How Supplements & Mitochondria Can Speed Up Brain Injury Recovery | Scott Sherr

What if the reason you're exhausted, you're tired, you're distracted, maybe forgetful or emotionally reactive isn't your fault?

94% of US adults have mitochondrial dysfunction.

Millions of people worldwide are walking around with undiagnosed brain trauma, maybe from a fall, a car accident, a sports hit, or even emotional stress, and it's silently holding you back. A lot of people don't realize that when they were young, they probably had more brain injuries than they What if the real cause was an invisible injury to your brain, one you didn't even know that maybe you had?

Once you've had one concussion, your brain's still at risk for more, even many years later.

But here's the great news: your brain can heal.

If you can get somebody into a hyperbaric chamber with a severe brain injury, you can save their life 50% more of the time overall.

It's kind of like your recovery superpower.

Mind your GABA.

Mind Welcome back, Kwik Brains. I'm your host and your brain coach, Jim Kwik. Today we're talking about something close to my heart, which is brain recovery. You know, in our trainings, we talk about the 10 tenets to having a limitless brain, and one of them is brain protection. But how do you recover after you've had an accident? You know, so whether it's a concussion, you're suffering from brain fog, you're suffering from a traumatic event, Maybe some burnout. Your brain is constantly healing. It's looking to heal. And if you've ever wished for like a reset button, then this episode is for you. Over 2.8 million people in the US sustain roughly a traumatic brain injury every single year. There's about a quarter of a million hospitalizations, upwards of 69,000 deaths from TBI in 2021 alone. 1 in 60 people in the US lives with with a TBI-related challenge. An estimated 69 million people globally experience a TBI every single year. Today we're talking with one of the world's leading experts on brain recovery, Dr. Scott Sher. Whether you've had a brain injury, what Scott is going to reveal is the cutting-edge science of how to regenerate your mind, restore your Your functionality, your memory, and reignite your limitless potential. So whether you've had a concussion, you deal with these kind of issues, this episode really has been the one you've been waiting for. Dr. Sher is a board-certified in internal medicine physician, has a passion for healing the brain using a number of powerful, and some of them very little-known tools, but science-based. He combines science with a systems-based integrative approach to help people recover from brain injuries, optimize their cognitive performance, and feel fully alive again. I just wanna remind you the small little quick disclaimer, like all our podcasts and programs, this material is, is meant for educational purposes. It is not intended to diagnose or treat any medical conditions. So use this information as part of your personal research and talk to your health practitioner or medical doctor for your, or maybe you're learning this for a family member for their specific situation. So if you or someone you love is struggling with a brain injury or something else, or maybe, or you just want to boost your brain's ability to perform, to be able to heal, to repair, to be able to grow, this conversation will show you really what's possible. So welcome to the show, Scott.

Well, thanks for having me, Jim. It's good to be here. I appreciate it.

We've been friends for a bit. You know, many people listening know that I had a TBI, traumatic brain injury, when I was a child. Before age 14, I've had a number of concussions on top of that. And the team sent me some stats, which is, you know, which is interesting. And just for people to, just to really for this to land, you probably, if you're not struggling in this area, this episode will still help you to be able to have better brain health, but certainly help somebody that, you know, that the listener knows, right?

Absolutely, yeah.

Over 2.8 million people in the US sustain roughly traumatic brain injury every single year. There's about a quarter of a million hospitalizations, upwards of 69,000 deaths from TBI in 2021 alone. 1 in 60 people in the US lives with a TBI-related challenge. And, you know, this is something that is, when I say it was invisible, some people don't even know that they're struggling with this, right? TBI is a leading cause of death.

Yeah.

and disability worldwide. I hope that lands. An estimated 69 million people globally experience a TBI every single year. And so this is why I'm saying this is very, I mean, near and dear to my heart. I just came from an event where I was speaking at and over a dozen people came afterwards and talked about their TBI recovery. So let's jump in, Scott. So for those unfamiliar with your work, maybe we could start with What are some of the common types of brain injuries that people are experiencing, you know, and how do they silently affect their learning, their memory, their mental performance very long after the, the incident?

It's a great, I think, great introduction, Jim, to just the pervasiveness of the issue. And I think the major challenge, even though there's been more interest and more visibility on brain injury over the last decade or so, maybe the last 5 years especially, A lot of people don't realize that when they were young, they probably had more brain injuries than they realized overall. And I found I was sometimes when I was talking to people that came in with headaches, migraines, for example, or brain fog, concentration problems, and I was the first doctor to ask them about brain injuries when they were kids. And they would be like, oh yeah, I forgot that I, I got my bell rung playing football every day for, you know, for 5, for 5 to 10 weeks every, every fall when I was playing football. Or other ones. And it became pretty evident to me very early on. I mean, the statistics don't lie, of course, but just how pervasive it was in causing such significant cognitive issues in so many people. And what I realized very early on too was that in, in the framework that I think about traumatic brain injury, there was a huge spectrum of how people were manifesting or presenting in my office overall. And, and the, you asked the most common reason for brain injuries, the most common still actually is motor vehicle crashes or motor vehicle accidents overall. That's the most common reason people do get brain injuries. But it's so much, it's very common in all the different types of sports for kids, football, of course, but also soccer, not only in women, women as well as men as well, lacrosse, other sports as well. And we think that maybe with football, for example, that people have, they're wearing helmets that makes it more protected. But we know that Sometimes having a helmet makes you hit people harder than if you don't have a helmet overall as well. So people present very differently for brain injury depending on where their brain has been injured. But in essence, usually they present with some aspect of cognitive challenge, right? That could be from a learning perspective, it could be from a memory perspective, it could be from a visual spatial recognition. You don't remember where you put your keys or something like that. And so It can run a huge kind of spectrum overall, but in essence, what's happening is that the brain has been injured. And what's interesting about the brain, many things, of course, but if you injure your knee, for example, your knee creates this response. It's a swelling response, for example, that brings a whole bunch of immune system tissue or products, white blood cells to the area to help try to heal it. But the brain doesn't have the ability to swell. And as a result, because if the brain does swell, that could cause a herniation of the brain and you can die. So the, the The process of healing a brain injury is much harder actually than healing something that you injured, you know, like your knee, for example, as I was mentioning. And so oftentimes these injuries do not fully resolve on their own, resolve as a knee injury would. And then you're left with these hidden scars, like you said, that can build up over time. When the blood flow is not optimized to an area, the area around that is going to start not working very well. And as a result of the blood flow not working very well, then the nerve tissue is not going to work very well. And then there's going to be deterioration over time.

In our programs, we teach people how to accelerate their learning, how to read faster, improve their memory, focus, you know, at will. And that's more of like the way I see it is more like the software, but you also have to take care of the hardware, right?

Yeah.

The brain itself. And so whether we all know people, people come to us about, and I'm sure for you, concussions and falls, emotional trauma, long COVID, right? I mean, the list goes on and on. You and I have had conversations about neuroplasticity, you know, as a— it's kind of like your recovery superpower. Maybe you could walk our listener through what neuroplasticity really means in the context of the healing process, and how can we enable or activate more of that?

So neuroplasticity, the idea here is that you can repurpose areas of your brain To create different functions that other— when things are trying to compensate for dysfunction overall. And the brain is very, very good at this. And a very good example of this from a neuroplastic perspective is somebody that is blind, for example, right? So somebody that is blind has amazing hearing compared to an average person. How is that possible? Well, the brain starts rewiring itself in ways to help with that increase in capacity for hearing because you can no longer see. And so you have the capacity. The brain is a very plastic, very plastic organ overall. We used to think that once you're— when you're young, it's plastic, and when you're old, it stops being that way. But no, we actually— that's not the case at all. In fact, we know it's plastic up until the very ends of our lives, that we can continue to obviously make new memories. And new memories are an exact example of neuroplasticity. Memories are being formed in the hippocampus part of our brain, and that is our brain becoming more plastic to the information that's around us. So We can leverage that plasticity. But what that plasticity requires is a brain that can bring on that change with given the right inputs, the right capacity. So vitamins, minerals, nutrients, cofactors, the things that allow you to create energy and also blood flow to the tissue obviously is primary to allow those cells to work optimally. So neuroplasticity is something that we all have the capacity to do. But if our brain is already compromised, it can be harder if you're not working on the hardware along with the software, as you just mentioned.

For neuroplasticity, we talk about 2 of the keys are novelty, right? And also nutrition. And I see part of nutrients is oxygen, right?

Right. So 100%. Yeah.

Hyperbaric oxygen therapy, commonly referred to as HBOT, has been a really powerful tool in in your protocol. Maybe you could explain what it does for a brain or an injured brain and how it creates an environment or conditions to support recovery even years after the injury. Like, I had my injury when I was only 5 years old, and, you know, the challenges lasted a long time. And then I had a brain scan by Dr. Daniel Amen a very long time ago.

Yeah.

And part of the protocol was 40 hyperbaric oxygen sessions, which most cities have clinics that they could go and do, you know, this kind of protocol. But maybe you could talk about what HBOT is and what is it doing to a compromised brain.

Yeah. So hyperbaric therapy has been around a long, long time. In essence, the definition of hyperbaric therapy is a combination of increased inspired oxygen and increased atmospheric pressure. Oxygen, we all kind of know we breathe it in the air around us. There's only 21% oxygen in the air at sea level. Where I live here in Colorado, it's about 16%. I live at 5,500 feet. And so oxygen is the, what's called the final electron acceptor in your mitochondria, which means that it's required for us to have oxygen in our system to make energy. ATP is our energy currency. Oxygen helps you make it. We make about 165 pounds of ATP every day. So we need lots of oxygen around to help us do that. Okay, so how can you increase the amount of oxygen-carrying capacity that you have in general? You could increase the amount of red blood cells in circulation because red blood cells are the cells that carry oxygen all around. We can do this by coming to a high altitude like Colorado, and you have a hormone that gets released called epogen, or EPO for short, which is also the doping drug that's going to increase the number of red blood cells you have in circulation. You can also give yourself a red blood cell transfusion, and that's going to give you more oxygen-carrying capacity as well. But the thing about it is that if you really want to increase the amount of oxygen-carrying capacity without those techniques, you can go into a hyperbaric chamber, which increases the amount of pressure on the body. It simulates the pressure you feel under a certain amount of seawater. And that pressure is heavy. If you've ever been under 15 or 20 feet of seawater, you look up, all that water is extremely heavy. If you picked up a bucket of water, everybody knows that it's a heavy kind of feeling or heavy. It's obviously be heavy to lift. And so, that heaviness basically changes your physics in your body and creates the stimulus to drive more oxygen not only on red blood cells but also in the liquid of your bloodstream. And, the liquid of your bloodstream is called your plasma. Your plasma has very little oxygen in it at sea level, but you can increase it about 1,200% into the liquid of your bloodstream by, or even more depending on the pressure, by creating a pressurized system simulating the pressure you feel under a certain amount of seawater. And so now you have all this extra oxygen in circulation, Jim. And what all this extra oxygen can do is many, many things. In the short term, if you have an acute injury, you have an acute trauma, for example, you can get more oxygen to tissue and that can save your brain. So there are studies showing that if you can get somebody into a hyperbaric chamber with a severe brain injury, you can save their life 50% more of the time overall and decrease their morbidity or their disability by 50% as well. And they're doing some confirmation studies on this now looking at acute traumatic brain injury using hyperbaric therapy, just 3 sessions the first 3 days when somebody hits the ICU with a severe TBI. And so, you're reversing low oxygen state, you're decreasing swelling as well, you're releasing stem cells from the bone marrow and other areas. And stem cells are the baby cells in our body that can help heal tissue and regenerate new tissue with these stem cells. You're also improving the capacity to have lymphatic flow or detoxification. immune system activation. So that's all happening immediately.

There's so many benefits outside of just the brain also, right?

Yeah, exactly. This is all systemic, right? And then the other aspect just to mention here is that chronically, so over a longer protocol like the one you did with the Amen Clinic, Jim, when you went in 40 sessions, what's happening there is that not only do you have the acute benefit of being in the chamber, but the long-term benefit is what's called an epigenetic modification of DNA expression. So basically, how our genes are expressed changes with a hyperbaric program, with a hyperbaric protocol like that. And not only do you have a reverse low oxygen state initially, you actually create new blood vessels in tissue to help regenerate that tissue over the long term. You downregulate inflammatory mediators that get dysregulated when you have inflammation in an area that has low oxygen. You can fight infection. Those stem cells mature. And the immune system optimizes that you have less scarring. of tissue as well. And so, it's a pretty powerful, very, very powerful technology because it has this capacity initially to reverse these low oxygen states and decrease swelling. But over the long term, it has the capacity to really regenerate and rebuild tissue. And, when we're talking about a brain injury, the way I like to think about this, Jim, is that you have, if you can imagine a still lake and you throw a whole bunch of pebbles in there, those pebbles are creating an impact zone with ripples around them. You can think about this as like a brain injury. The impact zones are relatively small, but the ripple areas are quite large. And, the direct area where the ripple, where the rock hit or the pebbles hit, that area might actually be dead overall. But, the rippled area is the dysfunctional tissue. They're not doing as well as it could. This is called the pericontusional area if you're looking at the medical term for this.

Okay.

The pericontusional area is the area that's damaged but not fully dead and can be rebuilt with the right nutrients. And the first primary one is going to be oxygen to help rebuild and, and keep those cells alive and then rebuild the tissue over time with new blood vessels, etc.

You've seen in your practice, you know, many patients come back from serious brain injuries, not just bounce back, but, you know, a number of them bouncing forward. Do any of them You know, maybe a quick story for maybe one of them, or, and also, and what, what does that illustrate? What does it teach us about, you know, the human brain's potential?

The brain has so much potential if you give it what it needs. And I think that's what you've been so good about educating for such a long time, Jim. And I think oxygen is sort of the main nutrient. I mean, the brain itself takes 20% of the oxygen The entire system that's going into the body, 20% of your oxygen goes to the brain to help it move and help it do what it needs to do. And, that's because there's a huge amount of mitochondria in the brain overall. And, it's only second to sperm and eggs, the amount of mitochondria per cell in your brain. And so, when those are not functioning well, you suffer and you suffer with brain fog and concentration problems and fatigue and Just, you can't show up the way you want to show up. And so we know how powerful our brain is and how much capacity it has, but how much support it requires on a regular basis to keep it healthy. And a good story, one that I, that I really love, is I had a young teenager. He was probably 12 or 13, and he had— he came to get hyperbaric therapy after maybe his 3rd or his 4th concussion. skiing. And he was no longer able to go to school. He was depressed. He was talking about hurting himself. And he was— he had therapists and he was even doing some neurofeedback and seeing some, you know, some, a little bit of benefit. And neurofeedback's like actually a common technology that I use in combination with hyperbaric therapy along with various other things that we can talk about. But he was just despondent and his parents were despondent, right? He, we know they knew really he couldn't go back to skiing because he'd had 3 concussions already, but they just want him to go back to high school and go back to school. And, and he came in and he did 20 sessions with us. Um, initially did— initially did 20, eventually did 40 sessions, 5 days a week and 60-minute sessions. And by treatment 20, he was back to school. He was no longer depressed. He was doing well in school, and he was asking when he could go ski again. And we were telling him as best as we could that please don't go skiing anytime soon because he'd already had these 3 concussions. And, the thing is that when you're younger, it's much easier to heal as we know. As we get older, there's lots of things we can do to heal much more than you can ever think about from a conventional perspective. That is definitely true. But, even somebody that young with 3 concussions going and being on the mountain skiing, I did not recommend going back to go skiing after that just because of the the high risk of his brain. I mean, we just know that once you've had one concussion, your brain's still at risk for more, even many years later. I saw him completely resolve all of his symptoms though. It was pretty amazing. Just over the initially the 20, then he did 40 in total and the kid was back to normal. The kids, the parents, uh, were amazed. And then he did neurofeedback testing before and after and his brain just lit up like a Christmas tree compared to what it looked like before. And when you're looking at neurofeedback, you're looking at all these areas of the brain where you have connections and things are moving and, and the voltages are high enough and I know you know about this, Jim, very well. And so it's a common thing where I've used neurofeedback in combination with hyperbaric therapy over the years to help retrain the brain for that neuroplasticity aspect while you're doing hyperbaric therapy as well. And this is somebody that, you know, it was just a transformative kind of experience for his family, for him. And I have many, many stories like that over the years.

I hope when people are listening to this, it gives them a sense of hope. And real help. And, you know, the 60-minute session, people could do other things also because people could say like, okay, there's a little bit of a cost involved for sure.

Yes.

You know, I find that most cities I go to, I could find a facility that offers HBOT, but I could also use that 60 minutes to read, to meditate, to listen to a podcast, right? And so it's kind of a way of stacking while you're getting that recovery.

This is the key. Yeah, this is the key, Jim. And I hope you don't mind me messaging. This is an important thing is that what I'm so emphatic about is that before, during, and after hyperbaric therapy, you can optimize your whole protocol right there. And that's— you were talking about something that's very important, which is when you're inside a hyperbaric chamber, We know that oxygen carrying capacity has gone up. We know from some studies actually that your multitasking capacity goes up as well. If multitasking is really real, that's a question. It's more like task switching, right? But multitasking as we know it. And so you can leverage that oxygen while you're in the chamber to do things that you're working on that you're having a hard time with. So if you had a brain injury, for example, you have a hard time remembering things. You can bring in things to the chamber to help you remember, for example. And you can do things like serial 7s, which is my least favorite test of all time. Or, you could do Sudoku puzzles or things like that that are working on your brain. But, even before you go into the chamber, Jim, this is super important because when I first got into hyperbaric therapy, I didn't really realize and understand this as importantly as I do now is that if you've had a brain injury for a while, for example. So, if you've had a brain injury yesterday, then getting into a hyperbaric chamber as long as you've been cleared is absolutely something you should do. Do not pass go other than getting cleared because it's going to help you get more oxygen to that tissue. You're going to save brain. You're going to see a benefit. No doubt about it at this point in my career, as far as I understand it. But if you've had a longer-term issue, say you've had a concussion for 3 months or 3 years or longer, then what's happened is that it's really, really important to create the machinery to allow you to harness the energy that we're going to put in the body with hyperbaric therapy. What I mean by that, do you have the optimized levels of things like vitamins, minerals, nutrients, and cofactors? And what other supplements can we give you that really can support the brain while you're using hyperbaric therapy so you can most benefit from it. And of course, your diet is a big part of this, right? If you're having McDonald's and drinking alcohol every night, that's not going to be very good for your brain no matter what hyperbaric therapy or other technologies that you're going to do. So, my perspective is a challenge sometimes for patients because I tell them, and for clinics as well, that it may not be the right time to go into a hyperbaric chamber Right now, if you've had a brain injury for 3 months or 3 years, it might be better to really optimize that system and work on your diet, work on your lifestyle, get your supplementation in order. And then from there, you're going to benefit so much more from being in a hyperbaric chamber, which you mentioned, right? There's a cost involved. There's a time involved as well. And so when I think about the best ways to use hyperbaric therapy, sometimes it's to wait. Sometimes it's to not go in. right away and use that framework that I've developed over the last decade or so. What lab testing is necessary? What supplementation is helpful? What dietary changes? What other practices? What other technologies? Things like that can help support. And then, if you can create a whole program, which is I know what you do as well, Jim, and the way you think about things, if you create a whole program, that's where the power is, not only in the short term, But in the long term, because, and I'm sure you have questions, but because what I've seen over the years is that if you don't have this perspective, you don't optimize, you don't see the benefit as much as you could if you did, of course. And then also the long term is that you don't heal these injuries as much as you could as well. And that's what you care about is long-term benefit, right? And so the framework is so important. And then I guess the final part is that that's the before, there's the during, then there's the after, right? What are you doing after hyperbaric therapy to truly leverage that oxygen that you just got in. So you can actually do additional things to work on your brain after you get out of the chamber, or you can even work on the detoxification side as well. But the key is the framework. So to keep it simple is what are you doing before, what are you doing during, and what are you doing after? And there's some simple things that we can go through if you'd like, Jim, to kind of help people get a sense of what those things could be as well.

And what I like about this is if you're listening to this, even if your brain hasn't been compromised with some kind of physical trauma or emotional trauma, chemical trauma, whatever it is, people could still follow a protocol to increase their cognitive performance, right? To learn better, to be able to have more, to be able to clear any kind of those mental cobwebs. Let's unpack this a little bit. So if you, outside of hyperbaric, if you had, let's say, 5 minutes to teach a classroom full Of people, students to seniors, how to protect their brain for life. What would you say?

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The focus that I would have would be 2 different things, but very related. One would be mitochondrial function, and the second would be parasympathetic activation. And so I'll start with parasympathetic activation, I think, first. Well, it doesn't really matter. We can start. I'll start there. And so parasympathetic activation is the activation of your nervous system that is part of your rest, digest, detoxify system, right? So our sympathetic nervous system Helps us activate fight or flight, you know, get away from danger. Our parasympathetic activation helps us do the things that I just mentioned. And if you've had a brain injury or if you're just a human at this point, you likely are spending more time than you need to in fight or flight on a regular basis. If you're on fight or flight, you cannot heal. This is the hustle culture that you and I know very well, Jim. It's the go, go, go. I'll sleep when I'm dead kind of thing. When I went to medical school, we had shirts made that said sleep is for quitters, for example. And this is the ethos of being a medical student, being somebody in a job. I'll work, I'll work on work, and I don't know how to relax. And so, the first thing I've realized over the— that I want to mention here is that I've realized time and time again, if you are in fight or flight, you will not heal in a hyperbaric chamber. I don't care how much hyperbaric therapy I do for you. If you're always in sympathetic dominance, it's not going to work. And I've seen it Over and over again. And, and I, I just want to say that there are ways to calm down. Relaxation is so important. And the way I think about this is in the GABA, the GABA system. It's called the GABAergic neurotransmitter system, where GABA is a neurotransmitter that helps us relax. And you want to think about ways to do that. So meditation, taking walks in nature, you know, yoga, mindfulness, these are all ways to leverage the GABA system, but you have to find ways to relax. I use a lot of compounds in my clinical practice that leverage the GABA system specifically and look at how you can optimize— you can really help people right now while they're on a longer path of understanding how they can meditate and how they can calm down their nervous system. But calming down your nervous system is so, so important. And the GABAergic nervous system or neurotransmitter system, GABA being our most prominent inhibitory neurotransmitter, so relaxes the firing of our brain. It helps us have less insomnia, So we sleep better, less anxiety, less depression, less perseverating thoughts where our mind just start— can't stop racing and racing and racing. And so GABA calms you down. And so mind your GABA, mind your parasympathetic nervous system. That's number 1. And so, and then number 2 is your mitochondria. Of course, being stressed also stresses your mitochondria. So that's why I wanted to mention it first. But your mitochondria are your powerhouse, the energy-producing parts of your cell. And as a result of producing energy, we also produce rust or waste products of energy metabolism, and these can build up and cause deterioration over time. And so, minding your mitochondria is so, so important. And so, having the right inputs into the mitochondria, these are things like our vitamins, minerals, nutrients, and cofactors, the food that we're eating really, and then how we're supporting that with supplementation. And then also the outputs of our mitochondria. So our mitochondria make energy, that ATP. They also make water and carbon dioxide, but they also make reactive oxygen species, which are these signaling molecules that in low amounts are really important for signaling how the mitochondria are reacting to the environment around it. But at the same time, too much of this can cause too much stress on the system, and we need antioxidants to help to neutralize that. And so One compound that I use a lot of and that you know about, Jim, is something called methylene blue. And methylene blue at these low, at very low doses at 4, 8, 16 milligrams is a fantastic way to support mitochondrial function. And there have been some studies in Alzheimer's, in cognitive capacity. And so, I use it a lot in clinical practice as a way to support mitochondrial health, at least in the short term while we're doing longer work of optimizing mitochondrial inputs and outputs as I described here. But, the cool thing about methylene blue is that it works in both capacities. It can help you make more energy and it helps with detoxification as well. It can act just like an antioxidant. And so, I use it a lot in my hyperbaric protocols as a way to support the mitochondria while people are getting into the hyperbaric chamber. And, I really do see a fantastic benefit there because if you've had a brain injury, if you're alive at this point, 94% of U.S. adults have mitochondrial dysfunction.

Hmm.

And, of course, there's going to be a spectrum there, but severe mitochondrial dysfunction if you had a brain injury, maybe less so if you're just getting older, as they say, and your brain doesn't work as well as it did a couple of years ago. They can benefit from mitochondrial support. Almost all of us can. And what's great about methylene blue is that it really does work on that cellular foundation to help you while you're working on some of the harder things that take longer to see the benefits. So these would be the main things that I think about. When I'm looking at a program for a patient is mitochondrial activation, mitochondrial efficiency, rebooting it using things like methylene blue, and then parasympathetic activation, calming down the nervous system. I can tell you from personal experience, Jim, so many patients that I work with over the years, they didn't focus on these two aspects of things. They did not get better or not as well as they wanted to get. And if there's a psychosocial emotional aspect of things where you've had trauma, especially. Physical, social, sexual, additional types of trauma that are related to your brain injury, hyperbaric therapy can be fantastic. But again, if you're stuck in the fight or flight because you haven't addressed the trauma, you won't see the benefit that you're looking for most of the time, unfortunately.

Are there other brain-healthy nutrients on top of methylene blue? I mean, omega-3s, magnesium, creatine, ketones, NAD+. You know, what are kind of your, your go-to for yourself or for the people you work with?

I mean, you just hit on a lot of them overall. What I like to think about is you can just give certain things that can be helpful, but even better is to take another step and actually test to see what you need. And I use something called metabolomic testing in my clinical practice, and it's based on a framework called Health Optimization Medicine, which is a nonprofit organization which I help run that trains practitioners on how to optimize health. And we educate practitioners that you can focus on what's called metabolomic testing, which is basically looking at how your cells are working in real time, looking at environmental inputs, looking at how your nucleus and cytoplasm and all the other aspects of your cells are working. And then you can actually give nutrients that are required because your cells need them. And it's common for people to take things that they hear about online and by, you know, because people know that, oh, I need this, I need that because I hear it from various sources, but it's better if possible to actually test what you need and then optimize from there. And then so what I always say with my patients is like the foundation of what you're taking should be related to what you need based on testing and then following that testing over time. Do you need magnesium? Do you need NAD support? Do you need a probiotic, for example? Because if your gut isn't working very well, then you're not going to have a blood-brain barrier that's working very well. And if your blood-brain barrier is not working very well, you're not going to feel very well. And so a good indication for this, for example, I was mentioning GABA before. I don't give GABA supplementation typically because GABA is too big of a molecule to get across the blood-brain barrier. But if it does work for you, if you take GABA supplements and they work, this can often be because your blood-brain barrier is leaky and your gut is leaky as well. And so I'm very focused on gut health. Oftentimes you have 80% of your immune system in there as well, and obviously neurologic connections or neurons as well that are in your gut. And so for me, it's looking at all these aspects together. And so I wouldn't give GABA supplementation. I would give things that support the GABA system, probiotics, for example, that help the GABA system and help with the gut being less leaky, but also things like kava or CBD or CBG or something called honokiol or agarin, which is from a psychedelic mushroom. These are all things that work on the GABA system that can help with sleep, that can help with anxiety, but they can work even if you have a blood-brain barrier that's working well, which is what we all hope for, right? So in essence, the big things for me when I'm looking at brain health are going to be focused on what people need overall, and then I'm going to be building out from there depending on what their symptomatology is. So if it's parasympathetic, I'm working on the GABA system. If it's more mitochondrial, then I'm working on things like NAD, for example, which can be good, or creatine, as you mentioned, is a really great one as well. Magnesium, vitamin D is really important. important. Vitamin D is extremely important. So if you're low on vitamin D, vitamin D is not just a vitamin, it's also a hormone. Melatonin is also very important. Melatonin is one of our most powerful antioxidants in our mitochondria as well. People think of it as just in our brain, but it actually gets made in the mitochondria too. So there's lots of different things, but in essence, testing what you need and supporting what you need is the most important. And then from there, you can build a stack depending on what your exact goals are. Like, is your brain your goal? Then we have brain-focused things. Is it healing from a wound outside your You can focus on various things. Is it muscle building? Is muscle strength? You can, you can create a whole suite of things related to that as well as technologies to help you as well.

Wow. I think people could benefit from relistening to this episode. Before I let you go, I'm curious, our community, they have a passion for learning faster, performing better. But if someone doesn't realize that they had a past injury that may be holding them back. What are some of the subtle signs or symptoms that someone may be living with to indicate they might have an undiagnosed brain injury? And then how should that interaction with their physician happen? You know, so what are some of the signs, potential signs that somebody has had some kind of physical, emotional trauma that's affecting their brain? And then how should they proceed in terms of working with their health practitioner?

Yeah, that's a great question.

I mean, is it brain fog, memory lapses, irritability, sleep issues, attention issues, chronic fatigue? I mean—

Yes, all these, all these things are really important. I remember there was a study that came out maybe about 5 or 6 years ago that said even one Brain injury can— it doesn't have to be a severe brain injury, like a mild to moderate brain injury can severely alter the entire life of somebody that has one. And I, and I think what, what can often happen, the younger you are that you, when you have a brain injury, the more you're gonna have a hard time realizing that you've had it to some degree because you've been compensating for such a long time in various ways to try to, again, compensate for the brain injury. So I know, Jim, you've had many stories that you've talked about and how you've tried to do this over the years and how you've— worked with your brain to compensate for the challenges. And I think these can be very subtle for some people that they just know that they're never going to remember anybody's name, for example, and they have to always write people's names down. Or it can be that, you know, that every day at 2 or 3 o'clock, your brain just says you're done and you don't know why. But everybody else, even when you were younger, didn't have any problems. But you always have had a problem. You said irritability, sleep issues, anger issues, emotional outbursts, challenges with partners, relationships. These are all signs that could be subtle or not so subtle. Having a hard time keeping a job, having a hard time getting up in the morning and feeling like you don't wake up until noon every day. These are all subtle signs or sometimes not so subtle signs. And when you're talking to your practitioner, this is a challenging conversation, a challenging thing. I mean, the good news is that more doctors now realize the severity and the consequences of concussion now more than ever. The major challenge that we have, Jim, and you and I know this, is that the therapeutic modalities that are available from the conventional side are still not very awesome and not very robust. They're better than they used to be. But if you're going to your conventional doctor, they may send you for physical therapy, occupational therapy, speech therapy, but there is very little that they can offer you. And so if you're looking, you really have to find facilities and locations that have expertise in brain injury. And the good news is that almost every city has a place like this now where they're not just following the standard of care. Now, I don't have a problem with the standard of care. I'm trained as an internal medicine physician. We are really good at acute care. If you have an acute traumatic brain injury, please go to the hospital. But as soon as they clear you, please find a hyperbaric chamber because it's going to help you recover faster. And so, like you mentioned earlier, Jim, there's tons of facilities out there now that are doing hyperbaric therapy, and I think that's great. I think it's also important to realize that there's different types of hyperbaric chambers, and there's soft chambers and there's hard chambers, and the pressures can change if you've had a brain injury. The good news is that soft or hard chambers likely will help you, but if you have the capacity, maybe a hard chamber would be better if you have an acute injury versus a soft. If you can, they don't go to as deep a pressure. But the good news is that there's more people out there that can help you. You just have to look a little further afield than conventional care, but you can find them. And then getting on some basic supplementation can be really, really helpful overall before you even see a doctor, like having something like an activated multivitamin with methylated Bs, vitamin D, a fish oil, for example, as long as you're not on blood thinners. Probiotic. These are basic things that have everybody that has had a brain injury get on as soon as possible. And also, some methylene blue can be really helpful here too. And then, making sure very low doses of methylene blue like 4 milligrams or 8 milligrams, not a lot, but can really be supportive for that mitochondria while it's under more inflammation and more stress. And so, anybody that comes to see me, I always get them on basic stuff before we even get get going with any other treatments, acute injury or even a chronic injury until we can get more laboratory testing if it's been more of a long-term injury. So just know you're not alone too. There's so many people out there that are having challenges, but all of us, no matter the spectrum from the worst brain injuries to no brain injuries, can benefit from optimizing our brain health. And looking at this before, during, and after hyperbaric therapy, even if you didn't go into the chamber as part of that, You're still going to get your brain functioning so much better. So you start doing your work, Jim, and working on the exercises and things that you do. Think of other technologies like neurofeedback that can help you. So there's lots of things that you can do to optimize your brain no matter where you are in that spectrum.

Outstanding. Well, we'll put all your suggestions in the show notes as well as links to a number of things that you mentioned, including your website. And your social media and some of these resources. I'll talk to you, your team, you know, in terms of products you might recommend.

Sure.

It's always at jimkwik.com/notes. Highly recommend you go there. Highly recommend you go to our YouTube to watch extended version. If you're listening to this on audio, there's another 20 minutes that we put here on YouTube. You can join 1.8 million subscribers. Before we wrap, Scott, we always ask, since this podcast is all about learning, right? The deep love of learning. I'm just curious, what is, what is one thing that you're currently learning about or studying outside of what we talked about that has you particularly excited? What's lighting you up?

Oh, wow. That's cool. So right now I'm making a lecture. It's a new lecture. So I've done a lot of lectures over the years on many topics, obviously hyperbaric therapy. I've talked a lot about methylene blue, the GABAergic nervous neurotransmitter system. But right now, I'm actually creating a lecture on parasympathetic activation during or before workouts, during workouts, and after workouts, and understanding how important it is to leverage the parasympathetic nervous system to work out smarter, not harder overall. And, that's been really fun because most of us think we need to just kind of be hard charging to go to the gym and just power out weights and rocket, rocket, rocket. But, You realize that you can actually do more and actually you're stronger if you relax your nervous system before you work out, during your workout, and actually especially after your workout too. If you can get yourself down out of that sympathetic state into a resting digesting state faster, you're going to recover faster. You're going to actually have muscle growth and synthesis happen more optimally as well. And so, I've been looking at various strategies at how you, how you can downregulate your nervous system, things like CO2 tolerance or the types of food that you can eat before you work out, or HRV training, breathwork, and supplementation as well that can help you do this. So I'm actually— it's really exciting because I know how this feels, Jim. Sometimes you give a talk over and over again that you love and you know it helps people, but it's so much more fun for us to dive into a nuanced but really cool topic and say, okay, we're going to really dive into parasympathetic activation to optimize your physical and cognitive performance during a workout, but especially your physical performance. Right? So that's, I've been really excited about that and finding interesting avenues like neurotransmitters that are activated and, you know, and it's really cool. I'm, I'm, I'm having a lot of fun there.

And I love that you, when, when you're focusing on this, it's for physical health, physical fitness and performance, but also you get all the benefits of the brain, which is obviously part of your body. You get all the cognitive health.

Yes. People forget this.

Please Performance also. But the brain, you don't get to see as much as you can see some changes in the rest of your body. So I always wear brain on my shirt, always pointing to my brain just to kind of build that awareness. I love that. Dr. Sher, how do people— I'm sure many people want to go deeper with you. How can they best do that?

Well, thanks for having me, Jim. This has been awesome. So from my perspective, If you're interested in on the hyperbaric side of things, I have a website. It's integrativehbott.com, and I do consulting all over the world, helping people optimize their hyperbaric programs. I work with clinics all over the world as well that are bringing in hyperbaric therapy to more of an integrated model. I have a company called One Base Health that does a lot of work in integrating technologies together using an app and software and education. So that's all available. My Instagram is @DrScottSher, D-R-S-C-O-T-T-S-H-E-R-R, and I have a company that's called Transcriptions that makes products that are based with methylene blue and leveraging the GABAergic neurotransmitter system. That's @transcriptions on Instagram or transcriptions.com. And then final link would be the nonprofit that I help run called Health Optimization Medicine and Practice. That's a 7-module certification for practitioners. Don't have to be a licensed practitioner. You can be non-licensed and seeing patients or clients and you look into how to optimize the health of your patients and clients. Shifting the perspective from disease to health and optimizing something called your metabolomics, which I mentioned earlier. You can check that out at homehope.org and @homehopeorg on Instagram as well.

We'll put again all that in the show notes so you could just run there right now. Go to jimkwik.com/notes and you get all those links so you could go deeper with Dr. Scher. You know, and I really hope that you who are listening, you're breathing a little deeper after this episode and maybe think a little differently about how your brain recovers and not only bounces back, but potentially can even bounce forward. So big thanks, Scott, for sharing your knowledge and your time and your experience with us.

My pleasure. Thanks again, Jim. It's been great.

As always, I mentioned this before, you could find many more insights like this on our YouTube channel. Channel where we post the extended version of this interview. Also clips of me on stage and so much more. If you love this episode, the highest compliment, if you could subscribe and share, you know, and if you want, leave a comment. Let us know what your big aha will be, who you're going to share this with, how are you going to put this into action. I read every, I speed read every single comment. So your feedback is It's very important to us. And until next time, this is your brain coach, Jim Kwik. And I just want to remind you that your brain is, is your number one asset. So take care of it by feeding it oxygen and nutrients, and it'll take care of you back. Until our next episode, be limitless.