***This 3 part article series is from a deep-dive video I made on chronic pain, inflammation, common pain meds and curcumin. Click here to watch the DEEP DIVE video (49 min) or click here to watch the shorter (6 min) video***
[Disclosure: Some of the links below are affiliate links, meaning, at no additional cost to you, I will earn a small commission if you click through and make a purchase]
Remember, you’re not what you eat, you’re what you absorb. We’ve already mentioned how a black pepper extract (piperine) increases curcumin bioavailability by 2000%.
Image Source: https://recipes.timesofindia.com/articles/food-facts/turmeric-and-black-pepper-can-do-magic-together/photostory/67437291.cms
By itself, piperine actually works in similar ways as curcumin, as an antioxidant and inflammatory cell signaling regulator. A trademarked version of piperine, BioPerine, is a source of piperine that’s undergone clinical studies in the U.S. to substantiate its safety and efficacy for nutritional use. BioPerine is 95-99% pure piperine. Remember, piperine and BioPerine are concentrated extracts and are not the same as regular black pepper. The regular kind of black pepper that you probably have in your kitchen at home is only 3-9% piperine. 
One of my favorite curcumin products is made by Sports Research. Their 500mg turmeric extract softgels contain 95% curcuminoids, or 475mg curcuminoids per softgel. Each softgel also contains 5mg of bioperine to increase curcumin’s bioavailability. As an added bonus, this product is free of potentially harmful fillers that find their way into many supplement products.
There are several different types of turmeric extract available (such as C3, BCM-95 and Meriva, among others). My preference is for C3 which contains 95% curcuminoids; to me it’s the extract that makes it easiest to figure out if you’re hitting therapeutic dosage levels with your curcumin intake.
You can order the Sports Research Curcumin Softgels through Amazon by clicking here.
You can also purchase curcumin in powder form. The pros here are that it’s usually a better value. The cons are that it’s a little less convenient to take AND you typically won’t find a high quality curcumin supplement powder containing the right amounts of piperine to increase bioavailability. That said, if you’re a regular smoothie maker I’d encourage you to consider a curcumin powder. In addition to piperine, ginger and fatty acids can also increase curcumin’s bioavailability. So if you’re making a smoothie using curcumin powder, I’d add some healthy fats in there, such as MCT oil. Curcumin powder has a milder taste than plain turmeric, and most don’t report any major problems with its palatability.
You can order the BulkSupplements Curcumin Powder through Amazon by clicking here.
If you’re using curcumin powder and want to use piperine powder for increased bioavailability there aren’t a ton of options. You might consider the piperine powder product made by Liftmode. Alternatively, there are BioPerine capsules you could purchase and simply empty the capsule contents into your smoothie or shaker bottle.
You can order the LiftMode Piperine Powder through Amazon by clicking here.
Price-wise, curcumin is probably a little more expensive than most nutrition supplement raw materials, but it’s definitely not the most expensive.
Image Source: www.youtube.com/watch?v=V_L8RImYjHI
If you’re dealing with pain, I’d suggest starting with 2g of curcumin a day, as that’s what the clinical data finds effective. Remember, several studies have used 8g/day and one used 12g/day, with no serious adverse effects. Also, recall that you’ll want approximately 5mg piperine (or BioPerine) for every 500mg curcumin, to increase its bioavailability. 
With piperine you might see some cautions out there warning you not taking more than 20mg/day. Despite those, studies have used up to 60mg a day (taken with 6g curcumin) and the LiftMode product instructions allow for an individual to consume 120mg a day, presumably because this is the suggested amount for someone taking 12g curcumin a day (the max dosage used in clinical trials). 
Again, for pain I’d suggest most people start by taking 1g curcumin and 10mg piperine/BioPerine per dose, 2 doses a day, for a total of 2g curcumin and 20mg piperine/BioPerine. You could then titrate up based on tolerance and results.
Adverse effects are rare and mild and may include temporary GI upset. Starting with a lower dose and taking with food minimizes this risk.
How long before you feel noticeable effects? That depends on several factors, including the size of the individual, the severity of their condition, the state of their digestive system, dosage amounts and bioavailability enhancers. Some can feel benefits within hours; that said, as with many other supplements, optimal effects may happen after a few weeks to a few months of consistent use.
…let’s next take a look at lab tests. There are several lab tests for inflammation…
Image Source: www.prevea.com/medical-services/Pathology-Lab
A 2019 study in the British Journal of General Practice found that the c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) tests are the most common lab tests for measuring non-specific, systemic inflammation. 
Image Source: www.power2practice.com/article/is-there-an-optimal-cut-off-value-for-highly-sensitive-crp/
C-reactive protein is a protein released by the liver in response to inflammation in the body. As you can see from the image above, lower risk ranges are 0-2mg/L whereas higher risk is >2mg/L. 
Erythrocytes are red blood cells; so the ESR could also be called the red blood cell sedimentation rate test. The ESR test works like this- fibrin is a clotting protein that’s elevated in the blood when inflammation is high. Fibrin tends to cause RBCs to clump together, which results in them falling faster in the vial during the ESR test.
Note that CRP has a marginally superior diagnostic accuracy compared to ESR, and is generally the preferred test for measuring systemic, non-specific inflammation levels in the body. [6-7]
If you’d like to order these tests without having to see your provider, you can do it through one of many direct-to-consumer lab testing companies online. How it works: order the test online; if it’s a blood test you’ll print off order form and visit nearest LabCorp or Quest facility where they’ll draw blood and send off to lab; you’ll get your results in a few days to a week. The advantage here is that you can run your own labs on your own terms. The disadvantage here is that you do have to pay out of pocket initially but can then submit paperwork to your insurance for reimbursement.
While running labs through a qualified provider who understands functional and alternative approaches can be great, running labs through a provider who is close-minded and just wants to throw drugs and surgery at you can be incredibly frustrating. So whether utilizing a DTC lab service is a smart way for you to go depends a lot on who your providers are (and also your “health IQ” so to speak).
The CRP and ESR tests are relatively cheap, and you should be able to order each for $20-$30. Note that some New England states don’t allow their residents to fully utilize DTC lab testing services.
If you’d like to order the CRP test without going through your provider you can do so here.
If you’d like to order the ESR test without going through your provider you can do so here.
While not discussed above, the homocysteine test is another relatively popular test for systemic inflammation. If you'd like to order a homocysteine test without going through your provider you can do so here.
And if you’d like to order a test containing several inflammatory markers (CRP, ESR, ANA, RF) in addition to other markers from commonly run labs (CMP, CBC, lipid panel and others) without going through your provider you can do so here.
Image Source: created by Drew Dreiling using Canva.com
While I’ve talked about some of the positive effects turmeric and specifically curcumin can have on chronic inflammation and pain, I think it’s important to talk just a little about what a smart, holistic approach looks like, which can help to maximize efforts to reduce chronic pain and inflammation and improve health…
The right mattress, pillow, body position and proper amounts of sleep can all help reduce chronic inflammation and pain. For most people the goal here is consistently getting at least 7 hours of quality sleep a night.
WITH INTENTIONAL EXERCISE
Certain exercise habits can be more therapeutic than others, and some exercise habits can be pro-inflammatory and exacerbate chronic pain issues. As far as components of fitness go, I generally emphasize a regular habit of SMR or self-massage work, mobility work (which includes ROM, stretching and decompression exercises) and corrective strength training that targets muscle imbalances, weak muscles and problematic joints.
As far as specific exercise types are concerned, I generally advise my clients who’re dealing with significant chronic pain to consider swimming and water exercise, gentle yoga (ex. yin yoga) and certain types of Pilates. There are several good books out there on physical therapy and corrective exercise, including those by Pete Egoscue, Robin A. McKenzie and Esther Gokhale. Bottom line with exercise- the type of exercise and frequency of habit tend to trump exercise duration and intensity, or as a popular exercise influencer (Gray Cook) has said “First move well, then move often.”
WITH DAILY PHYSICAL ACTIVITY
The goal here is cultivating a habit of not sitting for more than 60 minutes at a time. It’s also helpful to consider if your work space ergonomics are contributing to chronic pain.
Staying hydrated is important. So too is cleaning up your diet by removing those pro-inflammatory items (I usually have people start by removing or reducing wheat and gluten, most dairy and unhealthy sugars like cane sugar and refined sweeteners). Working toward a balanced macronutrient intake is also crucial; here we’re talking about fiber, proteins, dietary fats and net carbs. For many people dealing with excess weight and/or chronic inflammation and pain, a ketogenic diet or “quasi keto” diet where net carb consumption drops considerably can help improve the gut microbiome, starve pathogenic microbes in the gut, reboot the pancreas, and burn excess body fat. Using time-restricted eating or intermittent fasting is another powerful tool that can help to drive down inflammation and pain.
Using keto or some form of carb restriction as well as I.F. to reduce excess weight is especially pertinent in the U.S., where more than 70% of American adults are obese or overweight, with the average American being 35-40lbs overweight. This is also important when we’re talking about pain and inflammation, because excess body weight increases the likelihood of joint pain and arthritis.
While I talked about curcumin in this video, there are 8 additional supplements to have on your radar if you’re dealing with chronic pain. If you’re looking for faster relief from more severe pain you might consider kratom. Some of the controversy with kratom revolves around it’s opioid-like effects (without many of the adverse reactions). Of course this presents a market threat to the drug companies. Additionally, there are some unscrupulous sellers of kratom, and anyone purchasing kratom should do extra research to ensure their product is pure and unadulterated.
For slower, more long-term relief of chronic pain I’d consider the following: CBD oil (usually best for nerve pain), magnesium, high dose fish oil (EPA and DHA), MSM, collagen protein powder (types 1 and 3), collagen type 2 (UC II) and hyaluronic acid. There are other supplements with a reputation for pain relief, including ginger, cayenne and glucosamine and chondroitin (the latter two are popular but usually take at least 2 months to feel noticeable effects). Still others include Montmorency tart cherry juice and serrapeptase, a proteolytic enzyme that can help break down and dissolve excess fibrin in joints that may be contributing to joint pain. Lastly, there are combination supplements (like one made by NutraBio) that contain several of these raw materials.
ON THE MEDICAL/HEALTHCARE SIDE OF THINGS
Massage and other soft tissue manipulation therapies can be helpful, as can gentle chiropractic and spinal decompression therapies. During the last few years we’ve seen a rise in assisted stretching services, and I’ve personally experienced the benefit from using them. Additionally, contrast temperature therapies like cold baths and hot tubs can be very effective for driving down pain and inflammation. For joints and soft tissue that isn’t responding to traditional treatments, or for those who want to accelerate their healing, platelet rich plasma (PRP) and/or stem cell therapies may offer pain relief.
And finally, there’s absolutely a place for surgery here too, including surgeries to repair torn cartilage, ligaments and tendons, or to remove bone fragments or other debris in joints that can be driving joint degeneration and pain.
It’s first important to identify the primary root causes driving your pain and inflammation. This can be done through various lab tests, observation and clinical assessment, so that your therapeutic interventions are more likely to have significant, lasting results.
Image Source: https://clipartstation.com/recap-clipart-1/
Well that’s it for today’s topic! Real quick let’s recap what we’ve covered so far…
>100 MILLION AMERICANS IN PAIN
We talked about how the prevalence of chronic pain is widespread in the U.S. and projections are that those numbers will continue to increase.
THE AGAPE HEALTH APPROACH
We next talked about the 7 main pillars of the Agape health approach, and why a smart holistic, integrative, natural-leaning approach is best for optimal health outcomes.
SERIOUS PROBLEMS WITH COMMON PAIN MEDS
We also talked about some of the major problems with common conventional pain meds, including acetaminophen/Tylenol, NSAIDs and opioids. The risks here center around liver damage from Tylenol use, stomach and intestinal damage from NSAIDs and opioids, and of course the life threatening risks that highly addictive opioid’s carry with their use and abuse.
HOW WE GOT INTO THIS DRUG-SATURATED MESS
We also talked a little about how America ended up in this pharmaceutical drug-saturated mess.
THE CLINICAL DATA ON CURCUMIN & PIPERINE
We then looked at some of the clinical data on curcumin and piperine, in particular their effects on pain and inflammation, as well as on cancer and Alzheimer’s.
WHAT DOES THE BIBLE SAY ABOUT INFLAMMATION & DISEASE?
We also peeked at what the bible has to say about inflammation, and saw that inflammation was linked to disease even 3000 years ago!
CURCUMIN & PIPERINE SUPPLEMENTS & DOSAGES
Next we looked at some high quality curcumin and piperine supplements, including those in pill and powder form, that are available on Amazon and through other retailers. Here we discussed therapeutic dosages and saw from the clinical literature that most will find benefits 2-8g/day range for curcumin, in divided doses, and will likely benefit from taking 5mg piperine for every 500mg curcumin, to increase bioavailability.
LAB TESTS FOR SYSTEMIC INFLAMMATION
Next we looked at some lab tests that measure whole body inflammation, specifically the CRP and ESR tests, giving slight preference to the CRP test. We also discussed how you can order your own lab tests without going thru your provider by using one of the many DTC lab services available online.
HEALTHY LIFESTYLE & SMART HEALTHCARE CHOICES TO DRIVE DOWN PAIN & INFLAMMATION
And finally we talked a little about what a smart lifestyle (sleep, exercise, nutrition, etc.) and smart healthcare choices might look like with a goal of driving down inflammation and pain.
Well that’s it, I hope you enjoyed the video and found the information useful. If you liked it, please click that like button. If interested in more health and wellness content like this, please click the subscribe button. I’ve placed links in the video description notes if you’d like to order any of the nutritional supplements or lab tests discussed. Also wanted to let y’all know about a few more things...
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1 www.sabinsa.com/newsroom/sabinsa-products-faq/bioperine-faq (BioPerine is 95-99% piperine, whereas conventional black pepper only contains 3-9%)
2 www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/ (2017 scientific review of the clinical data for curcumin)
3 www.ncbi.nlm.nih.gov/pmc/articles/PMC5358025/ (2017 study that found 6g curcumin and 60mg piperine a day can attenuate some, but not all, aspects of muscle damage due to exercise)
4 https://bjgp.org/content/69/684/e462 (2019 scientific journal article showing CRP and ESR as most popular non-specific inflammation lab tests, with slight preference given to CRP)
5 www.power2practice.com/article/is-there-an-optimal-cut-off-value-for-highly-sensitive-crp/ (2017 article discussing CRP reference ranges and interpretations)
6 www.verywellhealth.com/sedimentation-rate-what-does-it-tell-about-arthritis-189602 (general info on ESR test)
7 www.practicalpainmanagement.com/treatments/erythrocyte-sedimentation-rate-c-reactive-protein-old-useful-biomarkers-pain-treatment (interaction of inflammation & pain, plus usefulness of CRP and ESR in pain conditions)