 

• Intestinal inflammations and pain syndromes [9] [71]
• Ulcerative colitis [72] [73] [74]
• Morbus Crohn [75] [76]
• Irritable Bowel Syndrome [77] [78]
• Proctitis [79] [80] [79]
• Chronic abdominal pain due to an unclear cause [82] [78]

Skinconditions

• Chronic inflammations of the skin due to an unclear cause [16] [85] [86] [87] [88]
• Chronic itching due to an unclear cause [89] [51]
• Atopic and contact dermatitis [91] [92] [93] [94] [95] [96] [97]
• Psoriasis [98] [99] [100]
• Notalgia paresthetica (also through local creams, such as Algonerv)

Other conditions

• Asthma and COPD [101] [102] [103]
• Hay fever and allergic rhinitis [104]
• Angina pectoris and Kounis syndrome [105] [106] [107]
• Progressive arteriosclerosis [108]
• Ocular hypertension (high eyeball pressure) [109] [110]
• Depression [111]
• Parkinson’s disease [112]
• Alzheimer’s disease [113] [6]
• Paraplegics [24]

As said before, this circle has been designed as a guideline for colleagues. Part of the potential indications is only supported by data, based on animal studies, such as depression, paraplegics, Parkinson’s disease and Alzheimer’s disease.

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