PAIN?
– My Solution –

Dr. Al Danenberg Nutritional Periodontist

March 28, 2021

 

 

Pain is very subjective. What is painful for one may be only slightly uncomfortable for another.

 

I live with pain all the time. But I now have a new solution that can help me deal with it.

 

I have bone pain from multiple myeloma as well as leftover pain from my pathological fractures of both my femurs, my right humerus, several ribs, and 2 vertebrae. Most of the time, Pulsed Electromagnetic Field (PEMF) Therapy (part of my Unconventional Cancer Protocols) has reduced this pain to tolerable levels. However, some pain gets to me, and I need something additional for relief.

 

Usually when I need pain medication, I go for ibuprofen 600mg as needed. I have tried CBD oil, but I have not had success with it. I do not take narcotics.

 

Now I found a new substance that works well for me – Boswellic Acids. It works better than ibuprofen with minimal side effects. And when I discussed it with my conventional oncologist, he was impressed and was interested in the medical journal reports I shared with him.

 

Also, since I need to take a small dose of dexamethasone (a corticosteroid) along with my monthly immunotherapy, Boswellic Acids may be a perfect substitute for that steroid. There is evidence that Boswellic Acids may replace this steroid while providing the same results with little to no side effects.

 

If I still were treating patients in my office, I would not hesitate to recommend this medicine as an anti-inflammatory and pain reliever.

 

 

What are Boswellic Acids?

Boswellia, also known as Indian frankincense, is an herbal extract taken from the Boswellia serrata tree. It is a series of pentacyclic triterpene molecules. Boswellia resin made from boswellia extract has been used traditionally for thousands of years. In Ayurvedic medicine, it is one of the most prized medicinal herbs for the treatment of arthritis and inflammatory disorders. Today, research is discovering Boswellia’s efficacy in treating a number of health problems, which I list later in this post.

 

Boswellic Acids from the resin are responsible for the herb’s anti-inflammatory properties. These acids are reported to have expectorant, antiseptic, anxiolytic, anti-neurotic, analgesic, tranquilizing, and antibacterial effects. The strength of Boswellia products is generally rated on its concentration of Boswellic Acids in the product. I look for at least 65% Boswellic Acids in the capsule or softgel. These medicaments are available as a resin, pill, or cream.

 

Based on the research I have read and my personal experience, Boswellic Acids appear to be a healthier alternative to steroids and nonsteroidal anti-inflammatory drugs (NASIDS) for pain and inflammation.

 

CAVEAT: If you have gastritis or gastroesophageal reflux disease (GERD), you may not be able to take Boswellia. If you are taking blood thinners or on prescription steroids, you must consult with your doctor before you try Boswellic Acids.

 

 

Problems with NSAIDS Like Ibuprofen[1],[2],[3]

NSAIDS are the go-to, over-the-counter drugs of choice for pain. However, ibuprofen and other NSAIDS can cause bleeding, increased blood pressure, heart attack, stroke, and renal damage. They may be the culprit in heartburn, stomach pain, nausea, vomiting, and diarrhea or constipation. NSAIDS can also damage the gut microbiome, decrease the diversity of species in the gut, and damage the gut epithelial barrier.

 

 

Problems with Steroids Like Dexamethasone[4],[5],[6]

Dexamethasone is a strong, anti-inflammatory, corticosteroid drug. It is used to treat conditions such as arthritis, blood and hormone disorders, allergic reactions, skin diseases, eye problems, breathing problems, bowel disorders, cancer, and immune system disorders. It relieves pain and inflammation.

 

Unfortunately, dexamethasone has significant adverse side effects such as water retention, weight gain and puffiness, suppression of the immune system, increase in blood sugar, weakness in arms and legs, insomnia, osteoporosis, and damage to the adrenal glands. Also, steroids damage the mucous layer in the gut.

 

However, this drug is widely used and considered a necessary evil in patient management for various diseases.

 

 

Dosage of Boswellic Acids[7],[8],[9]

One study has shown that the elimination half-life of Boswellic Acids is about six hours. This means that dosing every 6-8 hours orally may be important to maintain the proper blood level. Also, it took about thirty hours after the initial dose to reach a stable blood level. So, expected benefits may not be reached until the second day after the starting dose. In addition, absorption is better when taken with a meal that is high in fat. Since I eat a high-fat diet, I’m good to go!

 

Dosing guidelines are suggested by each of the product’s manufacturer. However, the general dosing guidelines suggest taking one capsule or softgel orally one to three times a day. Different medical conditions would require specific dosing concentrations of the active ingredients – Boswellic Acids.

 

 

Rare Side Effects from Boswellic Acids

In 2019, a double-blind study was reported where 48 patients with osteoarthritis were divided into 2 groups. Over the course of 4 continuous months, the control group took a placebo, and the experimental group took 87mg of Boswellic Acids in capsule form twice a day. The experimental group’s knee pain and function significantly improved. It is important to note over the course of 120 days, there were no statistically significant changes in the participants’ body weight, blood pressure, respiratory rate, or pulse rate. Also, there were no abnormal lab or diagnostic parameters recorded. In addition, Boswellic Acids significantly reduced the serum levels of high‐sensitive C‐reactive protein, a systemic inflammatory marker. And none of the individuals developed any serious side effects during the entire 4-month study.[10]

 

Although side effects are rare, you should be aware that Boswellic Acids …

  • May accelerate menstrual flow and may induce miscarriage in pregnant women
  • May increase bleeding
  • May cause nausea
  • May aggravate acid reflux
  • May cause diarrhea
  • May cause skin rashes
  • May interact with steroids, ibuprofen, aspirin, and other NSAIDs

 

 

Boswellic Acid Science[11],[12],[13],[14],[15]

Boswellic Acids have the ability to modulate multiple mediators involved in the pathogenesis of many diverse diseases. Currently, there are a number of research projects actively investigating the efficacy of using this medicine as a treatment modality. Here are a few of the chronic diseases that have been, and are being, studied:

 

  • Osteoarthritis (OA)
  • Rheumatoid Arthritis (RA)
  • Inflammatory Bowel Disease (IBD)
  • Asthma
  • Various Cancers
    • Breast Cancer
    • Bladder Cancer
    • Brain Cancer
    • Cervical Cancer
    • Colon Cancer
    • Leukemia
    • Liver Cancer
    • Lung Cancer
    • Prostate Cancer
    • Pancreatic Cancer
    • Melanoma
  • Atherosclerosis
  • Renal Intestinal Fibrosis
  • Diabetes
  • Central Nervous System Disorders like Parkinson’s, Alzheimer’s, and Multiple Sclerosis
  • Ischemia-Reperfusion Injury (IRI)
  • Psoriasis

 

 

My Solution

I have read about, and experienced the benefits of, Boswellic Acids as a supplement in capsule or softgel form. There are many products on the market.

 

I selected a product that contains 65% Boswellic Acids in 500mg Boswellia Extract. Therefore, each softgel has 325mg of Boswellic Acids. The recommended dose is 1 softgel, 1-2 times per day. When needed, I take 1 softgel 3 times a day with food containing high fat.

 

For me, this is an excellent substitute for an anti-inflammatory pain medicine when I need it. It also might be considered as a promising alternative to corticosteroids in the treatment of diseases requiring steroids.

 

My oncologist has allowed me to experiment on myself. As you know, I don’t hesitate from being a study of N=1! But he will monitor me.

 

So, starting with my next monthly immunotherapy infusion, I will begin to replace my 3 declining doses of dexamethasone (4mg, 2mg, 1mg) with Boswellic Acids.

 

Even though I only take small doses of the steroid, I retain about 5 pounds of water weight as a result that lasts about one week. Also, this minimal dose of the steroid still gives me insomnia for about 5 days. I am looking forward to avoiding these steroid side effects if the Boswellic Acids work instead.

 

 

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809680/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426480/

[3] https://onlinelibrary.wiley.com/doi/full/10.1111/apt.14451

[4] https://www.ncbi.nlm.nih.gov/books/NBK531462/

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402247/

[6] https://www.ncbi.nlm.nih.gov/books/NBK279156/

[7] https://pubmed.ncbi.nlm.nih.gov/15643550/

[8] https://pubmed.ncbi.nlm.nih.gov/15070181/

[9] https://accp1.onlinelibrary.wiley.com/doi/abs/10.1177/0091270011422811

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681146/

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229515/

[12] http://www.koliskoinstitute.org/wp-content/uploads/2014/09/Therapeutic-Advantages-of-AKBAv2.pdf

[13] https://doi.org/10.1155/2019/3041438

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747466/

[15] https://www.lifeextension.com/magazine/2014/12/boswellia-new-studies-show-effective-pain-relief

 

 

 

 

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Dental Implants & Inflammation

Alvin H. Danenberg, DDS Nutritional Periodontist
January 23, 2017

Can titanium dental implants cause inflammation? I used to believe the answer was, “No”. Now, published medical research suggests the answer may be, “Yes”.

 

Dental Implants

There are an estimated 3 million people in the US who have dental implants, and that number is increasing by 500,000 each year. In addition, over 95% of these implants seemingly have been successful and symptom free. Complex healing stages must occur before a dental implant becomes attached to surrounding bone tissue. But, all this may need to be reinterpreted and further investigated.

 

Problems with Dental Implants

I see patients all the time with existing dental implants that are functioning well with no obvious infection and no obvious inflammation. However, I see a few patients with infection around implants that is causing rapid destruction of the supporting bone. Some reasons for this destruction are obvious to me as a periodontist:

  • Poor oral hygiene and unhealthy food choices allowed bacterial infection to take hold around dental implants as it would around natural teeth.
  • Sometimes there was excess cement under the crown that attached to the implant, which caused inflammation and infection.
  • There might have been excessive biting forces on the implant putting unhealthy pressures on the bone.
  • Occasionally, the dentist may have created damaging heat when placing the implant in the jaw, leading to bone destruction.

While I could understand and identify most of these causes, I saw patients with failing implants that stumped me. I could not determine a cause, and science wasn’t able to give me an answer.

  

Perplexing Problem

One question I needed answered was this: Was there something about the metal of titanium that was causing an inflammatory problem in the surrounding tissues?

After I reviewed the recently published medical research, I became concerned. I found documentation that medical implants using titanium sometimes created problems in the bone. Some of these implants in various areas of the body created chronic inflammation and severe bone destruction. This breakdown was without infection and was apparently related to titanium particles that were released into the tissues.

Up until now, I could not find peer-reviewed studies that addressed the potentially damaging effects of titanium particles from dental implants. Was there a cause and effect relationship of titanium particles creating inflammation in the jawbone?

  • This study in 2015 evaluated 22 dental implants from various international implant companies. Surprisingly, 7 out of 22 “sterile” implants had endotoxin contamination on their surfaces, which would generate an inflammatory response in the body.

 

  • In 2016, researchers reported that bacteria around dental implants could trigger inflammation. In addition, these bacteria also caused corrosion on the titanium implant surfaces. Corrosion dissolved the titanium surface and released titanium particles into the surrounding periodontal tissues. These particles aggravated the inflammatory response. These researchers also noted that fluoride ions from mouthwash, toothpaste, drinking water, and food could potentially cause corrosion on titanium implant surfaces.

 

  • In January of 2017, a published research paper showed that titanium particles actually were released from an implant surface after it was cleaned with ultrasonic scaling instruments. These titanium particles reacted with immune cells in test cultures, which led to bone destruction. In addition, researchers studied the results of placing these titanium particles into bones of mice. The result was severe inflammation, which quickly caused the bone to melt away. This same study showed that these titanium particles were more damaging than specific types of bacteria, which were the cause of severe periodontal disease.

  

Beyond the Mouth

My concern goes beyond damage to the jawbone, which is serious enough. My concern is that these titanium particles could leak into the blood system. Once in the blood system, they could cause other serious chronic inflammatory reactions affecting other organ systems. And, all of this might take many years to manifest.

Research has shown that harmful bacterial particles from the gut can enter the blood system and cause chronic inflammation, resulting in various chronic and autoimmune diseases. As I mentioned, these diseases could take decades to develop clinically. Since titanium particles have been shown to cause more inflammation than bacterial fragments, what potential damage could free titanium particles produce in our body?

  

Moving Forward

I am concerned. Dental titanium implants are an excellent way to replace missing teeth. Yet, titanium particles can be released from the surface of these implants. These particles have been shown to cause inflammation, which may translate into implant loss and potentially serious chronic diseases over time. Well-designed studies must be devised and published to give my profession more information about what is happening with titanium implants and what needs to be done.

 

 

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If You Did Nothing Else, Do These 3 Things to Reduce Inflammation

        Alvin H. Danenberg, DDS       November 18, 2015

 

evolution rInflammation is a major problem.

 

If you read my blogs, you know I personally follow a primal diet and lifestyle. Also, if you read my blogs, you probably are concerned about your overall health as well as the health of your mouth. But, unlike me, you may not be as passionate as I. Yet, you still may want to do the best you can do within your personal limitations.

 

If you did nothing else for your overall health, do these 3 things to reduce chronic systemic inflammation. Chronic inflammation is the most incipient factor leading to chronic disease. These 3 steps will put you on the right track for a healthier body and a healthier mouth.

 

1. Eliminate processed seed and vegetable oils from your diet.
These oils contain large amounts of Omega-6 polyunsaturated fatty acids. Examples are soybean oil, canola oil, corn oil, sunflower oil, and safflower oil. Although omega-6 fatty acids are one of the essential fatty acids that we must consume, they should come from whole foods and be consumed in moderation. These processed oils are inflammatory. In addition, they generally are damaged from the industrial processing and frequently come to us in an oxidized state, which adds an additional unhealthy problem for our bodies.

 

2. Eliminate processed grains from your diet.
Processed grains come in the form of bread, crackers, cereals, pasta, muffins, bagels, pretzels, cookies, cakes, and the list goes on and on. These are made from wheat, rye, barley, rice, oats and other grains that have a high carbohydrate density with little nutritional value. Many of their proteins cannot be digested properly and may irritate the intestinal lining. Irritation of the intestinal lining creates inflammation in the gut and leads to leaky gut, which is a breakdown in the gut lining. From there, other food particles and bacterial remnants can invade the blood system through a breakdown in the gut lining creating serious chronic inflammation and immune responses that may damage other organs of the body.

 

3. Eliminate processed sugars added to foods.
Processed sugars are inflammatory, spike insulin, and have little nutritional value. These refined sugars are contained in candy, soda, syrups, and table sugar to name a few foods. They contribute to weight gain, tooth decay, and disruptions in various hormones. They also promote unhealthy growth of bad bacteria and yeast in the gut that can threaten overall health from irritable bowel syndrome to brain disorders.

 

If you effectively eliminated these processed foods from your diet, within 30 days you would notice significant positive changes in your health.

 

For example, in a paper published in 2009 in the Journal of Periodontology, researchers studied a group of 10 people who lived for 30 days in a replicated Stone Age environment near the Rhine River in Switzerland. The design of this research required a diet that was devoid of these types of processed foods. In addition, during the 4-week course of the study, these individuals were not allowed to brush or floss their teeth. At the beginning of the study, any existing gum problems were recorded and the types of bacteria present in their mouths were determined.

 

At the completion of the 4-week experiment, the quantity of bacteria at the gum line around the teeth increased as expected. However, researchers were surprised by a reduction in gum infection. Bleeding from the gum pockets also decreased significantly. Although good bacteria increased, bad bacteria decreased. As I stated, these 10 individuals could not perform any oral hygiene for the entire 30 days – the researchers were shocked by the results! Eliminating these processed foods made a huge health difference.

What Did You Say I Have?

        Alvin H. Danenberg, DDS       November 8, 2015

 

evolution r“What did you say I have? I brush my teeth everyday and floss when I can. Now you say I have gum disease that is eating away at my jawbone! How did this happen to me?”

 

You are not alone!

 

A study published in 2010 demonstrated that 93.9% of adults in the United States had some form of gingivitis, which is inflammation of the gum tissues surrounding the teeth.

 

Another study published in 2012 by The Centers for Disease Control and Prevention stated that 47% of the US adult population has periodontitis (the advanced stage of gum disease that eats away at the jawbone). If you were over 65 years old, the prevalence of this advanced infection jumped to 70%. Wow!

 

Advanced gum disease typically does not hurt. The earlier stage of this disease, which is gingivitis, usually produces bleeding gums. But, if gingivitis progresses to the more advanced stage of periodontitis, the bleeding generally stops as the infection moves deeper under the gums to begin destroying the jawbone.

 

If left untreated, periodontitis will cause teeth to get loose. Teeth will become sore and painful to the touch. Chewing will become uncomfortable. Infection that is around the tooth root could be pushed into the blood system, affecting other areas of the body. These gum infections could also become severe in the mouth resulting in much swelling, bleeding, and odor. Once the structure of the jawbone is significantly destroyed, the only option would be to extract the teeth involved. In addition to mouth problems, gum disease has been associated with many other bodily conditions such as diabetes, pre-term and low-weight babies, heart disease, and many more.

 

There are many causes. The most common is bacteria that get under the gums around the teeth that thrive off of the sugars and refined carbohydrates we eat abundantly everyday. Another cause is the lack of efficient oral hygiene, which includes effective tooth and gum cleaning habits. Additional causes are the health of our digestive system, the nutrients that are in our foods, our stress level, and our genetic predisposition. Frequently, habits like gritting or grinding your teeth, even if you are not aware of this habit, could weaken the jawbone and result in further destruction.

 

You cannot change your genetics, but you can change the quality of foods you eat and your lifestyle, and you can learn to properly clean around your teeth and gums.

 

Those who read my blogs may know that I am a periodontist (gum specialist) with 41 years experience in treating patients with advanced gum disease. I also am licensed in the laser gum treatment called LANAP® (Laser Assisted New Attachment Procedure), which is patient-friendly and involves no cutting with scalpels and no stitches. I have found this to be the best way to treat advanced gum disease. In addition, I am a Certified Functional Medicine Practitioner using this background to guide patients to a healthier diet and lifestyle. Some of my patients decide to complete a 3-Day Food Journal, which allows me to evaluate their eating and lifestyle habits and then to recommend healthier food and lifestyle choices.

 

I offer my patients a Lifestyle Repair Plan, in which I recommend an anti-inflammatory diet, selecting from a host of nutrient-dense foods. These are the foods that have a great deal of nutrients packed into each calorie. My Plan also incorporates changes in lifestyle that are critical for overall health. Included are concepts of health maintenance like Oral Care, Restorative Sleep, Efficient Exercise, and Stress Reduction – concepts that I have summarized into simple and doable steps.

 

My goal for my patients is to treat their active gum infections, teach them methods to maintain a healthy mouth, and assist them with eating and lifestyle changes that could lead not only to a healthier mouth for the rest of their lives but also to a healthier body.