My client isn’t dealing well with the anticonvulsants prescribed for her atypical neuralgia. She has a history of low bone density, feels extremely fatigued, constipated, hormonal imbalance, and is taking a combination of pregabalin and carbamazepine. She’s been on it for over a year now and feels her health is steadily declining. Since the TMJ treatment is giving her extreme headaches and muscle cramps, she isn’t continuing it at this point in time. Since both medications have GABA relations, do you think supplementation with GABA might be helpful to calm her nerves? What about LDN? I really want her off the pills but haven’t yet found an alternative.

Dr. Amy Nett:  Yeah, I don’t know that I would put her on any sort of GABA supplement though, while she’s on those medications. If she successfully weans off them, then you might be able to try doing things certainly, whether it’s liposomal GABA from Quicksilver or Kavinace potentially. The Quicksilver GABA might may be a particularly good option. It’s a liposomal form that may be a little with better absorbed. So that’s an option. I think with people for chronic pain is incredibly difficult to treat. So I’m assuming it’s neuralgia, you’ve already looked into B vitamin sufficiency like any nutrient deficiencies, anything like that. So assuming you’ve done all the basic workup in terms of symptomatic treatment. I don’t think we can predict what’s going to work for people, unfortunately. And chronic pain is really one of the most difficult things to treat. Low-dose naltrexone has been used in the setting of chronic pain. I think it’s a reasonable approach. So I would be, I think, trying low-dose naltrexone is reasonable. I would also try cannabidiol. So again we use the Ojai Energetics cannabidiol, and that might help with pain modulation as well.

Some people have reported benefits from the low-level laser therapy. I’ve seen pretty mixed results from that. Let’s see here. Yeah, and then also just make sure there’s like no metal toxicity, maybe look at chronic inflammatory response syndrome; like other things, it can be associated with the ongoing pain. But in terms of supplements, once she’s off the medications you mentioned, you can consider like a liposomal GABA, low-dose naltrexone, cannabidiol, obviously boswellia, curcumin, or the supplement I mentioned, InflamAway. Those are all things to consider, but I think to some extent when it comes to chronic pain it’s really going to be trial and error. But definitely make sure all the pieces are set up in terms of nutrient sufficiency, getting rid of inflammation, metals, toxins, that sort of thing. Because I’ve seen a lot of chronic pain being solved with metal detox.