Working with Your Doctor to Cure CRPS
Stephen L. Smith M.D.
CRPS is a treatable condition despite what you may have heard. This CRPS treatment is not focused on the pain, but the underlying cause of the pain. Having successfully treated a number of patients with CRPS. I started noticing a pattern. The pattern is not based on symptoms, but on physiology and pathology. Here are the general findings:
1. Low Glutathione – glutathione is the primary detoxifier for the body. If we don’t have enough of it in times of stress than we can get very depleted and stuck in a pattern of chronic illness.
2. Lymphedema – The area affected has stagnant lymph trapping toxins in the area. This, in turn, causes an immune response and increased inflammatory cytokine response. The increased cytokines cause even more inflammation and we have a self-sustaining positive feedback loop. We call this condition CRPS.
3. Genetic Markers – All of the patients I have seen have had abnormalities in certain enzymes controlling the production of glutathione.
Your physician can help by ordering the appropriate laboratory tests and administering IV glutathione.
Laboratory Tests Recommended
1. Glutathione Level – European Laboratories is the recommended lab. The test is Glutathione oxidized and reduced. The cost is less than $200.00. You will need to order the kit and then go to your local laboratory to have it processed. Your physician may have to order the test and the kit for you.
2. GI Panel if there are any GI complaints. The gut is a source of the inflammation in the body. There are several laboratories that offer a good evaluation of the GI tract. Genova Diagnostics offers a full spectrum of functional testing. The Genova GI Effects is the test we use to evaluate bowel function. Most naturopathic physicians are quite familiar with treating bowel inflammation.
3. Genomic Profile – 23andme offers an affordable profile for $99.00. The raw data obtained in the Ancestry profile can be uploaded to a number of companies offering an analysis of the data, which is of very limited use in its raw form. Livello is the one I use, but there are several companies offering similar services: Genetic Genie, Promethease, PureGenomics, Athletigen, and several more. A table comparing the various services can be found at Xcode.life.
To treat this condition, glutathione levels need to increase, which is easy to do with either oral supplements or an IV push of glutathione. However, raising glutathione will also cause the excretion of more toxins into the extracellular space, which is already overloaded with toxins. Sounds like a catch 22 and it is. Before we can start raising glutathione levels significantly, we first need to start clearing the lymphatic space by treating the lymphedema. The viscosity of the lymphatic fluid can be lowered by using proteolytic enzymes to break down larger proteins in the space and by using herbs and homeopathics to improve lymphatic flow. Once this is accomplished, the next step is to slowly increase glutathione levels. This best accomplished with an IV glutathione push. A glutathione push is a simple IV made up of glutathione and sterile water mixed in equal parts in a 60 ml syringe and administered with IV push using a butterfly to obtain IV access. The whole process takes less than 10 minutes. This requires a licensed physician or naturopath to administer. Immediately following the IV toxins in the liver will be mobilized and are excreted into the bile within a few minutes after the IV is administered. Some of the toxins released will be reabsorbed by the small intestine if a binding agent is not given at the time of the IV to block reabsorption of toxins. Charcoal capsules should be taken at the time of the IV and again 3 hours later to block this reabsorption. After 5 days the effects of IV glutathione are worn off.
The general rule of detoxification is the drainage (clearing of toxins) should always exceed the detoxification rate. If this rule is not followed the IV will cause toxic side effects such as fatigue and body ache. If this occurs, then the dose of IV glutathione needs to be reduced. Conversely, if no side effects are experienced, the IV glutathione dose may be increased. A starting dose of 500 mg is usually safe and can be increased in 500mg increments with each subsequent IV until a dose of 3,000 mg of glutathione is reached. If side effects occur then just drop back to the next lower dose for a couple of IVs before trying to progress again.
It is not unusual to see pain levels drop in half the day after a glutathione IV and then slowly increase as the glutathione wears off. These glutathione IVs will reduce the overall toxic load and gradually break the pain feedback loop.
Reactive scars may be responsible for the dysfunction of the regional autonomic nervous system. The scars can act as a capacitor storing electrical energy, which in turn disrupts normal autonomic nerve function. Reactive scars can be treated by an injection of local anesthetic down the length of the scar or by scar cream and preferably both. If the scar is causing an issue the injection is usually quite painful for a few minutes after the injection as the injection releases the electrical charge.
It is difficult to see improvements in your health if you consume an unhealthy diet. A smart step is enlisting the help of a dietician. However, most patients will benefit from increasing the number of fresh fruits and vegetables in their diet and reduce the amount of meat and grains in the diet. Eliminating dairy is especially important because dairy products tend to clog up the lymphatic system and produce excess mucus. It is no surprise to learn the dairy consumption is associated with increased rates of lymphoma. Juicing is the fastest way to increase the number of antioxidants and enzymes in your diet. I recommend masticating juicers like the Slowstar as they are more efficient and don’t damage the juice. Hidden gluten intolerance is common, so eliminating gluten may also be helpful. Once the CRPS is under control you may be able to broaden your diet, but in the beginning, it is best to eliminate all potential sources of inflammation from your diet.
The key supplements are proteolytic enzymes Enzyme Defense to thin the stagnant lymph, homeopathics to improve lymphatic function, and absorbable glutathione supplement. We start with Recancostat and push the dose until we reach 1,200 mg a day or get side effects from excessive detoxification. Chlorella is also helpful in binding and removing toxins from the system. The product we recommend is Chlorella Caps made by Biotics. Biotics Detox Packs are also an excellent choice as they are a complete detox solution that comes in daily packs.