Case Study: Nerve Pain and Gastroenteritis

A 75-year-old woman presented with both nerve pain and gastroenteritis with a long history of multiple health conditions.

Here is an overview of her health history:


• The patient developed myeloma and received treatment.
• Ongoing IBS-D since chemotherapy and bone marrow transplants.


• Shingles post-chemotherapy, resulting in nerve damage around the trigeminal area on the right side, affecting one eye (paralysis).
• Nerve pain returns intermittently in the form of strong intermittent cranial pain that lasts for several weeks in the crown of the head. During 2018 this required treatment with Pregabalin (Lyrica) when it flared up during treatment with Lenalidomide.


• Experienced remission from 2009 – 2015, but cancer cells were detected again in 2015.
• The patient was prescibed Lenalidomide.
• This again caused such severe, increasing gastro-intestinal distress and the patient was unable to continue the therapy from October 2018 and was diagnosed with gastroenteritis.


• Osteoporosis diagnosed.
• BCC was removed, cranial nerves were affected again, with intermittent pain continuing on both the left and right sides of the head. The patient describes it as a nerve sensitivity triggered by the movement of the hair across the top of the head with intermittent trigeminal nerve pain.

Current treatments include:

• Pamidronate every 12 weeks,
• IgG infusions every four weeks.

Previous medications have included:

• Lenalidomide,
• Thalidomide (which caused neuropathy)
• Zoledronic acid.


March 2020

The patient experienced nerve pain on the left side of the head, around the area of the BCC. Oncologist ruled out multiple myeloma skull lesion involvement on the 17th of March. On the 24th of March, the patient started 300mg PEA (Palmitoylethanolamide), containing 200mg lecithin, morning and night. There was some improvement initially but then intermittent pain increased again.

April 2020

The dose of PEA was increased to 600mg morning and night. The pain was significantly reduced within 48 hours, but by the 4th of April, the patient was experiencing severe diarrhoea, which seemed to be related to PEA dosing.

She reduced the dose to 300mg due to gastrointestinal upset but the cranial pain intensity increased again when the dose was lowered. On the 8th of April, the patient was prescribed RN Labs micronised excipient/lecithin free PEA, at a dose of 600mg morning and night. On the 9th of April, there was only occasional pain with increased sensitivity in the evening.

The patient continued this dose for the following two weeks without experiencing any exacerbated gastrointestinal symptoms. However, on the 14th of April, she reported forgetting one dose and the significant pain returning again during the night.

Over the next week, she continued seeing improvements with occasional bouts of mild pain. She noted there was no further diarrhoea, like that experienced on the other form of PEA. Ten days after starting the pure micronised PEA, the cranial pain was described as only a mild sensitivity to touch in the evenings.

Against instructions from the practitioner and citing personal financial concerns, the patient reduced the dose to 450mg, morning and night, after two weeks of no pain on 600mg twice per day of PEA.

June 2020

The sensitivity began to return again and the patient began the full dose of 600mg morning and night once again. By 5 June 2020, after taking PEA at variable doses between 600-1200mg per day for 10 weeks, the patient had reported no gastrointestinal symptoms. In fact, she reports significant improvement in chronic colitis pain and diarrhoea. She reports halving the dose again to 300mg morning and night and experiencing the return of the neuropathic cranial pain within a few days.
She has been encouraged to remain on a dose of 600mg morning and night for best long term results.


Positive results were noted for cranial nerve pain within 48 hours. Complete resolution of cranial pain was reported after two weeks on a dose of 600mg morning and night. Reduction in GIT inflammation and diarrhoea was noted after 10 weeks of treatment.


The complete resolution of cranial nerve pain occurred while remaining on the prescribed dose of 600mg, morning and night of pure micronised PEA. The patient also experienced significant improvement of colonic inflammation and chronic diarrhoea after 10 weeks of treatment.

The patient is extremely surprised by the improvement in bowel motions and symptoms. Such a marked improvement in gut health has not been experienced by the patient since the chemotherapy treatment in 2008 and Lenolidamide treatment, in spite of seeing slow improvements with the use of pre and probiotics. Because of the initial worsening of diarrhoea on PEA with excipient, the patient had been nervous about staying on a high dose long term. She now believes the micronised PEA has actually increased the healing of her gastrointestinal tract.

Her oncologist had diagnosed her with gastroenteritis in October 2018, which had resulted in the discontinuation of the chemotherapy agents due to this being a common side effect. Other myeloma patients had gone on to develop bowel cancer following these treatments.

S QLD / N NSW Area Manager

Jessica Morland

Jess is a qualified Nutritionist with a Bachelor of Health Science in Nutritional Medicine. She believes that there is no one size fits all approach and is passionate about educating, inspiring and supporting clients and practitioners with a customised approach to healthcare. Specialties include preconception, pregnancy, post-natal and infant care. 

Jess is excited to build relationships, educate and share her knowledge with both retail and practitioners in South Queensland and Northern NSW.

Lauren Matich, BHSc (Nat.)

Lauren Matich

BHSc (Nat.)

Lauren is an NHAA accredited Clinical Naturopath with a Bachelor of Health Science. She is incredibly passionate about natural health and educating clients on the foundational importance of nutrition, lifestyle and stress management and believes complimenting these building blocks with nutraceutical support and functional testing often holds the key to optimal health and vitality. Lauren looks forward to supporting practitioners and clients in these key areas.

Specialties include supporting thyroid health, digestive disorders and mental health.