Acetaminophen patient education and substituting a three-herb combination that surpasses the drug for safety and pain relief
With one-third of adults suffering needlessly, pain is likely part of everyday life in your practice. Working with patients to help them reduce their pain safely and effectively — especially when they are away from your office — is a challenge. Acetaminophen patient education is a must for or anyone dealing with acute pain, as the temptation to find quick answers for pain relief is understandably overwhelming.
Fortunately, a combination of curcumin, boswellia and black sesame seed oil has been shown to be as fast-acting and effective as over-the-counter acetaminophen — but without the negative effects.
Black sesame oil
One of the deciding factors in the combination’s strong response is black sesame seed oil.
Curcumin and boswellia are already well-established as pain-fighting herbs. Curcumin fights COX-2 inflammation and modulates virtually every other inflammatory pathway as well. It has been used for reducing delayed-onset muscle soreness, relieving rheumatoid arthritis symptoms, and alongside boswellia, has shown excellent effects for individuals with osteoarthritis. Boswellia works primarily through the 5-LOX inflammatory pathway, making it a good partner to curcumin for pain relief.1,2
But emulsifying these two herbs in black sesame seed oil made a distinctive difference for the speed of relief and the patients’ states of mind. In part, that’s not a surprise. Sesame seed oil has anti-inflammatory actions that have been recognized in Ayurvedic practice and in scientific and clinical research. The botanical’s compounds reduce the activity of TNF-a, an inflammatory cytokine recognized as a prime culprit behind the joint damage of rheumatoid arthritis (RA).3 Other scientific studies show that sesame seed compounds can help increase type II collagen and prostaglandins and prevent the breakdown of joint-supporting fatty acids.4-6
Clinical research and results
In clinical research, sesame seed supplementation alone reduced inflammatory markers, decreased pain scores, and relieved symptoms for patients with knee osteoarthritis.7,8
But aside from its anti-inflammatory power, sesame seed also helps other nutrients including vitamin E tocopherols, vitamin C and vitamin K absorb more effectively.9.10 And these traits are what attracted researchers to choose black sesame seed oil (which contains higher levels of beneficial lignans phenolic compounds than white sesame seeds) when developing a pain-relieving combination.11
As I mentioned, curcumin from turmeric and boswellia are two well-established pain fighters, so it’s no surprise that researchers wanted to include them in a formulation to battle acute pain. The clinical trial found some fascinating results.
First, the combination was just as effective, and essentially just as fast, as acetaminophen for reducing pain — about an hour on average. In fact, the results regarding the relief of pain intensity and magnitude were so close as to be negligible in their differences.11
That alone is reason to celebrate, because even though acetaminophen (one brand name is Tylenol) is available everywhere, it isn’t benign or necessarily safe, requiring acetaminophen patient education on the part of the doctor. The numbers tell a frightening story.
Acetaminophen patient education for a dangerous drug
Tracking reports from 2008-12, there was an average of more than 100,000 calls per year to poison control centers in the United States due to acetaminophen. About 67% of those calls were because of unintentional poisoning, that is, most people were simply trying to relieve pain, and didn’t realize the danger of acetaminophen overdose or buildup.12
Acetaminophen also dramatically lowers levels of glutathione — one of the key health-promoting antioxidants made in the human body.13,14
But what’s also interesting about this study was that the combination of curcumin, boswellia and black sesame seed oil also reduced the negative emotional aspects of pain 8.5 times better than acetaminophen.11 This is an extremely important aspect of pain relief.15,16 After all, a person’s state of mind is critical for any type of healing. And acetaminophen has some potentially disturbing side effects on that front.
There is a growing body of research that acetaminophen reduces a person’s capacity to feel empathy for another’s pain or joy. In fact, due to the way it works in the brain, some researchers have called acetaminophen a “social analgesic” because it cuts off the ability to socially connect at a basic, human level with other people. When you consider that over 600 medicines include acetaminophen, it creates a frightening picture of the way this drug can emotionally separate us from one another and points to the need for acetaminophen patient education.17-19
The emotional factor is a major piece of the pain-fighting puzzle. Additionally, when you consider the stress, fatigue, and literal social isolation that many of your patients have endured over the past couple of years, there is even greater urgency behind finding and recommending a different approach.
New pain-relief promise
Curcumin, boswellia and black sesame seed oil show the great promise of botanicals for safe, fast and effective pain relief. To take it a step further, these ingredients are potentially even more efficacious if the curcumin is blended with turmeric essential oil for enhanced absorption (another clinically proven innovation) and if the boswellia is standardized for higher levels of acetyl-11-keto-beta-boswellic acid (AKBA), one of the herb compounds most recognized for fighting 5-LOX inflammation.
These herbs can make an excellent addition to your patients’ regimens following acetaminophen patient education that truly rival over-the-counter options. The synergy of these time-tested botanicals using leading-edge science provides perfect support to your thoughtful guidance and professional treatment.
JACOB TEITELBAUM, MD, is one of the most frequently quoted integrative medical authorities in the world. He is the author of the best-selling “From Fatigued to Fantastic!, Diabetes Is Optional, Pain Free, 1,2,3!, the Beat Sugar Addiction Now!” series, “Real Cause Real Cure, The Fatigue and Fibromyalgia Solution,” and the popular free smartphone app, Cures A-Z. He is the lead author of seven studies on effective treatment for fibromyalgia and chronic fatigue syndrome, and a study on effective treatment of autism using NAET. He appears often as a guest on news and talk shows nationwide, including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health. Learn more at vitality101.com.
- Chandran B, Goel A. A Randomized, Pilot Study to Assess the Efficacy and Safety of Curcumin in Patients with Active Rheumatoid Arthritis. Phytother Res. March 9, 2012 doi: 10.1002/ptr.4639.
- Antony B, Kizhakedath R, Benny M, Kuruvilla BT. Clinical Evaluation of a herbal product (Rhulief™) in the management of knee osteoarthritis. Abstract 316. Osteoarthritis Cartilage. 2011;19(S1):S145-S146.
- Khansai M, Phitak T, Klangjorhor J, et al. Effects of sesamin on primary human synovial fibroblasts and SW982 cell line induced by tumor necrosis factor-alpha as a synovitis-like model. BMC Complement Altern Med. 2017 Dec 13;17(1):532.
- Phitak T, Pothacharoen P, Settakorn J, Poompimol W, Caterson B, Kongtawelert P. Chondroprotective and anti-inflammatory effects of sesamin. Phytochemistry. 2012 Aug;80:77-88.
- Khansai M, Boonmaleerat K, Pothacharoen P, Phitak T, Kongtawelert P. Ex vivo model exhibits protective effects of sesamin against destruction of cartilage induced with a combination of tumor necrosis factor-alpha and oncostatin M. BMC Complement Altern Med. 2016 Jul 11;16:205.
- Srisuthtayanont W, Pruksakorn D, Kongtawelert P, Pothacharoen P. Effects of sesamin on chondroitin sulfate proteoglycan synthesis induced by interleukin-1beta in human chondrocytes. BMC Complement Altern Med. 2017 May 31;17(1):286.
- Eftekhar Sadat B, Khadem Haghighian M, Alipoor B, Malek Mahdavi A, Asghari Jafarabadi M, Moghaddam A. Effects of sesame seed supplementation on clinical signs and symptoms in patients with knee osteoarthritis. Int J Rheum Dis. 2013 Oct;16(5):578-82.
- Khadem Haghighian M, Alipoor B, Malek Mahdavi A, Eftekhar Sadat B, Asghari Jafarabadi M, Moghaddam A. Effects of sesame seed supplementation on inflammatory factors and oxidative stress biomarkers in patients with knee osteoarthritis. Acta Med Iran. 2015;53(4):207-13. PMID: 25871017.
- Hanzawa F, Nomura S, Sakuma E, Uchida T, Ikeda S. Dietary sesame seed and its lignan, sesamin, increase tocopherol and phylloquinone concentrations in male rats. J Nutr. 2013;143(7):1067–1073. doi:10.3945/jn.113.176636
- Ikeda S, Abe C, Uchida T, Ichikawa T, Horio F, Yamashita K. Dietary sesame seed and its lignan increase both ascorbic acid concentration in some tissues and urinary excretion by stimulating biosynthesis in rats. J Nutr Sci Vitaminol (Tokyo). 2007;53(5):383–392. doi:10.3177/jnsv.53.383
- Rudrappa GH, Chakravarthi PT, Benny IR. Efficacy of high-dissolution turmeric-sesame formulation for pain relief in adult subjects with acute musculoskeletal pain compared to acetaminophen: A randomized controlled study. Medicine (Baltimore). 2020;99(28):e20373.
- Major JM, Zhou EH, Wong HL, et al. Trends in rates of acetaminophen-related adverse events in the United States. Pharmacoepidemiol Drug Saf. 2016;25(5):590-598. doi:10.1002/pds.3906 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676300/
- Subramanya SB, Venkataraman B, Meeran MFN, Goyal SN, Patil CR, Ojha S. Therapeutic Potential of Plants and Plant Derived Phytochemicals against Acetaminophen-Induced Liver Injury. Int J Mol Sci. 2018;19(12):3776. Published 2018 Nov 28. doi:10.3390/ijms19123776
- Smith GJ, Cichocki JA, Manautou JE, Morris JB. Acetaminophen at low doses depletes airway glutathione and alters respiratory reflex responses. FASEB, 2013; 27: 1107.4
- Vallath N, Salins N, Kumar M. Unpleasant subjective emotional experiencing of pain. Indian J Palliat Care. 2013;19(1):12-19.
- Löffler M, Kamping S, Brunner M, et al. Impact of controllability on pain and suffering. Pain Rep. 2018;3(6):e694. Published 2018 Oct 22. doi:10.1097/PR9.0000000000000694
- Mischkowski D, Crocker J, Way BM. A Social Analgesic? Acetaminophen (Paracetamol) Reduces Positive Empathy. Front Psychol. 2019;10:538. Published 2019 Mar 29. doi:10.3389/fpsyg.2019.00538
- Tully J, Petrinovic MM. Acetaminophen study yields new insights into neurobiological underpinnings of empathy. J Neurophysiol. 2017;117(5):1844-1846. doi:10.1152/jn.00723.2016
- Mischkowski D, Crocker J, Way BM. From painkiller to empathy killer: acetaminophen (paracetamol) reduces empathy for pain. Soc Cogn Affect Neurosci. 2016;11(9):1345-1353. doi:10.1093/scan/nsw057