The effect of balneotherapy on the serum beta endorphin level

1
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
2
The effect of balneotherapy on the serum beta
endorphin level
(the data are from English abstracts from Pubmed)

• 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

3
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. 199251(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.199425(5)333-6.)

4
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 Aug20(4) 205-9.)

5
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 Mar45(1)83-8.)

6
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
  Winter6(4)181-9.)

7
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
  10108(32)601-3.)

8
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.)

9
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.199919(1)27-33.)

10
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 Jun112(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.198857(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
  Jan22(1)44-6.)

11
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
  Oct121(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.)

12
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.)

13
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.