Supplements for Pain & Healing with PRP & Stem Cells

Samuel G Oltman, ND, RMSK

What supplements are best to take to help joint pain and optimize the stem cell and PRP treatments we do here at Cascade Regenerative Medicine? Supplements can play an important role in achieving optimal health but they are always “supplemental” to good food, movement, and quality rest. 

Less Is More

My overall philosophy is: less is more. It’s easy to recommend a list of 20 supplements and justify it with the supposed marginal benefit of each one. But this is not efficient nor cost effective. I look for “high leverage” opportunities where 0-3 supplements can do the most good and find the remaining benefits in diet, lifestyle, and movement. 

Scientific Evidence Bias

The evidence for individual supplements varies. The misleading take you hear from a lot of conventional medicine is “supplements don’t work” or “supplements don’t have any good evidence” as if supplements are one thing. It’s like saying “pharmaceuticals don’t work”. Which ones? For what? For who? When? 

Often when you read negative articles on supplements in mainstream medical outlets the headline will be misleading. For example, a study will look at the use of multivitamins and they find no benefit and then the headline is “supplements don’t work”. But what they studied was a multivitamin specifically, and what is meant by “work”?. Or the conclusion is “supplements are dangerous” and this is based on a case report on a single person who took a completely unreasonable amount of a single herb and got sick, as though that represents a normal dosing pattern or general use case. There are plenty of supplements that have been found to be ineffective but this should not be generalized to an entire category. 

There are mountains of positive evidence for specific supplements in specific situations. Like with everything in medicine, more robust evidence is desirable. But there is ample evidence to support the use of certain supplements for specific conditions.

Feel The Difference

You may not feel anything different after starting a supplement, and that may not be the point. With some supplements, the point of taking it is to feel some difference after taking it– that is the case with most of the things I recommend because in almost all my patients we’re treating some aspect of pain, a fundamentally subjective experience. So, when you take magnesium, you feel less pain and tightness.

But keep in mind that there are other situations, just like with pharmaceuticals, where taking a supplement will not make you feel any different and that doesn’t mean it’s not working. 

When I recommend melatonin, it’s for stem cell activity, something you don’t feel. When people are given statins, you don’t feel your cholesterol levels go lower. When you take an osteoporosis drug you don’t feel your bones getting denser. 

Supplement Quality

One of the biggest issues in the supplement industry is quality variations between brands. This is a product of the supplement space not being regulated by a body like the FDA so you don’t always know what you’re getting. I think it is a good thing overall to not be regulated by the FDA, but the downside that comes with that is a large variation in quality. There have been many studies showing OTC supplements do not even contain most of what the label claims. 

The way around this is simply by trusting the brand. It’s not a perfect system but it is the best work around. The brands I recommend have been quality-vetted by me personally. Generally, getting bargain supplements means you get even less than what you pay for. What you pay for with quality supplements is high-grade testing and quality assurance so you know you’re getting what you pay for. 

Supplements We Carry In Office

In my practice, my supplements focus on 2 main goals: pain reduction and promoting the healing process. These 2 goals obviously intersect, as healing leads to pain reduction in most cases, but they are distinct goals.  

MUSCLE

Magnesium glycinate lessens muscles soreness and tightness from long-term guarding patterns common with chronic pain. It’s probably the most common supplement I recommend. Magnesium deficiency is quite common and most of us don’t get enough magnesium in our diets due to soil depletion (1,2). 

RELIEF

Boswelia is a botanical medicine useful for decreasing inflammation. I find that it works better for musculoskeletal pain than curcumin alone and can be more effective than NSAIDs without the side effects. Curcumin is the most common herbal antiinflammatory but it works better when combined with Boswelia. The formula we carry is a combination of the two (3). 

JOINT

The evidence for glucosamine is not very robust when it comes to osteoarthritis pain. The evidence is stronger for chondroitin, and best for MSM. Joint formulas with these ingredients are aimed at healing and preserving cartilage, while also lowering pain levels. The forumla we carry contains glucosamine, chondroitin, MSM, and green-lipped mussel (containing high amount of GAGs that improve joint function) (4,5). 

CELL

Melatonin is known as a sleep aide but it also help stem cell survival and promotes stem cell renewal. I recommend a small does to all my patients who do stem cell therapy (6). 

RESOLVE

Fish oil decreases muscle soreness. The fish oil I recommend is a high-concentration extract specifically for inflammation. I recommend it in cases of swelling like bursitis. If you eat fish regularly (more than 3 times per week), fish oil supplements have less of a beneficial effect because you’re already getting the nutrients in your food (7). 

COLLAGEN

Choline stabilized orthosilicic acid is a building block of collagen and taking it can improve bone density, skin appearance, hair growth, and preserve cartilage in osteoarthritis (8). 

NERVE

We carry a nerve formula that contains magnesium, l-theanine, inositol and a few other ingredients. L-theanine is the anti-oxidant found in green tea and has been shown to help with nerve pain. Inositol has been shown to improve nerve function in neuropathy. Taken together, this is something I recommend for patients with nerve pain like sciatica or carpal tunnel syndrome to help with nerve-specific inflammation (9, 10). 

By keeping it simple most people can benefit from a couple of well-picked supplements. Often none is the right answer. A super long list is rarely necessary. But keep in mind that they should “supplement” a healthy diet, regular movement, and deep rest. A full supplement review is done with every new patient here at Cascade Regenerative Medicine to ensure that you’re taking what you need to and not taking what you don’t have to. See the difference and schedule with us today.

References:

1. Reno AM, Green M, Killen LG, O’Neal EK, Pritchett K, Hanson Z. Effects of magnesium supplementation on muscle soreness and performance. J Strength Cond Res. 2022;36(8):2198-2203.

2. Workinger JL, Doyle RP, Bortz J. Challenges in the diagnosis of magnesium status. Nutrients. 2018;10(9):1202.

3. Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2020;20(1):225.

4. Toguchi A, Noguchi N, Kanno T, Yamada A. Methylsulfonylmethane improves knee quality of life in participants with mild knee pain: a randomized, double-blind, placebo-controlled trial. Nutrients. 2023;15(13):2995.

5. Abshirini M, Coad J, Wolber FM, et al. Green-lipped (GreenshellTM) mussel (Perna canaliculus) extract supplementation in treatment of osteoarthritis: a systematic review. Inflammopharmacology. 2021;29(4):925.

6. Hardeland R. Melatonin and the programming of stem cells. International Journal of Molecular Sciences. 2022;23(4):1971.

7. VanDusseldorp TA, Escobar KA, Johnson KE, et al. Impact of varying dosages of fish oil on recovery and soreness following eccentric exercise. Nutrients. 2020;12(8):2246.

8. Geusens P, Pavelka K, Rovensky J, Vanhoof J, Berghe DV. Sat0441 effect of choline-stabilized orthosilicic acid on symptoms of knee osteoarthritis in a randomized, double-blind, placebo-controlled trial. Annals of the Rheumatic Diseases. 2014;73(Suppl 2):753-754.

9. Yang CC, Wang MH, Soung HS, et al. Through its powerful antioxidative properties, l-theanine ameliorates vincristine-induced neuropathy in rats. Antioxidants. 2023;12(4):803.

10. Salway JG, Whitehead L, Finnegan JA, Karunanayaka A, Barnett D, Payne RB. Effect of myo-inositol on peripheral-nerve function in diabetes. Lancet. 1978;2(8103):1282-1284.