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PeaPure is a glial modulator. It is available in Italy and the Netherlands as a food supplement and has been studied in multicenter clinical trials in Europe for several years. It is well tolerated with no side effects and is very helpful for neuropathic pain, headache, and osteoarthritis. It is anti-inflammatory and neuroprotective.
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Because it inhibits astrocyte activation and the over-expression of pro-inflammatory molecules and signals, it is being investigated in Alzheimer’s Disease.
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The mechanism of action of PEA was discovered in 1993 by Nobel laureate Rita Levi-Montalcini in her work on nerve growth factors. She found it is involved in metabolism of mast cells and published a series of papers on its self-healing effect of the body in response to inflammation and pain. Two recent publications from Jan M Keppel Hesselink, MD, PhD, and his colleagues at the Institute for Neuropathic Pain, Amsterdam, The Netherlands, describe case reports, one of which is the case of a woman with CRPS.
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The purpose of this post is to clarify dosing of PeaPure and how to take it for a sudden flare of pain. My apologies for failing to recall the source of these instructions which I believe was from the manufacturer and from here and here. The latter includes an excellent review of its mechanism.
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Description of PeaPure® 400 mg capsules
PeaPure® is a food supplement based on a natural and fatty-acid like compound.
The substance palmitoylethanolamide (PEA) is a physiologically active molecule that the body produces naturally.
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What the user should know prior to ingestion:
• There are no known significant side effects.
• PeaPure® can be taken simultaneously with other medicine. In case of doubt, it is recommended to first consult your doctor or a pharmacist.
• Use during pregnancy is NOT recommended.
• PeaPure® does not contain sugar, yeast, allergens, sorbitol, magnesium stearate, povidone or other ingredients.
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Dosage and administration – please refer to the manufacturer.
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UPDATE SEPTEMBER 2014
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It is with a heavy heart that I report this news:
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Palmitoylethanolamide is
now available only from the Netherlands,
sold as PeaPure, a food supplement.
It is no longer able to be imported by a pharmacy, but we are hoping
that may change if we can interest a supplement manufacturer to make it available for the US.
Patent rights, attorneys are far beyond the resources of my local pharmacy.
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I have published this year, 2014, on the treatment of
vulvodynia and proctodynia with PeaPure and a topical cream.
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There are no studies to show us how often it may relieve nerve pain, but it is astonishing when it works. No toxicity, no side effects. Your brain makes it, plants make it. There is a growing literature on it and I have posted on some of its mechanisms. And in particular, its Anti-inflammatory, Analgesic, Neuroprotective Mechanisms.
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The material on this site is for informational purposes only, and is not a substitute for
medical advice, diagnosis or treatment provided by a qualified health care provider.
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Please understand that it is not legal for me to give medical advice without a consultation.
If you wish an appointment, please telephone my office or contact your local psychiatrist.
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For My Home Page, click here: Welcome to my Weblog on Pain Management!
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03/27/2013 at 2:42 am
Reblogged this on palmitoylethanolamide4pain and commented:
A recent entry of the USA painspecialist Dr Nancy Sajben, MD on the use of palmitoylethanolamide (PeaPure) in chronic pain states, such as neuropathic pain, headache and osteoartrhitis.
05/13/2013 at 3:39 am
Hi Dr. Sajben!
How do your patients usually obtain PeaPure? Over the internet?
Thanks!
05/14/2013 at 8:59 pm
Update August 2016: PEA is now sold in the US by Vitalitus – see my recent post on them July 26, 2016.
Previous comment about PJ’s no longer applies, therefore deleted.
05/27/2014 at 6:51 am
I cannot get it from PJ’s since their order is in FDA holding. I ordered it directly from the Netherlands and MY ORDER of less than $400 is in holding by the FDA. What’s happening!? PEAPure has and is working for my RSD pain. I’m off all narcotics for my pain and just take PEAPure. I don’t want to go on the narcotics. I WANT my PEAPure! it actually works! And I recommend it to others. Laura from MI
06/03/2014 at 12:34 am
Just heard today from a man who received his direct from Netherlands. It just takes a few days.
06/06/2014 at 2:03 pm
I just wanted people to know that while my early May order of PEAPure is STILL held up by the FDA, I did get my end of May re-try order! So, I’m back treating my RSD with PEAPure and in less pain! So, I guess there’s some type of random stopping procedure happening. Try another order if it happens to you.
07/17/2014 at 9:51 am
Dear Dr. Shaven, I have also received a direct shipment from the Netherlands back in May, it also only took a few days to receive.
07/16/2013 at 1:51 pm
Palmitoylethanolamide: new data on safety, safe up to 100 mg/kg BW:
http://palmitoylethanolamide4pain.com/2013/07/16/palmitoylethanolamide-normast-peapure-safe-up-to-100-mgkg-bw/
07/21/2013 at 10:14 pm
That link suggests these dosage changes:
Dose recommendation PEA (PeaPure, Normast)
First 4 weeks dose 1200 mg/day
If not enough response double the dose after 4 weeks for another month.
If good response, reduce dose after 4 weeks to see what dose keeps you stable
If response is not as expected, stop PEA after 8 weeks, it is unlikely to kick in in the majority of patients when they have been on PEA for 8 weeks.
10/18/2013 at 11:50 pm
New insight in mechanism of action on EFIC 2013: http://palmitoylethanolamide4pain.com/2013/10/14/new-insights-in-the-anti-inflammatory-action-of-palmitoylethanolamide-pea/
12/04/2013 at 1:02 am
Thank you! That link discuses the evidence announced recently that PEA Inhibits TLR4.
Quoting from them:
“At the EFIC (a Congress for European Pain Specialists) 2013 Dr Svik Assaw and colleagues from the School of Life Sciences, Medical School, University of Nottingham, United Kingdom presented new exciting data on the mechanism of action of the fatty acid amide N-Palmitoyethanoalamide (PEA) and presented the effects of PEA after activation of toll-like receptors (TLRs) by the inflammatory substance carrageenan.”
11/26/2013 at 8:56 am
Dr. Sajben: I’ve had RSD since I fell climbing up to Grinnell Glacier in Aug. 1994. Obviously, it has changed my life and my family. I have tried/done all the conventional treatment out there that my pain clinic knew. This past Aug. with a very high level of pain and after being on narcotics/opiods for over 15 years, I developed LQT that was way too high. That meant a month of de-toxing off of the narcotics/opiods, mainly Methadone, for a month. I was allergic to the de-tox med, so I had to do it cold turkey. Not fun. A month later, I returned to the pain clinic and was immediately put on a methadone patch. I wore it for 2 hours and wondered what I was doing. I ripped it off. I had been in MORE pain being on the pain killer methadone than I was in being off of meth. That was when I decided to search the internet for treatments. The more I read about PEAPure, the more I wanted to try it. Naturally occurring, safe, no real side effects, helps pain. I took a lot of info into my doctor and was told that if I wanted to waste my money trying it, I could. I had decided it was either change doctors or try it. I tried PEAPure. For the first week, I felt no change. But then I read that I could take 2 capsules in the AM and 1 in the afternoon. As soon as I started taking it that way, I immediately noticed an improvement. I made it through 1.5″ of rain in 24 hours and could still walk. I’ve never ever been able to walk on a rainy day, let alone a heavy rain like that. I’ve been off of PEAPure for a week, after being on it for a month. I’ve gotten worse again. So, I’ve just called PJ’s and re-ordered. The gal I spoke with is where you’ll be for Thanksgiving. They’re great there. Keep up the great work that YOU do in keeping us informed about treatments. My doctor is now thinking about suggesting others try PEAPure. I have also gotten her to prescribe LDN for me. I think I’m they’re guinea pig! But having had RSD for so long, and having not taken charge of my treatment until now, this is such a change for me. Some of it is just having a brain again after being the methadone. I had no idea what it had done to me. PEAPure RULES!!! Thanks one last time. Laura from MI
06/02/2015 at 4:07 pm
i HAVE BEEN ON pea FOR THREE WEEKS…i HAVE RSD IN MY HAND, WRIST AND SHOULDER. i AM DOING EXCEPTIONALLY WELL. This medicine is miraculous!!!!
07/24/2015 at 11:37 am
I have been diagnosed with vestibular vulvodynia and am currently on 100mg daily of Pregabalin. This is working on the whole providing I don’t do anything to provoke a flare up (exercise, tight clothes, sex, etc). However, I would dearly like some of my life back and am keen to try something else in addition to the Pregabalin to relieve the symptoms during a flare up. Could this medication work and how would I combine it with the Pregabalin? I am resident in the UK. Many thanks in anticipation! Victoria Markou
12/20/2015 at 11:00 pm
UPDATE AUGUST 2016
PEA is available in the US from Vitalitus. I posted on that July 26, 2016.
~~~~~~~~~~~~~OUTDATED WARNING ~~~~~~~~~~~~~~~
Get PEA only from Netherlands otherwise beware if some website or Amazon advertises it.
I was just told by a pharmacist with experience on the subject:
“It’s most likely adulterated PEA from China – we received multiple offers back in the day as well. Don’t buy it, don’t use it…”
07/16/2016 at 12:04 pm
Dr. Sajben is right to warn everyone to be careful sourcing PEA. After having a thoracic vertebra removed due to a very rare type of bone lesion, followed by radiation treatments, I was left in significant pain and progressive lower body functional losses from poorly managed lymphedema, radiation-induced scaring, and varied neuropathies (MS-like symptoms). My profession crosses over into medical research, so I learned about PEA from EU doctors as another option. Pregabalin reduced my pain, but left me unable to work, and did nothing for the functional losses). At first I mistakenly obtained PEA from a US pharma supplier, checked it (I have full analytical lab access), and everything was fine, except this PEA was not micronized (it came in flake form). As supplied, it was barely absorbed at all, and did very little. After switching to the recommended micronized (absorbable) form, PEA proved to be amazing.
PEA gave me my life back. Exercise, sex, etc. was also impossible for me until I took PEA for the progressive pain and functional issues for a few weeks. I also take Wobenzym N to help control how lymphedema causes transient compression of my spinal cord. Full feeling and use of a nearly non-functional lower leg has returned, and I no longer have any tingling, sharp pains, or the other debilitating issues that developed over time.
07/16/2016 at 9:02 pm
Your story takes my breath away. Thank you for taking the time to give every detail. What was the name of the US pharma supplier?
How long did it take before you felt pain relief?
I am thrilled to hear how profound your improvement with PEA has been:
–significant pain and progressive lower body functional losses from poorly managed lymphedema, radiation-induced scaring, and varied neuropathies (MS-like symptoms)
–nearly nonfunctional lower leg now has full feeling and use; exercise, sex, etc has been impossible until took PEA.
–gone are tingling sharp pains, other…
What was the name of the US pharma supplier?
I was just about to advise a patient to switch to one. Until recently, I had known only of the PEA from Netherlands.
07/25/2016 at 8:18 pm
Prismic Pharmaceuticals in Scottsdale AZ has applied for a patent, and is now clinically evaluating the use of PEA, combined with various existing pain medications, to take advantage of the “Entourage Effect” noted with this FAAH inhibitor. They recently started a number of Phase 1 trials according to their website. Let’s just say I was told to “follow the money” by friends in the business, and PEA was a big part of what I found.
A chemical formulary company in New Rochelle, NY is their likely PEA source, but this company’s PEA does not appear to be micronized for proper absorption. If a pharmacy were willing to purchase an air mill to micronize the PEA, and a particle sizing system to verify their results, sourcing problem solved.
07/25/2016 at 10:17 pm
Does Vitalitus micronize their PEA?
What was the name of the American company that you had tried and tested?
07/25/2016 at 8:52 pm
I’d like to note a fringe benefit from PEA use: The Wobenzym N dose I take for lymphedema routinely caused intestinal disturbances; this side effect abated with PEA.
07/26/2016 at 4:50 pm
Vitalitus is an American company that now manufactures and sells PEA since early 2016.
It is not flakes – which would be a huge size.
The CEO says they have a micrograph on their website that shows their PEA consists of micron sized crystals, about 3 microns. Not flakes.
Patients need to know it is fat soluble – lipophilic, meaning *****take PEA with something fatty like peanut butter, milk, etc —- it will not dissolve in water.*****
Who is that other Amerian company?
05/17/2017 at 1:40 pm
Can peA be taken with fentanyl patch?
05/17/2017 at 4:24 pm
fentanyl causes inflammation.
PEA does opposite. Waste of money, and then you will be sorely disappointed because you will never know.
12/03/2017 at 5:26 pm
Hi, first let me share sympathy with everyone! I thought I was badly off….about 4 months after breaking my right wrist in April 2016 & having it tacked back together with a chitan implant (“permanent”) I seemed to be having a lot of pain so got a 2nd opinion -CRPS. They gave me the nerve block shots until the pain doctor hit it wrong, etc. I have been taking pregabalin, mainly, though earlier this year I weaned myself off opoids (“Tramadol”) and felt better immediately, though the initial 2 months was like being on vacation. Fearful of worse pain to come I asked the specialist what else was there and he has basically been threatening me with SCS. I asked the same doctor who diagnosed me and he discouraged me; my rehabilitation therapist seconded that. Only 18 months in and I am ready to try anything, so those of you with years and years must really be desperate!
So, after seeing this website I looked around for PEA and independantly decided to steer clear of the American suppliers (“big muscles! sex!”) & ordered PeaPure from Holland, now waiting and I will let you know. (If they even let it into Japan. I asked my specialist about cbd and he just laughed. It’s considered a dangerous drug right up there with heroin in this country)
I also wanted to add that nobody seems to mention mirror therapy for CRPS. I have been doing this for about a year, with my bathroom mirror and also a virtual reality game (a trial). It convinces my right hand that it is OK to grab and use things. Too much of this means more pain but just enough means unconscious rehabilitation. My legs are OK so I try to excersize as much as possible. Weird blood circulation issues with CRPS make good excersize helpful.
That’s all for now – Again, best wishes & hope you all find something to lighten your load, even for a few minutes, today.
12/06/2017 at 2:48 pm
Vitalitus makes excellent PEA capsules and I have seen CRPS patient much better 3rd week after starting. Take for 3 months before deciding it helps.
Use search function top left, type in CRPS and read many posts for 7.5 years.
01/13/2018 at 6:06 pm
Please find a way to keep this site active?!?! Such a wealth of knowledge cannot be lost. I was going to move out that way to see you! CRPS!! IL-10. God save us. Blessings Dr. Nancy from afar. I’ve read your work for years!!! I wish you peace, love, joy and strength. Like a Phoenix rising from the ashes…
01/14/2018 at 7:48 pm
Careful, my ego …….