Hydromorphone (dilaudid) not interact with CYP-450 enzyme system, but rather metabolized by another pathway. Many patients w. EDS have defective CYP-450 metabolism, a genetic trait, so the active metabolites of other opiates are underproduced, resulting in ineffective analgesia. t.co/Hr0vn5P7GT
Dr. Tenant demonstrated many of the more widely promoted (by doctors) analgesics like hydrocodone (Norco) are metabolized by CYP-450 enzymes & in many people there are genetic defects (CYP-2D6, CYP-2C9, CYP-2C19) that ineffectively generate the active metabolite, w. ill results.
Doctors are mostly ignorant of these enzyme dynamics. When patients complain of ineffective analgesia, doctors assume the patient is “drug seeking”. Once branded, the patient commonly finds resistance vs. opiates from other doctors who review the medical record.
A problem in patients with pain generated in soft tissues is that blood tests & imaging studies do not reveal the pain generators, which are often inflamed entheses, loci where soft tissues (ligaments & tendons) attach to bone.
IMO, etiology of inflamed entheses is chronic biomechanical stress on soft tissues attempting to hold the body together & upright within the ambient gravitational field. Lose joints (injuries & inheritance) affect this ability. Weak muscles from sedentary inactivity are complicit
Cortisone & local injectable anesthetics can provide a few days or weeks of respite, but in #HSD patients there are frequently too many (myriad) inflamed loci to treat. This is where opiates become useful to allay pain so patients can rehabilitate.
Rehabilitation requires physical therapies to reduce (massage) muscle spasms, correct (exercise) crossed muscle syndromes, tonify (aqua therapy & walking) muscles of upright posture, and correct joint subluxations (Prolotherapy).
The general rehabilitation concept is to strengthen & stabilize the body tower. Efforts also need to be made to reduce body tower mass with a Paleolithic style ketogenic diet that is low carbohydrate high fat (LCHF).
CONCLUSIONS: Meat is good. Analgesics help rehabilitation efforts.
Share this Scrolly Tale with your friends.
A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.