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Oxytocin and Pain By Jorge D. Flechas MD, MPH 80 Doctors Drive Ste # 3 Hendersonville, NC, 28792 877-900-5556 877-900-5556.

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Presentation on theme: "Oxytocin and Pain By Jorge D. Flechas MD, MPH 80 Doctors Drive Ste # 3 Hendersonville, NC, 28792 877-900-5556 877-900-5556."— Presentation transcript:

1 Oxytocin and Pain By Jorge D. Flechas MD, MPH 80 Doctors Drive Ste # 3 Hendersonville, NC, 28792 877-900-5556 877-900-5556

2 Introduction of Pituitary Gland. In vertebrate anatomy the pituitary gland, or hypophysis, is an endocrine gland about the size of a pea and weighing 0.5 g (0.02 oz.). It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity (sella turcica) covered by a dural fold (diaphragm sellae). The pituitary fossa, in which the pituitary gland sits, is situated in the sphenoid bone in the middle cranial fossa at the base of the brain. The pituitary gland secretes hormones regulating homeostasis, including tropic hormones that stimulate other endocrine glands. It is functionally connected to the hypothalamus by the median eminence via a small tube called the Pituitary Stalk. It is considered to be the "master gland".

3 Pituitary: The Master Gland The pituitary, a pea-sized gland at the base of the brain, produces a number of hormones, each of which affects a specific part of the body (a target organ or tissue). Because the pituitary controls the function of most other endocrine glands, it is often called the master gland. Hormone Target Organ or Tissue Adrenocorticotropic hormone (ACTH) Adrenal glands Antidiuretic hormone Kidney, Brain memory (hippocampus) Beta-melanocyte–stimulating hormone Skin Endorphins Brain and immune system EnkephalinsBrain Follicle-stimulating hormone Ovaries or testes Growth hormone Muscles and bones Luteinizing hormone Ovaries or testes Oxytocin Uterus and mammary glands (social memory, control fear) Prolactin Mammary glands Thyroid-stimulating hormone Thyroid gland

4 Estrogen stimulates the making of Oxytocin Oxytocin in Human Plasma: Correlation with Neurophysin and Stimulation with Estrogen* * J. Amico et. al. 1981 oxytocin in men was 1.80 ± 0.07 μU/ml and normal women (1.71 ± 0.07 μU/ml). In women chronically receiving estrogen as an oral contraceptive, oxytocin was greater than normal, (4.59 ± 0.51 μU/ml; P < 0.01). Estrogen–stimulated neurophysin was also elevated (8.45 ± 1.99 ng/ml; P < 0.005). Acute ingestion of estrogen caused an increase in the level of oxytocin in plasma by 12 h and a concomitant elevation of estrogen stimulated neurophysin



7 Oxytocin and AVP Frontiers in Neuroendocrinology Vol. 25, Issues 3-4, September–December 2004, Pages 150–176 Vasopressin and oxytocin release within the brain: a dynamic concept of multiple and variable modes of neuropeptide communication Rainer Landgrafa Inga D. Neumann

8 Oxytocin and Pain There has been reported in the medical literature that giving oxytocin IV can get rid of migraine headaches. Phillips, WJ Relief of acute migraine headache with intravenous oxytocin: report of two cases. J Pain Palliat. Care Pharmacother. 2006; 20 (3): 25-8

9 Oxytocin and Pain CONCLUSIONS: Plasma oxytocin level is low in patients with abdominal pain of psychosomatic origin and inflammatory bowel disease. Measurement of plasma oxytocin may be of some help in the differential diagnosis of recurrent abdominal pain, but does not differentiate between psychosomatic abdominal pain and pain associated with inflammatory bowel disease. Alfven, G Plasma oxytocin in children with recurrent abdominal pain. : J Pediatr Gastroenterol Nutr. 2004 May;38(5):513-7.

10 Oxytocin and Pain CONCLUSIONS: Oxytocin significantly increases thresholds for visceral perception in IBS patients at doses equal or to greater than 20 mU/min, possibly by acting at the level of visceral afferents. Louvel D, Delvaux M, Felez A, Fioramonti J, Bueno L, Lazorthes Y et al. Oxytocin increases thresholds of colonic visceral perception in patients with irritable bowel syndrome. Gut 1996; 39(5):741-747.

11 Oxytocin and Pain Oxytocin has been given to get rid of back pain in a study done by the Chinese in human subjects. STUDY DESIGN: The effect of oxytocin on low back pain in patients and its mechanism in rats were investigated.

12 Oxytocin and Pain CONCLUSIONS: These results suggest that oxytocin induces analgesia in low back pain involving the endogenous opiate peptide system and may be effective and safe in acute and chronic low back pain.. Yang J. Intrathecal Administration of Oxytocin Induces Analgesia in Low Back Pain Involving the Endogenous Opiate Peptide System. Spine 1994; 19:867-871.

13 Oxytocin has been found low in: Depression (Evans J. 1997) Autism (Panksepp 1993; Panksepp J. 1993, Schulkin 2007) AIDS (Purba et al. 1993) Multiple Sclerosis (Moller et al. 1985) Low Estrogen states (Amico et al. 1981) Low Thyroid T3 (Argiolas et al. 1990) Chronic Stress Situations (Panksepp 1992; Kalin et al. 1985; Argiolas et al. 1990) Chronic Opioid Use (Greidanus Van Wimersma & Ten Haaf 1985; Greidanus Van Wimersma & Ten Haaf 1985) Prader Willi Syndrome (Evans J. 1997) Parkinsons (Evans J. 1997) Fibromyalgia (Anderberg UM 2000)

14 FM and Oxytocin n=18 10 units given with ¼ cc of lidocaine IM bid or 10 units per tablet 1-5 tablets per day Muscle pain decrease p=.0002 Joint pain decreased p=.0003 Joint swelling decreased p=.002 Fibromyalgia Impact Questionnaire before treatment score 55.6 after treatment 30.9 P=.0000003

15 Oxytocin-Nitroglycerin Biologic Functional Probe At the time of an office visit Oxytocin injectable 20% of patient blush NOTE: no blushing with oxytocin is usually due to lack of DHEA and a defective phosphytylinositol pathway If no blush: give nitroglycerin.3mg ½ tablet sublingual 53 % will blush 27% do not blush due to lack of sulfa in the body.

16 Oxytocin and Orgasm Oxytocin makes you much warmer due to vasodilation and it being exothermic. It can be given in the office to see if operational by vasodilation of ears. In men it will make them sleepy and loss of interest in sex after orgasm due to increase production of prolactin. In women the sex desire goes up and will not go away until it is satisfied!!!!!!!!

17 Oxytocin Stimulates making Nitric oxide: vasodilation of ears

18 Oxytocin Vasodilator test To 10 units of oxytocin add ¼ cc of lidocaine. Give IM after signing consent to let patient know what you are doing. Patients ears should turn red in 5 min. They should also become warm and feel relaxed. They will not have a orgasm. If no response look for reason: such as high prolactin, drug inhibition, lack of DHEA or Testosterone etc….

19 Oxytocin-Nitroglycerin Biologic Functional Probe If the injection of oxytocin induces a headache consider a obstruction of the foramen magnum by the cerebellar tonsils Which can be either a Chiari Malformation or a Hypoplastic Posterior Fossa

20 Oxytocin and Headache

21 Oxytocin and Head pressure

22 Oxytocin and Sex A injection of oxytocin in the medical office may sexually turn on a woman within about 1 hour. In America 1 in 4 women has been sexually assaulted. The oxytocin injection may bring back some very strong sexual feelings that she may be wanting to forget.

23 Oxytocin and FM Sexual activity 13 % of American women are mutiorgasmic Of my patients taking oxytocin for FM pain 53 % have become mutiorgasmic

24 FM pain and Iodine Go to and look at the iodine research articles, there you will find a medical article about a patient with FM who was given iodine due to a defect in iodine absorption at the cellular level. With iodine repletion her muscle pain went away. I have seen the same multiple times as we give iodine to get rid of FBD pain and see the body muscle pain go away also

25 FM pain and iodine Body iodine: 3 % in the thyroid 20 % in the skin 32 % in the muscle 35 % in the fat 10 % rest of body

26 FM pain and iodine Lack of iodine in thyroid you get: goiter Cyst, nodule, enlargement, scar tissue Low iodine in the breast : add pain Low iodine to the ovary: add pain Low iodine to the skin: add no sweating Low iodine to the muscles: no cyst Low iodine during fetal life: low IQ, ADD, Cretin

27 FM and oxytocin Why does oxytocin work: It is known that oxytocin stimulates the NIS system of cellular absorption of iodine. Oxytocin is a pain kill in its own right working at the CNS level and modulating sensation input at the dorsal horn neuclous of the spinal cord. With no oxytocin made in the body of children with autism, I frequently see muscle pain present with these children.

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