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Palmitoylethinolamide (PEA)

PEA is a naturally occurring fatty acid amide, found in the human body. If you have low levels of PEA in your body, it can worsen some peoples chronic pain experience. PEA is actually a natural substance taken from protein rich foods such as peanuts, soya beans and egg yolks. PEA does not need a prescription as it considered a dietary supplement - like taking magnesium or vitamin.

There are many studies demonstrating benefits of PEA in treating chronic and neuropathic pain. A benefit is that because it is a natural substance, there is a very low risk of side effects from the treatment and it is very unlikely to interact with any of your specific medications. Very rarely people can suffer nausea, palpitations or drowsiness. Starting with a lower dose and building up can reduce the risk of these already very rare side effects.

The benefits of PEA can take anywhere from a few weeks to three months to reach full effect, so it is important to trial it for at least a month or two before deciding whether or not it is working for you. Approximately 50% of people will get a beneficial response to PEA with up to 20% getting a profound improvement.

Dosing PEA is generally available in 300mg or 400mg capsules. The maximum daily dose is 2400mg/day (i.e.8 x 300mg or 6x 400mg capsules). A simple regime for treatment is to take 1 x 400mg tablet three times per day. If this is not effective after a couple of weeks increase the dose to 2 x 400mg capsules three times per day. If after 1-2 months this does not provide a significant benefit then you may not be a responder to PEA and you can cease the trial.

For people that find 3x/day dosing difficult or would like to take things more slowly and alternative regime wound be 1 capsule twice daily. You can then add an extra capsule every 4-5 days until youget to the maximum dose above. An example would be to start with 1 capsule twice daily. Then increase to 1 three times per day. Then increase to 1 in the morning and midday and 2 at night. Then 2 morning, 1 midday, 2 night. The 2 capsules morning, noon and night.

For dosing we tend to prefer 400mg capsules to reach a therapeutic effect more quickly. However,  some patients find the capsules quite large and difficult to swallow. In this case 300mg capsules may be better and the dose can be adjusted as is suitable for the patient. In fact increasing dosing to 4 or more times per day may allow for even better for absorption but tends to be easier to forget a dose.

The cost of PEA is approximately $50-60 for 100 tablets from a compounding pharmacy. Depending on the dose required the cost tends to be about $1-3/day. Sometimes after the initial trial many people find they can reduce the dose and maintain thetherapeutic effect. Some people can reduce back to 2 or 3 capsules per day making treatment more cost effective.

Where to buy: We recommend purchasing PEA from a compounding pharmacy. The primary reason for this is because PEA is considered a dietary supplement and in Australia there is no formal testing of dietary supplements to guarantee their contents. However, any compounded product must have certification that the product does contain what it says.

If you find the cost difficult to justify one potential option is to do a 1-2 month trial of compounded product to ensure the trial is genuine. If you get a benefit and want to continue you could considerpurchasing a cheaper non-compounded product and compare if it is equivalent for you.

This is just one of many therapies available and suggested at times by your Resolve Pain team. Your team can help suggest the best combination of therapies to maximise your recovery and help to improve your quality of life.

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