Trigeminal neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve, which transmits sensations from the face to the brain. Around 150,000 people are diagnosed with TN annually, with women affected more than men. Characterized by intense, stabbing pain, primarily in the lower jaw but potentially felt across the entire face, TN can be triggered by seemingly innocuous stimuli like brushing teeth. Due to the degradation in the function of the trigeminal nerve, finding effective therapies to manage this condition is crucial. While conventional treatments like medications and surgery exist, dietary interventions are gaining recognition as a complementary approach to alleviate pain and improve the quality of life for TN sufferers.
Understanding Trigeminal Neuralgia
Trigeminal neuralgia is marked by severe facial pain due to nerve stimulation. Patients seek therapies that provide maximum relief for extended periods. The pain, often described as an intense, stabbing sensation, is primarily felt in the lower jaw but can extend across the face. Symptoms vary among individuals, highlighting the complexity of this condition.
The Role of Nutrition in Trigeminal Neuralgia
Food provides macronutrients and micronutrients that influence overall health. The most popular dietary approach for TN is a low saturated fat diet, which has been studied and published in medical journals. Many patients following this diet have reduced or eliminated their reliance on prescription medications, reporting a significant decrease in pain severity within a month.
Myelin and Nutrition
Trigeminal neuralgia type 1 is associated with a lack of myelin around the trigeminal nerve. Myelin, like other membranes in the body, contains high levels of lipids essential for its formation. This connection suggests that nutrition plays a role in myelin formation and nerve health. Research indicates that a high-fat diet can positively impact myelin maintenance and restoration. A study at UF showed that a high-fat diet favorably impacts myelin by maintenance and restoration.
Dietary Triggers
Identifying and avoiding triggers is crucial in managing TN. Common triggers include:
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- Temperature Extremes: Very hot and very cold temperatures can irritate the trigeminal nerve, leading to misfiring. Hot soups and cold drinks are frequently cited as triggers.
- Specific Foods and Drinks: Caffeine, citrus fruits, and bananas have been reported as triggers for some individuals.
- Alcohol: The trigeminal neuralgia alcohol trigger should also be avoided.
- Touch: Washing the face, shaving, or applying makeup can be problematic for those sensitive to touch.
- Air Exposure: Air blowing on the face, such as from an AC vent or open window, can also initiate pain.
- Mouth Movements: Actions like brushing teeth, eating, drinking, smiling, talking, and kissing can trigger attacks.
- Movements: Head movements or vibrations from walking or riding in a car may also induce pain.
Dietary Strategies for Managing Trigeminal Neuralgia
Dietary changes can be a valuable component of a comprehensive TN treatment plan. Adjusting food choices to minimize flare-ups and reduce medication dependence is key.
- Low Saturated Fat Diet: This diet aims to reduce inflammation and nerve irritation by limiting high-fat animal products.
- Vegan Diet: A vegan diet, which excludes all animal foods and byproducts, is often beneficial due to its anti-inflammatory properties and avoidance of high-fat animal substances.
- Soft Food Diet: Since chewing can trigger pain, opting for softer foods may reduce the likelihood of attacks.
Pain-Triggering Foods
Sharp, hot, or spicy foods, as well as those requiring significant chewing effort (such as dried fruits and nuts), may trigger TN attacks. It's important to note that triggers can vary among individuals.
Pain-Safe Foods
Soft, easy-to-chew foods are generally considered pain-safe. Examples include:
- Cooked rice
- Khichdi (Indian lentil-rice dish)
- Soft fruits (mango, ripe bananas, chikoo)
- Cooked green leafy vegetables
The Olive Oil Intervention Study
UF is conducting a clinical trial on TN with a high olive oil intervention. The study aims to determine the feasibility of daily intake of olive oil and its potential to alleviate facial pain. Participants are ecstatic. The purpose of the study is to determine the feasibility of daily intake of olive oil and its potential to alleviate facial pain. The study involves participants consuming four tablespoons of olive oil daily, consistent with high olive oil diets like the Mediterranean Diet. Dietary changes are assessed throughout the 16-week study, with participants completing daily questionnaires to measure pain levels.
Extra Virgin Olive Oil and Trigeminal Neuralgia
Extra virgin olive oil (EVOO) may contribute to neuroprotection and influence pain symptoms in adults with demyelination-related TN. A study explored the feasibility of daily EVOO intake and its potential to alleviate facial pain. Participants consumed 60 mL/day of EVOO or followed their usual diet (control) for 12 weeks after a 4-week baseline period.
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Study Results
The EVOO group demonstrated significant improvements in the Penn Facial Pain Scale, particularly in areas of interference with general function, orofacial function, and pain severity. Compared to the control group, the EVOO group showed a trend toward improved orofacial function. Additionally, the EVOO group experienced improvements in role limitations due to emotional and physical health. The EVOO group significantly improved their Healthy Eating Index 2015 component scores of fatty acids (primarily from increased oleic acid), sodium, and refined grains.
Feasibility and Benefits
The study concluded that daily intake of 60 mL of EVOO is feasible for TN patients and may reduce pain and enhance quality of life. The EVOO group, with 90% intake compliance, showed significant decreases in the Penn Facial Pain Scale items of interference with general function, interference with orofacial function, and severity of pain from baseline, whereas the control group showed no improvements.
Additional Considerations
- Balanced Diet: Eating a well-balanced diet is essential, though many TN patients struggle with chewing and prefer soft or semi-solid foods.
- Supplements: Vitamin and mineral supplements, such as Vitamin B12, Vitamin D, Vitamin C, Zinc, Chromium, and Selenium, can support nerve repair, especially for those with dietary restrictions.
When to Seek Specialized Care
If facial pain disrupts daily life, it's essential to consult a specialist. Trigeminal neuralgia is often misdiagnosed, leading to delayed treatment.
Common Signs of Trigeminal Neuralgia
- Sudden, electric-shock pain in the cheek or jaw
- Pain triggered by talking, brushing teeth, or eating
- One-sided facial pain that comes and goes
- Ineffective results from medication
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