Natural Painkiller: Palmitoylethanolamide (PEA), take home message
A very special molecule, produced in our own body, and now available as supplement (PeaPure and the new PeaPlex) and as cream (PEA cream), as wel as dietfood for medical purposes in Italy and Spain (Normast).
PEA has been explored since 1957 and has a clear analgesic and anti-inflammatory efficacy, and virtually no side effects. Meanwhile within the context of clinical trials 5000 patients have been using PEA, and its efficacy and safety has been documented in more than 500 scientific papers. Under this link the most comprehensive proof of PEA’s efficacy (with the Numbers Needed to Treat of 1.5).
Since 2012 it is also available in the USA/Canada and it is shipped to the the USA/Canada via the Netherlands. We regularly receive questions from those countries on how to obtain and use PEA. Meanwhile there are many hundreds of satisfied US/Canadian citizens using this natural painkiller. PEA is available as capsules PeaPure of 400 mg (step in dose: take 1200 mg daily), as enriched capsules PeaPlex, and as PEA cream. PEA can be combined without any difficulties with any other drug, painkiller or supplement. Supplementation with PEA encourages the body’s own natural healing and painkilling capacity to do its thing. Since 2014 there is also available a new PEA cream, to enhance the effects of PEA also via the thin nerves in the skin.
Reach us with questions and remarks related to PEA on Pea4Pain@hotmail.com, and help us to construct the biggest database ever on this remarkable molecule.
- painkiller and anti-inflammatory compound
- produced in our cells, natural compound
- protects cells
- is proven to be effective and safe in many clinical trials in more than 5000 patients
- can be combined with any other compound
- is available as capsules and as cream
PEA: safety, efficacy and purity, further details
Very few side effects are reported, and this painkiller is also easy to combine with all kinds of other medication and analgesics, and is proven to be effective in many chronic pain states. The efficacy of PEA is impressive, expressed as Numbers Needed to Treat (NNT) is 1.5 for sciatic pain (based on a full powered double blind, placebo controlled trial). Numbers Needed to Treat is the most up to date way to express efficacy, and the NNT of 1.5 means one needs to treat 3 patients with severe pain, to help 2 to find adequate pain reduction. Most painkillers have NNT of 2-6 (Meaning one has to treat 2 to 6 patients to help one…).
In table 1 we see the efficacy of PEA compared to many other painkillers. There is one issue to understand, because PEA modulates via various natural mechanisms of the body, the analgesic effects are build up day by day; most people notice the effects within 1 week, but sometimes 6-8 weeks is required, especially for chronic pain syndromes. To reset the system the molecule needs some time.
PeaPure is documented with a certificate of analysis for review and is produced according to the highest standards of GMP. In addition to PeaPure there are a number of other PEA containing products, but these all have a much lower % of PEA per serving, and to date, certificates of analysis are not available for these products to review.
There are also uncertified PEA supplements available (especially in the USA) containing herbal material of unknown origin. Recently there was an analysis of all PEA products, and the conclusion wast: the preference should be for the time being to treat patients with pure PEA without any of these additives. (Kriek, 2014)
PEA products such as PeaPure and PEA cream are based on a totally new therapeutic principle, based on activation of our own natural systems. This is due to the fact that the active principle in PeaPure is palmitoylethanolamide (PEA).
Nobel price winner Professor Rita Levi-Montalcini discovered the mechanism of action of PEA
The mother of the PEA principle is the Nobel laureate professor Rita Levi-Montalcini. In a separate section she will explain in a number of cartoons the essence of palmitoylethanolamide.
PEA is a body-own fatty compound, and is produced by our own living cells to restore balance in chronic pain and chronic inflammation. Its anti-inflammatory and painkilling properties are known in science many decades since the first description of this compound in 1957. in 1993 the Nobel price winner professor Rita Levi-Montalcini pointed out the relevance of PEA for medicine and since then more than 300 scientific papers on PEA have been published. She also was the first person discovering the mechanism of action of PEA. She worked with PEA in its purest version.
Many of the scientific data related to palmitoylethanolamide are discussed at this site in order to enrich modern medicine with more insight in the properties and the value of this all natural painkiller and anti-inflammatory compound. In references 1-5 you will find free PDF’s in peer reviewed journals summerizing all clinical data of palmitoylethanolamide.
5000 patients in clinical trials
To date around 5000 patients have been entered in double blind clinical trials, and the efficacy in chronic pain and inflammation of this natural compound is clearly documented (1-5). This makes PEA one of the best documented effective and safe nutraceuticals. Sadly enough pain physicians do not often read literature on supplements, and seem to believe that only pharmaceuticals can be effective (but not so safe).
At the 8th European congress on Pain (EFIC) in Florence (2013) palmitoylethanolamide was presented in one of the main symposia as a new kid on the block, we hope this will help opening the eyes of doctors that patients can be helped also with natural compounds, without side effects….
PEA has been used by more than 1 million patients, mostly in Europe. In the Netherlands and Germany since the beginning of 2011 many ten thousands of patients are using it. Mostly to their satisfaction. Meanwhile many other patients elsewhere, especially at the west coast of the USA, in Australia and Canada, are using PeaPure.
First a scientific introduction on the mechanism of action of PEA related to the cause of chronic pain in a Youtube presentation.
A new natural painkiller, palmitoylethanolamide (PEA) is available under the brandname PeaPure, produced in the Netherlands and available via the webshop from the distributor. In Italy PEA is available at pharmacists under different brandnames, such as PeaVera, Normast, PeaLut, Glialia, Adolene and Pelvilen. These products all contain PEA, but in different amounts (see below).
Information for prescribing doctors and for pharmacists related to PEA you find under this link.
While the certain products containing PEA belong to a specific category, food for medical purposes (such as Normast and PeaVera), and can be obtained only in countries were such categorization has taken place (e.g. Spain, Italy); other PEA products are classified as supplements (PaePure) and freely available. Here the list of all PEA containing products and their classification:
PeaPure: 100% pure PEA, supplement
PraVera:100% pure PEA, Diet-food for medical purposes (Italy)
Normast: 68% pure PEA, Diet-food for medical purposes (Italy, Span)
Visimast: 68% pure PEA, Diet-food for medical purposes (Italy)
Pelvilen: 50% pure PEA, Diet-food for medical purposes (Italy)
Adolene: 50% pure PEA, Diet-food for medical purposes (Italy)
Glialia: <50% pure PEA, Diet-food for medical purposes (Italy)
Achilles: <10% pure PEA, supplement
The classification food for medical purposes is only valid in Italy and Spain.
There are no clinical data supporting one product over an other product, the efficacy is comparable and the different formulations seem only to have its use in the context of formulation patents. In countries were PEA is not classified as food for medical purposes, only the supplement can be ordered.
Recently, based on various scientific facts, R. Kriek argued to make the choice for pure PEA, as in PeaPure and PeaVera (Kriek, 2014):
Based on additional studies discussed in this commentary and in view of the effects of ultra-micronization on the parameters discussed, as well as the potential side-effects of additives such as excipients and herbal extracts added to the products cited in the article, the preference should be for the time being to treat patients with pure PEA without any of these additives.
PEA and the scientific support for its use
PEA has been evaluated in a great number of scientific papers, more than 400! PEA is sometimes referred to as an ‘autocoid’. An autocoid is special modulating molecule, produced by our own tissue, and able to modify our own biological balance. PEA has been found useful in a variety of chronic diseases, amongst others in severe neuropathic pain, sciatic pain, prostate pain, pain after stroke and in MS and pelvic pain. Side effects are neglectable, due to the fact that this molecule is part of our own body. It has special analgesic properties, and in sciatic pain for instance, it is much more effective compared to the chemical analgesic Lyrica (pregabaline)!
PEA has been demonstrated in recent trials to decrease pain in diabetic neuropathic pain, zoster pain lumbosacral pain (sciatic pain), carpal tunnel syndrome and nervus medianus compression pain, endometriosis pains, menstrual pains, etc. It has been proven to be effective and safe in many different disorders, from chronic pains up to flu and common cold, due to its intrinsic anti-inflammatory and analgesic properties. Now PEA can also be considered as a breakthrough natural therapy for flu and common colds.
How to use Pea?
PeaPure as a supplement comes in capsules of 400 mg, containing finely powdered (micronized) pure PEA, no pharmaceutical additives or fillers or any artificial additive.
You can start taking three 4 400 mg capsules a day, in 2 or 3 gifts. The dose can be increased up to 2400 mg daily. Mostly we advise patients to double the dose only after 4 weeks, and only in case of issuficient efficaccy.
If pain improves after some weeks to 2 months one might want to decrease dose to 2 times 400 mg.
If no improvement after 2-3 months, stop. Painkillers such as PEA, but also Neurontin, Lyrica and Amitriptyline (brand name Elavil all need time to reset the system, mostly 1-2 months.
Always inform your physician just to keep him/her in the loop.
For physicians and pharmacists all relevant information can be found via the links to peer reviewed journals in:
2. 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
3. Keppel Hesselink JM, Kopsky DJ, Treatment of chronic regional pain syndrome type 1 with palmitoylethanolamide and topical ketamine cream: modulation of nonneuronal cells. Journal of Pain Research 2013
4. Keppel Hesselink, J M, Tineke de Boer, and Renger F. Witkamp. Review Article. Palmitoylethanolamide: A Natural Body-Own Anti-Inflammatory Agent, Effective and Safe against Influenza and Common ColdInternational Journal of Inflammation Volume 2013 (2013), Article ID 151028, 8 pages http://dx.doi.org/10.1155/2013/151028
5. Keppel Hesselink JM. Chronic idiopathic axonal neuropathy and pain, treated with the endogenous lipid mediator palmitoylethanolamide: a case collection. International Medical Case Reports Journal Published Date September 2013 Volume 2013:6 Pages 49 – 53
Kriek R. Palmitoylethanolamide: problems regarding micronization, ultra-micronization and additives. Inflammopharmacology. 2014 Mar 20. PMID: 24647619
Kriek R. Marketing messages in pharmacological papers and scientific chapters: The case of palmitoylethanolamide and its formulations. Pharmacol Res. 2014 Apr 24. pii: S1043-6618(14)00047-4. doi: 10.1016/j.phrs.2014.04.007.
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