Why a USA ophtalmologist prefers PeaPure over other supplements

structure-formule of palmitoylethanolamide

We will here reblog a recent in detail analysis of the USA ophtalmologist behind Fiteyes, explaining why PeaPure needs a special place as an eye-protectant over other supplements: worthwhile blogging in toto! Pea4Pain

PeaPure vs other supplements that reduced IOP significantly in studies

tl;dr: There is no comparison between the quality of research done on Mirtogenol® and that done on PeaPure / PEA.

On Wed, Jun 4, 2014 at 4:15 PM, a FitEyes member wrote:

This [PEA study] is a very small study, similar to many that we have seen in the past on other supplements [e.g., Mirtogenol] that showed statistically significant lowering of IOP

I will continue to believe in the magic or science in mindful meditation and home tonometry and remain skeptical on PeaPure for now.

I have tremendous respect for the FitEyes member who posted this comment, and if you read my prior reply to his entire message earlier in the week you know that I agree with him. I especially agree about the importance of meditation and lifestyle factors such as proper sleep, exercise, good nutrition, etc. Chronic stress is the factor underlying about 85% to 90% of all doctor visits and it plays the critical role in chronic degenerative diseases.

However, I have been working from the assumption that PeaPure (palmitoylethanolamide) is different from the other supplements we have examined in the past. I do not think the PEA research is similar to many studies that we have seen in the past – but please disagree with me (especially if you wish to go through and do the type of comparison I’m doing below).

I want to explain why I feel PeaPure is different – and why it is unfair to compare PeaPure to the prior supplements we have discussed. Of course this explanation doesn’t guarantee anything, but it will help clarify why I am more excited about PeaPure than I was about these other supplements in the past that claimed to reduce eye pressure.

The prime example of a supplement that claimed (and continues to claim) to significantly reduce eye pressure and had recent studies to back up the claim is Mirtogenol. In fact, The Life Extension Foundation even sells Mirtogenol under the name Eye Pressure Support with Mirtogenol®. This is the only product they sell that makes claims about IOP, so it is the best comparison for PEA.

Here is The Life Extension Foundation’s quote from the product page:

In a 2010 human study, Mirtogenol® induced up to a 24% reduction in already-healthy eye pressure.

Clin Ophthalmol. 2010 May 14;4:471-6

I will go through and compare the research on Mirtogenol with that on PEA (palmitoylethanolamide). I invite others to jump into this comparison whether you agree or disagree with my assessment.
My first comment is that the statement above from Life Extension’s Mirtogenol product page is total crap. Reading it makes me mad because it is so misleading. In particular, it was not a 24% reduction in already-healthy eye pressure. It just wasn’t. I’ll comment on the “already-healthy eye pressure” below.

Amount of research

The Life Extension Foundation cites only one single study on their product page for Eye Pressure Support with Mirtogenol®.



Disclaimer: the link is to the FitEyes eStore where we sell the Life Extension product. On that page we reproduce the Life Extension claims. However, I also add a disclaimer related to IOP that is not on the original Life Extension product page. And I link to the following FitEyes blog discussion:

Effect of Bilberry and Pine Bark Extracts on Improving Ocular Blood Flow and Lowering IOP

Although the Life Extension Foundation cites only one single study on their product page forMirtogenol®, FitEyes has examined two studies for this Mirtogenol in the past. These 2008 and 2010 studies are the only two published studies I am aware of (although PubMed lists a 3rd which appears to be a review of other research and which apparently mentions Mirtogenol without conducting any original research into it).

In contrast:

  • PEA has been described in more than 300 scientific publications.
  • PEA was described in 1957 for the first time.
  • PEA has already been used by more than a million people all over the world.
  • PEA has been the focus of groundbreaking neurobiology research (see below)

However, on PubMed I find only six published studies where PEA is investigated in terms of intraocular pressure. That is double the count on PubMed for Mirtogenol. But Mirtogenol only has two (3 if we are generous) studies in total, while PEA has double that count just for studies related to IOP.

In the next section, let’s examine the most influential studies for each product in terms of efficacy for glaucoma (visual field or intraocular pressure). NOTE: I did not read every PEA+IOP study I found in PubMed yet.

Representative studies


I want to compare these two studies as examples. The Mirtogenol® study I selected is the only one referenced by the Life Extension Foundation on their product page for Mirtogenol®.

Clin Ophthalmol. 2010; 4: 471–476.

Mirtogenol® potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects

NOTE: I previously examined the other Mirtogenol® study in my comment here:

Effect of Bilberry and Pine Bark Extracts on Improving Ocular Blood Flow and Lowering IOP | FitEyes.com

In summary, I felt that other study was poorly designed too and that it suffers from the same problems I will describe below for the Mirtogenol® study I selected here.
The PEA study I selected is one that focuses mainly on IOP reduction. There is a subsequent study that also looks at visual field results and, like the one I selected, it is a much more convincing study than any Mirtogenol® study I have seen. So I could have used either of these as my example.

Invest Ophthalmol Vis Sci. 2011 Aug 3;52(9):6096-100. doi: 10.1167/iovs.10-7057.

Ocular hypotensive effect of oral palmitoylethanolamide: a clinical trial.

Study design

The PEA study was a crossover design, where after a 1-month washout period, the groups were switched. Both before and after the crossover, only the PEA group saw a significant IOP reduction.
In contrast, the Mirtogenol® study randomly assigned subjects to three groups receiving either the supplement, or latanoprost eye drops, or both in combination. That’s a less convincing design.

The PEA study includes subjects with expected IOP values (baseline IOP, 21.6 ± 1.7 mm Hg).

In contrast, the Mirtogenol® study includes subjects who have a baseline IOP of baseline 38.1. This is highly questionable and FitEyes viewed this as a red flag as soon as we saw the study back in 2010. We think the researchers were manipulating the study in some way (and the financial disclosures [described below] reinforced that suspicion). And a baseline IOP of 38 is not an “already-healthy eye pressure”. How in the world could Life Extension make that erroneous statement?!


For Mirtogenol, we have the following statement:

“It is not known whether Mirtogenol® affects outflow pathways or aqueous humor inflow or both. This will remain very difficult to identify.”

The researchers are basically telling us that they cannot explain anything about the biochemistry of Mirtogenol® in glaucoma.

In contrast, there have been decades of research into the biochemistry of PEA. In fact, in a 1993 paper, Professor Rita Levi-Montalcini explained her discovery that palmitoylethanolamide is a key regulating molecule; this is considered a hallmark paper in the field of neurobiology.

Professor Rita Levi-Montalcini created a fundamental new neurobiological understanding of the analgesic and anti-inflammatory actions of PEA.

Professor Levi-Montalcini received the 1986 Nobel Prize in Physiology or Medicine for their discovery of nerve growth factor (NGF). So we are not talking about a lightweight scientist here.

There is no comparison between the quality of research done on Mirtogenol® and that done on PEA.

Financial interest

The PEA researchers have no financial interests or other disclosures. Overall, there is wide diversity amongst PEA researchers. In contrast, the Mirtogenol researchers were paid/financially supported by the manufacturer of the product they were investigating:

“This [Mirtogenol] study was supported by a grant from Indena S.p.A. Italy and Horphag Research UK Ltd.”

Furthermore, all the Mirtogenol® research has been conducted by this same group. So all the research is potentially tainted.

Proprietary product

Mirtogenol is a patented nutraceutical and the research was conducted on the patented product. PEA is not patented. Some aspects of manufacturing of certain PEA products are patent pending, but the research itself has been and is being conducted mostly on the plain old non-proprietary product.

Independent research

Mirtogenol we found only two published scientific studies that directly investigated Mirtogenol, neither of which were independent (i.e., without financial conflicts of interest). For PEA we have hundreds of independent studies by a wide variety of researchers spanning decades. And the IOP / glaucoma research with PEA has been done by a variety of groups according to my quick PubMed search. (I invite anyone to dig further into this if they wish. I didn’t have time.)

Product reviews

After the Mirtogenol® research was published, FitEyes was the main source of user-based product reviews and was the only source of any product reviews that included objective IOP measurements. And our reviews were universally negative in regards to significant IOP reduction.

At this point there are no user reviews about PeaPure and IOP. We anticipate that FItEyes will again be the first source of objective user reviews that include some IOP measurements.

However, there are years of user reviews (since at least 2012) about various PEA products (PeaPure, others) across the Internet and these reviews are universally favorable. The reviews are not just about one brand, they are not based on narrow treatment conditions and they are not coming from just one place.

According to these user reviews, PEA does what it claims to do when it comes to pain, neuroinflammation and other conditions. I found very positive user reviews from real users at a variety of forums that convinced me PeaPure (and PEA in general) are producing very significant results in real life. It is not another Mirtogenol®. I don’t know what PeaPure might do for our IOP yet, but it is certainly not a product we can dismiss because we were disappointed with supplements like Mirtogenol®.

Closing thoughts

I have probably been more disappointed than most that we did not find any dietary supplement yet that will significantly reduce IOP. Finding such a solution was the original reason I purchased my tonometer. It was only after I already had the tonometer that I was forced to address stress and emotions – that discovery via self-tonometry changed my life, and the failure to find a dietary supplement that reduced IOP was a blessing in disguise.

However, even with all that personal history, I am not so jaded that I cannot at least investigate a very promising new dietary supplement. Yes, i started off being skeptical of PEA, as you saw in my first posts. Our history warrants some skepticism about these kinds of claims. But as I read the research, I realized that this supplement is in a whole different class from any supplement we have tried before. Furthermore, even if it doesn’t reduce IOP, the neuroprotection effects may justify its importance in glaucoma treatment.

I am not making any claims for PEA. I do not know what it will do for my own IOP or for your IOP. It might be another disappointment. If PeaPure doesn’t lower my IOP, I will just move on. I am not reducing my current focus on meditation, exercise, healthy eating or anything else I’m doing and I advise you to stay focused on those things too.

But I think it is absolutely fantastic that the FitEyes community wants to find the truth about PEA’s glaucoma benefits, even in the face of past disappointments. Your enthusiasm excites me.

I hope all of you will continue to focus on finding solutions and not let past disappointments discourage you. This is very important in the case of meditation. Even if you have tried meditation in the past and (based on that past experience) felt that meditation was not for you, I strongly encourage you to try again – with a different and hopefully better meditation teacher, for example. Keep trying. I’m a strong believer in optimism and continual exploration.

I want to end with my usual disclaimer about supplements. Supplements are not the answer. Drugs usually aren’t the answer either. The ultimate answer where any chronic health issue is concerned is with ourselves – our lifestyle, our habitual thoughts and emotions, our sleep, our diet & exercise, our relationships, our spirituality are key factors and modern medicine can’t fix any of those things with pills or surgery.

We cannot guarantee a cure in any case. Modern medicine has a horrendous track record where chronic degenerative diseases are concerned. And lifestyle-based solutions also cannot guarantee a result. But disease is always a teacher; and we can always find inner peace even in the presence of disease when we travel the right path. Optimism is part of that path in my opinion, so I am allowing myself to be optimistic about PeaPure. 🙂

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