Nutrition Guidelines for Pain Relief
In a class about ion channels, receptors and pain mechanisms our lecturer emphasised the link between neuropathy and glial cell activation. By coincidence I had been reading about glial cells in the gut earlier that day and was curious about the role of the gut brain axis in pain. When I asked him he told me that this was a lecture on CNS mechanics and the gut had absolutely nothing to do with what he was talking about. Yes I am still fuming. And yes I still think that there are links between gut health and pain. Reading “Calm Your Mind with Food: A Revolutionary Guide to Controlling Your Anxiety” has reinforced this belief.
Dr. Uma Naidoo is a nutritional psychiatrist who explains the link between nutrition, gut health and anxiety. Reading her work through a lens biased towards chronic pain - it makes sense for this community too. Naidoo explains that an upset in the chemical balance of neurotransmitters along with inflammation exacerbate anxiety. Snap. This is also true for pain. Of course both conditions are biological, psychological and social in origin and cannot be purely “fixed” through nutrition. But when the medication doesn’t work it makes sense to understand how we can help ourselves through reducing inflammation; improving gut health; and eating to optimise our health and well-being.
Naidoo explains why gut health is important for anxiety. Her descriptions can easily be applied to pain management too. Her main points are:
Neurotransmitter precursors are made through the transformation of specific nutrients by specific gut bacteria and are carried through the blood stream, across the blood-brain barrier, and into the brain where they are assembled into neurotransmitters. Two that you may have heard of are serotonin and GABA. Serotonin is an inhibitory neurotransmitter, which means it helps calm down your nerve cells. Low dose SSRIs (selective serotonin re-uptake inhibitors) are prescribed for persistent pain because of their anti inflammatory effects. GABA is also an inhibitory neurotransmitter, and when GABA levels are low, your amygdala can be more reactive, triggering strong stress responses when they're not warranted. People experiencing nerve pain often have insufficient GABA function, this is why they are prescribed anti seizure medication. This picture below is typical of the puzzles that I would try to decode throughout my degree - essentially it is saying that serotonin 1A receptors decrease pain messaging and GABA inhibition thus increasing dopamine levels and creating an antidepressant effect.
Other compounds, like short-chain fatty acids and brain-derived neurotrophic factor (BDNF) also have key roles in the relationship between the gut and the brain, and also rely on gut bacteria to create them. BDNF is known in pain management as it is released in response to inflammation and is known as a nociceptive modulator for pain perception. This strange picture below lists studies that indicate BDNF's role in neuropathic pain and the proposed site of the mechanism of action.
The best thing that we can do for our gut health is to eat a diet high in fibre. Fibre has been shown to be a bulwark against inflammation and depression. Fibre is a prebiotic that promotes helpful strains of bacteria, discourages toxic strains, increases absorption of minerals, and improves gut permeability and immune response. The bacteria that produce important metabolism-regulating sub stances like short chain fatty acids thrive on the dietary fibre passing through your gut.
The worst thing you can do for your gut health is to eat a whole lot of processed sugary foods. Anxiety and depression can be worsened by excess sugar in the diet. Artificial sweeteners like sucralose (Splenda) and aspartame (sold under the brands NutraSweet and Equal), promote gut dysbiosis by providing bad gut bacteria with a feast. Aspartame in particular has been linked with anxiety symptoms in both animal and human studies.
Dr. Uma Naidoo Summarises the principles of her book into 6 pillars. They are
🥦To eat whole foods.
🌶To include a large variety of multicolored plants, herbs, and spices in your diet.
🍓To Identify any gaps in your diet through testing and consider supplementation if necessary. The most important vitamins to help quell anxiety are the B complex, vitamin C, vitamin D, and vitamin E. The most important minerals are calcium, iron, magnesium, and zinc. (This goes for pain too)
🥑A steady supply of healthy fats is one of the most important factors in keeping our brain
healthy and free of anxiety.
🫐Avoid processed artificial foods,
🍌Create sustainable dietary and lifestyle changes rather than falling into quick fixes and miracle diets. Eating is about powering your body but also about the pleasure that comes from a delicious meal.
The philosophy of Whole Body Mental Health emphasises nutrition’s role in brain health. It integrates evidence-based nutrition and lifestyle factors with psychological therapy. If we all applied this philosophy I’m sure that we would have fewer cases of persistent pain too.
xx
P