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The effect of balneotherapy on the serum beta endorphin level. IK Tefner 1 , É Kádas 2 , P Géher 3 , T Bender 3. 1 National Institute of Rheumatology and Physiotherapy, Budapest 2 Szeged Spas Inc. 3 Hospital of the Hospitaller Brothers of St. John of God , Budapest.
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The effect of balneotherapy on the serum beta endorphin level IK Tefner 1, É Kádas 2,P Géher3, T Bender3 1 National Institute of Rheumatology and Physiotherapy, Budapest2 Szeged Spas Inc. 3 Hospital of the Hospitaller Brothers of St. John of God, Budapest
The effect of balneotherapy on the serum beta endorphin level The effect of hot spring therapy/ thermal mineral water • very hot hot-spring therapy • balneophototerapy • radon hot spring therapy • salt water in combination with relaxation Effect of mud pack therapy Effect of sauna induced hyperthermia Effect of massage treatment (the data are from English abstracts from Pubmed)
Effect of very hot hot-spring bath on the serum beta-endorphin level 1., Very hot hot-spring bath called ’jikan-yu’ in Kusatsu-spa (47 degrees C) 7 healthy subjects 2 minutes after completing 3-minute bath BE increased (reason of intoxication feeling??) (Kubota K.et al.: A transient rise in plasma beta-endorphin after a traditional 47 degrees Chot-spring bath in Kusatsu-spa, Japan. Life Sci. 1992;51(24):1877-80.) 2., 21-year-old female showed ’dependence’ on very hot hot-spring bathing (after four 3-minute baths daily for a month) she could stop bathing with a month's isolation in hospital (explaned by a transient rise in the BE level) (Kubota K.et al.:Dependence on very hot hot-spring bathing in a refractory case of atopic dermatitis. J Med.1994;25(5):333-6.)
Effect of balneophototherapy on the serum beta-endorphin level 12 psoriatic patients 35 treatments after treatment BE no change PASI decreased (Hollo P. et al.: No significant change of plasma beta-endorphin levels of psoriasis patients after synchronous balneophototherapy. Photodermatol Photoimmunol Photomed.2004 Aug;20(4): 205-9.)
Effect of radon hot spring therapy on serum beta-endorphin level compared the radiation and thermal effect after radon hot spring therapy BE increase was higher after sauna room (only thermal effect) BE increased also (Yamaoka K. et al.: Biochemical comparison between radon effects and thermal effects on humans in radon hot spring therapy. J Radiat Res (Tokyo).2004 Mar;45(1):83-8.)
Effect of immersion in salt-water in combination with relaxation on the serum beta-endorphin level 37 patients - chronic pain of paraverterbral muscles 20 patients – immersions in salt-water 9 times in a 3 week-period 17 - control BE didn't change (anxiety, depression decreased, optimism, fall asleep increased) (Kjellgren A. et al.: Effects of flotation-REST on muscle tension pain. Pain Res Manag. 2001 Winter;6(4):181-9.)
Effect of thermal mud therapy on the serum beta-endorphin level /1. Fango therapy in the Eugenean thermal baths 6 healthy subjects BE transitorily increased (Giusti P et al.: Stress hormones liberated by fangotherapy. ACTH and beta-endorphin levels under heat stress. Fortschr Med.1990 Nov 10;108(32):601-3.)
Effect of thermal mud therapy on the serum beta-endorphin level /2. 17 patients with osteoarthritis 12 treatments BE ACTH cortisolafter first treatment decreased decreased after 12th treatment decreased decreased n.s. decreased 1 month follow-up decreased n.s. decreased n.s. decreased n.s. (Pizzoferrato A. et al.: Beta-endorphin and stress hormons in patients affected by osteoarthritis undergoing thermal mud therapy. Minerva Med. 2000 Oct; (10):239-45.)
Effect of thermal mud therapy on the serum beta-endorphin level /3. Patients with fibromyalgia syndrome Mud puck treatment + antidepressant treatment BE increased pain symptoms reduced disability improved depression improved quality of life improved (Bellonetti S. et al.: Function of the hypothalamic adrenal axis in patients with fibromyalgia syndrome undergoing mud-pack treatment. Int J Clin Pharmacol Res.1999;19(1):27-33.)
Effect of sauna induced hyperthermia on the serum beta-endorphin level /1. 12 healthy subjects 1 hour after sauna BE didn't change (Bussien JP. et al.: Haemodynamic role of vasopressin released during Finnish sauna. Acta Endocrinol (Copenh).1986 Jun;112(2):166-71.) 11 healthy women BE variable (no significant effect) (Laatikainen T: Response of plasma endorphins, prolactin and catecholamins in women to intense heat in a sauna. Eur J Appl Physiol Occup Physiol.1988;57(1):98-102.) 6 healthy subjects after sauna BE increased Methionin-enchephalin didn't change (Vescovi PP.: Circulating opioid peptides during thermal stress. Horm Metab Res.1990 Jan;22(1):44-6.)
Effect of sauna induced hyperthermia on the level of serum beta-endorphin /2. baseline se BE levels se BE after treatment 8 male heroin addicts (after 14 days of abstinence) decreased no change 8 norman men normal increased (Vescovi PP: Impaired ACTH and beta-endorphin response to sauna-induced hyperthermia in heroin addicts. Acta Endocrinol(Copenh).1989 Oct;121(4):484-8.) 8 male cocain addicts (after 14 days of abstinence) 8 normal men increased (normal values after 30 min) (Vescovi PP et al.: Hyperthermia in sauna is unable to increase the plasma levels of ACTH/cortisol, beta-endorphin and prolactin in cocain addicts. J Endocrinol Invest. 1992 Oct; 15(9):671-5.)
Effect of massage treatment on the level of serum beta endorphin 12 haelthy subjects, 30 min treatment BE before treatment 5th min after treatment increased (maximum!!) 30th min increased -until 60th min 90th min (Kaada B.et al.: Increase of plasma beta-endorphins in connective tissue massage. Gen Pharmacol.1989; 20(4):487-9.) 21 healthy subjects BE 10 patients: 30 min paravertebral massage no change 11 patients: - no change (Day JA et al.: Effect of massage on serum level of beta-endorphin and beta –lipoprotein in healthy adults. Phys ther. 1987 Jun; 67(6):926-30.)
Summary • the role, the exact localisation of the opiate-receptors, the mechanism of the effect of endogen opiates (also beta-endorphin) is still not completely clear; • there are no randomized placebo controlled double blind trials; • in other studies there are significant and not significant changes of se beta-endorphine reported; • the change of se BE is often not parallel with the clinical picture; • the clinical symptoms are not directly formed by circulating beta-endorphin; • in the future it is advisable to search for more correlation between the treatment and the clinical symptoms including se BE changes.