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Why Be In Ketosis? Part XIII: How Ketones Modulate Pain

DocMuscles in Downtown Denver

I traveled to downtown Denver, Colorado, this week.  It gave me the opportunity to talk to a number of really great people.  A number of those people that I chatted with were searching for relief from pain and other aliments.  Not surprisingly, being in the mile-high city, many of those were using derivatives of marijuana (pun not intended).  I was actually surprised at the number of people who spontaneously admitted to using tetrahydrocannabinol (THC) or cannabinol (CBD).  They use it in various forms to treat their pain or other complaints.  Only a handful of those that I had the pleasure of talking to had ever heard of nutritional ketosis as an approach to pain control. This got me thinking about my patients and their pain control.  Many of them have had significant improvement in pain using a ketogenic diet and exogenous ketones.

Nutritional Ketosis as a Method of Pain Treatment

I started using nutritional ketosis as an adjunctive treatment to disease twelve years ago. Quite a few of my patients reported improvements in their overall pain using this approach.  I started to see 50-60% improvement in the inflammatory types of pain, and 40-50% improvement in neuropathic pain.

Ketosis and Forms of Pain

There are a number of forms of pain: thermal, inflammatory, and neuropathic. Looking over the scientific literature, there is no strong data showing that ketogenic diets reduce thermal pain, however, there is data showing improvement in inflammatory pain.  Within two days of dietary changes, inflammatory pain and secondary swelling, as well as plasma extravasation (excess fluid accumulation around the area of swelling) show measured improvement.

Watch my four minute vlog below about pain control being one of the twenty-five reasons to use nutritional ketosis (This video has a mic problem, so turn your sound all the way up):

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Even though the published science has not caught up to fully clarified what we are seeing clinically, evidence demonstrates that ketones improve nerve pain. When ketones are present in increased amounts in the blood stream, the current evidence points to a number of poorly understood mechanisms.  Ketones compete with chloride ions in the peripheral nerve cells.  When ketones bind instead of chloride, there is a decrease in glutamate production, a key amino acid necessary in the signaling of pain fibers.  The lower glutamate level causes a rise in gama-aminobutyric acid (GABA). . . leading to decreased sensation of pain.

This is the same pathway that stops intractable seizures and may play a very significant role in dietary treatment of autism.

Denver is ranked No. 3 by Zagat on the list of “Foodie Capitals” of America. And, the downtown scene is absolutely beautiful, but I walked by eight different restaurants specializing in “carbage” while walking just two blocks.  Encouraging cities to eat less bread may be a challenge.   But, hey, you get to eat more bacon!  And, bacon is the duct tape of the culinary world.

Bacon Boy loves to travel. Click Here to take him on your next photo opportunity.