Palmitoylethanolamide (PEA) is produced in the body to combat pain and inflammation. This fatty acid can safely boost your natural cannabinoids and protect the nerves throughout your body. Its benefits are encouraging for a wide range of difficult-to-treat disorders. Learn more about this underrated and intriguing natural substance.
What is PEA?
Palmitoylethanolamide, or PEA, is produced in the body naturally to combat pain and inflammation. Many animals and plants also produce PEA. The highest amounts can be found in soy lecithin, soybeans, egg yolk, peanuts, and alfalfa [R].
As a supplement, PEA is available in tablet, capsule, and powder form. In Italy and Spain, PEA is marketed as a food for special medical purposes [R].
Since its discovery in the 1950s, researchers have been fascinated with PEA. As a strong and safe natural painkiller and anti-inflammatory, PEA offers hope for a lot of people suffering from chronic and neuropathic pain. PEA gets an unfairly low level of attention compared to the benefits it offers. More than 30 clinical trials so far have confirmed it can relieve complex pain [R].
New benefits of PEA continue to be discovered, leaving some scientists perplexed. It turns out that PEA can also activate the cannabinoid receptors, protect the brain and heart, improve mood, reduce allergies, and may help fight the common cold [R, R].
PEA is a fatty acid amid like anandamide, the main cannabinoid bliss molecule your body makes. Unlike regular fats, amid-containing fatty acids like PEA and our cannabinoids are directly involved in nerve communication. These intriguing and recently-discovered molecules are called “neuroactive lipids” [R].
Mechanism of action
PEA activates the energy-boosting, fat-burning, and anti-inflammatory PPAR alpha. By activating this key protein, PEA stops the activity of pro-inflammatory genes and the production of many inflammatory substances [R].
PEA reduces the activity of the bliss gene FAAH that breaks down natural cannabinoid anandamide. This increases the levels of calming anandamide in your body, helping to combat pain and increase relaxation. It may also activate the cannabinoid receptors (CB2 and CB1) [R].
PEA contains the palmitic acid in its structure. The starting point for making PEA in the body is precisely this saturated fatty acid [R].
However, simply increasing your intake of palmitic acid or other dietary fats will not affect PEA production in the body. This is because your body will use PEA only when it needs to compensate for inflammation or pain, and its levels will also normally vary throughout the day. The best way to get the benefits of PEA are standardized supplements, or alternatively PEA-rich foods [R].
Health Benefits of Palmitoylethanolamide
1) PEA Reduces Pain and Inflammation
PEA’s ability to reduce complex pain has been confirmed in over 30 clinical trials and a total of ~6k people since the 1970s [R].
In an analysis of 12 human studies, PEA supplements reduced chronic and neuropathic pain intensity without any serious adverse effects. At least 2 weeks need to pass to achieve pain relief. PEA was typically given over 3-8 weeks at dosages between 300 and 1200 mg/day. Taking it over a longer period of time strengthens its effects without causing tolerance [R].
In a pivotal trial of over 600 people, PEA (300 or 600 mg/day) strongly reduced sciatic pain, higher dose having a more beneficial effect. PEA reduced pain intensity by over 50% in just 3 weeks, which is rarely seen with most painkillers [R+].
PEA reduced lower back pain in a trial of over 100 people (600 mg PEA/day). It was so effective that half of the included participants stopped taking any additional painkillers by the end of the trial [R].
PEA could relieve pain caused by diverse health conditions. To outline some of these studies, PEA helped:
- Women with pelvic pain caused by endometriosis, an overgrowth of the uterus lining. In a trial of 56 women, PEA (300 mg/day) relieved pain and improved sexual function over 6 months [R]
- Pain caused by fibromyalgia. In 80 people, PEA reduced the intensity of pain and tenderness when added to the standard treatment (pregabalin) [R]
- People with sciatica who don’t respond to painkillers like Oxycodone [R+]
- Diabetics with pain from carpal tunnel syndrome caused by nerve compression (at a higher dose of 1,200 mg PEA/day) [R+]
- Pain after failed back surgery [R+]
- Cancer pain [R+]
- Arthritis pain [R+]
Importantly, PEA didn’t cause side effects or drug interactions in any of the above studies.
Animal studies add to its pain-relieving benefits and point that it may also help with other types of pain and inflammation in humans with more research. In experimental animals (mice and rats), PEA:
- Reduced nerve pain from a chemotherapy drug (Paclitaxel) [R].
- PEA’s derivative adelmidrol reduced acute and chronic pain and inflammation [R]
- Reduced inflammation and lung damage [R]
- Improved inflammation and pain in arthritis [R]
- Lowered inflammation from spinal cord injuries [R]
2) PEA Enhances Brain Health and Regeneration
PEA may be beneficial for neurodegenerative diseases and stroke because it helps brain cells survive and lowers inflammation.
In a study of 250 stroke sufferers, a formulation of PEA with luteolin (Glialia) greatly improved recovery. It had a beneficial effect on cognitive skills, overall brain health, pain, and daily functioning. The effects were noticeable after 30 days and further improved over another month of supplementation [R].
Both with luteolin and alone, PEA prevented Parkinson’s disease in mice, reducing damage in the brain and protecting dopamine neurons. Since the destruction of dopamine neurons is what causes Parkinson’s disease, PEA may be able to prevent this disease or its worsening [R, R].
In another study, PEA with luteolin enhanced the healing of nerves in mice with spinal cord injuries. It increased neurotrophic factors (BDNF, NGF), small but powerful proteins that help create new brain cells needed to regenerate tissues after traumatic damage of the spinal cord or brain [R, R].
But aside from its direct effects on brain cells, PEA is important for brain health due to its action on our endocannabinoid system. In the brain, our natural cannabinoids play diverse roles in behavior, cognition, mood, and seizure risk, among others.
One intriguing outlook on autism suggests that endocannabinoid imbalances contribute to autistic behavior and impaired immunity. In a case report, PEA improved cognition and social behavior in 2 children with autism. Interestingly, it also reduced eczema in one child. This was also the first report of PEA safety in children, adding to the fact that it doesn’t cause side effects [R, R].
Impaired natural cannabinoids may also play a role in epilepsy. PEA could relieve seizures and shorten their duration in rats by increasing cannabinoid activity in the brain [R].
3) PEA is Good for Your Eyes
PEA’s effects on protecting nerve cells are not restricted just to the brain. Healthy nerves in the eyes are crucial for maintaining proper vision.
Retinopathy is an eye disease that can result in vision loss. It’s triggered by inflammatory damage to the nerves in the eye, most commonly caused by glaucoma and diabetes. PEA safely reduced eye nerve damage in over 9 clinical trials used in doses up to 1.8 g/day [R].
In 32 people with glaucoma, PEA reduced high eye pressure and improved vision over 6 months. PEA supplementation was safe and didn’t cause any side effects [R].
People with glaucoma can choose to undergo laser surgery but risk experiencing high eye pressure shortly after that can cause damage. PEA prevented increases in eye pressure given shortly after laser eye surgery in 15 people [R].
Animal studies revealed how PEA may achieve these benefits. In diabetic rats, it reduced eye key inflammatory substances that break down the blood-retinal barrier. Like the blood-brain barrier protects the brain, this eye barrier is crucial for eye health. It nourishes the eye but prevents harmful substances from entering [R. R].
4) PEA May Protect Your Heart
Heart attacks result from a total blockage of blood vessels leading to the heart. For the damaged heart tissue to recover, proper blood flow needs to be recovered. In mice, PEA improved the recovery from heart attacks, reduced heart tissue injury, and lowered inflammatory cytokine levels [R].
PEA also reduces high blood pressure in rats and prevents kidney damage by lowering inflammatory substances. It also has specific effects similar to drugs commonly used to lower high blood pressure (ACEI). PEA blocked enzymes and receptors that increase blood pressure by narrowing the blood vessels (angiotensin receptor 1 and angiotensin converting enzyme) [R].
5) PEA Reduces Gut Inflammation
PEA was successfully used to relieve symptoms of inflammatory bowel disease (IBS) in animals. Mice with chronic gut inflammation have low PEA levels, while PEA supplements normalized bowel movement and prevented damage to the gut lining [R, R].
The gut damage caused by ulcerative colitis increases the risk of cancer. In mice, PEA prevented normal gut tissue from developing cancerous overgrowth [R].
6) PEA Reduces Depression
In a recent study of 58 people with depression, PEA (1,2 g/day) given over 6 weeks greatly and rapidly improved mood and overall symptoms. PEA was added to antidepressant treatment (citalopram) and lowered symptoms by an impressive 50% [R].
This clinical study was a follow-up on numerous studies in which PEA improved symptoms of depression in animals.
7) PEA Reduces Symptoms of Multiple Sclerosis
The analgesic and anti-inflammatory benefits of PEA make it an ideal candidate for Multiple Sclerosis (MS), which has a strong autoimmune and inflammatory nature. The first-line therapy (interferon IFN-β1a), on the other hand, often causes serious adverse effects. PEA may increase the effects of this immunotherapy while lowering the negative effects.
As an add-on to standard therapy, PEA reduced adverse effects and pain, improving the quality of life and cognition in a trial of 29 people with rapidly-advancing MS. The supplement also increased blood levels of PEA and anandamide [R].
The effects of PEA alone on MS has not been investigated yet. But it’s quite possible that PEA could aid in the prevention or benefit milder MS patients as a standalone therapy based on its mechanism.
7) PEA May Fight the Common Cold
As scientists became excited about PEA’s ability to relieve pain and nerve damage, its effects on the immune system were almost forgotten. In many early studies of over 4k people, PEA could fight the influenza virus that causes the common cold [R].
Despite achieving good results, the main problem with the initial studies was that egg yolk or other supplements that contained only small amounts of PEA were used. These were not standardized and it’s impossible to know how much PEA they contained. Fast-forward to the late 1970s, studies started using higher-quality PEA supplements [R].
PEA (1200 mg/day) reduced the duration of the cold and symptoms such as fever, headaches, and sore throat in a study of about 900 young soldiers. Its effects were confirmed in 4 additional studies: PEA lowered the chances of catching a cold and the severity of symptoms. Researchers even considered PEA superior to flu vaccines and antiviral drugs because it was efficient, safe, and without side effects [R].
8) PEA Reduces Histamine and Allergies
PEA is a safe histamine-release blocker. People with allergies, histamine issues, and Th2-dominance will likely benefit from it. In animal and cell-based studies, PEA improved eczema and skin allergies by lowering mast cell activation and blocking the release of histamine [R].
In dogs with eczema, PEA helped soothe symptoms by reducing skin inflammation and itching. PEA reduced inflammatory substances (TNF alpha) and increased endocannabinoids in the skin (2-AG), which altogether strongly diminishes the allergic response [R].
PEA Dosage & Safety
More clinical studies would be beneficial but there are still enough data to say that PEA is an exceptionally safe supplement. Even long-term PEA supplementation is not linked to any adverse effects.PEA was used in doses of 300 mg to 1.8g/day in clinical studies.
- At least 600 mg/day may be needed to relieve nerve pain, while doses of 1,2 g/day were used for diabetic nerve pain
- PEA up to 1.8 g/day was used for reducing damage to eye nerves in people with glaucoma or diabetes
- For fighting the common cold, 1,2 g/day was the standard dosage
The total dose can be split up into two during the day. We recommend starting out with the standard dosage of 1,2 g/day divided into 600 mg in the morning and 600 mg in the afternoon. Track your response and gradually increase the dosage after 1 month if needed.
Micronized PEA supplements were used in most studies are superior to other forms. Micronized PEA is a fine powder that is better absorbed and more effective. PEA combined with luteolin was also used in clinical trials and will be exceptionally beneficial for brain health.
Pregnancy and Children
A couple of studies have used PEA in children without any risks. Larger studies would need to confirm the safety, but PEA seems to be safe to use in children based on the available data. The dosage should be adapted based on weight.
In pregnant animals and in cells, PEA was completely free of toxic or harmful effects. PEA didn’t have any potential to damage cells, cause mutation, or cancer. Even long-term PEA given at the highest achievable doses to animals (1g/kg of body weight) wasn’t toxic. These studies suggest that PEA is safe to use in pregnancy, but we advise caution in pregnant and breastfeeding women due to a lack of clinical data [R].
Soy lecithin, soy products, and alfalfa are good food sources of PEA. However, these will not be a suitable option for people with food sensitivities. Egg yolk is another great food source for people who don’t react to eggs. If you’re on a meat-heavy diet or are prone to food sensitivities, PEA supplements are a safer and more effective choice.
Even though PEA is made from saturated fatty acids, including more saturated fats in your diet will not increase your body’s PEA production. On the contrary, a diet high in saturated fatty acid will probably only increase your risk for various chronic and inflammatory health problems.
Buy Palmitoylethanolamide Supplements
Note: Make sure you buy Palmitoylethanolamide and NOT Phenylethylamine (a completely different supplement that’s also sometimes referred to as PEA)
PEA Genetics and the Bliss Enzyme (FAAH)
As a fatty acid amine, PEA is broken down by the same enzyme as our natural cannabinoids are. This enzyme is called Fatty Acid Amide Hydrolase or simply FAAH. Since less FAAH activity will increase anandamide, FAAH is also called the bliss enzyme (ananda=bliss) [R]
If you are genetically predisposed to higher FAAH activity, you will likely benefit from PEA.
Having lower FAAH enzyme activity can offer plenty of benefits.
Mice completely lacking FAAH experience less pain and seizures. It was thought that these benefits result from increased anandamide. But scientists are now realizing how important a role PEA plays — it offers some unique benefits, while others overlap with or support our natural cannabinoids [R].
For one, a lower FAAH will boost PEA levels as less of it will be broken down. PEA blocks the expression of the FAAH gene, further boosting the activity of your natural cannabinoids[R].
FAAH not only breaks down cannabinoids, PEA, and similar substances but also degrades cannabinoid receptors (CB1 and CB2). By blocking FAAH, PEA boosts the number of these receptors and your body’s sensitivity to cannabinoids [R].
PEA can also activate other receptors that boost cannabinoid activity (TRPV1).
FAAH and CNR1 SNPs
If you really want to dig deeper, your genetic data can offer you a lot of powerful insight. For example, if you know that you are predisposed to low endocannabinoid levels (high FAAH and/or low CNR1 gene activity), you’re more likely to benefit from PEA. You’ll ideally be able to balance your cannabinoids before they cause any problems.
Matching your supplements to your unique genetic makeup is a powerful approach called nutrigenomics. PEA and the endocannabinoid system is a great example of this concept in action.
SelfDecode is a software tool we created to help you analyze your genetic data.
Look at the following FAAH SNPs:
To get a complete picture of your endocannabinoid genetics, you should also take a look at your cannabinoid receptor genes, CNR1 and the following SNPs in this gene: