Nutrition. Vitamins. You.
Throughout the COVID-19 pandemic, healthcare experts have been discussing the importance of Vitamin D. Hear about new and updated studies on this powerful nutrient in this episode of the InVite Health Podcast.
With flu season upon us, Senior Scientific Officer Jerry Hickey, Ph. revisits the topic of green tea’s benefits for our immunity. Tune in to hear him discuss the powerful constituents in green tea, as well as their abilities to help protect the body from infections such as COVID-19.
gabapentin
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Please see below for a complete transcript of this episode.
Hosted by Jerry Hickey, Ph.
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InVite Health Podcast Intro: Welcome to the InViteⓇ Health Podcast, where our degreed healthcare professionals are excited to offer you the most important health and wellness information you need to make informed choices about your health. You can learn more about the products discussed in each of these episodes and all that InViteⓇ Health has to offer at www.invitehealth.com/podcast. First time customers can use promo code PODCAST at checkout for an additional 15% off your first purchase. Let’s get started!
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Jerry Hickey, Ph.:
[00:00:40] Gabapentin is an important drug. It’s commonly used for nerve pain, and it really does work. They use it for nerve pain related to diabetes. They use it for nerve pain related to shingles. We’ll talk about this a little bit later in the episode. It does have side effects. It also has important nutrient depletions. And interestingly, some of these nutrients are needed for nerve health. So welcome to my podcast episode, Gabapentin Used for Nerve Pain Can Deplete These Important Nutrients.† [00:01:15]
[00:01:17] Hi, my name is Jerry Hickey. I’m a nutritional pharmacist. I’m also the Senior Scientific Officer over here at InViteⓇ Health. Thanks for tuning in today to the InViteⓇ Health Podcast. You can find all of our episodes for free wherever you listen or visit invitehealth.com/podcast. Please subscribe and leave us a review. You can also follow us on Facebook, Twitter and Instagram @invitehealth. The information on this episode is linked at the episode description, so I really want to get going here.† [00:01:43]
[00:01:45] So gabapentin was originally created for epileptic seizures. It works by reducing inflammation and over excitation in the brain. It’s a GABA analog. GABA is gamma aminobutyric acid. That’s a neuro inhibitory neurotransmitter, so it’s used for, for, for seizures. So we’re not discussing that here. We’re not going into anticonvulsant medications here. I’m strictly talking about gabapentin here for nerve pain. It’s also known as Neurontin. Now, normally it’s used for herpes zoster infection nerve pain, that’s shingles. It’s called shingles. So when you were a kid, you had chickenpox. Chickenpox never leaves your system. Later on, for whatever reason, your immune system isn’t working up to snuff and the chickenpox comes back, but this time it’s called herpes zoster, and it could cause very bad nerve pain. Especially, it depends on where it is, you know, behind the ear, near the eyes. It could be quite dangerous if it comes out in the lungs. So when it comes out like in your chest or in your face or on your shoulders or something, it causes this burning stabbing pain. Now, the pain can last for months and some people, it lasts for years.† [00:03:13]
[00:03:15] There are supplements, by the way, that help with nerve pain. Alcar with ALA. We’ve already spoken about that in previous podcast episodes. Alcar with ALA. It stands for acetyl-L-carnitine and alpha lipoic acid. They work really well together for nerve pain. They’re also good for energy, and they’re good for your brain and memory. That’s a winner. And another one would be benfotiamine, which is a form of Vitamin B, one that’s very good for nerve pain.† [00:03:40]
CAN NUTRITION HELP WITH SHINGLES PAIN? – INVITE HEALTH PODCAST, EPISODE 362. Listen Now>>
[00:03:42] But let’s get back to gabapentin. So it’s normally used for shingles-related nerve pain. They have a time release, an extended time release, one called horizant that’s used for restless leg syndrome. Now, we don’t know how it works for that. We don’t know how it helps restless leg syndrome. Restless leg syndrome usually happens at night when you’re trying to sleep and you get this vague pain in your legs and you have this irresistible urge to move the legs to get comfortable, it could last for hours. So they do use gabapentin, that extended release, the time release one, for restless leg syndrome. For post-traumatic neuralgia, which is the shingles pain, it seems that the gabapentin changes the way your body senses pain. They also use it for diabetic peripheral neuropathy. Diabetic peripheral neuropathy is that tingling and that numbness that you get from nerve damage in people with diabetes. They do use it for hot flashes. You know, the sudden strong feelings of heating and sweat… Heat and sweating that you see in women being treated for breast cancer.† [00:04:53]
[00:04:56] Now, gabapentin, one of the problems with it is it makes some people really fatigued, really drowsy. It could cause serious drowsiness. So you don’t want to take it with marijuana, which is legal in some states. You don’t want to take it with alcohol, you don’t want to take it with any drug that makes you drowsy. That could be dangerous. Another problem is if you take an antacid with it, like the aluminum and magnesium antacids, it can block its absorption so you don’t want to take it at the same time as antacids. It can increase your risk of thinking of suicide. We call that suicidal ideation. I’ll get into this a little bit more later. So if you’re first trying gabapentin and you don’t know if it’s going to make you drowsy, you better be careful if you’re driving. So common side effects with gabapentin, I’ll tell you a weird one. Nystagmus. Nystagmus means dancing eyes. Your eyes are bouncing or they’re jerking, of your eyeballs so it can cause that it could cause drowsiness, of course. Dizziness. Anything that causes drowsiness because dizziness. Fatigue, obviously. Ataxia means you’re kind of wobbly and dizzy. You could fall over. Sedation. And it could cause swelling of like the arms and legs. We call that peripheral edema. Now, if you’re finding you’re take the drug for pain because you don’t want the pain from shingles, it can really hurt. It can really lost a long time. It can be horrible, but you start to get like mood changes, like you get confused or you’re becoming depressed or sad or fearful, or you start to think of suicide. Anything unusual like that you really should call your doctor right away.† [00:06:29]
[00:06:31] Now, here’s why we’re having this conversation. I’ve been doing a number of episodes, podcast episodes on drugs, how they interact with herbs and nutrients, are there nutrients that you should avoid if you’re on a drug, are there nutrients that make the drug work better, are there nutrients that the drugs are taking out of your system that can lead to health problems that you better replete your body with these nutrients. So it turns out that gabapentin does deplete the body of nutrients, and gabapentin is very commonly prescribed. There’s a lot of people with nerve pain. There’s a lot of diabetics, a lot of older people that suffer with shingles.† [00:07:06]
[00:07:08] So the drug can deplete biotin. And that’s a problem. It’s an important nutrient. Biotin was… Is involved with controlling your blood sugar. And there are studies showing that when you give biotin to people with diabetes, it can help improve their blood sugar control. But biotin’s also needed for nerve health. That’s why they’re thinking that biotin might help people with multiple sclerosis and multiple sclerosis, the coating of the nerves is damaged. It’s called the myelin sheath. The myelin sheath insulates nerves and makes messages travel quicker from your body to your brain. And in people with multiple sclerosis, the, the coating of the nerve is getting damaged. You need biotin to help correct that. So it doesn’t mean you have to stop gabapentin. But I think if you’re on gabapentin, you should be taking about a thousand to 2000 micrograms of biotin every day. Biotin’s also called Vitamin H. Now biotin is also involved with your nails. If you lack biotin, your nails get brittle. It doesn’t mean that if you have enough biotin, you could take more and get better nails. If you like it, you get brittle nails. But it’s also involved with unruly hair. There’s actually a syndrome called uncombable hair syndrome that runs in families. They can’t comb their hair. It looks like wool. Biotin helps that. If you lack biotin, your hair thins. Also, if you lack biotin, you tend to develop seborrheic dermatitis. It’s, it’s a kind of dandruff where it’s kind of like big, greasy, yellow, scaly stuff on your forehead. In fact, there’s some relationship to a lack of biotin and cradle cap in children, which is basically like seborrheic dermatitis. So if you are on this drug for neuropathy, gabapentin also called Neurontin, you need to take some biotin.† [00:09:12]
BIOTIN FOR MORE THAN YOUR HAIR AND NAILS – INVITE HEALTH PODCAST, EPISODE 394. Listen Now>>
[00:09:13] But you also probably need calcium and Vitamin D. The research is showing that when you take gabapentin, you’re depleted of calcium and Vitamin D. Now, calcium and Vitamin D obviously are needed for bone health. They’re not the only thing for bone health. We’ve done podcast episodes on that also, but they’re a major part of bone health. But calcium is also at the core of using calories for energy. Your mitochondria that use oxygen and calories for energy won’t work if you lack calcium. Your muscles don’t work well if you lack calcium. Your nerves don’t work well if you lack calcium. You become fatigued if you lack calcium. You also have a higher risk of colon cancer and in women breast cancer if you lack calcium. Calcium is a very important nutrient. So if you’re on… And Vitamin D, I mean, Vitamin D seems to be involved with everything in the human body, including the immune system, building bone. It just, it just has so many different effects. Reducing inflammation, helping to fight and helping to prevent cancer. Helping treat diabetes. You need for activated Vitamin D to help regulate your blood sugar. It interacts with the mineral magnesium and the mineral zinc to regulate your blood sugar. So if you’re on gabapentin, not only should you be taking some calcium and Vitamin D, you should be taking some biotin.† [00:10:34]
[00:10:35] There’s also evidence that gabapentin depletes two major B-vitamins, Vitamin B12 and folate. That’s really important. B12, methylcobalamin and adenosylcobalamin in your body. That’s what it converts into. B12 is needed to help prevent your brain from shrinking and memory loss with age. And B12 is needed to create red blood cells. Without, without B12, you develop megaloblastic anemia, where your red blood cells get too big and they don’t work well and you become very fatigued. But B12 has also been shown to lower the risk of developing colon cancer, and B12 is one of nutrients involved with energy production your heart needs. But B12 is also needed for nerve health, so here’s gabapentin being used for nerve pain and it’s depleting biotin, and it’s depleting B12, both which are needed for nerve health, and they’re both needed for brain health. Now gabapentin also depletes folate, and that’s a problem. Lacking folate increases the level of a molecule in the brain called homocysteine that damages the brain that can lead to brain inflammation and depression. But it’s also a big risk factor for Alzheimer’s disease. Now, beyond that, folate is needed to help prevent heart disease by once again regulating homocysteine. But folate’s also needed to create good genes and healthy cells. So if you lack the active form of B12, which which is called methyltetrahydrafolate, I’m sorry, not B12, folate, we’re talking folate here. If if you like the active version of folate, methyltetrahydrafolate, you have a higher risk of cancer because methyltetrahydrafolate helps block the first two steps in the cancer process called initiation and promotion. Like, like a combination of a virus and radiation can damage your DNA inside your chromosomes so badly it can lead to the cancer process. Methyltetrahydrafolate helps prevent that, so you need methyltetrahydrafolate for a healthy heart. You need it for a healthy brain and to lower the risk of Alzheimer’s disease, and you need it to lower your risk of cancer, yet gabapentin is depleting it. Simple. Take it. Now, normally in a multivitamin you get folic acid, synthetic folate. Folate is named for foliage. It’s ubiquitous in plants, but it’s not easy to derive out of plants. So they add inexpensive folic acid to multivitamins because they can make a better profit like that. But it doesn’t work for everybody. A lot of people have trouble converting it to the active form. So look for a vitamin that has the active B12 methylcobalamin because that creates all the forms of B12 in your body and look for a folate that’s the active form of folate called methyltetrahydrafolate. You’ll be better off.† [00:13:26]
[00:13:26] So if you’re on gabapentin, it really should help with your nerve pain. Just be careful because it can make you feel sleepy, sedated, and you need to take the following nutrients separate, at a separate time from the gabapentin just to make sure they don’t collide in the intestines and cause a problem. Biotin, calcium, Vitamin D, active B12, which is methylcobalamin, and active folate, which is methyltetrahydrafolate.† [00:13:52]
[00:13:54] OK, thanks for listening to today’s episode of the InViteⓇ Health Podcast. You can find all of our episodes for free wherever you listen to podcasts. We have hundreds, hundreds of them on our website. I think it must be approaching 500 by now. So that’s invitehealth.com/podcast. Subscribe and leave us a review, if you could. You can follow us on Twitter, Instagram and Facebook @invitehealth and I hope to see you next time on another episode of the InViteⓇ Health Podcast. Thank you so much for listening. This is Jerry Hickey signing off.† [00:13:54]
In this episode of the InVite Health Podcast, Amanda Williams, MPH concludes her series on the workings of the immune system. Learn about the important role nutrients such as Vitamin A, Vitamin E and mushroom extract play in your immune defenses.
You’ve likely heard of autoimmune conditions such as rheumatoid arthritis and Hashimoto’s thyroiditis, but do you know how these occur? These issues take place when the immune system goes haywire and attacks the rest of the body.
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Please see below for a complete transcript of this episode.
Hosted by Amanda Williams, MPH
*Intro music*
InVite Health Podcast Intro: Welcome to the InViteⓇ Health Podcast, where our degreed healthcare professionals are excited to offer you the most important health and wellness information you need to make informed choices about your health. You can learn more about the products discussed in each of these episodes and all that InViteⓇ Health has to offer at www.invitehealth.com/podcast. First time customers can use promo code PODCAST at checkout for an additional 15% off your first purchase. Let’s get started!
*Intro music*
Amanda Williams, MPH: [00:00:40] Now that we’ve gone through and we’ve looked at both the innate and the adaptive immune system and understanding the complexity of how our immune system is working to protect us, now we have to look at the double edged sword in a sense of the immune system and understanding what immunosenescence is. One of the key components or actions of our innate or that immediate immune response is inflammation, which is good in one sense, but can be very damaging in another. And understanding that when our body has any type of illness or injury that the immune system starts to drive up this inflammation. So this is when we can start to look at those cytokines and look at neutrophils in different interleukins and tumor necrosis factor alpha. All of these things that we know are going to drive inflammation. And it’s one thing if we have acute inflammation, it’s another thing with if we have chronic inflammation. So inflammation and the immune system are directly related because it is the immune system that’s actually controlling that inflammation. And this is where immunosenescence is so critical to understanding… Just defining it, but then also understanding how this links in to the way that our body ages and our immune system’s deactivation or dysfunction that occurs as we get older.† [00:02:14]
[00:02:14] So I’m Amanda Williams, MD, MPH. And this is part two. We are going to be talking about immunosenescence. This is… Basically it’s a deterioration of the immune system that occurs during aging. So over time, our ability to fight off different pathogens, whether that be a bacteria or viruses, or just even respond to any type of an injury, which would then require an acute inflammatory response and when we think about wound healing, that this can be delayed. This is all a hallmark of the, the aging process. So what happens is that you have this delay in how the immune system reacts in terms of that inflammatory response. But then when it does, then we end up with this persistent chronic inflammation, which is incredibly problematic. Now we can see this especially in the setting of when people get older and how they are more prone to taking longer to heal from an injury or taking longer to recover from, say, the common cold, or they are just more susceptible to even developing the common cold. I’m just using that just as an example.† [00:03:36]
[00:03:37] But we know that there’s many other components to the aging immune system that impacts our health. There was a study that came out and was published in the International Journal of Cardiology, close to a decade ago now, talking about immunosenescence and inflammation, how this was a characteristic they were seeing in patients who had chronic heart failure. They were able to look at the inflammatory status of these individuals and look at their high levels of cytokines. And what their hypothesis was was that patients who had chronic heart failure could develop this immunosenescence in a more rapid rate due to this chronic inflammation. And so through this particular research study, they were able to look specifically at those different cells of the immune system and looking at their natural killer cells and looking at their interleukin levels and looking at T cells. They were surprised by how many areas of the immune system were actually implicated in this immunosenescence effect in these patients who had heart failure. They found a much higher degree of immunosenescence than their healthy, age matched controls, so meaning you take someone who’s 70 years old and they had heart failure, you take another 70-year-old and who doesn’t have heart failure. What they were able to to see was that cell differentiation between those two groups, the healthy 70 year old and the unhealthy 70 year old. They both had diminished levels of immune response, but those who had heart failure had significantly diminished response with this really high level of systemic inflammation that was occurring. So when I talk about heart disease, oftentimes I always say we focus so much and we have for so many years on cholesterol and cholesterol is the enemy. But what we actually know to be the case is that when there’s damage done to the vascular lining and the immune system is trying to go in and heal and repair, that that drives that sustained inflammation over time. And it’s that inflammation that is the true causative reason for all of the progression in heart disease.† [00:06:14]
[00:06:15] And so we see this in immunosenescence as well. So thinking about inflammation, understanding that this is the immune system’s response and oftentimes it’s a very welcomed response. Unfortunately, through the process of the delayed innate immunity as well as impact on adaptive because you even see this as people get older, their response to vaccinations usually is diminished. So say you have someone who has underlying health conditions and they get the annual flu vaccine or they get the, you know, pneumococcal vaccine and then they still get sick. And the problem is, is that because of that immunosenescence, because the immune system is less responsive than it was when they were 20 years old, that the body’s ability to react accordingly to that vaccination is not where it needs to be. So… And this is a whole nother area of immune system science and trying to to see how passive immunity is actually working when you understand, like, the hallmark signs of passive and active immunization. So we know that immunosenescence is certainly a component that we can, you know, tie in to that.† [00:07:48]
[00:07:49] So back to immunosenescence, you know, there’s many different things that are actually occurring. So once again, many moving parts. So we have this decline in the production of key immune cells that happens as we get older. So we see this in T-cell production. So when we think about what the action or the role of our bone marrow in the thymus is. So those T cells, which normally are activated through antigen exposure because remember, this is part of our adaptive immune response. Those naive T cells are very challenged as we get older. So they estimate that there is this real steady decline of this T cell production as we get older and once we hit about 70 years old, you really start to see this diminishment. So this is why it takes older people a much longer time to really mount a really good immune response to any type of a foreign pathogen, which is why people always have those concerns that, you know, if you’re sick, you don’t want to be around your grandmother. These, these are relevant concerns because we know that through immunosenescence, through this decline of number of immune-fighting cells, the capacity of the immune system loses a lot of that potential to be able to properly fight off and defend the body from any type of a virus or bacteria.† [00:09:33]
[00:09:35] So, and we see this in natural killer cell decline. We see this in how the thymus itself begins to atrophy. So once that starts to occur, then we’ve now lost a key production center for where immune cells are driving up. We also see at the same time as we get older, that this increased trend of inflammation begins to occur. So when we see people who are 60 years old with arthritis, with heart disease, we have to look at it more than just, oh, they have achy joints and they have to be on blood pressure medication. We have to look at that and say, “Okay, they have achy joints, they’ve got chronic inflammation, they have hypertension, which means the medications that they’re on are likely diminishing key micro and macronutrients that the immune system requires to be able to respond accordingly.” So on top of just natural immunosenescence, that reduction of immune system response… So really very complex when we think about how the immune system handles aging and to look at how many different immune-related problems arise as we get older. And I think we take for granted how much of an impact the immune system actually is playing into all of this. Which is why it’s key to, to understand the impact, this is why when we talk about why we want to have adequate antioxidant response to fend off reactive oxygen species and those free radicals because we know that the more wear and tear that is occurring in the body, the more problematic it is for our immune system to respond to this.† [00:11:50]
[00:11:53] And we can look at many different factors. Once again, we can look at how diet and exercise plays a role into this. We can look specifically at how medications can lower our immune defenses. There’s, as I mentioned, always many different moving parts to this. So at the end of the day, when we think about immunosenescence, we want to be looking at different nutrients that we know that can help to reestablish or rebalance or restore our immune system’s ability to more efficiently fend off any of these different pathogens. So, you know, one of the most widely studied ways of helping to regulate the immune system as we get older and through that aging process to avoid significant immunosenescence is the Mediterranean Diet. And when they looked at 17 different clinical trials, they found that adherence to a Mediterranean diet was directly associated with significantly reduced levels of two key markers for inflammation C-reactive protein, as well as interleukin 6. Now, both of those are implicated in immunosenescence. If we have excess C-reactive protein, we have excess interleukin 6, we’re going to have greater levels of immunosenescence. We go back to that study with the patients with heart failure and you see how when they had extreme levels of inflammation, they had greater loss of immune function.† [00:13:42]
[00:13:44] So there’s so many different ways that we can help to manage our immune system as we get older. You know, it’s not just about taking Vitamin C and Vitamin D and Zinc. Those are perfect, yes, but there’s many other things that we have to look at, too. We have to look at what are we doing with our diet? What are we doing with our exercise routine? What are we doing with managing stress? That’s a huge one. We have to look at the depletion of key hormones in the body that can lower once again our immune defenses. We can look at DHEA levels and understand that this very important adrenal steroid hormone is a very key determinant for immunosenescence. If you have low levels of DHEA as you get older, that should clue you in to your immune system is not as strong as you may hope it would be. So we know that we cannot avoid aging. We don’t have a magic pill that puts a stop on the clock. Aging is going to happen. I always say we want to age gracefully. We want to do everything in our power to help all of the little cells in our body to avoid added conflict from which they’re already exposed to every day from the environment, from the foods that you eat, from the products that you’re using. Because remember, there’s so many different ways that we impact our cellular health, so we have to think about ways that we can help to reverse that. And the deterioration of the immune system as a result of aging, so much of this we can play a part into. There’s so much research out there now looking at the impact of immunosenescence. I mean, even in today’s setting with SARS-CoV-2 and looking at how, you know, pathogen recognition, elimination, resolution, how those three components of the immune response can play a real driving force in terms of risk factors because of immunosenescence once again. Which is why, to this day, we still recognize that those who are most susceptible to a really significant risk of SARS-CoV-2 are elderly. And it comes down to that weakened immune system, so immunosenescence is something that we cannot ignore.† [00:16:38]
[00:16:40] We have to regulate inflammation in the body. We have to do the things to support the way that our cells are going to react in both that innate as well as adaptive immune response. And this is a critical aspect. There’s a whole area of science right now where they are looking at immunosenescence and this immune dysfunction and all of the different systems in the body to which immunosenescence is proving to be this hallmark. When we look at cancers, a lot of focus right now is looking at immunosenescence and that immune dysfunction that’s occurring because remember one of the things to which we know that the immune system is trying to achieve is to rid the body of things that are not supposed to be occurring. So if you have improper cellular division, as we see in cancers, then this is a real problem. So understanding all of these aspects, understanding your antibody-mediated and your cell-mediated immunity, you know, coming from both the innate and the adaptive. We have to get to the point where we realize that what we do, the actions that we take every day will impact us long term. And I think that at this point in time, the more foundational understanding of immunosuppressants and really seeing how a strong immune system is essential to our overall longevity has never been more important. So you don’t want to wait until you have a full-blown illness and then say, “Oh, maybe I should do something.” We want to be proactive in this approach. We have to be proactive in this approach.† [00:18:50]
[00:18:51] So in my next episode, what I’m going to talk about is the autoimmune component and understanding what it is to have an autoimmune condition and all of the many different ways that our immune system can go haywire and start to create destruction. I want to talk about passive and active immunization and what that actually means. There’s so much to immunopathology. So if I explain it in the setting of active and passive immunity, and we talk about autoimmunity, then you’ll have a better understanding of why, once again, we need to take our immune system serious because it is what maintains our health throughout our life.† [00:19:44]
[00:19:45] So that is all that I have for you for today. I want to thank you for tuning in to the InViteⓇ Health Podcast. Remember, you can find all of our episodes for free wherever you listen to podcasts or by visiting invitehealth.com/podcast. Now do make sure that you subscribe and you leave us a review. You can follow us on Facebook, Twitter and Instagram @invitehealth and we will see you next time for another episode of the InVite Health Podcast.† [00:19:45]
*Exit music*
