The frequent common denominator for pain, sensitivity, weight gain and more.

In earlier columns we discussed an organized approach to pain. This included the four domains of:

1. Biochemistry (herbals, nutrients and meds)

2. Structural (e.g. chiropractic, osteopathy, massage and myofascial release, etc.)

3. Biophysics (e.g. acupuncture, chakra, FSM, etc.)

4. Mind-body

We also discussed how each of these interact and need to be addressed. As well as how treating any of these impacts all four.

When you have stubborn pain that won’t go away, or which keeps recurring after treatment, addressing pain’s biochemistry can be very helpful. This also has four key components:

1. Muscle Pain: This is predominantly from low energy in the muscles, which causes them to get stuck in the shortened position. Our research shows that the SHINE Protocol powerfully increases muscle energy and decreases pain, using fibromyalgia as a model. A simple and powerful start for this? Optimize micronutrient support, especially vitamins B, C and D; minerals including magnesium, iodine and zinc; and other key nutrients including NAC and amino acids. This can easily be done with a new simple to use yet powerful multinutrient powder called Daily Recharge by EuroMedica.

2. Inflammation: We discussed balancing this easily with herbs (my favorite is a high absorption curcumin and boswellia called Curaphen) and diet.

3. Neuropathy: The link will give a comprehensive natural and pharmaceutical approach to effectively treating neuropathy.

4. Brain Pain: This brain inflammation, called by many names (e.g. microglial activation) is caused by many triggers.

Basically, brain inflammation (microglial activation) will be present in most people who come to see CAM practitioners. Why? Because most physicians are not even aware that this well researched problem exists. Making it impossible for them to treat.

But you can. Easily. I’ll show you how. This will be the focus of this article.

Why Brain Inflammation Matters

In recent years scientists have discovered that many chronic health conditions share a common driver: inflammation in the brain. This brain inflammation is driven by specialized immune cells called microglia. Microglia act as the brain’s gardeners. They patrol the nervous system, clear debris, fight infections and help repair injured tissue.

Under healthy conditions, these microglial “gardeners” are mild mannered. They quietly feed and tend to brain cells.

But sometimes they become overactivated. This is called microglial activation.

This can happen after:

• Viral and other infections—Such as chronic lyme, long COVID and EBV reactivation

• Pain lasting over six weeks- amplifying the pain

• Physical injury—e.g. TBI and other neurologic disorders

• Severe chronic stress

• Chronic autoimmune inflammation in the body (e.g. MS and Lupus)

• Toxin exposures and MCAS

Once activated, microglia release many inflammatory chemicals that can affect nerve signaling, energy production and brain communication. The most helpful treatments often work by calming several of these pathways at once.

Common Problems Caused By This Brain Inflammation (Microglial Activation)

Researchers now believe that excessive microglial activation may contribute to symptoms seen in conditions such as:

• CFS/fibromyalgia/long COVID/chronic lyme

• Weight gain

• Dementia, cognitive dysfunction and neurodegenerative disorders in general

• Chronic pain disorders including neuropathic pain

• MCAS and histamine sensitivity

• POTS

• Neuropsychiatric issues: As the authors note, “Accumulating evidence now implicates aberrant or chronic microglial activation as a central mechanism underlying neuroinflammation-associated behavioral and cognitive disturbances in a wide range of neuropsychiatric disorders, including major depressive disorder, schizophrenia, autism spectrum disorder, posttraumatic stress disorder and attention-deficit/hyperactivity disorder.”

A free five-minute online quiz (https://psytests.org/diag/csiren.html) called the Central Sensitization Inventory (CSI) can screen for microglial activation. Simply hit the begin button on the first two pages (you can ignore the rest) and do the questionnaire. It will give the final score at the end. Easy as can be!

To interpret it:

Mild: 30 to 39

Moderate: 40 to 49

Severe: 50 to 59

Extreme: 60 to 100

Microglial activation is a common denominator for so much of what we see in our CAM practices. Wouldn’t it be nice if it was easy to treat?

Fortunately, a rapidly growing body of research suggests that microglial activation can often be easily calmed or “reset.”

How to Calm Microglial Activation/Brain Inflammation

Below are the approaches that currently have the best combination of:

• Effectiveness

• Safety

• Accessibility

• Affordability

They are listed roughly in order of clinical usefulness.

1. Palmitoylethanolamide (PEA)

PEA is a naturally occurring fatty molecule produced by the body to regulate inflammation.

It helps stabilize immune cells in the brain and reduces inflammatory signaling.

Many clinicians consider it one of the most promising compounds for calming neuroinflammation. The main problem is poor absorption. So, I use PEA Healthy Inflammation Response, which contains natural gamma cyclodextrin to dramatically enhance absorption.

Typical Dosing
600-1,200 mg daily. For severe conditions, such as chronic pain, higher dosing of 1,200 mg daily for one month followed by 1,200 mg, twice a day for two months gives a fair therapeutic trial and may accelerate recovery.

Time to Benefit
Four to 12 weeks

Why it Stands Out
• Excellent safety profile

• Targets multiple inflammatory pathways

• Widely available as a supplement

2. Omega-3 Fatty Acids (Fish Oil)

Omega-3 fats help the body produce PGE3, which actively decreases inflammation. These compounds help shift immune cells from an inflammatory state into a repair mode.

Typical Dosing
2,000-4,000 mg combined EPA + DHA daily

A simper alternative? I use one with vectorized phospholipid forms of omega-3s. This is available as EurOmega 3 and allows one to two caps a day to replace seven to 14 large fish oil caps. I use Vectomega.

Time to Benefit
Four to eight weeks

3. Low-dose Naltrexone

At very low doses, this medication works differently than when used in addiction treatment. It helps regulate immune signaling and can reduce overactivation of microglia.

Many holistic clinicians use it for chronic pain, autoimmune illness and post-viral conditions.

Typical Dosing
1.5-4.5 mg at bedtime

Time to Benefit
Eight weeks

Advantages
• Inexpensive generic medication

• Generally safe and well tolerated though may need to start with very tiny doses and move up slowly.

Good general articles are available for the public on use of LDN and how to titrate dosing.

4. Curcumin

Curcumin is a compound found in turmeric. It helps turn down inflammatory signaling inside cells. It also supports antioxidant defenses in the brain.

Typical Dosing
500-1,500 mg daily of an enhanced-absorption formulation (e.g. CuraPro or two to three Curaphen daily instead if pain is present).

Time to Benefit
Four to eight weeks

Additional Benefits
• Marked pain relief

• Decrease of overall inflammation

5. Melatonin

Melatonin is best known as a sleep hormone, but it also strongly regulates immune signaling in the brain. It can reduce activation of inflammatory pathways and protect mitochondria.

Typical Dosing
3-10 mg at bedtime

Time to Benefit
Two to four weeks

Additional Benefits
Improves sleep, which itself reduces brain inflammation and pain. I use a 10 mg sustained release.

6. Regular Moderate Exercise

Exercise is one of the most powerful natural regulators of inflammation. During activity, muscles release molecules that signal the brain to reduce inflammatory activity.

Recommended Approach
• 20-40 minutes

• Most days of the week

• Moderate intensity

Time to Benefit
Three to six weeks

7. Good Sleep

Deep sleep is when the brain clears inflammatory byproducts and resets immune signaling. Improving sleep quality alone can significantly reduce neuroinflammation.

Key Strategies

• Consistent sleep schedule

• Darkness at night (an eye mask can help sleep quality)

• Reducing evening screen exposure (or switch away from blue to “warmer” night light settings—present in the Kindle and many cell phones)

Putting it All Together

A practical starting strategy to settle brain inflammation/microglial activation often includes:

1. Palmitoylethanolamide

2. Low-dose naltrexone

3. High-absorption curcumin

4. Omega-3s

5. Melatonin (if sleep is poor)

6. Lifestyle factors such as exercise and sleep remain key as well.

After three to six months, if the underlying triggers are also addressed, the treatments can often be weaned.

Bottom line? The benefits for relieving any kind of chronic pain, and the multiple other problems associated with microglial activation, can be dramatic! Give it two to three months to work, though it can be much quicker.

For an easy approach to pain relief, I invite you to read and share my newest book Pain Relief in 4 Simple Steps.

Jacob Teitelbaum, MD is one of the most frequently quoted post viral CFS, fibromyalgia, energy, sleep and pain medical authorities in the world. He is the author of 12 books including his newest Pain Relief- in 4 Simple Steps (3-23-26), You Can Heal from Long Covid, the best-selling From Fatigued to Fantastic!, Pain Free 1-2-3, The Complete Guide to Beating Sugar Addiction, Real Cause Real Cure, The Fatigue and Fibromyalgia Solution, and the popular free Smart Phone app Cures A-Z. He is the lead author of eight research studies and five medical textbook chapters on effective treatment for fibromyalgia and chronic fatigue syndrome. Dr. Teitelbaum appears often as a guest on news and talk shows nationwide, including past appearances on Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN and FoxNewsHealth. www.EndFatigue.com www.Vitality101.com Facebook Support Group: www.facebook.com/groups/recoveringfromfibromyalgiachronicfatigueand Instagram: www.instagram.com/jacobteitelbaummd/