Patient case (clinical description): A 61-year-old man comes to the emergency department complaining of an acute vision disturbance. He had an episode of vision disturbance in the right eye that occurred suddenly and resolved spontaneously in 15 minutes. He also has right jaw pain while chewing.  He also complains of fatigue and hip muscle aches over the last several months.  The patient has a history of mild hyperlipidemia that has been controlled by diet and lifestyle modifications.  On examination, his blood pressure is 130/70 mm Hg and pulse is 66/min.  Neurological examination is unremarkable.  Visual examination is also normal. ESR is 103 mm/h. Temporal artery biopsy shows multinuclear giant cells and internal elastic membrane fragmentation.

Patient's own account: I’m a 61-year-old man and I came to the ER because I had a sudden episode where I couldn’t see out of my right eye. It only lasted about 15 minutes and went away on its own but it really scared me. I’ve also been having pain in my right jaw when I chew. For the past few months I’ve felt really tired and noticed my hips ache a lot. I have a history of mild cholesterol issues but I’ve been managing that with my diet and lifestyle. When the doctors checked me my blood pressure and pulse were normal and my vision and neurological exams didn’t show anything wrong. However they ran some tests and said my ESR levels were very high and a biopsy of my temporal artery showed some inflammation and damage.

Clinical trial: Safety and Efficacy of Cunermuspir on Energy, Strength, and Fatigue in Patients With Nerve or Muscle Pain

Eligibility criteria:
Inclusion Criteria:

          -  Male or female age 18-75

          -  If female, subject is not of child bearing potential. Defined as females who have

          -  had a hysterectomy or oophorectomy.

          -  bilateral tubal ligation or are post-menopausal (natural or surgically with > 1 year
             since last menstruation).

          -  Female subject of childbearing potential must agree to use a medically approved method
             of birth control and have a negative urine pregnancy test result. Acceptable methods
             of birth control include: Hormonal contraceptives including oral contraceptives,
             hormone birth control patch (Ortho Evra), vaginal contraceptive ring (NuvaRing),
             injectable contraceptives (Depo--Provera, Lunelle), or hormone implant (Norplant
             System), Intrauterine devices, Vasectomy of partner, Total Abstinence

          -  Subject has unresolved persistent muscle or nerve pain (muscle or nerve pain
             population)

          -  Subjects using other therapies for nerve/muscle pain (e.g., exercise, TENS,
             acupuncture, exercise, psychotherapy, massage, physiotherapy, etc), must be used at a
             stable schedule for 1 month prior to the trial and subject agrees to continue these
             therapies at the same schedule during the trial avoiding changes in frequency or
             intensity and to record therapies in the study diary

          -  Agrees to comply with study procedures

          -  Has given voluntary, written, informed consent to participate in

          -  the study

        Exclusion Criteria:

          -  Women who are pregnant, breastfeeding, or planning to become pregnant during the
             course of the trial

          -  Planned surgery during the course of the trial

          -  Use of prescription drugs for fibromyalgia or nerve pain (e.g.Lyrica, Cymbalta and
             Savella and others).

          -  Use of prescription medications for depression, anxiety or other mental disorders

          -  Requires the use of prescription drugs to control pain (other than provided rescue
             medication)

          -  Use of oral or topical prescription or over the counter medications or natural health
             products for pain relief 3 days prior to randomization and during the trial (other
             than provided rescue medication)

          -  Use of natural health products including vitamins and minerals within 3 days prior to
             randomization and during the trial

          -  Use of blood thinning medications (e.g. warfarin)

          -  Chronic lyme disease or chronic parasitic infections

          -  Uncontrolled hypertension defined as untreated systolic blood pressure > 160 mmHg
             and/or diastolic blood pressure > 100 mmHg

          -  Subjects with diabetes

          -  History of bleeding disorders, or significant blood loss in the past 3 months

          -  Alcohol use >2 standard alcoholic drinks per day and/or alcohol or drug abuse within
             the past year

          -  Allergy or sensitivity to study supplement ingredients or acetaminophen

          -  Participation in a clinical research trial within 30 days prior to randomization

          -  Individuals who are cognitively impaired and/or who are unable to give informed
             consent

          -  Any other condition which in the Investigator's opinion may adversely affect the
             subject's ability to complete the study or its measures or which may pose significant
             risk to the subject
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Contradiction