Why Some Concussions Never Fully Heal - The Hidden Causes of Chronic Brain Inflammation with Dr. Aaron Hartman | E168
7 Aug 2026 · 10 min
Dr. Aaron Hartman explains why some concussions cause chronic brain inflammation that lasts years. He identifies five feedback loops that keep inflammation going: blood-brain barrier damage, gut dysbiosis, mold exposure, hormonal deficiencies, and mitochondrial dysfunction. Treatment involves omega-3s, diet changes, hyperbaric therapy, and addressing underlying toxins and hormonal issues.
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One study showed that 100 patients referred for persistent symptoms of post-concussive syndrome had them up to 6.9 years after an injury. So that's a big deal. A lot of people are dealing with ongoing symptoms and they don't even realize it. Point is, people again get stuck. And part of it is not— is being able to diagnose that. Because we have this diagnostic challenge. Like, how do we diagnose post-concussive syndrome? It's based mainly on symptoms, not biological testing. Not anatomical testing, not inflammatory testing, just symptoms. Why is it some people just don't get better? They had traumatic brain injury, concussion. Oh, they had a traumatic life event that resulted in an emotional stress-induced post-concussive syndrome, which actually is a thing. And they're just not getting better. They waited like the doctor told them, they rested.. And after 1 month, 2 months, 3 months, they are still stuck and not getting better. I want to talk about this episode. What are things that keep people stuck and keep the brain from healing after a brain inflammatory event, primarily traumatic brain injury, concussion, but also can be a stress trauma event as well. So that's what we're going to talk about now during this episode. If this information is helpful, please follow us, share this information. Most people listening to this right now actually don't follow us. So if you just click the button below, that'll be super helpful just for us to, one, to know that people are listening, and two, also to help get the word out there because that's how the stuff kind of in all the algorithms actually gets shared is by you engaging with it. So we'd be super appreciative if you would do that. So back to our discussion. Your brain is stuck in this firestorm, persistent inflammation. Is this that common? And what can be done about it? You know, one study showed that 100 patients referred for persistent symptoms of post-concussive syndrome had them up to 6.9 years after an injury. So that's a big deal. A lot of people are dealing with ongoing symptoms and they don't even realize it. We're not going to go through all the stuff we've— symptoms we've already discussed. But the point is people again get stuck. And part of it is not— is being able to diagnose that. Because we have this diagnostic challenge. Like, how do we diagnose post-concussive syndrome? It's based mainly on symptoms, not biological testing, not anatomical testing, not inflammatory testing, just symptoms.
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A typical post-concussive syndrome is persistent symptoms beyond the recovery window of 3 months for a mild TBI. Those don't include emotional trauma. They all include these micro-concussions that can build up over time. So you might have 4, 5, 6, 7, 8. If you're a football player, you might have, again, 20 on a Friday night, or soccer player. So all of a sudden, if you don't have the right criteria or the right understanding, you're going to overlook all large amount of these. And there's also a lot of research supporting underlying biological causes for this happening. So that's what we're going to talk about. The first one is the chronic brain neuroinflammation that just won't go away. You know, if you have disruption in your blood-brain barrier, if you have abnormality in fatty acids, you have a horrible diet. You know, we just got over the 70-year craze of low-fat diets. Well, one of the results of low-fat diets was introducing seed oils, processed fats, high carbohydrates, high sugar, and all these actually cause brain inflammation. So part of this chronic— many people actually have low-grade brain inflammation from the get-go, and they have an event that pushes them to the edge, and it's hard to pull that back because of this. This can be driven by ongoing leaky gut, leaky brain. It can be driven by ongoing bacterial overgrowth or gut dysbiosis. It can be driven by ongoing food reactivities. Maybe you react to gluten, dairy, soy, corn, tree nuts. A part of the dietary recommendations that we'll talk about the last episode for— there's actually a TBI, traumatic brain injury diet to follow, right? Well, if you're not doing that and you're eating lots of inflammatory foods, it can keep this cycle going. Mold and mycotoxins, you know, a lot of what we deal with in our clinic are people with chronic inflammatory response syndrome. So if you're still working in the moldy place, still going to that school, I feel like every school or most schools around here in Richmond, Virginia have some kind of mold and we travel. You know, we go out to Arizona a lot and it's a desert and there's so many buildings out there that have mold issues because of envelope, housing envelope issues. So it's amazing how prevalent building water damage buildings are in mold environment. Even EMF exposure. It's interesting. Being exposed to EMF by itself can disrupt your blood-brain barrier. That could be— now I'm truly found just down from our house. There's actually a house being built within 100 feet of a cell tower. You know, that's pretty close. You have high power lines.
Yeah.
There's a car dealership down the street from us I watched being built. And literally right behind it is a massive cell tower. So, the employees there are getting exposed to EMF all day long at work. So, all of a sudden, environmental exposures can kind of help keep blood-brain barrier going. And even hormonal deficiencies, maybe, you know, it's amazing how many people as they get older develop growth hormone deficiencies. And one of the things that growth hormone helps your body do is heal quicker. Well, if that's low, all of a sudden, You're going to stay stuck on sleep deprivation, chronic stress, stress, and even neurotoxin exposure like heavy metals, mercury in your mercury fillings, mercury in all sushi you're eating, lead, pesticides, heavy metals. All of a sudden, having a comprehensive nutritional analysis, heavy metal analysis, looking at your environment can all play into your symptomatology. One of my newer patients recently that I've been seeing, you know, with her autoimmune inflammatory issues, etc., etc. They live right on a golf course. And so she's been exposed to a lot of stuff routinely that can cause neuroinflammation. And so all of a sudden, you have this there and it just keeps this process going.
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There are 5 feedback loops that actually keep this perpetual brain inflammation going. The first is the inflammation cycle itself, which I briefly mentioned all the different ways. Stress, you know, low-grade stress, high cortisol can actually by itself induce leaky gut. And leaky brain. So all of a sudden, like, what things you do, what's your life look like? But people don't also realize that screen exposure into nighttime, you know, you shouldn't be getting any blue light screen, you know, got all these lights shining on me right now for this video recording. You don't want this within 2 hours of going to bed. All of a sudden, high light exposure driving cortisol, environmental stress, work-related stress, all these things can actually keep you stuck in this non-healing pathway. If your gut's off, we talked about that enough. I don't want to talk about the gut-brain axis more, but the idea, if your gut's off, it's going to keep your brain stuck. Pulmonary problems and even energy, mitochondrial damage, insulin issues, thyroid problems. You might have a low-level hypothyroidism, a low-level elevated cortisol or insufficient cortisol, insulin resistance, nutrient deficiencies. All of these things can keep you stuck in this feedback loop. And the problem is our standard healthcare system overlooks almost all of these things. The standard concussion treatment is rest, right? And if you don't get better, you go to a special PT that does physical therapy to help with your post-concussive syndrome. And that is kind of sort of it. There's no full hormonal evaluation. There's no gut evaluation. There's no nutrient evaluation. If your omega-3 levels are low, you're going to have a pro-inflammatory phenotype, which means you're more prone to inflammation. So all of a sudden, Getting your omega-3 levels up can be super powerful. There's a really interesting— when I was in the military, I was actually deployed to Landstuhl Regional Medical Center during the Second Gulf War. We ended up seeing a lot of people with post-concussive things from IEDs and a bunch of different things. And it's amazing how much omega-3s were helpful with those individuals in lowering inflammation. There's a lot of interesting data on football players and athletes post-injury and having omega-3s can actually help lower the neural inflammation. The point is there's a lot of things at play here that our current system just overlooks and doesn't pay attention to. They don't look at any of that stuff. They don't look at stress as being a thing that can keep this thing going. So the point is, is that as you're doing evaluation for yourself or a loved one and thinking about what is keeping you stuck, why are you still there? Why is your body not getting— once you understand that, you can start addressing those. And what I want to talk about in the last episode is how do I look at these individuals and what are some of the protocols that I put together looking at diet, environment, toxins, brain health, gut health, to start getting the body to self-heal and self-repair. Because ultimately your body was made to self-heal and self-repair. If you can give your body what's lacking, remove the roadblocks to your body self-healing, it will do what it was made to do. And then obviously if you're lacking hormones, or you need to be a little older, peptides can be helpful. You know, hyperbaric can be amazingly helpful. There's a lot of cool things that can be helpful in helping your brain self-heal and self-repair., but you have to look at the whole milieu, the whole environment to really get a good plan together. So last episode, we'll talk about that. What does a plan— what does a generalized post-concussive syndrome plan look like? Take care. We'll talk to you soon.
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