Polyamines, A Route For Reducing Pain Through Diet?
Manipulating the diet to help reduce chronic pain symptoms remains an attractive option. However, to date there is a paucity of research on the topic. A previous article of mine addressed the key literature around low back pain and diet. However, recent research has hinted at a potential role for manipulating the polyamine content of the diet in improving chronic pain symptoms.
The polyamines are spermine, spermidine, and putrescine. They are biogenic amines, similar in structure to the biogenic amine neurotransmitters, histamine, serotonin, dopamine, epinephrine and norepinephrine. The main sources of polyamines are diet and gut bacterial metabolism. They play an important role in growth, maintenance and function of normal cells (Moinard et al 2005).
Simonnet et al (2013) theorise that by positively modulating the excitatory glutamate/N-methyl-d-aspartate receptor (NMDA-R), polyamines could facilitate central pain sensitization. Indeed rats fed a diet with a 10-fold increase in polyamine content exhibit central sensitisation (Simonnet et al 2013).
Experiments feeding rats a polyamine deficient diet have gleaned promising results. Namely they have shown reduced pain sensitivity and improved response to opioids (Simonnet et al 2013). The earlier work of the same group (Rivat et al 2008) found that a polyamine deficient diet reduce pain hypersensitivity from incision, inflammation and neuropathic origin.
Given that polyamines have a role in wound healing it may be that in the acute phase a higher level of polyamines in the diet may be preferable (Moinard et al 2005). In the chronic stage, a polyamine deficient diet may be preferable. However, Simonnet et al (2013) have suggested that there may be a role for a polyamine deficient diet initially to reduce the propensity for progression to central sensitisation. It should be noted that the major work in this area has come from the same group who are marketing a low polyamine food supplement. Nonetheless there published work is highly interesting.
If looking to trial this information clinically, high polyamine foods to minimise or exclude are cheese, beer, processed meats, citrus fruits, tomatoes, peas, potatoes, and sauerkraut (Zoumas-Morse et al 2007). A guide for choosing foods to form a low polyamine diet can be found here http://medical-nutrition.nutrialys.fr/wp-content/uploads/2011/09/Guide_to_Foodstuff_Low_Polyamine_Content.pdf.
Moinard, Luc Cynober, Jean-Pascal de Bandt 2005. Polyamines: metabolism and implications in human diseases Christophe Clinical nutrition, 24 (2), 184-197.
Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. The Biogenic Amines. Available from: http://www.ncbi.nlm.nih.gov/books/NBK11035/
Rivat, Cyril, et al. 2008. “Polyamine deficient diet to relieve pain hypersensitivity.” Pain 137 (1), 125-137.
Simonnet, G. Laboureyras, E. Sergheraert, L. 2013. Polyamine deficient diet: A nutritional therapy for relieving abnormal and chronic pain, PharmaNutrition, Available online; http://dx.doi.org/10.1016/j.phanu.2013.06.001.
Zoumas-Morse, C., Rock, C. L., Quintana, E. L., Neuhouser, M. L., Gerner, E. W., & Meyskens Jr, F. L. 2007. Development of a polyamine database for assessing dietary intake. Journal of the American Dietetic Association, 107 (6), 1024-1027.