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RadioMD Presents:Healthy Talk | Original Air Date: May 26, 2015

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DR MIKE: So, continuing with our conversation about wound healing, I have a question about a dog bite. It's really not about the dog bite.

"I'm recovering from a dog bite. There's no rabies, just a slow healing wound. I read that certain amino acids are critical to wound healing. Can you please review some of these?"

Yes, so this is a continuation from the previous discussion about wound healing where I talked about calories and making collagen and cell proliferation. I talked about carbs, protein fat, vitamin C, zinc, B vitamins, water --all those are important to any wound. It doesn't matter what caused the wound. But this person is specifically asking about certain amino acids that play a role in wound healing.

I had to do some research here. I was more familiar with more the general nutritional suggestions for wound healing but when it came to amino acids, I did some research and found some interesting stuff. And what I discovered--let me go ahead and --there's two amino acids that are really important.

But then, just doing this research, I discovered some other things like bromelains and glucosamine, aloe vera, curcumin. So, let me just kind of first start with amino acids but then I want to share with you some of the other information that I found when I was researching the amino acids.

So, the first amino acid that seems to be really important to any wound is arginine. I think most of you are familiar -- you know we use arginine, traditionally speaking, for nitric oxide production, cardiovascular system, erectile dysfunction for men, that kind of stuff. There's even a link to testosterone. But arginine also - besides all of that more traditional use - arginine is important to a part of the immune system called the cellular immune response. And it's the cellular immune response that fights bacterial infection.

And, as you know, in open wounds that's critical. Often one of the reasons a wound, especially from a bite -- human, dog, cat, doesn't really matter -- is the introduction of pathogenic bacteria and you get this smoldering ongoing infection that's really hard to treat in many cases. And that leads to this chronic wound that never really closes up. Maybe it does eventually close up. It could take months, even years down the line but now you have a nice scar.

Turns out arginine could really help in this process. It says here, I got this from some research coming out of-- let's see this was the Journal of Nutrition from a Dr. Patel in 2005--he was looking at arginine and found that it was not only important to the cellular immune response but it was also important to protein synthesis at the wound site and increases local wound immune function. He was recommending 17 to 25 grams of oral arginine a day and that's in contrast to the normal daily requirement of 5 grams. So, you're talking about a substantial increase in the amount of arginine for a chronic wound.

And again, it's fighting the bacteria and, according to Dr. Patel, it's also increasing protein synthesis at the wound site.

The second amino acid was glutamine. Glutamine is just critical for fast growing and multiplying cells along with B vitamins; along with zinc. I mentioned those before but in this case, just focusing on the glutamine. Glutamine probably has its largest effect, its greatest effect, I should say, on the proliferation of fibroblasts which are these cells that are important to your eating up the necrotic tissue and laying down brand new connective tissue.

So, fibroblasts play an important role in the closure of a wound. Glutamine has a great impact on those fibroblasts. As a matter of fact, there was, in my research, I came across a couple of pathology books that talked about how during the creation of a wound and in a few weeks after that wound was created, glutamine is one of the major amino acids that is lost during that tissue injury.

I thought that was pretty interesting. They didn't really explain why, but glutamine is depleted during tissue injury. So, that really implies a significant role, obviously, in wound repair. We've got to get that glutamine back into your system. According to researchers, glutamine possesses anabolic properties. That's building-up properties which are effective in wound healing.

But you need amounts about two to seven times greater than required in healthy persons and that came from a Dr. Roth in 1990. So they've been looking at glutamine for quite some time now in wound healing. But you've got to do a lot - two to seven times more than what a healthy person might need.

Now, what about some of these other...So those are the two amino acids--arginine and glutamine--for wound healing. But in this research, as I said, I came across some other pretty interesting stuff. Bromelain from pineapple, some proteolytic enzyme, and I've heard about bromelain's healing properties before.

I even know some plastic surgeons that use bromelain to close up wounds, surgical wounds. It just has strong anti-inflammatory properties and is able to break down and dissolve proteins that need to be broken down in the wound so that you can rebuild that connective tissue. There is even a study showing that bromelain led to a faster resolution of swelling and a decreased dependence on pain medications.

Now in that particular study, it was looking at patients with open wounds from fractures. Those can be horrific open wounds, you know? Bromelain was beneficial in those really horrific type injuries. So, that's very promising. That's bromelain. Now, if you eat pineapple you'll get a little bit of bromelain. It does break down protein, as we said. As a matter of fact, you can use pineapple and stuff like that, papaya, as meat tenderizers, because there's bromelain in there and it breaks down the protein. But you're not going to get enough.

You are going to have to look for bromelain supplement. Glucosamine is very important. I think most of my listeners, you guys are familiar with glucosamine as a joint product, right? Glucosamine, MSM, chondroitin, although I don't use chondroitin. It's too big of a molecule. It doesn't absorb well. But glucosamine is classic for joint health, joint repair. And yes, it's great for wound healing as well. It repairs connective tissue. It repairs skin, tendons, ligaments, joints. Animal studies show that levels of glucosamine increase in injured tissue during healing. So, the body knows it's important so when someone is trying to heal, you can measure a certain amount of glucosamine in the healing tissue.

Now, the human studies, when I was doing my research, the human studies on the effects of glucosamine in wound healing really weren't there yet. There's a lot of cell culture studies. There are some studies identifying the fact that glucosamine is in a healing wound, like I mentioned, but there's not a lot out there about the ability of glucosamine to actually heal, to repair, to regenerate and close up the wound.

So, it's hard for me to even give you a dose on this. But I would, probably, if you want to try glucosamine, you're probably going to want to maybe double what you might normally find in a joint product -- so 1500mg, 2000mg, maybe even 2500mg of glucosamine.

Aloe vera has some healing properties, so that's something else you might want to try. An animal study showed that it's helpful in frostbite, electrical injuries, diabetes. And then, of course, one of my favorites, curcumin, is a great anti-inflammatory. So, there are some suggestions but to answer the question, arginine and glutamine -- good amino acids for healing.

This is Healthy Talk on Radio MD. I'm Dr. Mike. Stay well.