depression , 145 , 146 anxiety , 145 , 147 mood , 145 stress , 148 memory , 148 sleep , 145 145 , 147
anger , digestive disorders , 28-30 skin conditions , 149 inflammation , 150 and oxidative stress . 150 In a pilot study , 39 patients with chronic fatigue syndrome were randomised to receive either 24 billion colony-forming units ( CFU ) of Lactobacillus casei strain Shirota or a placebo daily for two months . There was a significant decrease in anxiety symptoms among those taking the probiotic vs placebo ( p = 0.01 ). 44 A 1910 study found that a gelatin-whey formula with live lactic acid bacteria improved symptoms of depression in adults with melancholia . 151
Lactoferrin Lactoferrin is an iron-binding glycoprotein 152-156 of the transferrin family . 152-155 It is a cell-secreted mediator that bridges innate and adaptive immune function . 156 Lactoferrin is considered a first-line defence protein involved in protecting against microbial infections and in the prevention of systemic inflammation . 156 Lactoferrin has immunemodulating activity , 156 bacteriostatic and bactericidal effects , 156 152 , 156
antiviral , antimicrobial , 152-154 152 , 156
anti-parasitic , anti-fungal , 152 , 156 anti-inflammatory , 152-154 antioxidant , 152 , 156 reducing oxidative stress , 156 and iron-binding 156 activities . As an antioxidant , lactoferrin reduces intracellular reactive oxygen species ( ROS ). 156 The antibacterial activity of lactoferrin has numerous mechanisms of action , including iron sequestering , altering bacteria virulence , altering bacterial growth , proteolytic activity , preventing biofilm formation , and interfering with cell adhesion . 152
Water This leads us to water and hydration . Hydration via regularly drinking water is essential for metabolism , 157 cellular homeostasis , 157 temperature regulation , 157 , 158 and circulatory function . 157 Water acts as a carrier for nutrients and waste products 158 for substrate transport across membranes . 157 NHMRC guidelines for adequate water intake is 2.1 L / day for females and 2.6 L / day for males . 159
Conclusion
Chronic fatigue syndrome is a debilitating fatigue condition that affects many body systems and has a wide range of symptoms . Nutritional medicine plays a major role in the management of chronic fatigue syndrome via various mechanisms of action . Further research is suggested to determine the causes , biomarkers , and management of chronic fatigue syndrome .
For a full list of references , please email the Editor : sandra . grace @ atms . com . au
Understanding Chronic Pain Management
The benefits of saffron and PEA and their influence on the endocannabinoid system
Chronic pain is on the rise and sufferers are more likely to experience psychological concerns such as depression , anxiety and sleep disturbances . PEA and saffron have the unique ability to influence the endocannabinoid system and in turn , manage chronic pain and its associated symptoms .
Chronic pain is persistent pain lasting more than 3-6 months . Over the past 10 years , general practitioners have seen a 67 % rise in patients experiencing chronic pain . 1 Chronic pain is complex and it is often reported that chronic pain sufferers concurrently experience psychological distress and symptoms such as poor mood and sleep . 1 The body is equipped with a variety of mechanisms and systems to alleviate and resolve pain , including the endocannabinoid system . Compounds , such as palmitoylethanolamide ( PEA ) and Crocus sativus ( saffron ), have the unique ability to influence the endocannabinoid system and in turn , manage chronic pain and its associated symptoms .
The endocannabinoid system is involved in the modulation of pain and inflammation . Cannabinoid 1 ( CB1 ) receptors are located within the brain and central nervous system whilst cannabinoid 2 ( CB2 ) receptors are found primarily in peripheral tissue and cells of the immune system . 5 Endocannabinoids are produced endogenously or can be supplied exogenously to manage pain . Whilst PEA is not a cannabinoid itself , it is a naturally occurring endogenous fatty acid that is produced in response to inflammation or injury . In conditions such as chronic pain , it has been noted levels have been altered , highlighting the benefit of PEA supplementation . 3
PEA works through :
• Enhancing tissue levels of anandamide , a cannabinoid that acts upon CB1 and CB2 receptors , providing analgesic properties . 6
• An affinity to PPAR-α receptors , which reduces inflammation and the secretion of pro-inflammatory signalling molecules . 6
• An affinity to receptors GPR55 and acts to desensitise TRPV1 which is involved in the sensation of pain and heat . 7
• Inhibition of mast cell degranulation and subsequent histamine release whilst controlling glial cell behaviours . 3
Ultimately , PEA provides analgesic , anti-inflammatory and neuroprotective benefits . Due to its fatty nature , PEA has poor absorption . Levagen + is considered a superior form of PEA which utilises LipiSperse ® technology to increase bioavailability . 6
Saffron is a notable adjunct therapy to PEA as chronic pain sufferers are more likely to experience psychological concerns such as depression , anxiety and sleep disturbances . 1 Saffron has been shown to provide anti-inflammatory , antinociceptive , immunomodulatory , analgesic , antidepressant and anxiolytic effects . 8
Saffron works through the following mechanisms :
• Attenuates pro-inflammatory mediators such as TNF-α and IL-6 . 8
• Reduces eosinophils , neutrophils and lymphocytes , leading to a down-regulation of leukotrienes , prostaglandins , cytokines , ROS and NO . 8 , 9
• Partial agonism and selective desensitisation of the TRPA1 channel . 10
• Antioxidant activity reduces oxidative damage by attenuating endogenous ROS . 11
• Reuptake inhibitor of dopamine , serotonin , and norepinephrine . 11 For optimal patient results , choose a standardised form of Saffron such as affron ®. affron ® is standardised by HPLC ( high performance liquid chromatography ) to Lepticrosalides ® and has been shown to support mood , relaxation and sleep , 12 critical for chronic pain sufferers .
For more information on managing chronic conditions , visit fxmedicine . com . au Your gateway to the latest research and information in functional and evidence-based complementary medicine .
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