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.
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.
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.
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.
We are out of:
Chaste Tree + Digest Forte until early next week.
The shipment is at the border, so do not panic 🙂
3.8 Million Canadians suffer from diagnosed Asthma.
When I wrote an article back in 2006, that number was 2.5 million with an overall rate of 10.8% of the population. This reflects an overall increase incidence by 67% between 2000-01 to 2011/12. Approximately 600,000 or 67% of these are children. Compared to the Global incidence of 339 million people and 1000 deaths per day, Canadians are at much lower risk. However the Canadian economic impact is estimated at 2.1 billion annually with asthma being the third most common reason for work loss due to absenteeism. See www.globalasthmareport.org for an excellent 2018 WHO report. Naturopathic physicians have a lot to offer this population – especially children. Here are some recommendations using Promedics remedies and some of my favourites over the years. I have mentioned great articles on the www.mediherb.ca website. You need to create another log in for their website in order to access the e-monitor as well as all Phytotherapist’s Perspectives. This is a wonderful resource for the Mediherb products and the wisdom of Kerry Bone.
Asthma is a chronic disturbance of the immune system with asthma attacks being the tip of the iceberg. Treatment of the airway only is superficial and will not change the chronicity of the disease. Looking at underlying causes and providing a multi-factorial model of individualized care for each patient will provide the best outcomes. Asthma can be classified as extrinsic or allergic asthma with positive skin tests for allergens and intrinsic asthma with negative skin tests and chronic infection and other causation factors.
Preconception care is really the best way to prevent asthma in children. (Pre and Post Natal Care patient handout). The nutrients that specifically prevent asthma include probiotics, antioxidants, vitamin D and essential fats (J Fam Pract. 2018 Feb; 67(2): 100–102.) The “Hygiene Hypothesis” holds that children growing up in cities and particularly in a sanitized environment experience an absence of exposure to pathological micro-organism which results in poor and imbalanced development of the immune system. The excessive use of antibiotics need to be also considered. Asthma incidence is higher in industrialized countries and lower in rural areas. Another thing lacking in the modern environment is exposure to common childhood infections such as measles which has been suggested to be protective against asthma. Environmental tobacco smoke, air pollution, and use of antibiotics and acetaminophen early in life all contribute to increased risk of asthma in children. Breast feeding and a diet high in fresh fruit and vegetables lowers risk. Over the years using “Optinatals” from Eclectic has produced good birth weight healthy babies in my practice.
Environmental and Foods – Extrinsic Asthma: These can include food allergens or sensitivities, environmental allergens, genetics, exposure to moulds, dust mites (found in non- feather pillows, flour), atopy, air quality in the home. Identifying causations is important in any treatment program. Good quality essential oils in the home in diffusers can provide some relief. These can include: peppermint, frankincense, lavender, thieves, lemon, and eucalyptus. Sinus Forte for intrinsic asthma. Extrinsic asthma treatment includes Baical Skullcap. The flavonoids are anti-allergic, anti-asthmatic, anti-oxidant and also inhibits histamine.
Sinusitus – Intrinsic asthma: Has been associated with asthma in several studies. Sinus Forte is a very effective remedy at 3-4 per day for adults (smaller dosages in children) along with saline nasal lavages are recommended. I use this acutely but also lower dosage for those with chronic sinusitis. One of my favorite Sanum remedies over time has been Pleo not and pleo quent that can be taken orally as well as inhaled and put into ears ideal for children and very effective in adults too. (These are only available from UK dispensaries at the moment but these have been my desert island remedies for years!)(Ed: recently a stubborn case of chronic allergic rhinitis has cleared with low dose naltrexone but if she stops it the sinusitis returns).
Bronchial Constriction: Ginkgo has bronchodilation effects, and also anti-PAF activity preventing anaphylactic symptoms. It is good for atopy, and inhalant allergies as well as exercised induced asthma and treatment of COPD. Ginkgo is effective in both children with atopy improving flow parameters and in adults some were able to stop corticosteroid therapy. Curcumin is anti-inflammatory through Cox2 and arachidonic pathways amongst others and is effective in acute and chronic inflammation with similar efficacy to cortisone. It inhibits allergen induced airway constriction and hyperactivity. Boswellia improves shortness of breath, number of attacks and respiratory capacity as well as lowering inflammation. Works best in ASA and exercise induced asthma. (Boswellia Complex or BCQ). Tincture to consider for asthma is equal parts Licorice (moistens the lungs and stops coughing), Baical Skullcap, Echinacea and Withania (for stress).
My Pincott Asthma formula includes: Symphlocarpus, Lobelia, Khella, Basal Skullcap, Albizia, Echinacea Premium.
Kerry Bone’s favorite Breathe Easy Formula for children: Echinacea 30ml, eyebright 20ml gindelia 15ml ginkgo 20ml and baical skullcap 20ml.
Poor Digestion: Dr. Jonathon Wright has repeatedly reminded us over the years that hypochlorhydria is associated with an increase incidence of asthma in adults primarily. This is linked to deficient vagal output so bitter herbs are indicated ie Digest Forte (one tab OD before meals.) GERD contributes to intrinsic asthma in 61% of cases. Acid suppression with PPI’s improve asthma symptoms in 73% of asthmatics with GERD. Sweet Fennel essential oil not only has dyspeptic qualities it also lessens catarrh of the upper respiratory tract and is bronchodilatory. Any treatment of GERD requires food combining and probiotics – Ther-Biotic Complete. My favorite GERD remedy over the years has been M6 from Naturpharm. If there is an underlying dysbiosis, implement a candida program for three months (See my blog on digestive health) including the use of Citricidal CapsPLUS. In children ages 8 or older I use Citricidal Tabs (these are also anti-bacterial, anti-fungal, anti-viral).
Breastfeeding and Diet: Absence of or breast feeding for less than 3 months increase the risk of developing asthma. A diet high in oily fish may protect against asthma in childhood. A diet high in dairy may contribute to mucous production even though there is no frank allergic reaction but avoidance provides considerable relief. Other foods that can contribute include salt (dehydrates mucous membranes), refined carbohydrates and excessive protein. Eating onions during an asthma attack may be helpful as they have an anti-PAF effect. Essential fatty acids are crucial! I have had several cases of asthma cured just from taking fish oils. Ultimate Omegas (3000mg per day for adults) and Arctic CLO or DHA Jr for children (2000-3000mg per day). Find one they like and keep them on it for life!
Infection and infestation: Most hospital admissions due to asthma occur over the winter soon after the start of school terms due to viral infections. Children in the first year of life hospitalized with RSV bronchiolitis develop asthma within five years. Aspirin sensitive asthma results from a chronic viral infection. Bacterial infections have been linked to adult onset asthma specifically exposure to Chlamydia pneumonia. Any remedies that improve the immune system overall are considered: Andrographis complex (has Holy Basil good for recurrent infections improving T-helper cells and NK cells. Used for catarrh, bronchitis and breathlessness), Echinacea premium and St. John’s Wort (anti-viral). Also Cordyceps has a long history of use for asthma, chronic bronchitis, and other chronic respiratory diseases (COPD) and can be used long term. Astragalus Complex and Goldenseal.
Stress and Hormones: insufficiency of various adrenal and extra-adrenal mechanisms has been associated with asthma. Stress and anxiety contributes to muscular tension in the diaphragm and disturb rhythmic breathing. It is imperative to treat any asthmatic case with adrenal support no matter the age. For children I used Ribies Nigrum bud therapy from Seroyal or Reckeweg and also homeopathic combination remedy R76, Unda 5 and 15, and or Rubimeds from Biomed. For adults I recommend Withania Complex or Rhodiola & Ginseng and Ginkgo. Assist patients in stress management techniques: breathing, yoga, etc and for children quiet reading activities away from their devices! Reading on a Kindle or Kobo is very para-sympathetic (NOT ON TABLETS or anything with the blue light. Apply low lights apps to devices: Nightshift or Twilight) ( Read Phytotherapist No 58 on http://www.mediherb.ca).
Anti-oxidant status: steroid dependant asthma patients have higher free radicals and low selenium levels. Oxidative stress contributes to inflammation and tissue damage in the respiratory system. Nutrients that increase glutathione include selenium, NAC, and reduced glutathione supplementation. (Thorne SR Glutathione). A diet low in Vitamin C is a risk factor for asthma. Aller C and Vitanox and Greens First.
Sources: Read Phytotherapist No 96 April 2006 + No 97 May 2006 + No 15 January 2015 after you make your account with www.mediherb.ca
Pincott Perspective: Optimizing the Gut Microbiome May 2018 for her GI protocols.
See you in 2019 🙂
MagSRT™, a time-release Magnesium supplement from Jigsaw Health, was tested vs. placebo in a human clinical trial of 91 people.
The results of the Scottsdale Magnesium Study were published by the highly-acclaimed, peer-reviewed Journal of The American College of Nutrition (JACN) in 2018.
For one month before delivery, I recommend a uterine tonic containing helonias, mitchella and viburnum. This prepares the uterus for an easier delivery and, when taken one month postpartum, helps the uterus recover faster. I also recommend Klaire Labs Ther-Biotic Complete probiotics at one per day, all the way through pregnancy, and especially just before delivery, to optimize the flora of the vaginal tract. This may lessen the chances of the baby developing thrush after birth.
High EPA and DHA fish oil, Nordic Naturals ProOmega at 4 per day or Arctic Cod Liver Oil at 2 teaspoons per day, is also imperative during the pre and post-natal period. Adjust vitamin D dosage, as this will provide 2000 IU’s of vitamin D. I recommend at total of 4000-5000 IU’s of vitamin D for most adults including pregnant women. Testing 25(OH) prenatally along with homocysteine, Ferritin, CBC, fasting blood sugar and HgA1C, and TSH and T3 can provide a good baseline for women.
Homeopathic Arnica 200 ch, taken several times per day for one week postpartum, will help the body heal from the physical trauma of delivery. I also recommend giving this to the baby once or twice daily. The pellets can be dissolved in water and taken in drop dosages. This can help with swelling and bruising of tissues.
One of the bigger concerns during the postpartum period is postpartum depression and fatigue. Siberian ginseng taken in tincture form is one of the best adrenal supports that is safe to take during breastfeeding. I recommend it in teaspoon dosages once to twice daily, for up to the first three months after delivery.
Basic nutrients including B-complex, calcium and magnesium are more important now, especially if the mother is breastfeeding.
If the mother is anaemic, supplementing with iron can be cause colic in babies. Iron Plus C is an option but if baby cannot tolerate consider Fluoravit, a liquid iron supplement available in health food stores, that is both effective and well tolerated in sensitive patients.
Babies don’t need much supplementation in the first year of life, when breastfed. However, I do recommend extra vitamin D at 2000 IU’s per day, administered in drop from. I start fish oil supplementation after one year of age. I also recommend probiotics in the first year of life. After one year, consider Ther-Biotic Complete in powder form, dosed at ¼ tsp once daily. This combination of supplements will set the stage for a healthy immune system.
I offer a food introduction chart to mothers and emphasize how important this is to prevent future food allergies. Also an updated handout on Pre- and Postnatal care that you can review with your patients. I like to review this with patients as soon as they know they are pregnant. Heres to a healthy baby!