A Real Recovery Plan for Concussion

All right. This is our last episode in our series on concussions, traumatic brain injuries. Don't forget that PTSD, traumatic emotional life events, can induce the same type of brain impact, high cortisol, et cetera, like a traumatic brain injury. So keep that in mind as we go through this. But what are the basics behind treating a patient? We've— hopefully by now you understand the nuances of Why the whole body is involved with a traumatic brain injury concussion, why it's difficult to diagnose, how our system overlooks it. So the question is, so what? Now what? That's what we're going to talk about now. Hopefully this information is helpful. A little bit of housekeeping. Most people listening to this right now actually do not follow this podcast. So if you could just click the button below, that'll be super helpful to us. Part of this is just getting the word out, and that's how you can help us get the word out there. So let's kind of dive into this and talk about what are some of the basics behind traumatic brain injury. But I want to start with this. When I see a new patient who's just had a traumatic brain injury, one of the most important things that you can do acutely is hyperbaric diving because that automatically bypasses a lot of the metabolic issues we've talked about already and the blood flow issues. And then, if you don't have access to that, doing sensory deprivation in a float tank. I had one of my patients who was diabetic, had uncontrolled diabetes, who she couldn't afford to do hyperbaric. It was amazing to see how quickly she responded to sensory deprivation, doing that twice a week over the period of 4 weeks. And when we started doing it, she already had had post-concussive syndrome symptoms for almost 6 months. So, it's really interesting to see how powerful flotation and hyperbaric are. So, that's just something to keep in mind if you're looking for a quick fix, those can be super helpful. And most people, I think, have access to the sensory deprivation in our country, which are the float tanks. Hyperbarics a little more tricky and a little more pricey. But outside of that, for the acute stuff, what is your? What's the general plan? The first, the first thing you have to have is you have to have a a general plan for actually decreasing the inflammation. And the first thing I do is actually have people do a TBI diet. It's a diet that actually helps control brain inflammation. It's a standard gluten-free, dairy-free, soy-free. It's an anti-inflammatory diet. Avoiding genetically modified foods, avoiding sugar, processed foods, but you got to get lots of healthy fats, particularly omega-3s, omega-6s. You know, 30% of Americans actually have a C15 deficiency, which is a special saturated, essential saturated fatty acid that you get actually from fermented dairy cream. So low-fat milk, low-fat cheese, low-fat stuff has removed that from our diet. And up to 30% of Americans have a low level of this. So just getting healthy fats in can be a super huge thing. Obviously avoid alcohol, avoid any drugs. Don't treat the anxiety and the worsening OCD with marijuana because that actually slows brain healing. You have to make sure you get adequate protein, healthy, clean, lean sources of protein, cruciferous vegetables, green colorful things that are anti-inflammatory, and lots of choline. One of the things that I'll do in my clinic is actually intravenous phosphatidylcholine and oral phosphatidylcholine where nature's source for this is actually like egg yolks. Chicken, turkey, collard greens, broccoli. You know, it's amazing how helpful these things diet-wise can be. And that's like stage 1, getting an anti-inflammatory diet. There are certain nutrients that particularly are brain protective. And one of my favorites, you know, in addition to omega-3s I mentioned over and over again, which omega-3s, particularly a clean fish-derived omega-3, is actually curcumin. There's actually a type of curcumin called C3-desmethylcurcumin. Which is in— it's a small subset of a typical turmeric supplement, but it acts in your brain like butyrate. So, if you have gut issues and you're not making appropriate butyrate, all of a sudden, the curcumin can actually be super helpful. And those doses are anywhere from 1,000 to 2,000 milligrams a day. And the DHA is usually 2 to 4 grams a day. SPM-Active is another great anti-inflammatory supplement that actually acts like a steroid. It's an extract from fish oil. They're pro-resolving mediators is the actual fancy term for them, but they have a potent anti-inflammatory impact. And, a lot of times, I'll use things like BPC-157 because that can quickly start lowering the leaky gut and leaky brain particularly. So, these are all simple things that can be quick on the front end to help. Then, there's quercetin, pycnogenol. I don't use a lot of antibiotics like minocycline, which can actually help with inflammation in your brain and lower endotoxin counts. But there are some— there's some research out there. That's all the stage 1. Stage 2 is actually stabilizing the blood-brain barrier because ultimately when you get a leaky brain, you get leaky gut. And so stabilizing that will minimize, one, toxins leaking out of your gut causing inflammation in your brain. And if they do leak out, they'll have less impact if your brain is tight. So again, curcumin, lipoic acid, resveratrol. It's interesting how important vitamin D levels and how many people are deficient in vitamin D. Depending on what you read, maybe 40%, maybe 60% of the population. My clinical experience is almost all my patients who aren't supplementing with vitamin D, the levels are low. And the optimal level you want for the anti-inflammatory effect is a level between 60 and 80. You have to also focus on stabilizing cell membranes. Again, that's going back to omega-3s, phosphatidylcholine, balanced omega-3s and 6s, taka-torsodeoxycholic acid, which is a bile acid derivative that actually helps stabilize cell membranes, and butyrate, which I've mentioned multiple times. You can actually buy butyrate. And there's actually a type of butyrate called glycerylphenylbutyrate or Tributrin is the brand name. That's a specific kind of butyrate that's well absorbed and actually helps with brain injuries more than the standard. The standard butyrate actually mostly stays in your gut and works through the bacteria in your gut. This Tributrin actually will pass through your GI tract and actually gets better penetration to your brain. And then, taurine is a great amino acid. It's an anti-inflammatory but actually helps in bile production, gut balance, and membrane stabilization. And you want to minimize the toxicity of your brain. Magnesium is probably one of the best things for this, which sensory deprivation, sometimes doing high doses of oral magnesium. Some of my patients actually will do IV lipids as well as IV, not at the same time, you can't mix them, IV vitamin C. And I'll put a little extra magnesium sulfate in that. Again, that can actually by itself be an antidote to the brain inflammation going on from a traumatic brain injury. Earlier in my career at the Medical College of Virginia, patients would come in sometimes with seizures, horrible migraines, and we'd do IV magnesium and it worked so great. That was before triptans became a thing and before a lot of the newer seizure medications came on board. But it's old school, it works pretty safe. And when you look at the average American is deficient in magnesium, we just kind of need more of that in our life. And then you want to work on— the last part is working on mitochondrial restoration, improving mitochondrial function. If you heard on the earlier episodes, one of the things that happens through the disruption of glucose metabolism, you have an energy production issue. So all of a sudden, getting adequate amounts of B vitamins, vitamin 3, B12. There's a particular B vitamin called nicotinamide riboside, which actually is an active form of niacin, that is super potent. CoQ10. You know, as we get older, all of our CoQ10 levels go down to the point that— Yeah. A general recommendation is anybody over 50 should consider 100 milligrams of CoQ10 daily. Individuals with brain injury all need some type of CoQ10 support. And there's some other kind of cool things like Synapsin, which is a nasal spray. It's actually a ginseng extract that helps block cortisol impact with nicotinamide riboside, which is that B3 vitamin specialized form, but plus B12 through nose to your cribriform plate has a profound brain anti-inflammatory impact. I've had multiple patients who do well just with that. Yeah. We talked about earlier on, part of this is balancing your hormones. So, depending on your age, if you're 12, 16, if you're 50 or 60, there'll be different needs there and gets a little tricky. So, and hormone optimization is its own podcast series, which we've done earlier on. I won't dive too much into that. But, with brain injuries, you tend to see issues with growth hormone, sex hormones, men, particularly testosterone. So, if you notice that, Just replenishing those can help the brain to self-heal and repair. And, there's lots of great data between— with growth hormone stimulators as well as progesterone there. And, if someone's cortisol is high, which can happen, abating that and giving people the antidote for that, which are certain adaptogenic drugs— herbs, I'm sorry. It's really interesting. Back in the 1960s, a lot of Russian athletes started using adaptogenic herbs because what it does is it stops the inflammation from extreme exercise. So, it allows you to recoup better so you can keep on training really hard, which is what The athletes in Russia were using it for. I use it in my patients in a similar way but different. And so, my patients with a brain injury or chronic cortisol levels elevations related to their health issues, you can use things like ashwagandha, astragalus, andrographis, et cetera, to help abate some of that impact. And then, things that can actually help your brain make new neurons. So, low doses of nutritional lithium orotate, 10 to 20 milligrams. Melatonin is a very, very powerful It's a very powerful brain anti-inflammatory. And pretty much all my traumatic brain injury patients will have some kind of sleep disturbance. And so, using a 5 or 10 milligram of melatonin at night before they sleep, super, super powerful. And then, there's other things like C-Lanc, C-Max, which are some peptides which are a little more difficult to get a hold of these days. Methylene blue is really, really super interesting. It's a blue jean dye that was invented in the 1880s. That actually is neuroprotective. There's interesting research on it with Parkinson's patients, but also can be helpful in brain injury patients. It also helps— it's a mild MAO inhibitor, which means it actually improves certain neurotransmitters gently. Obviously, you're going to be getting this from a provider. And then you want to help your brain. The next stage is helping your brain remodel, rebuild. That's when you start adding in graded exercise. You don't try to push it too much. You kind of feel where your body is at and start with a, you know, it could be just walking 15 minutes a day. It could be whatever your threshold is. You want to be right below that. One of the issues that people with traumatic brain injuries or concussions will do is they won't realize there's a metabolic threshold and they'll push it over that. And what happens is you will feel worse the next day. If you ever do anything and it takes you 2 or 3 days to recover from it, you did too much. Like a good day, a good workout, you know, for me it's yard work or doing whatever. Usually I wake up the next day, I feel good. Right. If you wake up and you feel draggy, like, oh my gosh, I'm still recouping from yesterday's activities, you pushed your mitochondrial capacity, you pushed it too much, and you just got to keep that in mind. And there's a lot of brain retraining stuff. And this is where sometimes working with, if you have the vestibular issues I mentioned before, working with a neuro-ophthalmologist to figure out where in your vestibular system you have a deficit to get certain exercises, crossword puzzles, luminosity, Things that make you use your brain, but don't stress it. And that's one of the, you know, early on, you know, when you have a concussion, right? You do brain rest, right? Well, once you're into the chronic phase, you can actually do exercises to help the brain kind of repair and help itself. But you have to realize there's a threshold. And if you push past it and your anxiety gets worse, your sleep gets worse, you know, your sleep quality goes down, you pushed it too much. So think about these therapies. In light of the past symptoms from the first 3 episodes, if you're doing anything that makes those things worse, stop. Don't keep on pushing it because that's how people can actually make their traumatic brain injury worse. And there's actually been other— there's been— I've seen cases of individuals who pushed it and their brain injury got worse over time because they weren't respecting that metabolic threshold. And then, you know, there's a lot of interesting things with vagal nerve activation using frequency-specific currents, you know, vagal nerve activation with electrical devices on your ear. It depends on what other symptoms you may be having. If you're having migraines, there's Cefaly is an electrical stimulation device that actually activates your vagal nerve through your V1 up here on your forehead. Different things like that can actually help with neural stability and be indirect ways to actually rekindle, modulate your brain. So, just be aware of that. But you want to make sure that whatever you do, you don't push it and make things worse. That's the key. And that's where particularly young people get in trouble because they start feeling better. And they push it and then they crash out. You've got to realize there's a threshold and you don't want to put push past that. And we already we already mentioned hyperbaric, and then long term, like how do you actually? What are things you can do to help prevent a second, third, or fourth injury? That's where getting your omega three levels up, making checking blood levels, making sure your D, vitamin C, those levels are appropriate. Adding on creatine, which actually helps make energy and helps improve some of the energy issues. Having curcumin, vitamin. Mixed vitamin E, mentioned D, magnesium. You know, the average something like depending on what you read, anywhere from 40 to 60% of Americans are magnesium deficient. You know, so just adding in magnesium glycinate or bisglycinate, the glycine turns into GABA, which actually is brain calming. The magnesium helps on that NMDA receptor I mentioned in episode one and two to block that fee forward cascade. Putting magnesium in can be part of a neuroprotective to prevent another event kind of protocol. And then, are you having emotional sequelae, mood swings, et cetera? Using different amino acids, tryptophan, theanine to help with anxiety, taurine, even doing cognitive behavioral therapy or some kind of brain rewiring, brain training. One thing that happens actually, you can get from these things, limbic kindling, you can get activation of your amygdala. And so, you basically, your emotional status is not stable. And so, doing some kind of brain retraining, whether it's dynamic dynamic neural, DNRS, dynamic neural retraining, whether it's primal trust, even acupuncture can be helpful here with calming your nervous system down. But the core is you have to look at the big picture of what's going on and start addressing it one piece at a time. And finally, I want to tell people there are answers, there is hope. I've dealt with some people with some really, really bad traumatic brain injuries, some for years, who we've actually been able to get better with Peptides, with phosphatidylcholine, with hyperbaric. The more complicated people, you tend to have to look at all these factors, their gut and their hormones and their environment and heavy metals and toxins. And even something like if you have a lot of gut issues, something as basic as activated charcoal, which is the best binder for endotoxins, lipopolysaccharides. Sometimes adding these little things in while you're working through a gut protocol can be super helpful. So that's the end of our traumatic brain injury series. I think we put together 6 of these. If this was helpful, please follow us, Please share. That's how we get this information out there. If there's a topic you'd like to talk about, you'd like me to take a little deep dive into it like I did with this one, please ask us. That's how this kind of came out. We had some people, multiple people actually asking us about it. My team kind of got it forwarded to me and we put it in our queue. So, thanks so much. Hopefully, this is helpful. Take care and we'll talk to you soon.