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Archive for the ‘Pain’ Category

Regel Rectal Rocket

Have you ever wondered what we are doing in the lab?  Here is a little sample of us preparing one of our favorite options for hemorrhoids.

If you need some relief from your hemorrhoids give me a call.



Are you “Rocking it”? 5 tips for preventing kidney stones.

Have you had the pleasure of having a kidney stone?  If you have I would recommend you take a look at your nutrients.

Kidney stones can be extremely painful, and in some cases, patients may require medical treatments or even surgery to remove them.  Most people that I have talked with about kidney stones would do anything to avoid the pain of passing a kidney stone.  Chances are if you have had a kidney stone your are likely to have another one.  My hope in writing this is to help you avoid having to suffer through this again.

The Basics

The most common type of kidney stone is calcium oxalate. Patients with these stones exhibit hypercalciuria (elevated urine calcium) and hyperoxaluria (elevated urine oxalate).  Simply put, we want to reduce the calcium and oxalate from our urine.  To reduce the chances of a recurrence of these stones, patients should follow dietary adjustments to calcium, protein, sodium and oxalate. Calcium from food sources should be encouraged over calcium from supplements. Calcium from food sources will bind with oxalate in the intestine and prevent it from moving to the kidneys and urine. High protein and high sodium diets can increase calcium in the urine, so moderate protein and sodium consumption should also be recommended. Water intake should be high enough (minimum six liters per day) to increase urine output so that the patient needs to urinate every two to three hours through the day. Because vitamin C degrades into oxalate in the body, vitamin C intake should stay at or under the recommended daily allowance (RDA), which is 90 mg for men and 75 mg for women. Due to its low bioavailability, there is no current consensus on the effects of dietary oxalate in stone formation. However, most physicians will recommend lower intakes. One surprising nutritional fact is that cranberries are high in oxalates. Spinach is also high in oxalates, but kale is low. As a guideline, you can find a list of foods that are highest or lowest in oxalates online here.

5 Steps to prevent Kidney Stones

  1.  Get calcium from food sources.  Do not take as much calcium from supplements.
  2.  Limit your sodium intake and monitor your protein intake.  50 to 100 grams of protein is safe to consume.
  3.  Increase water intake to 6 liters per day.
  4. Limit Vitamin C intake
  5. Limit foods with high oxalates (Cranberries, Spinach, etc) See link for list.

If you have struggled with kidney stones what advice would you share?  Please comment below.

My perspective on the opioid epidemic

Is there a problem?

I am sure you are aware that there is an opioid epidemic out there and many are overdosing and some are dying.  Overdosing is not a new problem.  So why is this topic being talked about so much?  Is there something new going on or is this one of those things the media has overblown?

In my opinion, this problem is getting worse and this subject is not getting reported enough.  I am sure many of you have heard reports or you may know of a family that has been affected by a drug overdose.  My intention in writing this is to help make you aware of the problem and understand what you can do to help prevent this problem from directly affecting your family.

The reports that I have read are putting the blame on the easily accessible medications that are sitting in your medicine cabinet right now.  Many of us have had dental work or minor surgery and an opioid was prescribed for pain.  Even a medication that is years beyond it’s expiration date can still be effective.  Your teenager or young adult may not be the one to take the medications out of your medicine cabinet but did you think about friends and relatives that come to visit?  You probably would not even know the medication was gone.

A few years back the Drug Enforcement Agency (DEA) made one of the most common pain medications (Lortab, Vicodin, Hydrocodone) a schedule 2 medication.  This change made these medications a lot more difficult to get on the street.  So the supply of medication was not meeting the demand.  This forced the price “on the street” to go up for these illegal medications.  What the drug dealers saw was an opportunity.  This opportunity was by lowering the price of another opioid that was plentiful and easily smuggled in they could profit more.  That opioid is heroin.  When I first thought about it I asked myself “who would decide to take heroin?”  Many make this decision for several reasons, the price of the prescription opioids, the availability and the higher high from a stronger opioid.  Also, there are many names that heroin goes by and often times individuals don’t know that they are taking heroin.

For $5 to $10 you can get a dose of heroin.  Heroin is 3 times more powerful than morphine and will cause a pronounced high (euphoria).  So, for many, this is a perfect solution to their addiction.  Cheaper and more powerful.

The latest reports indicate that some of the heroin on the street is being mixed with another opioid that is 50 to 100 times more potent than morphine.  This opioid is called fentanyl.  Fentanyl is a synthetic opioid that is used in cancer pain and other chronic pain situations.  It is usually dosed in a slow release patch.  When snorted along with heroin the effect is immediate and can be deadly.  There is no way for someone to tell if their heroin has fentanyl in it.

So the reason I think that we are seeing more overdoses is the individual is addicted to prescription pain medications first.  Then there is a need for a cheaper version that gives a higher high.  Then the addicted person unknowingly takes a heroin/fentanyl combination and overdoses.

What can you do to avoid being apart of this epidemic?

Get rid of your old pain medications.  You can drop off medications at area locations for disposal.  Click here to find out were you these facilities are located.

Do your part and dispose of these medications.  These medications in the wrong hands can affect you or your loved one for a lifetime.

Did you know that the compounding pharmacists at Regel Pharmalab can help you control your chronic pain?  If you have uncontrolled chronic pain and would like me to review your story, give me a call or send me a message.  You can reach me (901) 757-9434 or  I look forward to helping you with your pain and possibly reduce the amount of pain medications that is required for your pain.

Comment below on other ways to help prevent opioid addiction.

A compounding pharmacist’s guide to Migraines

Have you tried everything for migraines?

Many of our patients that suffer from migraines tell me that they are glad that they asked “What can you formulate for my migraines?”  Many of these patients are desperate for something that really works.  If you or someone you know struggle with migraines I may have a couple new ideas to consider.

It has been estimated that migraines cost ~ $20 Billion a year in medical expenses and loss of productivity.  Affecting 36 million Americans.  Migraines can last from hours to days.  With several reasons that can cause a migraine, it is a difficult problem for patients as well as for physicians to deal with.

What are the current treatment options?

When you are diagnosed with migraines most likely your physician will prescribe a medication that is in the family we call triptans.  Examples of this family are:

  • Imitrex (Sumatriptan)
  • Zomig (Zolmitriptan)
  • Maxalt (Rizatriptan)
  • Relpax (Eletriptan)
  • Treximet (Sumatriptan and Naproxen Sodium Tablets)
  • Amerge (Naratriptan)
  • Frova (Frovatriptan)
  • Axert (Almotriptan)
  • Sumavel DosePro (sumatriptan)
  • Zecuity (sumatriptan iontophoretic transdermal system)

These medications do have side-effects and many cannot take them.  They are also very expensive and can be out of the price range for many patients.  These medications are not recommended for patients that have cardiovascular disease, history of a stroke, and uncontrolled blood pressure.

Another option for patients that have 15 migraines or more a month is Botox.  These injections can cost $6000.00 up to $10,000.00 a year.  And this option requires a monthly office visit for each shot.

Migranal is a nasal spray that can cost $1500.00 up to $2500.00.

With these options many report poor success relieving migraines.  A study has shown that 56% of patients report inadequate relief 2 hours after their treatment.  Since there is not a current cure for migraines and there are many causes, a product that has multiple benefits may be more effective than using just one medication.

What can a compounding pharmacist do for migraines?

  • A compounding pharmacist can provide medications in different dosage forms
    • Combining several medications into:
      • capsules
      • sublingual tabs
      • transdermal gels.
      • Nasal Sprays
  • Using TRNA therapy
  • Taking a medication like sumatriptan in a transdermal gel and administering it at the base of the head/neck area.
  • Ketamine can help with the prolonged aura that meany patients suffer with as well as increasing blood flow.
  • Gabapentin reduces the release of inflammatory neuropeptides that are consistent with headache pains, such as calcitonin gene-related peptide and substance-p.
  • Tizanidine inhibits the release of norepinephrine and acts as a muscle relaxant.
  • Magnesium reduces inflammation, relaxes muscles and blood vessels, and modulates calcium ion channels within our cells.  This can trigger the release of neurotransmitters.  Magnesium also decreases the release of substance P and may be more effective in migraines with auras.  For more information on Magnesium click here.
  • Lavender oil is known for its soothing and calming effect.  71% of patients inhaling the fragrance of lavender oil for 15 minutes fully or partially improved their headache.
  • Lidocaine is a local anesthetic that can help by its membrane-stabilizing effect, which inhibits the release of vasoactive substances from platelets.  This inhibits the inflammatory response.
  • Caffeine can inhibit neuronal activity.  Activating adenosine receptors leads to antinociception in neuropathic pain and inflammatory models.
  • Hormones can effect migraines when there is a sudden drastic drop in estrogen usually at the start of a menstrual cycle.  Progesterone can play a huge part at balancing the effects from the estrogen dropping.  Progesterone also calms the stimulatory effect of estrogen.  Read more about Hormones and Migraines click here.

As you can see, a compounding pharmacist can provide quite a few more options than the standard of care.  If you would like me to help you talk with your physician about your migraines give me a call.  What we will do is set up an appointment for you to meet with myself or Anita Hester, RN.  We will work out a plan and send a recommendation for your physician to consider.  Our best results for patients usually happen when we team up with you and your physician.

What is your trick to prevent migraines?  Post in comments below.

5 Quick Tips for Migraines

Migraine Quick tips


I always recommend replacing what is deficient before starting medications, herbs or essential oils.  All of these can have a place in treating migraines, but I have found that replacing some key nutrients and minerals can reduce the number of migraines and how bad they hurt.  What I am talking about is prevention of migraines.

Tip #1

Sleep – There is nothing better for migraine sufferers than getting a full 7 to 8 hours of sleep.  Some individuals may require more sleep.  Contact me for help with getting better sleep.

Tip #2

Magnesium Glycinate (or any chelated magnesium).  This powerful mineral is used in over 300 different enzyme reactions in the human body.  According to the experts we are all deficient.  You may not see this deficiency in the blood, because only 2% of our magnesium is found in the blood.

Recommendation:  Magnesium Glycinate 100mg up to 400mg at bedtime.  

Tip #3

Riboflavin (Vitmain B2)

One 1998 study of 80 patients who suffer from migraine with aura or migraine without aura found that 400 mg of Riboflavin worked better at preventing migraines than an inactive placebo pill. After three months, patients in the Riboflavin group experienced fewer migraines and decreased severity of migraines than those in the placebo group.


Recommendation: Riboflavin 400mg take one capsule every morning.

Tip #4

Hormone Balance – Replace the missing hormones.  Progesterone is my favorite hormone for patients with migraines.  Even those patients that cannot take estrogen can benefit from this hormone therapy.  Call me to set up a time to discuss your hormone balance.

Tip #5

Stress relief

One of our most difficult problems to work with is stress.  Exercise is my favorite tool for stress along with prayer.  Letting go of those frustrations and problems that life throws at you can impact you migraines.

If you would like to order the Magnesium Glycinate or the Riboflavin you are welcome to stop by or order online (click here).

Sore hands and feet from Chemotherapy

Hand-Foot Syndrome

I recently became aware of a condition caused by chemotherapy medications.  This condition is called Hand-Foot Syndrome (not hand, foot and mouth).  I cannot imagine having to deal with a constant irritation to the palms of the hands and bottoms of the feet.  The longer the patient is on chemotherapy and the higher the dose of the chemotherapy the more severe the symptoms.  Sometimes the oncologist has to stop therapy because the symptoms get so intolerable.  

The most common chemotherapy medications that can cause this syndrome are fluorouracil and doxorubicin.  There are many others on the list of chemotherapy that have the potential to cause this syndrome.  Let me know if you would like me to review the medication that you or your loved one is taking.

Mild symptoms include:  redness, swelling, tingling or burning, tenderness, tight skin, thick calluses and blisters on the palms and soles.

Severe symptoms include: cracked, flaking and peeling skin, blisters, ulcers, severe pain, and difficulty walking and using hands.

If you know someone that has this condition give me a call, we have answers that can help.  In the mean time here are a few things to do to manage the pain and discomfort.

Managing Hand-Foot Syndrome

  1. Limit exposure to hot water when bathing and washing dishes.
  2. Carefully pat skin dry after bathing.
  3.  Cool hands and feet with ice packs or cool running water.
  4. Avoid exposure to sources of heat.
  5. Avoid contact with laundry detergents or household cleaners.
  6. Avoid use of rubber or vinyl gloves.  If you must use them, wear white cotton gloves underneath them.
  7. Avoid using tools or household items that require pressing your hand against a hard surface like a garden tool or knife.
  8. Avoid applying friction to hands.
  9. Avoid walking barefoot.

Every day I have the privilege of working with patients and I enjoy learning about new issues that patients are struggling with.  If you have an issue that you are struggling with, I would appreciate the opportunity to find an answer for you.   Give me a call (901) 757-9434 or email

Go to war on Hemorrhoids!

It is time to wage war on your hemorrhoids!

Hemorrhoids can be a thing of the past.  In a recent post I discussed was to care for hemorrhoids.  Click here to take you to the post.  Now it is time to got to war.  I am here to equip you for the battle.  One of my favorite products that I have seen over these last 20 or so years is the Rectal Rocket.   No, you don’t light this rocket and there is no explosion.  This rocket is inserted at bedtime and slowly melts.  While the rocket is melting the medications are released.  The medications reduce the size of the hemorrhoid and the pain.

Several clients have asked how we formulate the Regel Rectal Rocket so I decided to let you in on our “secret process”.  I hope you enjoy.

Now you know the secret formula.  We have had several comments on these over the years.  But most every patient that has used these has been successful at reducing the pain and size of the hemorrhoid.  One local OBGYN used these for her own hemorrhoid and now is symptom free.  Is it time for you to arm yourself with the Regel Rectal Rocket.

This is a prescription medication so we will need to contact your physician for authorization.  If you would like me to send your physician a recommendation for Regel Rectal Rockets give me a call (901) 757-9434 or e-mail

6 tips for hemorrhoid care

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If you have or have had hemorrhoids, I don’t have to tell you how frustrating and distracting the itching and burning can make you feel.  Here are some of our favorite tips to help you take better care of your hemorrhoids.

  1.  Be gentle – When wiping the area after a bowel movement or after a bath or shower, pat the area dry.  Try not to use force when cleaning or drying the area.  I know you may feel like using steel wool on the area but try to resist this as much as possible.
  2.  Stool Softener – one thing that can make a difference is to soften the stool.  What I have found to be successful in accomplishing this is a minimum of 2 liters of water a day and Docusate 100 mg softgel.  Take one to three capsules by mouth once at bedtime.  These can be used indefinitely and are not like stimulant laxatives that can cause your body to rely on them to have a bowel movement.  Softening of the stool with docusate may take 12 hours up to 3 days.
  3. Increase dietary fiber – Foods rich in fiber are the best source.  I always think of fruit such as apples and pears.  There are many food sources for fiber so find one that you like and keep a good supply around.  Additional fiber can be supplemented.  We recommend Regel Pharmalab’s Fiber Blend.
  4. Exercise – 20-30 minutes of a brisk walk can help stimulate normal bowel function and make you regular.
  5. Take a bath – After a bowel movement sit in a tub of warm water for 20 minutes.  You can do this several times a day to relive the symptoms of itching, burning and spasms of the anal sphincter.  This is also accomplished with a “Sitz” bath.
  6. Topical ointments – I recommend topical  non-prescription hydrocortisone ointment to treat the inflammation, burning and itching.  This should be applied 3 times a day.  The ointment is the best choice because it stays in place for a longer period of time.IMG_1225
Now what?

For those of you that have tried these steps and are still struggling with this nuisance contact me.  I have found a treatment that can provide significant relief within 3 days.  This medication does require a prescription so I will have to discuss this with your physician.  I look forward to helping you get relief.

What hemorrhoid treatment works for you?  (please comment below)


Low Dose Naltrexone (LDN)

Low Dose Naltrexone

We have answers

I was recently able to participate in a discussion on Low Dose Naltrexone that I thought was worth sharing.  Let me first say that I am a big skeptic on things that seem to “fix” everything.  What I have found with most products that have multiple uses is that those products tend to be really good at one thing but show little to no benefit for anything else.

First, let me introduce you to Naltrexone.  Naltrexone has been used for years for patients that are addicted to alcohol or pain killers.  It has been proven to be safe and effective for this purpose for many years.  The normal milligram strength for this purpose is ~ 50 mg.  (Low dose Naltrexone is any strength below 5 mg).  Naltrexone works by interfering with the same receptors that alcohol and pain killer use.

When I reviewed Low Dose Naltrexone (LDN) several years ago I found that there was a little evidence to use this product for Multiple Sclerosis and Fibromyalgia.  Since I am always skeptical about putting any chemicals into the body, I was reluctant to recommend this for anyone with the evidence that was available.  I have listened to several pharmacists and physicians that are having success after success using LDN.  A few of the physicians in the area are now providing a prescription of LDN for various reasons.  The results that I am hearing are impressive to say the least.  In my opinion, a trial of LDN is acceptable if the other treatment options have failed and there is evidence that LDN may help.

So far there is evidence that LDN may be used for the following conditions:

Post Traumatic Stress Disorder – Nervenarzt. 2015 Mar;86(3):346-51. doi: 10.1007/s00115-014-4015-9.
Cancer – Integr Cancer Ther. 2006 Mar;5(1):83-9.
Crohn’s Disease – Am J Gastroenterol. 2007 Apr;102(4):820-8. Epub 2007 Jan 11.
Fibromyalgia – Arthritis & Rheumatism Volume 65, Issue 2, pages 529–538, February 2013
Multiple Sclerosis – Multiple Sclerosis. 2008 Sep;14(8):1076-83.
Inflammation and Chronic Pain – Clin Rheumatol. 2014; 33(4): 451–459.
AIDS/HIV –  Journal of AIDS and HIV Research Vol. 3(10), pp. 180-188, October 2011
Complex Regional Pain Syndrome (CRPS) – Journal of Neuroimmune Pharmacology , Volume 8, Issue 3, pp 470-476
Autism – Expert Opin Pharmacother. 2012 Aug;13(11):1615-29. doi: 10.1517/14656566.2012.674110. Epub 2012 May 3.
Lyme Disease
Itching (chronic) – J Am Acad Dermatol. 2007 Jun;56(6):979-88. Epub 2007 Feb 22.

There are other articles that I have found but these are the ones that I share with physicians when they ask about LDN.  I recently had the opportunity to recommend this treatment option for a man with fibromyalgia.  He has tried Lyrica, Neurontin (Gabapentin), and Cymbalta to control the pain that he is having.  It will take between 6 and 9 weeks to see the results.  So I will try and keep you posted on his progress.

As you can see we are involved in a number of different medical problems.  I would welcome any question that you may have.  How about scheduling a time to talk about your specific needs?

Have you had experience taking LDN?  Are you struggling with one of the conditions that LDN might provide relief?  Let me know, I am here to help.

Pain relief through the skin

Why do topical pain medications work?

Pain does not always have to be addressed by pills and injections.  Pain medications make some people feel tired, sleepy, or as if they are on another planet.  Some people taking oral pain medications find it difficult to function at their optimum.  Some people fear addiction to pain killers.  There are other pain treatment options available that are less invasive to the body, yet provide an effective solution to the pain you may be experiencing.

Pain Photo Collage

One common side effect for many using non-steroidal anti-inflammatory drugs (NSAID’s, such as Aleve® [Naproxen,] Advil® [Ibuprofen,] Mobic® [Meloxicam,] & Celebrex, etc. ) is stomach problems.  Our pharmacists can provide topical methods to benefit patients who are unable to take medication in the more common forms.  It offers an easy alternative to taking multiple pills and patients love it.  Use of a topical cream can often mean the difference between treatment success or failure.  Because they allow medications to successfully penetrate the skin, these topical creams show the potential to sidestep many common side effects of drugs, such as upset stomach, and minimize the effects on other organs.  Read about one patient who experienced success with one of our pain cream formulas:

If you have neuropathic pain, arthritis, back pain, inflammatory pain, or any other pain that you think may be applicable, take the following steps to find out if one of our topical pain solutions may be suitable for your situation.

How to obtain topical pain medications: 

Step 1:  Talk to one of our pharmacist, Josh or Natalie at Regel Pharmalab by calling (901) 757-9434 or emailing

Step 2:  Josh or Natalie will consult with you and send a written recommendation to your provider.

Step 3: Your provider will sign off on the recommended prescription.

Step 4:  Our administrative staff will contact your insurance company.

Step 5:  One of our staff members will contact you to let you know the cost/coverage and when your prescription may be picked up or mailed.


What Some Regel PharmaLab Patients Are Saying

Burning Feet:  “The medication does wonders!  It really worked well.  My feet no longer burn on the bottom.”

Inflammation:  “It’s a miracle drug.  I don’t care what anybody says!  I am back to walking three miles a day again.  It’s done quite a number for me.”

Stomach Issues With Pain Medications:  “This pain cream my pharmacist recommended really works.  I have been struggling with pain for 2 years and finally I have something that takes my pain away without tearing up my stomach.”

Organ Concerns With Pain Medications:  “I don’t have to worry about my dad’s kidneys so much with a topical pain medication.”


May we assist you with Pain Therapy Questions?

Give us a Call, (901) 757-9434


What type of side effects have you experienced with over the counter or prescription pain medications?  Comment below





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