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Acupuncture

D-phenylalanine (DPA) for easing both physical pain (tooth pain) and emotional pain over the holidays

By Trudy Scott 33 Comments

dpa for pain

Today I share how the amino acid D-phenylalanine (DPA), used as a supplement multiple times a day, and opened on to my tongue, eased both the physical tooth pain I experienced for 14 days and the emotional pain I was feeling over the holidays.

In this blog I share more about DPA and endorphins when it comes to pain – both physical and emotional. I also share two DPA products I recommend, product label confusion and more about how DPA differs from DLPA (DL-phenylalanine). I am often asked this question and even long time users of DLPA are sometimes surprised to learn how different DPA is. As always, I like to share some research and other related blogs on the topic. Here is my recent and very positive personal experience with DPA, a firm favorite of mine:

I’m just back from the dentist – my crown was re-cemented and I’m a happy camper now. It popped off just before Christmas and I had to wait until now! There was a tiny cavity beneath the crown which is why I was having daily pain.

Thank goodness I always have DPA (the amino acid d-phenylananine) on hand. I gravitate to it for pain relief – sports injuries like muscle sprains, the rare headache and this time for tooth/jaw pain.

I opened a DPA onto my tongue as soon as I could feel the dull ache start and the pain relief lasted a few hours. It works by boosting endorphins to provide pain relief – kind of like acupuncture.  I call it “powdered acupuncture”.

Some days I used 3-4 and one day I needed 6. Taking one before bed was wonderful.

I also got bonus benefits for emotional well-being over the holidays. It’s the first Christmas without my darling mom and I really needed the endorphin boost to help with the emotional pain.

The DPA product I used was Doctor’s best (details below) and I opened up the 500 mg capsule onto my tongue each time I needed pain relief.

The number of capsules I needed seemed to vary by how much chewing I was doing (for example, I had more pain after a steak meal vs smoked salmon) and what I was eating or drinking (for example, I had more pain after drinking something cold). I simply used a DPA capsule when the dull pain started, making sure it was away from protein (not always but most of the time).

UPDATE: Sept 13, 2024
DPA has come to my rescue yet again and this time the tooth pain has been very severe. I initially suspected it was the crown again but when I got into the dentist an xray confirmed an abscess at the tip of one of the roots.

It’s a first for me and I’ve never experienced a toothache like this. The pain ramps up from zero to 10 (with 10 being most severe) in a matter of seconds. The only thing that helps right now is DPA. I’m opening a capsule every few hours and have even had to use it every 30 mins when it’s really severe like after drinking or eating something. It brings to pain down to a 3 in a matter of minutes.

I’ve figured out that using a straw to drink liquids helps a ton. I’m also  using a soft ice-pack a few times a day too. Strangely it’s worse just before bed, after I take my bedtime supplements. I need the DPA and ice-pack but fortunately I have no pain through the night.  Thank goodness for that!

I’m also using a herbal antibiotic and herbal mouth swish from my naturopath while I get a second opinion, learn about my options, and decide next steps.

All this has solidified DPA as my go-to supplement for pain relief.

One of the DPA products I recommend: Doctor’s Best D-Phenylalanine

There are not many d-phenylalanine/DPA products available but of those I have two that I recommend: Doctor’s Best D-Phenylalanine and Lidtke Endorphigen. Both contain 500 mg DPA but the labels can be confusing at first – at least until you’re familiar with them.

Also, this amino acid, DPA, is not to be confused with docosapentaenoic acid (also abbreviated as DPA), an omega-3 fatty acid similar to eicosapentaenoic acid (EPA).

dr's best dpa

Here is the Doctor’s Best D-Phenylalanine description:

Doctor’s Best D-phenylalanine is a non-protein amino acid that acts as an inhibiting agent to enzymes that degrade enkephalins, naturally occurring peptides in the body that metabolize endorphins. Endorphins are neurotransmitters that play a key role in the function of the nervous system and are associated with feelings of pleasure. By limiting production of enzymes that break down endorphins, the supplement can help support a healthy mood and normal functioning of the nervous system.

  • Helps support healthy mood
  • Helps support endorphin metabolism
  • Help support neurotransmitter function

This is the actual product that I used over the past 2 weeks and have used it on and off as needed for a few years. It was one of the nutrients that helped when I sprained my ankle when visiting my brother in Las Vegas. More here

As you can see there is no mention of pain on the label or product description. I share more on the pain/endorphin connection below.

You can purchase this online from their website or from iherb. If you use my iherb link you’ll save 5%. This is a good option if you’re not in the USA and already use iherb for one-stop shopping of quality products.

The other DPA product I recommend: Lidtke Endorphigen

The other product I recommend is Lidtke Endorphigen which also contains 500 mg DPA and a small amount of vitamin B6 and riboflavin (vitamin B2). As you can see, this product does mention pain but not the emotional support/mood benefits on the front label.

lidke endorphigen

Here is the Lidtke Endorphigen description

Ease Minor Pain & Feel Good with Healthy Endorphin Level Maintenance

Endorphins are nature’s way to relieve common minor pain and promote a cheerful mood. Research shows that endorphins are released in response to pain and stress, bringing relief. The second wind and runner’s high during and after a vigorous run are results of endorphins. Acting as an analgesic and sedative, endorphins diminish our perception of pain…. But there is more.

Recovery centers report that endorphins promote recovery from a wide variety of unhealthy cravings.

Low endorphin symptoms and typical dosing of DPA

I use the symptoms questionnaire to help clients identify if they have low endorphin symptoms (you can see that here).

Typical dosing is 500 mg to 1000 mg DPA 3-4 x day between meals/away from protein. I do find having clients open the capsule onto their tongue to be more effective for quick pain relief – with results as quickly as 5-10 minutes.

DPA vs DLPA: they are quite different but have some overlaps

I am often asked if DPA and DLPA are the same – they are quite different but have some overlaps as outlined in this blog post on the topic: What is the difference between DPA and DLPA (amino acids) and which one do I use for weepiness, heart-ache, pain and energy?

The precautions are also not the same so I always review contraindications with all my clients and encourage you to do the same.

DPA for MS pain, weepiness, emotional pain and more

Here are a few blog posts illustrating the use of DPA in multiple sclerosis, weepiness, physical pain, emotional pain and resilience, cravings/emotional eating and even helping to wean off prescription pain medication:

Be sure to use the search feature on the blog to find additional applications of DPA.

DPA research on pain and depression

The use of DPA is not new as you can read in this paper from 1982 – D-phenylalanine and other enkephalinase inhibitors as pharmacological agents: implications for some important therapeutic application

A number of compounds have been shown to inhibit the degradation of enkephalins. As expected, these compounds produce naloxone reversible analgesia and potentiate the analgesia produced by enkephalins and by acupuncture.

One of these, D-phenylalanine, is also anti-inflammatory.

D-phenylalanine has proven to be beneficial in many human patients with chronic, intractable pain. It is proposed the enkephalinase inhibitors may be effective in a number of human “endorphin deficiency diseases” such as depression, schizophrenia, convulsive disorders and arthritis.

Additional resources when you are new to using DPA and the other amino acids as supplements

We use the symptoms questionnaire to figure out if low endorphins or other neurotransmitter imbalances may be an issue for you.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all – including the Lidtke Endorphigen 500 mg that I mentioned above.

Also mentioned above is Doctor’s Best D-Phenylalanine which can be purchased on iherb.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you had success using DPA for toothache, dental abscess or your other pain issues – what kind of pain has it helped and how much has helped you?

Has DPA also helped with emotional pain and weepiness? And cravings/emotional eating?

If you’re a practitioner do you have success using DPA with your clients/patients?

Feel free to share and ask your questions below.

Trigeminal neuralgia and anxiety: GABA, tryptophan, St. John’s Wort, acupuncture, DPA, gluten, herpes and Lyme disease

By Trudy Scott 30 Comments

trigeminal neuralgia and anxiety

I get a surprisingly high number of questions about trigeminal neuralgia asking if there is a role for the amino acids GABA or tryptophan to help ease some of the nerve and associated face pain. It’s surprising because trigeminal neuralgia is considered a rare neurological disorder.

Nerve pain is not my area of expertise (anxiety is), and because anxiety and depression is common in this population, there are very likely similar underlying causes (more on that below). The targeted individual amino acids that we use for anxiety, also help to ease pain, so I’m sharing some of what I know in case it helps you or a loved one.

Read on to learn more about this condition and GABA, tryptophan, DPA, acupuncture, St. John’s Wort, Lyme disease, herpes and B vitamins.

About trigeminal neuralgia and the incidence

The NIH fact sheet defines trigeminal neuralgia (TN) as

a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical or “classic” form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode.  These attacks can occur in quick succession, in volleys lasting as long as two hours.  The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1.  Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.

The incidence of new cases is approximately 12 per 100,000 people per year and women are impacted more than men.

A number of studies show anxiety, depression and insomnia are common when someone has trigeminal neuralgia. The question is this – is the pain causing the anxiety, depression and insomnia OR are there common underlying physiological causes for both. It’s likely a combination of both especially when it comes to idiopathic trigeminal neuralgia i.e. when there is no known cause. Known causes include head injury, multiple sclerosis, dental procedures, tumors and cysts.

By using some of the approaches outlined below, we may see pain relief and improved mood, less severe anxiety and better sleep.

When to consider GABA and serotonin support

There is no research on either GABA or tryptophan/5-HTP helping with symptoms of trigeminal neuralgia, however medications that work on both GABA and serotonin are typically prescribed for trigeminal nerve pain. For this reason I would consider a trial of GABA and/or tryptophan (or 5-HTP if other low GABA physical anxiety symptoms and low serotonin worry-type anxiety symptoms are also present. You can find the symptoms list here.

There is research-based and clinical evidence that GABA and serotonin support help with other types of pain:

Both help with the anxiety, low mood and insomnia that is often present with pain conditions like this.

St. John’s Wort for nerve pain and mood

In one case report, Hypericum perforatum (St. John’s Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN), a 53-year-old Hispanic female patient with a history of trigeminal neuralgia used an over-the-counter preparation of St. John’s Wort and found it relieved her pain completely.

St. John’s Wort is a herb that is primarily “used for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. ” This case report is one of many studies on this herb and trigeminal neuralgia and other neuralgias (nerve pain).

It has anti-inflammatory and antioxidant effects and also supports serotonin and GABA production which further supports the above recommendations to trial the amino acids.  GABA and tryptophan would also be safe options if St. John’s Wort can’t be used as in the case of blood thinners, the birth control pill and other medications

Pain relief with endorphin support: acupuncture and DPA

Acupuncture offers pain relief via endorphin boosting and can be an option for the treatment of  trigeminal neuralgia, also offering relief for the “secondary myofascial pain associated with it.”

DPA (d-phenylalanine) is an endorphin-boosting amino acid that may also offer some pain relief. It can also be used to wean off prescription pain medication and improve sleep.

Other research-based pain-relief approaches for trigeminal neuralgia

Physical therapy, chiropractic care, using a custom dental appliance, and addressing myofacial pain may offer relief or be part of the solution.

There are some less recognized approaches too:

All of the above can also improve mood and insomnia and reduce anxiety too.

Other factors to consider: B vitamins, Lyme disease, herpes and gluten

As with any condition, a full functional medicine work up should be done to rule out and/or address gluten issues, low vitamin B6/B1/B12, and even herpes zoster and Lyme disease as a root cause (or contributing factor).

Current approaches and emerging interventions – disappointing for a 2021 paper

I was excited to read the title of this paper, Trigeminal Neuralgia: Current Approaches and Emerging Interventions, published late this year. The authors share that it “summarizes over 150 years of collective clinical experience in the medical and surgical treatment of trigeminal neuralgia.”

What is disappointing is there is no mention of any of the approaches listed in this blog. It’s published by neurosurgeons so it is understandable that they would say: “The first-line treatment remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them.”

Medications and/or surgical options may work well for you but if not, you need to know there are other options. You may also be looking for a medication-free or non-invasive approach.

Keep in mind that this is what you’ll be offered unless you work with a functional medicine practitioner.

I do agree with and am encouraged by these statements:

  • What is increasingly clear is that there is no catch-all medical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that it is likely a heterogenous group of disorders that jointly manifests in facial pain.
  • Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.

Complementary approaches: NIH fact sheet

What is encouraging is that the NIH fact sheet I link to above, does mention low-impact exercise, yoga, creative visualization, aromatherapy and meditation.

Other than the standard medications (carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine and valproic acid and tricyclic antidepressants such as amitriptyline or nortriptyline) and surgical options they do also mention acupuncture, chiropractic, biofeedback and nutrients.

Botox is listed too but I have concerns about this approach.

This blog is not intended to be a comprehensive approach for pain relief for trigeminal neuralgia but rather some options you can consider and explore with your practitioner – especially when you also have anxiety, depression and insomnia too.

Resources if you are new to using tryptophan/5-HTP, GABA and DPA as supplements

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low serotonin, low GABA and low endorphin symptoms) and a brief overview here: Anxiety and targeted individual amino acid supplements: a summary.

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.

Has any of the above approaches helped you or your loved one? If not, what has helped you?

What conventional treatment have you had and did it help? Were you offered any of the above non-medication and non-surgical treatment approaches?

If you’re a practitioner, has any of this helped? Please share your treatment approaches too.

Feel free to ask your questions here too.

Acupuncture boosts GABA to reduce back pain and oral GABA further reduces the pain

By Trudy Scott 13 Comments

I fell and injured my back last week but I am doing much better already. I’m going to be sharing a series of articles on post what I’m doing to ease the pain and heal – acupuncture and cupping being two of the approaches. As well as heat (with a hot water bottle), I’m also using a long list of nutrients such as:

  • high-dose fish oil and curcumin (as anti-inflammatories)
  • relaxing magnesium
  • arnica for bruising
  • GABA for relaxing my muscles and helping with the acute pain, and for easing the fear and anxiety (initially I was very fearful I had a serious back injury) and
  • DPA (d-phenylalanine) for the endorphin-boosting pain-relief

Today I’m going to share some research on GABA and how it helps with pain reduction and muscle tension, and how the acupuncture actually boosts GABA (as well as endorphins) to reduce pain.

Based on the examination I have soft tissue bruising around the lumbar area (L3 to L5). Sitting had been impossible until 2 days ago and even now I have to alternate between sitting and standing. I also twisted my ankle in the fall so initially standing was even challenging!  

I had one acupuncture and cupping session last Saturday and will be having another one this coming Saturday. I felt some immediate relief after this session and my back has been getting better and better each day.

Oral sublingual GABA for the acute pain and muscle relaxation

In the interim, between acupuncture/cupping sessions I felt I needed relaxing support for my stiff and spasming back muscles so I immediately started using high doses of GABA for the acute pain. And it’s been working amazingly well.

Right after the fall I was taking 1g of GABA powder every few hours (held in my mouth for 1-2 minutes) and now I only need to take it 2 or 3 times a day as needed. This is the dose I started with only because I know this dose works for me for the rectal spasms I sometimes experience. I always have clients do a trial and start low and increase slowly based on need and response. The starting dose is typically 125mg as found in GABA Calm but I suspect this is likely too low if you are someone needing pain relief.

With the oral sublingual GABA I feel relief from the pain within 5 minutes and it lasts a few hours.

My pain level was 10/10 and is now down to 2/10 most of the time with a few times during the day when it is 4/10. I’m walking, standing, able to turn over in bed and sleep through the night, and able to get off the bed without assistance. I can now also put on my yoga pants, socks and shoes myself – these were impossible tasks in the first 5 days after my fall!

Acupuncture boosts GABA and downregulates substance P and CGRP

I have not been able to find research on oral GABA for easing pain but do have some research to share. In this first paper, Effect of electroacupuncture on thermal pain threshold and expression of calcitonin-gene related peptide, substance P and γ-aminobutyric acid in the cervical dorsal root ganglion of rats with incisional neck pain the authors state that it is known that acupuncture therapy effectively reduces post-surgical pain, but its mechanism of action remains unclear. The aim of the study was to investigate:

whether expression of γ-aminobutyric acid (GABA) and the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) in the primary sensory neurons of cervical dorsal root ganglia (DRG) are involved in electroacupuncture (EA)-induced analgesia [pain reduction]in a rat model of incisional neck pain.

The conclusion is as follows: acupuncture increases the pain threshold i.e. it reduces pain and the mechanism is likely related to

downregulation of pronociceptive mediators SP/CGRP and upregulation of the inhibitory transmitter GABA in the primary sensory neurons of cervical DRGs

In case you’re not familiar with the terms substance P (SP) and calcitonin gene-related peptide (CGRP) I’m going to explain what they are, how they are connected to pain and why downregulation helps with pain reduction.

What is substance P (SP)?

Founders and Directors of Neuroplastix, Marla Golden, DO and Michael Moskowitz, MD share this about substance-P (SP), the main pain neurotransmitter:

It has five basic functions in the body. They are pain, inflammation, anxiety, depression and nausea. Even though these seem like negative experiences, they are important for survival. Problems arise with excessive production and release of Substance-P.

They share a very descriptive video that:

depicts a nerve injury causing a massive release of Substance-P, up to 5 times greater than in acute pain. This diffuses out to three to five times more local area. This is a major way that the pain map expands in persistent pain and keeps the pain going.

Be sure to watch the video on this page.

What is calcitonin gene-related peptide (CGRP)?

Calcitonin gene-related peptide (CGRP) is relatively new marker for pain as this recent review paper discusses – Calcitonin gene-related peptide and pain: a systematic review

The present review revealed the association between measured CGRP levels and somatic, visceral, neuropathic and inflammatory pain. These data suggest that CGRP may act as a neuromodulator in non-headache pain conditions. However, more studies are needed to fully understand the role of CGRP in nociceptive processing and therapy of chronic pain.

Oral GABA lowers substance P and CGRP in asthmatic children

As I mentioned there is no research on the effects of oral GABA on pain reduction so I’m going to extrapolate from this study on asthma – Effect of gamma-aminobutyric acid treatment on plasma substance P and calcitonin gene-related peptide levels in children with asthma.

In this study of 75 children with asthma, 36 children were in the GABA treatment group and received oral GABA (25-30 mg/kg per day) in addition to standard asthma medications. For a 100 lb /45 kg child this would equate to 1125-1350mg of GABA per day.

The conclusion of the study is that oral GABA

can significantly decrease plasma levels of SP and CGRP in children suffering from acute asthma.

The authors propose that airway inflammation may be a factor in asthma and since GABA reduces SP and CGRP, eases neurogenic inflammation and tracheal spasms, it may offer a new approach for the prevention and treatment of asthma (this is my best translation from the Chinese paper).

In summary, oral GABA, used sublingually has helped me tremendously with the acute pain of my muscle injury, and it helped ease the anxiety and fear I felt right after the incident.

As you read above, I am using more than just the GABA, but because it works so quickly I saw benefits right away and had hope while all the other approaches are starting to slowly help too. I just love that I get to experience this first-hand and share it with you – although I would have preferred not falling and that initial severe pain!

I also have a good history of GABA helping me so this was a clue for me to try it now. It was my life-saver when I first experienced my terrible anxiety and panic attacks and helped me tremendously within a few days.  I also did very well with GABA when I used it for throat spasms during  my vagus nerve issue after that scary plane ride, and another incidence when I was getting terrible ice-pick type headaches that turned out to be a jammed neck issue.   I really am a GABA girl aren’t I!?

I have used high doses of GABA like this with one client who had a back and neck injury after a construction accident. It also helped him tremendously.

Have you used high doses of GABA for muscle injuries and seen improvements like this? Or do you use this approach with your clients/patients?