Video summary
Trigeminal neuralgia is a debilitating condition characterized by brief, recurrent electric shock-like pains in the face, typically triggered by innocent stimuli such as light touch. While standard medical practice often relies on epilepsy medications like carbamazepine or surgical interventions when drugs fail, these approaches have significant limitations; many patients experience unsatisfactory pain relief or severe side effects, and surgery carries risks of complications, persistent pain, or new facial pain sensations in a substantial portion of cases. Consequently, there is a growing search for alternative treatments that can effectively manage this severe neuropathic pain without the drawbacks of invasive procedures or heavy medication reliance.
A promising dietary approach involves adopting a low-saturated fat diet, inspired by Dr. Roy Swank's groundbreaking work on multiple sclerosis and further validated in studies involving trigeminal neuralgia patients. Research demonstrated that restricting saturated fat intake to approximately 10 grams per day led to dramatic improvements, with nearly all participants experiencing a significant drop in pain levels within just one month. This dietary intervention allowed many patients to reduce or stop their medications entirely and transformed excruciating pain scores from near the maximum down to minimal levels comparable to a minor paper cut, even for those who had undergone multiple failed surgeries or suffered from continuous atypical pain.
Despite these striking results, such findings have largely been overlooked by the mainstream medical community due to a bias toward evidence-based medicine that prioritizes randomized controlled trials over observational studies and nutritional interventions. Critics often dismiss long-term dietary success stories because they lack randomization, ignoring the fact that healthy diets carry no downsides and can offer profound benefits, unlike expensive and risky pharmaceutical drugs. This skepticism is evident in how Dr. Swank's extensive research on multiple sclerosis was excluded from major reviews despite showing that patients could remain ambulant and disease-free for decades, suggesting that the medical field may be missing out on life-saving treatments simply because they do not fit rigid methodological criteria.
Read the full video transcript
[music]
>> The trigeminal nerve comes off our
brainstem and as its name suggests,
splits into three main branches to
innervate our face.
The top branch goes to the forehead and
eyes, the middle branch to the cheeks
and upper lip, and the bottom branch to
the chin, lower jaw, most of the tongue.
Trigeminal neuralgia typically manifests
as brief, recurrent electric shock-like
pains in one of the branches on one side
of the face and is typically triggered
by innocuous stimuli like light touch to
that area of the face.
Attacks tend to only last a few seconds
or a minute or two, but people can
suffer dozens of attacks per day, which
can be so severe they're highly
disabling. Trigeminal neuralgia affects
about 1 in 500 people with a higher
prevalence in women with average age of
onset in our 50s. An MRI of the brain is
indicated to make sure nothing is
compressing the nerve like a tumor, but
there isn't anything actionable, then
the standard medical approach is to try
to control symptoms with epilepsy drugs
like carbamazepine. Uh due to
unsatisfactory pain relief and or
medication side effects, as many as 50%
of patients in specialty centers end up
going into surgery. Though neurosurgical
procedures can be highly effective, they
may result in complications in as many
as 29% with the pain staying the same or
even worsening in 19% of the patients
and the new and different facial pain
felt after the operation in 33%. What
else can be done?
There are various ways scientists create
lab animal models for neuropathic pain,
including surgically tying off major
nerves or damaging them with toxic
chemicals, but another way is just
feeding them a high-fat diet.
Rats fed a diet high in saturated fat
and cholesterol develop nerve damage, a
significant narrowing of their nerve
fibers and surrounding insulation. Found
to be due to the diet-induced oxidative
stress and inflammation.
The researchers noted their study has
some limitations. For example, the
number of the rats in each group may be
augmented. Uh the limitation I'm
thinking of though is
that they're rats. Then, at the 2012
annual meeting of the American Academy
of Neurology, a study was presented
low-saturated fat diet that is effective
in trigeminal neuralgia, which was
subsequently published the following
year. It all started with a civil
engineer and his friend. She had been
suffering with severe trigeminal
neuralgia for 21 years and was scheduled
to go into surgery.
He discovered Dr. Roy Swank's remarkable
work on controlling the nerve disease
multiple sclerosis with a diet low in
animal fats and suggested she give it a
try for her condition. She did and her
pain dramatically improved, her surgery
was canceled, and for 13 years and
counting, she continues to feel better
after decades of suffering before. So,
our engineer teamed up with a
neurologist to put it to the test to see
if this was just a fluke.
55 patients with trigeminal neuralgia
for an average of 8 years were placed on
a diet with a goal of only 10 g of
saturated fat per day, which is about 4%
of calories.
Nearly all of them had been suffering
daily attacks of severe pain averaging
9.6 out of 10 on a scale [clears throat]
of 0 to 10 despite medications and
nearly a third had already gone through
a total of dozens of failed surgeries.
Uh the researchers even included a set
of patients with atypical cases of
trigeminal neuralgia with continuous,
never-ending discomfort. Within 1 month,
96%
of those with typical trigeminal
neuralgia had their pain levels drop
from nearly 10 out of 10 pain down to
less than two out of 10.
And that was after 72% were able to
reduce or stop their medications
altogether.
They went from an average pain score of
more than nine out of 10 down to an
average pain of less than one within an
average of 16 days
after suffering for an average of eight
years.
Even the atypical continuous pain
patients went from about a nine out of
10 pain level down to two out of 10 in a
matter of weeks. The post-surgical
patients after a total of dozens of
failed surgeries and still suffering
severe pain, same thing.
They went from living with more than
nine out of 10 excruciating pain down to
less than
one out of 10
which is like a little paper cut or
something. Now, the post-surgical group
took 20 days to get better instead of 16
days, but they'd been suffering for 11
years straight. Years of extreme
suffering, then 20 days later, gone.
They had the power all along at any time
if they had known they could just change
their diet. Every day that decade,
instead of surgery after surgery, they
were just 20 days away at any time
from being free.
By the time the study was sent for
publication, the patients had been on
the low saturated fat diet for an
average of 20 months, and the only
reported side effect was a weight loss
of 5 to 75 lbs. The researchers
recognized placebo effects could not be
excluded, although dramatic and
sustained improvement even in the
post-surgical group with severe and
intractable pain makes it unlikely.
Uh they do acknowledge that the results
seem too good to be true and call for
further trials to be performed.
Yet no such studies have been
forthcoming. How is that possible? They
reported some of the most striking
findings in the entire field of pain
medicine. Originally presented in the
single most widely read and highly cited
peer-reviewed neurology journal in the
world,
but it appears their study has been
completely lost down the memory hole.
The only reference to it that I could
find in the entire medical literature
was a single mention in a dental journal
back in 2014.
I'm reminded of the medical community's
collective reaction to the multiple
sclerosis work that inspired the
trigeminal neuralgia study.
Before we lost him in 2008 at the age of
99,
Professor Emeritus of Neurology Roy
Swank published the longest running
study of diet and multiple sclerosis in
history in one of the most prestigious
medical journals in the world. His work
has been considered the most effective
treatment of multiple sclerosis ever
reported in the peer-reviewed
literature.
In patients with early stage MS, 95%
were without progression of their
disease 34 years after adopting his low
saturated fat dietary program.
Even patients with initially advanced
disease showed significant benefit.
Today, no medication or invasive
procedures ever
come close to demonstrating such
success.
Dr. Swank concluded his study indicated
that in all probability MS is caused
largely by consumption of saturated
animal fat.
Again, when the gold standard systematic
review dietary interventions for
multiple sclerosis was published, it
didn't even consider Swank's work
because it did not fit the inclusion
criteria.
Uh Swank's study was excluded because it
was not a randomized control trial as if
you could effectively randomize people
to stick to specific diets for 34
consecutive years.
Demanding randomized trials makes sense
for drugs, which are expensive and
risky, killing large amounts of
Americans every year, but a healthy diet
has no downsides and even good side
effects. So,
we shouldn't have to wait on randomized
controlled trials to start saving
people's lives.
This is a perfect example
of how evidence-based medicine biases
physicians against nutrition.
Doctors are encouraged to ignore any
information that doesn't come from
double-blind randomized controlled
trials.
Unfortunately, this approach can easily
degenerate into ignoring most of the
truly important evidence.
Like the dismissal of Dr. Esselstyn's
work on reversing the progression of
coronary artery disease with a
plant-based diet, or Dr. Kempner's work
at Duke, or Pritikin's work, or
McDougall's work, or Dr. Barnard's work
at the Physicians Committee for
Responsible Medicine. Remarkably, a
50-year
follow-up study was published on Swank's
patients, who by then were in their 70s
and 80s.
The research concluded that with a
healthy enough diet, those with multiple
sclerosis can expect to survive and be
ambulant and otherwise normal to an
advanced stage. The accompanying
editorial was dismissive, suggesting one
should be cautious in drawing
conclusions from the report. Not only
was it not a randomized controlled
trial, but a reasonable explanation was
not provided to account for the positive
results.
The editorial ended with "The big
question is,
if the results are so stunningly
impressive, why haven't other
physicians, neurologists, and centers
adopted this method of treatment?" That
is a good question.
Why, indeed.