Neuroinflammation: The Key to Complex Brain Disorders
(Summary of Dr. Bob Scott’s Lecture Oct ANM 2018)
Inflammation of the nervous system has been shown to the be the pivotal causation of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, traumatic brain injury and stroke. Recent research also indicates that the key element of neuroinflammation is also the cause of neurotransmitter dysregulation that leads to depression and anxiety, schizophrenia and chronic pain. This article will review the inflammatory pathways and treatment protocols to prevent and treat this pathway for optimal brain health.
The biggest causes of neuroinflammation include neurotoxins (environmental and lifestyle), pathogens (ie toxoplasmosis), head trauma or traumatic brain injury (TBI), autoimmunity, aging and microbleeds.
Neurotoxins
Diet: alcohol, smoking, trans fats and deep fried foods. HgA1c is a measurement of glycation of the brain. Want to keep this below 5.4. It is the #1 marker of the size of the brain. (Diet high in phytochemicals such as garlic, green tea, turmeric, rosemary and spices lowers inflammation in the brain.)
Exercise: 30 minutes at 70% maximum heart rate 3 times per week increases expression of SIRT1 indication mitochondrial biogenesis.
Environment: pollution increases risk of suicide!
Gut Health: dysbiosis in the gut drives neuroinflammation and makes the gut leaky. Gluten makes the gut more leaky for 4 hours after ingestion. Gut molecules interfere with tryptophan metabolism leading to depression and cognitive impairment. Niacin (B3) prevents this process of forming the inflammatory kyurenic acid. Anti-depressants deplete B3! (Detoxification herbs to consider include schisandra, rosemary and milk thistle.)
Stress: Nrf2 pathways in the cells that help protect the cell against stress and prevents NF Kappa B inflammatory activation. Nutrients and phytochemicals that protect this pathway include turmeric, rosemary, green tea, garlic, broccoli, pomegranate, ginkgo, grapeseed, schisandra NAC and cruciferous vegetables. NrF2 is the true anti-oxidant pathway.
Nrf2: combats neuroinflammation, relieves depression, increases BDNF (brain derived nerve factor), protects the body against toxins, (increases phase II and phase III transporter proteins), decreases oxidative stress, enhances mitochondrial and exercise performance, protects against hypoxia, slows aging and improves the vascular system.(Phase III detox happens in the intestinal tract, this is how arsenic from rice is eliminated from the body).
Stress can be measured in the blood looking for IL-1B, IL-6, TNF alpha (not CRP). Chronic stress suppresses SIRT1 leading to atropy of the hippocampus the region most associated with depression and memory loss.
Pathogens: lyme and other stealth organisms
Head trauma: contact sports such as hockey, soccer and football or accident resulting in any blow to the head starts the inflammatory process. Auto-antibodies start to form as do Tao proteins that build up over time that contributes to the cognitive decline seen in NFL players. (see the movie Concussion). Curcumin has been shown to protect the cytoskeleton of tau proteins and when taken preventively by people playing contact sports, can prevent the tangling of tau proteins post trauma.
Autoimmunity: There are now blood tests to measure auto-antibodies to the blood brain barrier (BBB). Chronic systemic inflammation resulting in elevated CRP correlates to the shrinking of the hippocampus the brain’s memory center. DHA essentials fats is the #1 nutrient to increase the size of the hippocampus.
What is driving mental health is a change in the immune system. Microglia is the hallmark for activation of neuroinflammation that ultimately leads to the production of auto-antibodies to the brain. Taking 1 gram of RNA per day stops this leakage of inflammatory molecules into the brain.
Immune modulating herbs: echinacea, ashwagandha, eleuthero and Korean Ginseng.
Aging: melatonin, the main anti-oxidant of the brain, decreases with age.
Treatment Targets
System inflammation resulting from the above factors can be down regulated with diet, exercise and phytonutrients. Specific brain anti-inflammatories include boswellia, turmeric, omega 3 essential fats (emphasizing DHA) and bacopa. Down regulating systemic inflammation requires the above nutrients in addition to resolving dysbiosis, stealth organisms; supporting detoxification pathways in the liver, supporting the HPA axis with adrenal tonics and upregulating Nrf2 pathways. (Detoxification of the brain and the liver happen through Nrf2 pathways).
Mitochondria: Increased production (biogenesis) of mitochondria in the brain can occur with the following:
- Hawthorn and ginkgo.
- Increasing Sirt-1 is the anti-aging gene and this is activated with schisandra and Korean ginseng.
- Nrf2 herbs
- Omega 3 essential fats
- Medium chain fatty acids (coconut oil MCFA)
- Magnesium and B vitamins
- High intensity interval training (HIIT)
- Sun exposure (vitamin D)
- Cold thermogenesis
- Ketogenic high fat diet
- Increase nitric oxide by eating beets
- Caffeine (100mg of caffeine reduces risk of depression).
Enhance Neuroprotection and Microcirculation: with key herbs such as saffron, turmeric, B12, magnesium, omega 3 EFA’s. Microcirculation is enhanced with grapeseed extract, ginkgo and diet.
5 Point Microcirculation diet by Kerry Bone includes: dietary nitrates sources include: green leafy vegetables especially beetroot or juice; 85% dark chocolate; berries to include pesticide free blueberries, strawberries, raspberries and blackberries; raw garlic and spices such as turmeric and ginger. All of these will protect the endothelium of the microvasculature.
Sleep: During sleep the lymphatic system of the brain called “glymphatic system” increases dramatically during non-REM sleep. Metabolic waste products of neural activity are cleared out at a faster rate than during the awake state. Brain cells shrink during sleep allowing for this process to occur. Less sleep increases amyloid plaque, the underlying cause of Alzheimer’s disease. Taking turmeric at bedtime enhances this cleansing process.
Sleep onset recommendations: valerian, kava kava, passion flower, Jujube, corydalis, Californian poppy, chamomile.
Sleep maintenance: valerian, kava, licorice or rehmannia
Non-restorative sleep is due to adrenals so consider withania, rhodiola, Korean ginseng, licorice and rehmannia.
HPA axis support: (new term for adrenal insufficiency) adaptogens and nervines: ashwagandha, Korean ginseng, rhodiola, schisandra, astragalus, bacopa, saffron, skullcap and St. John’s wort.
Neurogenesis: The brain renews and upgrades itself in two areas; the olfactory and the hippocampus area. Most trauma happens in the hippocampus where neurons are regenerated. The brain requires an enriched environment for the neurogenesis which is provides by BNDF and NGF (Nerve growth factor).
NGF pulls mitochondria into the area which is required for the process of neurogenesis. Low NGF is associated with increased risk of depression. Romantic love increases NGF.
NGF is stimulated by: omega 3 EFA’s, green tea, curcumin, grape seed extract, ginseng extract, ginkgo, melatonin and rhodiola. To a lesser degree: vitamin E, tryptophan, 5HTP, DHEA and pregnenolone, blueberries, whole soy foods, quercetin, piperine, mulberry, lithium, goji berries, lotus root extract, apigenin, luteolin.
BDNF governs the formation of new neurons and the development of synapses and various lines of communication within the brain. Low levels of BDNF are associated with Alzheimer’s, memory loss and other brain processing problems. Intermittent fasting from 16-18 hours has been shown to boost BDNF levels. (This is eating less often, not eating fewer calories).
BDNF is stimulated by ashwagandha, St. John’s wort, milk thistle, vitamin D, cocoa and chocolate and resveratrol. To a lesser degree: B5, huperzine A, phosphatidylserine, cinnamon, alpha lipoic acid, magnesium-L-threonate, beta-alanine, L-carnosine and magnolol.
Specific Phytonutrient Effects
Tumeric: increases Nrf2, normalizes mitochondrial genesis, repairs hippocampus of Tao proteins, hepatic protective, neuroprotective, kidney protective, anti-cancer (flags and destroys metastatic cells in the blood stream), slows progression of neurological diseases including Parkinson’s Disease, improves cognition and memory and concentration, powerful anti-depressant, increases serotonin in the body, boosts stem cell production in the brain (as does exercise and fasting).
Boswellia slows the progression of Parkinson’s Disease and Alzheimer’s Disease. It is a specific herb to prevent and treat neuroinflammation. It crosses the BBB and is best absorbed when taken with fat within a meal or with fish oils.
Saffron: 30mg per day has the same effect as the drug Prozac for the treatment of depression. (Those who have had a heart event have three- fold increase risk of depression). It blocks glutamate receptors, it is an anti-oxidant, it is a neuroprotective and has no effect on serotonin. It is as effective for early AD as donepezil and memantine.
St. John’s wort: for the treatment of depression is NOT the serotonin effect but the effect it has on BDNF!
Rhodiola: Improves depression, insomnia and emotional instability versus no improvement in placebo groups. It was as effective as sertraline without the side effects.
Kava: improves anxiety and depression and can be combined with rhodiola and saffron but NOT St. John’s wort.
Resources
The Neurogenesis Diet and Lifestyle, Upgrade Your Brain, Upgrade Your Life by Dr. B Cortright
End of Alzheimer’s by Dr. Dale Breseden M.D.
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