September 24, 2024 • 29 mins
Chemobrain, cloudy thinking with challenges in short-term memory and concentration affects the majority of cancer thrivers. On this episode, co-hosts Dr. Lise Alschuler and Karolyn Gazella will discuss what chemobrain is, what causes it and they will highlight some natural ways to reduce the symptoms. Join us to learn how to get those wheels turning!
Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com).
Five To Thrive Live Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
Five To Thrive Live is broadcast live Tuesdays at 7PM ET and Music on W4CS Radio – The Cancer Support Network (www.w4cy.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com).
Five To Thrive Live Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:30):
Hello, everyone, welcome to five to Thrive Live. And I'm
(00:50):
also Lisa Sure and I'm joined by my good friend,
an amazing co host who I'm sure is not now.
Speaker 3 (00:57):
Wet with their water.
Speaker 2 (00:58):
No, Hey, Carolyn, how are you today?
Speaker 3 (01:01):
I'm perfectly dry over here. I'm actually doing great. Lise,
how are you?
Speaker 2 (01:11):
I'm good. I yeah, I had a good day today
and thirsty he but yes, I'm good.
Speaker 3 (01:20):
Good, I'm glad you're I'm glad you're staying hydrated. So well,
you know what, Lise, you got to pick the topic
for today's show. So what did you pick and why
did you pick it?
Speaker 2 (01:35):
Yeah, So we're going to talk about chemo brain, and
we'll talk about kind of what that is and what
it's not, and you know, ins and outs, and then
of course we're going to talk about some of our
favorite strategies to address chemo brain or chemo fog is
what another another terminology for it. But before we dive in,
(01:59):
let's introducer sponsors, Carolyn, can you do that?
Speaker 1 (02:02):
Yeah?
Speaker 3 (02:03):
Absolutely, And you know, I was really psyched when you
pick this topic because it's so prevalent, in so common.
A lot of people suffer from this, so I was
really happy that you picked this topic. So I would
love to thank our sponsors. Beginning with Amuse, a unique
patented post biotic that gives your immune system a key advantage.
Immuse as an ingredient in many immune supporting dietary supplements.
(02:27):
Look for Amuse on the label or go to immusehealth
dot com for more information. Also cognizance citicoling, which is
nature's way of keeping the brain's energy producing centers firing
on all cylinders. If you're looking for a way to
enhance your brain function, including memory, focus, and attention, look
for cognism on the label or vote to cognizant dot
com for more information. Prothriver's Brain is a product that
(02:50):
contains Cognizant as well as other brain supporting nutrients and urge.
You can find Prothrivers Wellness Brain online at pure formulas
dot com. Also look for pro Thrivers Wellness Sleep, a
supplement which combines higher dose melatonin and other sleep supporting
natural ingredients specifically designed for thrivers. You can find pro
(03:11):
Thrivers Wellness Sleep and pro Thrivers Wellness Brain at pure
Formulas dot com and of course doctor oh here is Probiotics.
It's a best selling probiotic for more than thirty years,
and it contains twelve programotic strains that are shelf stable,
so no refrigeration is required because of a unique three
year fermentation process. It's a very effective probiotic. Learn more
(03:32):
at doctor Oheira probiotics dot com. So one thing I
wanted to point out is that if you are a
listener who has not had chemotherapy, but you're still interested
in enhancing and preserving brain power, the strategies that we're
going to talk about will help you as well. So, okay, Lise,
(03:54):
when it comes to chemo brain specifically, where would you
like to start?
Speaker 2 (04:00):
Yes? Indeed, well, you know, I guess I want to
start by saying that you said it was common. It
is really common. So it's estimated that sixty six percent
or two thirds of all people who go through any
kind of cancer treatment develop some degree of chemo brain.
It's a little bit of a misnomer, this chemo brain,
(04:21):
because people who have had baseline cognitive issues are more
prone to developing a worsening of those issues. People can
develop this cognitive difficulty even without getting chemo, but just
going through the diagnosis and the disease of cancer as
well as radiation. So this all makes sense when we
(04:42):
think about the fact that chemo brain. Will just use
that word because that is still in the literature and
kind of the vernacular, if you will, but that chemo
brain is really an inflammatory condition of the brain. So
anybody who has any kind of baseline inflammation in their
brain is going to that worsened by chemotherapy or even
radiation therapy. And it also means that anything that is
(05:06):
anti inflammatory and that can cross in through what we
call the blood brain barrier, which is kind of a
physiological barrier of tissue blood vessels. But if things can
get into the brain, then it's and they have anti
inflammatory properties, they're likely to be of benefit to chemo brain.
(05:27):
So it's really important to think about and to remember
as we go through the rest of this show that
chemo brain is essentially a condition of inflammation of the brain,
and when people's brains are inflamed, they can't think very clearly,
so they have slower processing speed, they have more difficulty multitasking,
(05:49):
they have challenges with name recall, they may have a
difficulty with short term memory. So these are all symptoms
or aspects of chemo brain.
Speaker 3 (06:00):
Yeah, and I have been watching this research now and
I'm so excited to see that more research in this
area is being done because i mean, you know, not
that long ago, it's like, oh well, it's all on
your head, you know, I mean, it just really wasn't
even acknowledged. And now it's not only being acknowledged, but
we're being proactive, and I'm really excited about that. Yeah.
Speaker 2 (06:26):
So, Calyn, given that chemo brain and brain thug are
basically inflammation of the brain, it makes sense of course
that bodily inflammatory conditions would increase the risk of chemo brain.
So have you found any evidence to support that association.
Speaker 3 (06:42):
Absolutely.
Speaker 1 (06:43):
So.
Speaker 3 (06:43):
A great example is with obesity. We know that carrying
extra weight is inflammatory, and it appears as though there's
a direct association between obesity and poor brain function in
people who've received chemotherapy. By the way, I'm really glad
that you pointed out that it's not just chemotherapy. Research
(07:04):
is showing that people who have experienced who've had radiation,
experienced chemo brain, and as you mentioned, just the diagnosis
and treatment of cancer can bring on cognitive difficulties. So
back to obesity. So in one study, here's an example,
obese participants were almost three times more likely to have
brain function impairments. Now there's another study looking at the
(07:27):
long term effects of chemotherapy on brain function in childhood
leukemia survivors, and that study found that those who were
obese scortes significantly lower on all measures of executive function,
including memory planning, also low on processing speed and attention span.
(07:48):
Now this really illustrates the fact that chemo brain can
linger for years, so that's why it's so important to
address this. Now, another study found that age was also
a fact, showing that breast cancer survivors who had abdominal obesity,
which is highly inflammatory and they were over age sixty
(08:08):
had problems with memory, verbal fluency, and attention span compared
to younger survivors who had normal weight. So we definitely
know that there's a strong connection between obesity and increased
risk of chemo brain. So that's why it's so important
to maintain normal body weight before cancer treatment or get
(08:29):
back to normal body weight after cancer treatment. And of
course we know one way to do that is with exercise.
When we exercise and reacted, we can lose weight. Now,
as luck would have it, research shows that exercise interventions
improve chemotherapy related cognitive impairment. Now isn't that a great
little fit there? So you know, this is kind of
(08:52):
a new area of research. But according to a twenty
twenty review of randomized controlled trials travel those trials showed
a statifics totistically significant effect of exercise on self reported
cognitive function. And the good news about exercise, and something
that I always like to point out is that it
doesn't take a lot, especially if you've been fairly inactive.
(09:15):
You know, just developing a consistent walking routine is a
step in the right direction, and that was a pun
intend at least. But no, I think movement is critical,
and I think trying to avoid obesity is critical in
this area. So least, there's really not much published evidence
(09:37):
on strategies for improving chemo brain. But I know you've
found some things that work for some people and that
have some evidence for use in other conditions of cognitive impairment,
which then means, h maybe they'll work with chemo brain.
So tell us about your findings there.
Speaker 2 (09:57):
Okay, So there are several which I have been using
what we practitioners say empirically, meaning I've taken looked at
the evidence in similar other conditions, and based on a
benefit risk analysis high likelihood of benefit, low risk of harm,
(10:17):
started using them in patients that come to see me
with symptoms of chemobrain. And I've been watching their response
very carefully, and I've found excellent results. So I'm really happy,
and I hope that we can you know, we'll see
some research specific to this population at some point. So
let me share some of my favorites. So one of
my very favorites is a mushroom, a medicinal mushroom called
(10:38):
Lion's maine. This is actually an edible mushroom, but it's
hard to eat anything every day in therapeutic quantities. So
this is typically used as an extract mushroom extract, and
this has been studied for cognitive impairment in people who
have kind of a vascular related type of cognitive impairment
(11:02):
early sort of mild cognitive impairment. It has been studied
in women who have depression, because actually depression can be
an inflammatory disorder of the brain, and in both of
those conditions it's been shown to be quite effective. One
of the mechanisms that lions main has been found to
have is it has some components in it which increase
(11:24):
the brains production of something called nerve growth factor. So
when the brain makes more nerve growth factor, the neurons,
which are the cells in the brain, can grow more
axons which reach out to connect with other neurons, so
that the connection between neurons increases, which is what we
call neuroplasticity or increased neural connectivity, and that's really necessary
(11:51):
for us to think better, to think more clearly, to
be able to use our brain more effectively. We also
know that lines made mushroom inactivate some of the cells
in the brain that perpetuate the inflammatory response, so it
has direct anti inflammatory response. And in the meantime, remember
this is a medicinal mushroom, and when we use extracts
(12:13):
of medicinal mushrooms, we also get the immune supportive actions
from those mushrooms, and mushrooms have a very particular way
in which they interact with the immune system such that
they increase the activity of certain immune cells, natural killer
cells and cytotoxic T cells that are directly targeting viruses,
(12:37):
virally infected cells, and tumor cells. So these mushroom extracts
also increase our own immune defenses against cancer while they
are improving our cognitive function and reducing inflammation. So it's
kind of a three for one with lines made mushroom extracts.
Speaker 3 (12:54):
Yeah, I'm going to add a four because I think,
I know, I love this this extract lines main is
also considered to be an adaptogen, so it actually helps
with our stress response. So I think that these madicial
mushrooms are powerful, and I do like this one specific
to brain function. And you know what else, I actually
(13:18):
was amazed least to learn how mindfulness improves cognition. So
research shows that mindfulness affects both functional connectivity which you
just mentioned and structural anatomy of the brain. In other words,
it can help us rewire the brain to enhance brain function.
Speaker 2 (13:36):
You know.
Speaker 3 (13:36):
For example, a twenty twenty three analysis of eleven randomized
controlled trials found that mindfulness interventions positively impacted brain plasticity
in areas of the brain associated with pain management and attention.
Another study involving rest answer patients used MRI to see
how the brain change and found that there was enhanced
(13:58):
brain connectivity and there is also reduced emotional stress, fatigue
and subjective cognitive impairment. So what are we talking about
when we say mindfulness based interventions. We're talking about things
like meditation. But you know what, if meditation isn't for you,
there's lots of other options. There's guided imagery, there's the
(14:18):
body scan technique, there's breathing exercises, mindful walking which I love,
yoga tai chi which I love, and chie goong. So
I think employing some of these mindfulness based techniques on
a daily basis is also going to help with cognition one.
Speaker 2 (14:37):
Hundred percent, you know. And mindfulness is the gift that
keeps on giving. People who practice mindfulness of any kind regularly, literally,
like you said, change the way their brain is wired.
And that benefit extends for quite a long time, really
for the rest of their life. And you know that,
and it will impact mood and in away impacts energy
(15:02):
because it reduces mental fatigue. So it really is important.
I think for overall health and well being.
Speaker 3 (15:09):
Yeah, I would agree, and other benefits as well, you know,
in addition to cognitive So okay, Lisa, do you have
another top cognitive enhancing strategy? I do, you know.
Speaker 2 (15:20):
And one of our sponsors actually produces a supplement with
this ingredient in it, which is called citicoline. So we
are sponsored by Cognizance cticholine, and I'm really happy to
have that sponsor because citicoline is a very well researched
compound that is very specific for enhancing neurological functions. So
(15:42):
one of the main building blocks for a key neurotransmitter,
which is a chemical that neurons produced to communicate with
one another, is acetylcholine. And cyticoline enhances the ability to
produce acetocholine, which in turn is going to improve the
ability for one neuron to communicate to another over time.
(16:03):
That's going to enhance the ability of our brains to
function on all cylinders quite literally. But it doesn't stop there.
So citicoline is also taken up into cell membranes because
it also is incorporated into a molecule called fossil title coline,
which allows the cell the nerve the neuron membrane to
(16:27):
be very fluid, and the more fluid that it is,
the more response of it is. So all the receptors
that express out of the membranes of our neurons receive
these NEU transmitters, and the more fluid that membrane is,
the better those receptors function. So it literally helps the
neurons receive the communication signals from their neighboring neurons. And
(16:49):
this has all been borne out in clinical research. There
have been several trials. In fact, there was even a
review of trials that was published by an organization called Cochrane,
which when they put their reviews out they use very
strict criteria and they only the recommendations are very conservative.
They have the highest standards in their review. And even
(17:10):
in the Cochrane review they said, you know what, citicoline
in the studies that we review does in fact enhance memory,
focus and attention. It does it within as little a
time as four weeks. Most of the studies aren't really long,
so they were only able to say that as long
as the studies are that these mental functions are enhanced.
(17:31):
But in my clinical practice, I've used citicoline a lot
and found it to be exactly that works very quickly.
Within a month, people are already noticing improvement in their
cognitive function and with chemo brain, as long as they
take it, you know, through the treatments or well, you know,
(17:52):
past the time a good period of time treatment, they
can eventually wean off in some cases and feel fine,
the brain is back working well, and they can always
kind of come on and off it depending on how
their symptoms are going, just because it does work so quickly.
Speaker 3 (18:07):
Yeah, I take it. And I'll tell you one thing.
One time the manufacturer was out and they were out
for a while, and I noticed a difference. The one
thing I'm very impressed with the research, and the one
thing I want to point out is that it is
important to get the right form of cytacoline. And that's
why I like our sponsor because Cognizant is the actual
(18:29):
form that was used in a lot of the studies.
So I think that's important as well. Now I have
an area of research that I am fascinated, i'd say,
kind of borderline obsessed. Lease, okay, you know how I get.
So this is the gut brain access. Now, while this
(18:50):
area of research is expanding, dramatically. The focus has been
mostly on mental health and just general cognition versus chemo
brain specifically. However, I did read a review from twenty
twenty that concluded that the health of the gut microbiome
may be implicated in chemotherapy related side effects. Then they
looked at fatigue and depression and anxiety, sleep disturbances, and cognitive impairment.
(19:16):
So we know that chemotherapy can negatively impact the gut microbiome,
which then in turn contributes to cognitive impairment or chemo brain. Now, interestingly,
the researchers of that review also looked at fear of
cancer recurrence and found that high levels of one type
of bacteria in the gut were associated with higher levels
(19:40):
of fear of recurrence, while higher levels of two other
bacteria were associated with lower levels of fear of recurrence. Now,
at least this is where I get so geeked out.
I think this is so interesting. It reminds me of
a podcast I did recently for the Natural Medicine Journal
with doctor Arpana Church. Doctor Church is unique. She's a
(20:03):
researcher who is a neuroscientist with microbiome expertise, so her
study participants the ones who had a healthy gut lining,
and they used uh, you know, MRI to look at
the brain. They used a fecal stool samples to look
(20:23):
at the gut, and then they did a resilience test
and what they found was that the study participants who
had a healthy, healthy gut lining were more resilient. They
also found that those same resilient people with the healthy
gut were more mindful, kind compassionate, and that the people
(20:47):
who had legy gut or dysbiosis had a lack of
resilience and were not as mindful. Now, I think that's
pretty cool. Here you have a neuroscientist with microbiome expertise
and she's looking at resilience and kindness and compassion as
it relates to the brain and the gut. I realize
(21:08):
that I'm deviating from chemo brain a bit, but this
really illustrates the power. So if in fact we care
about our brain function, and we care about how our
brain is working, we should also care about the health
of our gut. The health of our gut as far
reaching implications, especially to the brain. And I'd love to
(21:31):
hear your thoughts on this, because I don't think you
and I have ever really geeked out on the gut
brain access.
Speaker 2 (21:38):
Yeah. Boy, so I love the thoughts. So so, first
of all, you know, I think that these studies are
really interesting and the gut brain axis is so important.
There is you know, we often react emotionally in our gut.
First we get an upset stomach or you know, something
like that, and that's because there's a lot of neurotransmitters
(21:58):
secreted in our gut. And the tight kind of association
between how we respond in our nervous system and the
changes that our nervous system makes in the mucosal lining
in our gut, which is where all the bacteria live,
and even slight changes can really affect which bacteria can
(22:18):
live in there. So it's not hard to imagine that
if we have a certain kind of emotional response, that
we can change the environment in our gut to create
different microbes. And the reverse can be true too. If
we eat a diet let's say that's devoid of a
good amount of fruits and vegetables, and which we know
(22:40):
fruits and vegetables support diverse microbiome. When we start to
narrow the type of bacteria that reside in our gut,
that in turn will affect the quality of our mucosa,
which when turn, will start to create nerve responses and
our intestines and activate our immune system, which create inflammatory kinds.
(23:00):
Those inflammatory chemicals can circulate up into our brain. We
start to inflame our brain, then we get anxiety depression.
So it's this bi directional thing that happens, which I
think is what makes it so interesting and you know,
also powerful because we can intervene at either of those
levels and both in fact, you know, really try to
(23:22):
adjust how we approach the world through mindfulness and exercise
and some of the things we've talked about, and adjust
the gut through our diet and our digestive process. And
when we do both, when we kind of address it
on both sides, I think that's where we start to
see the magic.
Speaker 3 (23:40):
I would agree, and I'm glad that you brought up
diet and some of these other strategies because we're learning
that these other strategies do impact the gut. And I
think that looking at the gut and gut health, I mean,
you know, if you're working with a naturopathic oncologist, they
will they can order tests to get a snapshot of
what's going on in your gut, and also something as
(24:01):
simple as fermented foods or a high quality probiotic prebiotic supplement.
And I think that that's it's important, so important to
include prebiotics. So I think that research has expanded dramatically,
so now we know we not only need the good bacteria,
but we need to feed that good bacteria, and we
(24:21):
do that with prebiotics. So I think that that's a
simple intervention. And it's interesting because when I was talking
to doctor Church, who's conventionally trained researcher in army, she's
really well accomplished in her area, you know. I asked her,
I'm like, are you telling me that probiotics, prebiotics, diet
(24:42):
and lifestyle could change the landscape of the gut micro biome,
which could in fact enhance brain health. And she said absolutely.
So I think this is a very exciting time because
this is where integrated medicine shine. We have so many
tools to heal the gut. It's interesting these I was
(25:05):
on a doctor Hoffman show the other day and I
was telling him, how about when I first started in
the industry, there was this naturopathic phrase death begins in
the colon and it sounds shocking and everything, But here
we are. I mean, I've been in this industry thirty years.
Here we are thirty years later, and boy, isn't it true.
(25:26):
Naturopathic physicians have had it right all along. Let's get
to the gut. Look to the gut, and we.
Speaker 2 (25:34):
Can kind of rephrase that so it's not so dire.
We can say that health begins and ends on that.
Speaker 3 (25:40):
That's much better.
Speaker 2 (25:41):
I like it better, right, Yeah, So I want to
just tie in one other little strategy. I'm going to
use a little cute metaphor here. I'm going to sprinkle
in another strategy, which is spices. Because when you're talking
about using gut to support a healthy microbiome, the microbiome
the might be bacteria in our gut feed on flabonoids.
(26:05):
That's their favorite food substrate, which is found in fruits
and vegetables, but also is found concentrated in spices, culinary spices,
and so spices actually helped to support a healthy microbiome.
And spices like turmeric and some of the spices in
the mint family, and rosemary and some of these really yummy,
(26:27):
delicious spices also have been shown to improve cognition and
cognitive functions. So this is probably because they're anti inflammatory.
It may be because of their effect on the gut,
But this is kind of just another important way to
think about, Like everything we eat has the potential to
(26:47):
do more than just feed or hunger it. It really
has the potential to facilitate health and well being everywhere,
even in our in our heads.
Speaker 3 (26:57):
Yeah, I would agree, I would agree. Good addition, I
love I love the addition of spices.
Speaker 2 (27:02):
Yeah, okay, Well, anything else that you'd like to share?
You have time for one last little nugget?
Speaker 3 (27:09):
Oh man, I think that gratitude. I can't talk enough
about gratitude. I have no studies regarding gratitude and chemo brain,
but I tell you, Lise, it's become a foundational thing
for me, and I really feel like if we can
infuse more gratitude into our daily lives, it's going to
help everything, not just our mental health, but our brain
(27:31):
health as well.
Speaker 2 (27:32):
Yeah. And you know what, there was a there's a
technique that psychologists sometimes used to help reframe chronic complaints,
where like if you have a let's say pain in
your foot, you just sort of think, well, you know,
what at least I'm grateful I have a foot to
have pain, and so I would say we can also
be grateful that we have a brain and enough to
(27:55):
even know that we're having trouble. I mean not to
minimize this, but I think gratitudo does form a really
important foundation and way to approach and incorporate some of
these health strategies. Okay, well we're gonna have to finish up,
so why don't you take us out and thank our sponsors?
Speaker 3 (28:11):
All right, I would love to you, so once again,
I'd like to thank immused post biotic to give your
immune system that extra boost, cogniz and citicola to help
enhance memory, focus and attention. And doctor here is award
winning shelf stable probiotic and pro thrivers supplements designed specifically
for the needs of thrivers. And may you all experience joy,
(28:32):
laughter and love. It's time to thrive.
Speaker 2 (28:35):
Everyone, have a great night.
Any health related information on the following show provides general
information only. Content presented on any show by any host
or guest should not be substituted for a doctor's advice.
Always consult your physician before beginning any new diet, exercise,
or treatment program.
Speaker 2 (00:30):
Hello, everyone, welcome to five to Thrive Live. And I'm
(00:50):
also Lisa Sure and I'm joined by my good friend,
an amazing co host who I'm sure is not now.
Speaker 3 (00:57):
Wet with their water.
Speaker 2 (00:58):
No, Hey, Carolyn, how are you today?
Speaker 3 (01:01):
I'm perfectly dry over here. I'm actually doing great. Lise,
how are you?
Speaker 2 (01:11):
I'm good. I yeah, I had a good day today
and thirsty he but yes, I'm good.
Speaker 3 (01:20):
Good, I'm glad you're I'm glad you're staying hydrated. So well,
you know what, Lise, you got to pick the topic
for today's show. So what did you pick and why
did you pick it?
Speaker 2 (01:35):
Yeah, So we're going to talk about chemo brain, and
we'll talk about kind of what that is and what
it's not, and you know, ins and outs, and then
of course we're going to talk about some of our
favorite strategies to address chemo brain or chemo fog is
what another another terminology for it. But before we dive in,
(01:59):
let's introducer sponsors, Carolyn, can you do that?
Speaker 1 (02:02):
Yeah?
Speaker 3 (02:03):
Absolutely, And you know, I was really psyched when you
pick this topic because it's so prevalent, in so common.
A lot of people suffer from this, so I was
really happy that you picked this topic. So I would
love to thank our sponsors. Beginning with Amuse, a unique
patented post biotic that gives your immune system a key advantage.
Immuse as an ingredient in many immune supporting dietary supplements.
(02:27):
Look for Amuse on the label or go to immusehealth
dot com for more information. Also cognizance citicoling, which is
nature's way of keeping the brain's energy producing centers firing
on all cylinders. If you're looking for a way to
enhance your brain function, including memory, focus, and attention, look
for cognism on the label or vote to cognizant dot
com for more information. Prothriver's Brain is a product that
(02:50):
contains Cognizant as well as other brain supporting nutrients and urge.
You can find Prothrivers Wellness Brain online at pure formulas
dot com. Also look for pro Thrivers Wellness Sleep, a
supplement which combines higher dose melatonin and other sleep supporting
natural ingredients specifically designed for thrivers. You can find pro
(03:11):
Thrivers Wellness Sleep and pro Thrivers Wellness Brain at pure
Formulas dot com and of course doctor oh here is Probiotics.
It's a best selling probiotic for more than thirty years,
and it contains twelve programotic strains that are shelf stable,
so no refrigeration is required because of a unique three
year fermentation process. It's a very effective probiotic. Learn more
(03:32):
at doctor Oheira probiotics dot com. So one thing I
wanted to point out is that if you are a
listener who has not had chemotherapy, but you're still interested
in enhancing and preserving brain power, the strategies that we're
going to talk about will help you as well. So, okay, Lise,
(03:54):
when it comes to chemo brain specifically, where would you
like to start?
Speaker 2 (04:00):
Yes? Indeed, well, you know, I guess I want to
start by saying that you said it was common. It
is really common. So it's estimated that sixty six percent
or two thirds of all people who go through any
kind of cancer treatment develop some degree of chemo brain.
It's a little bit of a misnomer, this chemo brain,
(04:21):
because people who have had baseline cognitive issues are more
prone to developing a worsening of those issues. People can
develop this cognitive difficulty even without getting chemo, but just
going through the diagnosis and the disease of cancer as
well as radiation. So this all makes sense when we
(04:42):
think about the fact that chemo brain. Will just use
that word because that is still in the literature and
kind of the vernacular, if you will, but that chemo
brain is really an inflammatory condition of the brain. So
anybody who has any kind of baseline inflammation in their
brain is going to that worsened by chemotherapy or even
radiation therapy. And it also means that anything that is
(05:06):
anti inflammatory and that can cross in through what we
call the blood brain barrier, which is kind of a
physiological barrier of tissue blood vessels. But if things can
get into the brain, then it's and they have anti
inflammatory properties, they're likely to be of benefit to chemo brain.
(05:27):
So it's really important to think about and to remember
as we go through the rest of this show that
chemo brain is essentially a condition of inflammation of the brain,
and when people's brains are inflamed, they can't think very clearly,
so they have slower processing speed, they have more difficulty multitasking,
(05:49):
they have challenges with name recall, they may have a
difficulty with short term memory. So these are all symptoms
or aspects of chemo brain.
Speaker 3 (06:00):
Yeah, and I have been watching this research now and
I'm so excited to see that more research in this
area is being done because i mean, you know, not
that long ago, it's like, oh well, it's all on
your head, you know, I mean, it just really wasn't
even acknowledged. And now it's not only being acknowledged, but
we're being proactive, and I'm really excited about that. Yeah.
Speaker 2 (06:26):
So, Calyn, given that chemo brain and brain thug are
basically inflammation of the brain, it makes sense of course
that bodily inflammatory conditions would increase the risk of chemo brain.
So have you found any evidence to support that association.
Speaker 3 (06:42):
Absolutely.
Speaker 1 (06:43):
So.
Speaker 3 (06:43):
A great example is with obesity. We know that carrying
extra weight is inflammatory, and it appears as though there's
a direct association between obesity and poor brain function in
people who've received chemotherapy. By the way, I'm really glad
that you pointed out that it's not just chemotherapy. Research
(07:04):
is showing that people who have experienced who've had radiation,
experienced chemo brain, and as you mentioned, just the diagnosis
and treatment of cancer can bring on cognitive difficulties. So
back to obesity. So in one study, here's an example,
obese participants were almost three times more likely to have
brain function impairments. Now there's another study looking at the
(07:27):
long term effects of chemotherapy on brain function in childhood
leukemia survivors, and that study found that those who were
obese scortes significantly lower on all measures of executive function,
including memory planning, also low on processing speed and attention span.
(07:48):
Now this really illustrates the fact that chemo brain can
linger for years, so that's why it's so important to
address this. Now, another study found that age was also
a fact, showing that breast cancer survivors who had abdominal obesity,
which is highly inflammatory and they were over age sixty
(08:08):
had problems with memory, verbal fluency, and attention span compared
to younger survivors who had normal weight. So we definitely
know that there's a strong connection between obesity and increased
risk of chemo brain. So that's why it's so important
to maintain normal body weight before cancer treatment or get
(08:29):
back to normal body weight after cancer treatment. And of
course we know one way to do that is with exercise.
When we exercise and reacted, we can lose weight. Now,
as luck would have it, research shows that exercise interventions
improve chemotherapy related cognitive impairment. Now isn't that a great
little fit there? So you know, this is kind of
(08:52):
a new area of research. But according to a twenty
twenty review of randomized controlled trials travel those trials showed
a statifics totistically significant effect of exercise on self reported
cognitive function. And the good news about exercise, and something
that I always like to point out is that it
doesn't take a lot, especially if you've been fairly inactive.
(09:15):
You know, just developing a consistent walking routine is a
step in the right direction, and that was a pun
intend at least. But no, I think movement is critical,
and I think trying to avoid obesity is critical in
this area. So least, there's really not much published evidence
(09:37):
on strategies for improving chemo brain. But I know you've
found some things that work for some people and that
have some evidence for use in other conditions of cognitive impairment,
which then means, h maybe they'll work with chemo brain.
So tell us about your findings there.
Speaker 2 (09:57):
Okay, So there are several which I have been using
what we practitioners say empirically, meaning I've taken looked at
the evidence in similar other conditions, and based on a
benefit risk analysis high likelihood of benefit, low risk of harm,
(10:17):
started using them in patients that come to see me
with symptoms of chemobrain. And I've been watching their response
very carefully, and I've found excellent results. So I'm really happy,
and I hope that we can you know, we'll see
some research specific to this population at some point. So
let me share some of my favorites. So one of
my very favorites is a mushroom, a medicinal mushroom called
(10:38):
Lion's maine. This is actually an edible mushroom, but it's
hard to eat anything every day in therapeutic quantities. So
this is typically used as an extract mushroom extract, and
this has been studied for cognitive impairment in people who
have kind of a vascular related type of cognitive impairment
(11:02):
early sort of mild cognitive impairment. It has been studied
in women who have depression, because actually depression can be
an inflammatory disorder of the brain, and in both of
those conditions it's been shown to be quite effective. One
of the mechanisms that lions main has been found to
have is it has some components in it which increase
(11:24):
the brains production of something called nerve growth factor. So
when the brain makes more nerve growth factor, the neurons,
which are the cells in the brain, can grow more
axons which reach out to connect with other neurons, so
that the connection between neurons increases, which is what we
call neuroplasticity or increased neural connectivity, and that's really necessary
(11:51):
for us to think better, to think more clearly, to
be able to use our brain more effectively. We also
know that lines made mushroom inactivate some of the cells
in the brain that perpetuate the inflammatory response, so it
has direct anti inflammatory response. And in the meantime, remember
this is a medicinal mushroom, and when we use extracts
(12:13):
of medicinal mushrooms, we also get the immune supportive actions
from those mushrooms, and mushrooms have a very particular way
in which they interact with the immune system such that
they increase the activity of certain immune cells, natural killer
cells and cytotoxic T cells that are directly targeting viruses,
(12:37):
virally infected cells, and tumor cells. So these mushroom extracts
also increase our own immune defenses against cancer while they
are improving our cognitive function and reducing inflammation. So it's
kind of a three for one with lines made mushroom extracts.
Speaker 3 (12:54):
Yeah, I'm going to add a four because I think,
I know, I love this this extract lines main is
also considered to be an adaptogen, so it actually helps
with our stress response. So I think that these madicial
mushrooms are powerful, and I do like this one specific
to brain function. And you know what else, I actually
(13:18):
was amazed least to learn how mindfulness improves cognition. So
research shows that mindfulness affects both functional connectivity which you
just mentioned and structural anatomy of the brain. In other words,
it can help us rewire the brain to enhance brain function.
Speaker 2 (13:36):
You know.
Speaker 3 (13:36):
For example, a twenty twenty three analysis of eleven randomized
controlled trials found that mindfulness interventions positively impacted brain plasticity
in areas of the brain associated with pain management and attention.
Another study involving rest answer patients used MRI to see
how the brain change and found that there was enhanced
(13:58):
brain connectivity and there is also reduced emotional stress, fatigue
and subjective cognitive impairment. So what are we talking about
when we say mindfulness based interventions. We're talking about things
like meditation. But you know what, if meditation isn't for you,
there's lots of other options. There's guided imagery, there's the
(14:18):
body scan technique, there's breathing exercises, mindful walking which I love,
yoga tai chi which I love, and chie goong. So
I think employing some of these mindfulness based techniques on
a daily basis is also going to help with cognition one.
Speaker 2 (14:37):
Hundred percent, you know. And mindfulness is the gift that
keeps on giving. People who practice mindfulness of any kind regularly, literally,
like you said, change the way their brain is wired.
And that benefit extends for quite a long time, really
for the rest of their life. And you know that,
and it will impact mood and in away impacts energy
(15:02):
because it reduces mental fatigue. So it really is important.
I think for overall health and well being.
Speaker 3 (15:09):
Yeah, I would agree, and other benefits as well, you know,
in addition to cognitive So okay, Lisa, do you have
another top cognitive enhancing strategy? I do, you know.
Speaker 2 (15:20):
And one of our sponsors actually produces a supplement with
this ingredient in it, which is called citicoline. So we
are sponsored by Cognizance cticholine, and I'm really happy to
have that sponsor because citicoline is a very well researched
compound that is very specific for enhancing neurological functions. So
(15:42):
one of the main building blocks for a key neurotransmitter,
which is a chemical that neurons produced to communicate with
one another, is acetylcholine. And cyticoline enhances the ability to
produce acetocholine, which in turn is going to improve the
ability for one neuron to communicate to another over time.
(16:03):
That's going to enhance the ability of our brains to
function on all cylinders quite literally. But it doesn't stop there.
So citicoline is also taken up into cell membranes because
it also is incorporated into a molecule called fossil title coline,
which allows the cell the nerve the neuron membrane to
(16:27):
be very fluid, and the more fluid that it is,
the more response of it is. So all the receptors
that express out of the membranes of our neurons receive
these NEU transmitters, and the more fluid that membrane is,
the better those receptors function. So it literally helps the
neurons receive the communication signals from their neighboring neurons. And
(16:49):
this has all been borne out in clinical research. There
have been several trials. In fact, there was even a
review of trials that was published by an organization called Cochrane,
which when they put their reviews out they use very
strict criteria and they only the recommendations are very conservative.
They have the highest standards in their review. And even
(17:10):
in the Cochrane review they said, you know what, citicoline
in the studies that we review does in fact enhance memory,
focus and attention. It does it within as little a
time as four weeks. Most of the studies aren't really long,
so they were only able to say that as long
as the studies are that these mental functions are enhanced.
(17:31):
But in my clinical practice, I've used citicoline a lot
and found it to be exactly that works very quickly.
Within a month, people are already noticing improvement in their
cognitive function and with chemo brain, as long as they
take it, you know, through the treatments or well, you know,
(17:52):
past the time a good period of time treatment, they
can eventually wean off in some cases and feel fine,
the brain is back working well, and they can always
kind of come on and off it depending on how
their symptoms are going, just because it does work so quickly.
Speaker 3 (18:07):
Yeah, I take it. And I'll tell you one thing.
One time the manufacturer was out and they were out
for a while, and I noticed a difference. The one
thing I'm very impressed with the research, and the one
thing I want to point out is that it is
important to get the right form of cytacoline. And that's
why I like our sponsor because Cognizant is the actual
(18:29):
form that was used in a lot of the studies.
So I think that's important as well. Now I have
an area of research that I am fascinated, i'd say,
kind of borderline obsessed. Lease, okay, you know how I get.
So this is the gut brain access. Now, while this
(18:50):
area of research is expanding, dramatically. The focus has been
mostly on mental health and just general cognition versus chemo
brain specifically. However, I did read a review from twenty
twenty that concluded that the health of the gut microbiome
may be implicated in chemotherapy related side effects. Then they
looked at fatigue and depression and anxiety, sleep disturbances, and cognitive impairment.
(19:16):
So we know that chemotherapy can negatively impact the gut microbiome,
which then in turn contributes to cognitive impairment or chemo brain. Now, interestingly,
the researchers of that review also looked at fear of
cancer recurrence and found that high levels of one type
of bacteria in the gut were associated with higher levels
(19:40):
of fear of recurrence, while higher levels of two other
bacteria were associated with lower levels of fear of recurrence. Now,
at least this is where I get so geeked out.
I think this is so interesting. It reminds me of
a podcast I did recently for the Natural Medicine Journal
with doctor Arpana Church. Doctor Church is unique. She's a
(20:03):
researcher who is a neuroscientist with microbiome expertise, so her
study participants the ones who had a healthy gut lining,
and they used uh, you know, MRI to look at
the brain. They used a fecal stool samples to look
(20:23):
at the gut, and then they did a resilience test
and what they found was that the study participants who
had a healthy, healthy gut lining were more resilient. They
also found that those same resilient people with the healthy
gut were more mindful, kind compassionate, and that the people
(20:47):
who had legy gut or dysbiosis had a lack of
resilience and were not as mindful. Now, I think that's
pretty cool. Here you have a neuroscientist with microbiome expertise
and she's looking at resilience and kindness and compassion as
it relates to the brain and the gut. I realize
(21:08):
that I'm deviating from chemo brain a bit, but this
really illustrates the power. So if in fact we care
about our brain function, and we care about how our
brain is working, we should also care about the health
of our gut. The health of our gut as far
reaching implications, especially to the brain. And I'd love to
(21:31):
hear your thoughts on this, because I don't think you
and I have ever really geeked out on the gut
brain access.
Speaker 2 (21:38):
Yeah. Boy, so I love the thoughts. So so, first
of all, you know, I think that these studies are
really interesting and the gut brain axis is so important.
There is you know, we often react emotionally in our gut.
First we get an upset stomach or you know, something
like that, and that's because there's a lot of neurotransmitters
(21:58):
secreted in our gut. And the tight kind of association
between how we respond in our nervous system and the
changes that our nervous system makes in the mucosal lining
in our gut, which is where all the bacteria live,
and even slight changes can really affect which bacteria can
(22:18):
live in there. So it's not hard to imagine that
if we have a certain kind of emotional response, that
we can change the environment in our gut to create
different microbes. And the reverse can be true too. If
we eat a diet let's say that's devoid of a
good amount of fruits and vegetables, and which we know
(22:40):
fruits and vegetables support diverse microbiome. When we start to
narrow the type of bacteria that reside in our gut,
that in turn will affect the quality of our mucosa,
which when turn, will start to create nerve responses and
our intestines and activate our immune system, which create inflammatory kinds.
(23:00):
Those inflammatory chemicals can circulate up into our brain. We
start to inflame our brain, then we get anxiety depression.
So it's this bi directional thing that happens, which I
think is what makes it so interesting and you know,
also powerful because we can intervene at either of those
levels and both in fact, you know, really try to
(23:22):
adjust how we approach the world through mindfulness and exercise
and some of the things we've talked about, and adjust
the gut through our diet and our digestive process. And
when we do both, when we kind of address it
on both sides, I think that's where we start to
see the magic.
Speaker 3 (23:40):
I would agree, and I'm glad that you brought up
diet and some of these other strategies because we're learning
that these other strategies do impact the gut. And I
think that looking at the gut and gut health, I mean,
you know, if you're working with a naturopathic oncologist, they
will they can order tests to get a snapshot of
what's going on in your gut, and also something as
(24:01):
simple as fermented foods or a high quality probiotic prebiotic supplement.
And I think that that's it's important, so important to
include prebiotics. So I think that research has expanded dramatically,
so now we know we not only need the good bacteria,
but we need to feed that good bacteria, and we
(24:21):
do that with prebiotics. So I think that that's a
simple intervention. And it's interesting because when I was talking
to doctor Church, who's conventionally trained researcher in army, she's
really well accomplished in her area, you know. I asked her,
I'm like, are you telling me that probiotics, prebiotics, diet
(24:42):
and lifestyle could change the landscape of the gut micro biome,
which could in fact enhance brain health. And she said absolutely.
So I think this is a very exciting time because
this is where integrated medicine shine. We have so many
tools to heal the gut. It's interesting these I was
(25:05):
on a doctor Hoffman show the other day and I
was telling him, how about when I first started in
the industry, there was this naturopathic phrase death begins in
the colon and it sounds shocking and everything, But here
we are. I mean, I've been in this industry thirty years.
Here we are thirty years later, and boy, isn't it true.
(25:26):
Naturopathic physicians have had it right all along. Let's get
to the gut. Look to the gut, and we.
Speaker 2 (25:34):
Can kind of rephrase that so it's not so dire.
We can say that health begins and ends on that.
Speaker 3 (25:40):
That's much better.
Speaker 2 (25:41):
I like it better, right, Yeah, So I want to
just tie in one other little strategy. I'm going to
use a little cute metaphor here. I'm going to sprinkle
in another strategy, which is spices. Because when you're talking
about using gut to support a healthy microbiome, the microbiome
the might be bacteria in our gut feed on flabonoids.
(26:05):
That's their favorite food substrate, which is found in fruits
and vegetables, but also is found concentrated in spices, culinary spices,
and so spices actually helped to support a healthy microbiome.
And spices like turmeric and some of the spices in
the mint family, and rosemary and some of these really yummy,
(26:27):
delicious spices also have been shown to improve cognition and
cognitive functions. So this is probably because they're anti inflammatory.
It may be because of their effect on the gut,
But this is kind of just another important way to
think about, Like everything we eat has the potential to
(26:47):
do more than just feed or hunger it. It really
has the potential to facilitate health and well being everywhere,
even in our in our heads.
Speaker 3 (26:57):
Yeah, I would agree, I would agree. Good addition, I
love I love the addition of spices.
Speaker 2 (27:02):
Yeah, okay, Well, anything else that you'd like to share?
You have time for one last little nugget?
Speaker 3 (27:09):
Oh man, I think that gratitude. I can't talk enough
about gratitude. I have no studies regarding gratitude and chemo brain,
but I tell you, Lise, it's become a foundational thing
for me, and I really feel like if we can
infuse more gratitude into our daily lives, it's going to
help everything, not just our mental health, but our brain
(27:31):
health as well.
Speaker 2 (27:32):
Yeah. And you know what, there was a there's a
technique that psychologists sometimes used to help reframe chronic complaints,
where like if you have a let's say pain in
your foot, you just sort of think, well, you know,
what at least I'm grateful I have a foot to
have pain, and so I would say we can also
be grateful that we have a brain and enough to
(27:55):
even know that we're having trouble. I mean not to
minimize this, but I think gratitudo does form a really
important foundation and way to approach and incorporate some of
these health strategies. Okay, well we're gonna have to finish up,
so why don't you take us out and thank our sponsors?
Speaker 3 (28:11):
All right, I would love to you, so once again,
I'd like to thank immused post biotic to give your
immune system that extra boost, cogniz and citicola to help
enhance memory, focus and attention. And doctor here is award
winning shelf stable probiotic and pro thrivers supplements designed specifically
for the needs of thrivers. And may you all experience joy,
(28:32):
laughter and love. It's time to thrive.
Speaker 2 (28:35):
Everyone, have a great night.
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