October 22, 2024 • 20 mins
Unlock the secrets to maintaining a healthy brain and ward off the stealthy culprit of neuroinflammation in our latest episode of the Inflammation Nation podcast. We promise to guide you through the maze of factors leading to what we call a "bad brain," from early developmental challenges to the hidden aftermath of concussions and the silent effects of aging. Join us as we chat with experts Drs. Rob Melillo and Peter Scire, who lend their insights into how brain injuries and metabolic imbalances can set off a chain reaction of neurological issues. If you've ever wondered about the long-lasting impacts of seemingly minor knocks to the head or the subtle ways nutrient deficiencies can alter brain function, this episode could be eye-opening.
Our exploration doesn't stop there. We also tackle the concept of microglial priming and its role in prolonged brain inflammation, an often-overlooked aspect that might be key to protecting your mental faculties. For practitioners and listeners interested in functional medicine, glean practical tips on using natural methods like diet and lifestyle changes to support brain health, all while emphasizing the critical role of professional medical advice. Whether you're a parent, a practitioner, or simply curious about the intersection of brain health and overall wellness, this episode offers a treasure trove of knowledge and actionable insights to help you better understand and improve your brain's resilience.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Hey everyone, welcome to the Inflammation Nation
podcast.
I'm your host, Dr SteveNoseworthy.
Speaker 2 (00:08):
One of the greatest obstacles to crafting health and
wellness is identifying andcontrolling inflammation.
It's at the core of all complexand chronic diseases and it's
the driving mechanism thatunderlies the most common
symptoms that people like youstruggle to overcome.
Join us as we explorecutting-edge science and
research to give you theinformation and tools you need
to create the quality of lifeyou want and deserve.
(00:30):
And now here is the host ofInflammation Nation, dr Stephen
Nosworthy.
Speaker 1 (00:37):
Hey guys, welcome back to the podcast.
This is part two of the BetterBrain Equation, and this
two-part series is really anintroduction to a multi-part
series of interviews that I'mdoing with two amazing
clinicians, researchers andeducators, and they are Drs Rob
Melillo and Peter Skier.
So if you missed part one ofthis introduction, go back and
(00:59):
listen to that.
Today I'm simply going tocontinue on where I left off in
part one, so it's important thatyou get the grounding of part
one.
The whole point of this seriesis to raise the bar on how you,
as a healthcare consumer,understands your brain as an
integral part of quality of life, and to understand how your
(01:21):
brain is involved to one degreeor another in all of the major
health issues that we see verycommon in the world today.
And since this interview isgoing to be on both of my
podcasts, I also want to partnerwith Drs Malolo and Skyer to
challenge our practitionercolleagues to develop their
understanding of the brain sothat we can all serve our
(01:43):
communities better.
And whether you are a parent ofa child with ADD, adhd,
developmental delays or evenautism, or if you're an adult
who yourself suffer with thingslike anxiety, depression,
insomnia, ocd, perhaps balanceissues, or if you are a
functional medicine practitionerand you want to learn more
(02:05):
about how the brain develops andworks, then I highly recommend
that you get Dr Melillo's bookDisconnected Kids and make sure
that you get the newly releasedthird edition, since it actually
has at least 30% newinformation over the second
edition.
That's how editions work Inorder to have a second edition,
you have to have 30% newinformation over the first, and
(02:26):
so on.
And just so we're clear, I haveno financial interest here.
I'm making theserecommendations based solely on
the quality and the utility ofthe information in the
Disconnected Kids book, as wellas my personal and professional
high regard for Dr Skyer andMalila.
All right, so in the lastepisode I told you that in this
(02:49):
episode we were going to talkabout how brains go bad and in
essence there are four coremechanisms.
Of course there are others, butthese are the main ones that we
need to think about and talkabout.
The first mechanism of a badbrain is poor development.
The second mechanism of a badbrain is head injury or
concussion.
Same thing, two different terms.
The third mechanism of badbrain is a metabolic imbalance
(03:13):
or disturbance that affects howthe brain functions.
And then the final mechanism ofthe bad brain is poor aging,
and notice that I said pooraging and not just simply aging.
Notice that I said poor agingand not just simply aging.
Now, these are not mutuallyexclusive.
You can have more than one, andhaving one tends to promote the
others.
For example, since the brain isin control of metabolism and
(03:37):
even, to a certain extent,immune function, poor
development of the brain tendsto lead to metabolic issues and
immune dysfunction, which thencan have an impact on how the
brain works.
So it's a reciprocalrelationship or two-way
communication.
But even if your braindeveloped in a perfectly
symmetrical way and on time,meaning that you hit all of your
(03:57):
developmental milestones as achild, injuring your brain with
a concussion shifts themetabolic states of the brain,
introduces this thing calledneuroinflammation We've talked
about that before on the podcastand this neuroinflammation then
affects how the brain controlsmetabolism and even immunology
again, to a certain extent.
And so while I'm introducingyou to a list of number one, two
(04:20):
, three and four, they're notdiscrete entities, they all
bleed into each other, so let'sgo over these one at a time.
We're going to do this insummary form because, again,
it's an introduction, it's not afull, detailed analysis.
The first mechanism of bad brainis development.
We talked a little bit aboutthat in the first episode.
In the interviews with DrSkyer-Malilla we talk a lot more
(04:43):
about that.
But as far as development goesvery quickly, your brain begins
to develop within the firstthree weeks of conception.
That's where we start to seethe tissue changing, which
eventually forms into a fullhuman, fully functional human
brain.
And you'll remember that, evenin utero.
So baby's brains run some ofthese primitive reflexes that
(05:06):
assist the birthing process butalso which support survival via
reflexive feeding behaviors oncethe baby's born.
So when babies get hungry theycry.
If you stroke the side of theircheek they will open their
mouth and turn their headtowards the side that you
stroked so that they can latchonto a nipple to eat, and this
(05:27):
is called the rooting reflex.
Now there are other reflexesthat have to do with feeding
behaviors.
There are others that relate tostartle reflexes, with loud
sounds, for example, others thatrelate to movement of the spine
and limbs.
But the key to remember here isthat these are brainstem
reflexes that, over the firstfew weeks and even months after
(05:49):
birth, drive information intothe cortex, into the higher
brain, so that the higher braincan develop is all about
survival, but the primitivesurvival reflexes drive
(06:09):
sophistication of the cortex sothat we eventually learn to move
and to speak and to emote, orcreate and explore our world and
connect with people and so on.
So bad development or impropertiming of development,
asymmetrical development of thebrain, is one way we can create
a bad brain.
The second mechanism of badbrain is injury and of course,
at any point in life we cansustain an injury to our brain
(06:34):
through concussion, whether thatis mild or even all the way up
to severe traumatic brain injury.
For example, if a baby fallsand hits their head, this could
affect development of theinjured regions, leading into an
imbalance.
Kids, teens, adults can sustaininjuries in sports, during
recreational activities, on thejob, tripping and falling.
(06:55):
I remember working many yearsago with a woman who sustained a
pretty nasty concussionstanding up quickly in her
kitchen.
She was bent over gettingsomething underneath the counter
and she stood up and hit herhead on an open cabinet door and
caused a severe concussion.
If I remember the detailscorrectly, because it's been a
(07:19):
while, she even lostconsciousness for about 10
seconds or so.
Car accidents are another commoncause of head injury, and one
thing that we know about headinjury is that the effect on the
brain itself isn't tiedexclusively to the magnitude of
the impact, because you wouldthink, well, a small impact
means no injury, and you have tohave a certain magnitude of
(07:40):
force to create an injury to thebrain, and that's not
necessarily true.
Now, of course, the magnitudeof impact matters, and it is
easier to understand how hittingyour head very hard could lead
to a concussion, but evensmaller forces can have major
impacts, especially if the brainis unhealthy to begin with or
(08:00):
there are multiple related lowforce injuries that accumulate
over time.
I spent many years of mychiropractic career early on
working with people who wereinjured in a car accident, and
many of them showedpost-concussive symptoms despite
not hitting their head when theaccident happened.
And it turns out that yourbrain floats on a thin cushion
(08:22):
of fluid inside your skull.
And when your head whipsforward and back during a car
accident, the brain literallysloshes up against the inside of
your skull, and so a concussionin that sense can be from an
internal impact rather than anexternal one.
Obviously, if you hit your headon a steering wheel or the
dashboard or a window, it's easyto see how you can get a
(08:43):
concussion, but many peopledon't understand that there
doesn't have to be an externalimpact to have a concussion in
the brain in the context, forexample, of a rear-end motor
vehicle accident.
So one of the factorsdetermining the effects of a
head injury is the magnitude offorce, but don't discount these
low-force injuries or eveninjuries without an external
(09:06):
impact, and this is more likelyto happen when the brain is
already unhealthy.
The pre-existing state of thebrain is a major factor to
consider, since unhealthy brainsare more sensitive to
lower-impact forces.
It would be a mistake to thinkthat a low-force impact wasn't
an issue because it wasn't ahigh-force impact.
And it would also be a mistaketo think that a low force impact
(09:28):
wasn't an issue because itwasn't a high force impact.
And it would also be a mistaketo think that a head injury
without immediate effects orloss of consciousness is not a
problem either.
The neurology literatureconfirms that any head injury
with loss of consciousness isvery significant, and the longer
you're out, the worse theeffects will typically be.
But just simply getting yourbell rung without losing
(09:49):
consciousness is alsosignificant.
So if we put all of thistogether, maybe into some kind
of a hierarchy from worse tostill bad but not as worse would
look like this the most severewould be a major head impact
with loss of consciousness.
Then the longer you're out, theworse the impact on the brain.
Typically the next still badbut not as bad would be head
(10:12):
injury without loss ofconsciousness, but with
immediate post-concussivesymptoms, again feeling like you
had your bell rung, you'redizzy, you're woozy, you're kind
of out of it, you feel offkilter, you're fuzzy.
However, you might describethat A little bit less impactful
would be a post-concussivesymptom that lasts for weeks or
(10:35):
days, versus those that mightlast only for a few hours or
maybe a day or two.
So if you have post-concussivesymptoms, even though you might
not have lost consciousness, thelonger those post-concussive
symptoms last, typically theworse it is for the brain.
The next step down would be anylow-force injury that creates
(10:56):
immediate or prolonged symptomseven though there's no loss of
consciousness, and then thefinal step on that ladder, if
you will, would be mild injurythat doesn't create any
noticeable immediate orshort-term effects, and so we
have a wide range of possiblepresentations or manifestations
that factor in the magnitude ofthe impact the pre-existing
(11:20):
state of the brain, whether ornot you had post-concussive
symptoms that showed upimmediately or a little bit
later and how long thosepost-concussive symptoms lasted.
And of course, loss ofconsciousness is a critical
factor there as well.
And so you can look at whatever.
If you have had head injuriesin the past, you can look at
that spectrum or that continuum,if you will, and just kind of
(11:43):
gauge for yourself okay, howserious could this potentially
be?
And on this last note of youknow maybe you've had a head
injury, but it was a long timeago I want to address this idea
that or the reality in a commonoccurrence that people tend to
discount head injuries thatnumber one they didn't lose
(12:03):
consciousness, or that happenedyears in the past.
They just don't think it'srelevant or it doesn't apply to
them today.
To that I would say this About15 years or so ago I was a
co-author of a paper thatreviewed the current medical
literature on the metaboliceffects of head injury and
concussion, and one thing thatwe all learned from that was
(12:27):
that head injury always comeswith a price, even if that price
isn't paid until decades afterthe injury itself, repaid until
decades after the injury itself.
And one of the main reasons forthis is that any head injury
creates what we call microglialpriming.
Now, microglial cells areimmune cells in your brain that
create brain inflammation, andwe need them to be active at a
(12:50):
low level to keep the brainhealthy.
But when they become overactiveor primed would be the right
word they create sustainedneuroinflammation which makes
the brain sensitive to otherthings.
In fact, the low force headimpacts that translate into
major brain injury.
It's usually because the brainis already inflamed through this
(13:13):
process of microglial priming,and this makes the neurons of
the brain much more sensitive,not just to mechanical forces,
but also to changes in brainchemistry.
In fact, the neurologicalliterature talks about something
called chemical concussion orchemical reconcussion, which is
where someone has a history ofpast tannetry, has lived for
(13:34):
some time with an inflamed brain, and all it takes is a stress
event, an illness or a bad shiftin your hormones, among other
things, to recreate the effectsof the concussion through a
biochemical change Not throughhead impact, but through
biochemical change.
And again, it's called chemicalreconcussion.
And this leads me into the thirdmechanism of creating a bad
(13:56):
brain, and that is any metabolicimbalance that affects the
brain, and I'm not just talkingabout changes in the internal
chemistry of the brain, meaningthings that are happening in the
brain itself, like microglialpriming, or people.
When you talk about brainchemistry, they immediately
think about things likeneurotransmitters.
I mean to include anythingabout your body's metabolic
(14:20):
state that can affect the brain.
So I'm just going to give you aquick list.
We've talked about these overand over again in the course of
the podcast in the last coupleof years, but things like low
iron status or being anemic,deficiencies of key nutrients
like vitamin B or I should say Bvitamins, because it's more
than just one that's applicableto the brain omega-3, fatty
(14:42):
acids, vitamin D, for example,blood sugar problems, adrenal
dysfunction and the changes instress chemistry, whether or not
you have a leaky, infected gut,do you have things like
irritable bowel syndrome, areyour hormones screwed up, are
you sensitive to environmentalchemicals, and the list goes on
and on and on.
And so, while the brain'senvironment is supposed to be
(15:06):
protected by this thing calledthe blood-brain barrier, it is
permeable to many things,especially when poor health
breaks that barrier system downand things normally excluded
from the brain are allowed toget into the brain In reality,
again, pretty much everythingI've talked about for the last
two years or so on.
This podcast has the potentialto impact your brain in one way
(15:29):
or another.
So if the goal is to fix yourbrain or the brain of someone
you love, or if it is to protecta brain from going bad as you
age, then you are obligated tofind and fix any and everything
about your metabolic state.
And that leads me to the finalmechanism of creating a bad
(15:50):
brain, and that is simply time.
Time is the enemy of health,and it is true that most of your
major systems start to falterwith age.
But while we can see decline inmajor body systems starting
around the age of 40, the ratesof decline over time and what
you have left at the end of yourlife is dependent on how well
(16:12):
you take care of yourself beforeand after the age of 40.
The healthier you are, the morephysically and mentally active
you are before.
40 gives you an extra reserve.
It gives you a better startingpoint, so that any inevitable
changes are taking away from asurplus, which leaves you with
plenty left over by the timeyou're, say, 85 years old.
(16:35):
Here's an analogy.
It's probably an imperfect one,but if you're going out with
your friends and you know thenight is going to cost you $50,
isn't it better to have $100 inyour pocket so that if something
else comes up, you have thecash to handle it?
You're not going to go out with$50 when you know the night is
going to cost you $50 because itdoesn't leave you any reserve.
(16:58):
The more reserve you have, thebetter you can handle the aging
process.
And the people who end up intheir 80s and 90s with their
brains and bodies intact aretypically those who had only
acceptable asymmetries betweenleft and right brains, because
they develop properly and ontime.
These are typically people whomaintained physical activity.
(17:21):
They were metabolicallycontrolled through their young
adult lives and their youth.
They typically stayed activephysically through their lives
and especially took on newphysical and new mental
challenges on a routine basis.
They weren't just doing thesame thing, the same way all the
time.
They were typically also, ortypically also are fortunate
(17:43):
enough to not have had any headinjuries or perhaps did but
manage the injury process itselfto mitigate any long-term
effects.
And instead of reducing theiractivities and interest as the
age which is what most people doas they get older they start to
participate less in life.
People with good brains inthose later ages continue to
(18:05):
pursue physical, mental,emotional and social enrichment.
All of these have an impact onthe health of your brain.
Have an impact on the health ofyour brain.
The worst thing that you can dofor your brain is either
nothing or do the same thing dayin and day out.
The same way, your brain lovesand thrives on novelty and
(18:25):
things that challenge itscurrent capacity.
In other words, one of thepaths to a healthy brain starts
with birth, and it runs thegamut of all the things that you
can do to stay active, sharpand metabolically balanced.
Let me give you a final note onthings like genetics, because
you'll probably notice that Ididn't include genetics in bad
(18:48):
brain mechanisms, and that'sbecause I don't want to focus on
bad genes.
If you have them, yes, if youhave a family history of things
like anxiety, depression, othermental health issues, there is a
higher probability that youwill struggle with that too, and
with a rich family history,it's more likely that you have
genes involved.
But I know that you've heardthat genes are not your destiny.
(19:10):
In fact, we've said this on thepodcast.
For the most part, all thegenes can do is increase your
risk, and since you can't changeyour genes per se.
You focus instead on what youcan control, and how does that
affect how your genes arebehaving?
So that ends my introduction tothe interview series with Drs
(19:33):
Malillo and Skyer.
Hopefully that gives you enoughgrounding in how the brain
develops and some of the thingsthat can go wrong to create bad
brains.
I think you're really going toenjoy the next two.
We have at least three episodesplanned.
Don't forget to check out DrMelillo's new edition of his
bestselling book DisconnectedKids, and I will see you on the
(19:56):
next episode of the InflammationNation.
This podcast is for generalinformational and educational
purposes only and does notconstitute the practice of
medicine in any form or capacity.
No doctor patient relationshipis formed.
The use of the information inthis podcast or any materials
(20:18):
associated with or linked to thepodcast is at the listener's
own risk.
The content of this podcast isnot intended to be a substitute
for professional andpersonalized medical advice,
diagnosis or treatment, andlisteners should not disregard
or delay obtaining propermedical advice when a health
condition exists and warrantsthat.
(20:38):
And finally, functionalmedicine is not intended or
designed to treat disease, butrather is a natural approach to
support restoring health andwellness, the use of diet and
lifestyle modifications, andnutritional supplementation is
supportive for adjunctive care.
Hey everyone, welcome to the Inflammation Nation
podcast.
I'm your host, Dr SteveNoseworthy.
Speaker 2 (00:08):
One of the greatest obstacles to crafting health and
wellness is identifying andcontrolling inflammation.
It's at the core of all complexand chronic diseases and it's
the driving mechanism thatunderlies the most common
symptoms that people like youstruggle to overcome.
Join us as we explorecutting-edge science and
research to give you theinformation and tools you need
to create the quality of lifeyou want and deserve.
(00:30):
And now here is the host ofInflammation Nation, dr Stephen
Nosworthy.
Speaker 1 (00:37):
Hey guys, welcome back to the podcast.
This is part two of the BetterBrain Equation, and this
two-part series is really anintroduction to a multi-part
series of interviews that I'mdoing with two amazing
clinicians, researchers andeducators, and they are Drs Rob
Melillo and Peter Skier.
So if you missed part one ofthis introduction, go back and
(00:59):
listen to that.
Today I'm simply going tocontinue on where I left off in
part one, so it's important thatyou get the grounding of part
one.
The whole point of this seriesis to raise the bar on how you,
as a healthcare consumer,understands your brain as an
integral part of quality of life, and to understand how your
(01:21):
brain is involved to one degreeor another in all of the major
health issues that we see verycommon in the world today.
And since this interview isgoing to be on both of my
podcasts, I also want to partnerwith Drs Malolo and Skyer to
challenge our practitionercolleagues to develop their
understanding of the brain sothat we can all serve our
(01:43):
communities better.
And whether you are a parent ofa child with ADD, adhd,
developmental delays or evenautism, or if you're an adult
who yourself suffer with thingslike anxiety, depression,
insomnia, ocd, perhaps balanceissues, or if you are a
functional medicine practitionerand you want to learn more
(02:05):
about how the brain develops andworks, then I highly recommend
that you get Dr Melillo's bookDisconnected Kids and make sure
that you get the newly releasedthird edition, since it actually
has at least 30% newinformation over the second
edition.
That's how editions work Inorder to have a second edition,
you have to have 30% newinformation over the first, and
(02:26):
so on.
And just so we're clear, I haveno financial interest here.
I'm making theserecommendations based solely on
the quality and the utility ofthe information in the
Disconnected Kids book, as wellas my personal and professional
high regard for Dr Skyer andMalila.
All right, so in the lastepisode I told you that in this
(02:49):
episode we were going to talkabout how brains go bad and in
essence there are four coremechanisms.
Of course there are others, butthese are the main ones that we
need to think about and talkabout.
The first mechanism of a badbrain is poor development.
The second mechanism of a badbrain is head injury or
concussion.
Same thing, two different terms.
The third mechanism of badbrain is a metabolic imbalance
(03:13):
or disturbance that affects howthe brain functions.
And then the final mechanism ofthe bad brain is poor aging,
and notice that I said pooraging and not just simply aging.
Notice that I said poor agingand not just simply aging.
Now, these are not mutuallyexclusive.
You can have more than one, andhaving one tends to promote the
others.
For example, since the brain isin control of metabolism and
(03:37):
even, to a certain extent,immune function, poor
development of the brain tendsto lead to metabolic issues and
immune dysfunction, which thencan have an impact on how the
brain works.
So it's a reciprocalrelationship or two-way
communication.
But even if your braindeveloped in a perfectly
symmetrical way and on time,meaning that you hit all of your
(03:57):
developmental milestones as achild, injuring your brain with
a concussion shifts themetabolic states of the brain,
introduces this thing calledneuroinflammation We've talked
about that before on the podcastand this neuroinflammation then
affects how the brain controlsmetabolism and even immunology
again, to a certain extent.
And so while I'm introducingyou to a list of number one, two
(04:20):
, three and four, they're notdiscrete entities, they all
bleed into each other, so let'sgo over these one at a time.
We're going to do this insummary form because, again,
it's an introduction, it's not afull, detailed analysis.
The first mechanism of bad brainis development.
We talked a little bit aboutthat in the first episode.
In the interviews with DrSkyer-Malilla we talk a lot more
(04:43):
about that.
But as far as development goesvery quickly, your brain begins
to develop within the firstthree weeks of conception.
That's where we start to seethe tissue changing, which
eventually forms into a fullhuman, fully functional human
brain.
And you'll remember that, evenin utero.
So baby's brains run some ofthese primitive reflexes that
(05:06):
assist the birthing process butalso which support survival via
reflexive feeding behaviors oncethe baby's born.
So when babies get hungry theycry.
If you stroke the side of theircheek they will open their
mouth and turn their headtowards the side that you
stroked so that they can latchonto a nipple to eat, and this
(05:27):
is called the rooting reflex.
Now there are other reflexesthat have to do with feeding
behaviors.
There are others that relate tostartle reflexes, with loud
sounds, for example, others thatrelate to movement of the spine
and limbs.
But the key to remember here isthat these are brainstem
reflexes that, over the firstfew weeks and even months after
(05:49):
birth, drive information intothe cortex, into the higher
brain, so that the higher braincan develop is all about
survival, but the primitivesurvival reflexes drive
(06:09):
sophistication of the cortex sothat we eventually learn to move
and to speak and to emote, orcreate and explore our world and
connect with people and so on.
So bad development or impropertiming of development,
asymmetrical development of thebrain, is one way we can create
a bad brain.
The second mechanism of badbrain is injury and of course,
at any point in life we cansustain an injury to our brain
(06:34):
through concussion, whether thatis mild or even all the way up
to severe traumatic brain injury.
For example, if a baby fallsand hits their head, this could
affect development of theinjured regions, leading into an
imbalance.
Kids, teens, adults can sustaininjuries in sports, during
recreational activities, on thejob, tripping and falling.
(06:55):
I remember working many yearsago with a woman who sustained a
pretty nasty concussionstanding up quickly in her
kitchen.
She was bent over gettingsomething underneath the counter
and she stood up and hit herhead on an open cabinet door and
caused a severe concussion.
If I remember the detailscorrectly, because it's been a
(07:19):
while, she even lostconsciousness for about 10
seconds or so.
Car accidents are another commoncause of head injury, and one
thing that we know about headinjury is that the effect on the
brain itself isn't tiedexclusively to the magnitude of
the impact, because you wouldthink, well, a small impact
means no injury, and you have tohave a certain magnitude of
(07:40):
force to create an injury to thebrain, and that's not
necessarily true.
Now, of course, the magnitudeof impact matters, and it is
easier to understand how hittingyour head very hard could lead
to a concussion, but evensmaller forces can have major
impacts, especially if the brainis unhealthy to begin with or
(08:00):
there are multiple related lowforce injuries that accumulate
over time.
I spent many years of mychiropractic career early on
working with people who wereinjured in a car accident, and
many of them showedpost-concussive symptoms despite
not hitting their head when theaccident happened.
And it turns out that yourbrain floats on a thin cushion
(08:22):
of fluid inside your skull.
And when your head whipsforward and back during a car
accident, the brain literallysloshes up against the inside of
your skull, and so a concussionin that sense can be from an
internal impact rather than anexternal one.
Obviously, if you hit your headon a steering wheel or the
dashboard or a window, it's easyto see how you can get a
(08:43):
concussion, but many peopledon't understand that there
doesn't have to be an externalimpact to have a concussion in
the brain in the context, forexample, of a rear-end motor
vehicle accident.
So one of the factorsdetermining the effects of a
head injury is the magnitude offorce, but don't discount these
low-force injuries or eveninjuries without an external
(09:06):
impact, and this is more likelyto happen when the brain is
already unhealthy.
The pre-existing state of thebrain is a major factor to
consider, since unhealthy brainsare more sensitive to
lower-impact forces.
It would be a mistake to thinkthat a low-force impact wasn't
an issue because it wasn't ahigh-force impact.
And it would also be a mistaketo think that a low force impact
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wasn't an issue because itwasn't a high force impact.
And it would also be a mistaketo think that a head injury
without immediate effects orloss of consciousness is not a
problem either.
The neurology literatureconfirms that any head injury
with loss of consciousness isvery significant, and the longer
you're out, the worse theeffects will typically be.
But just simply getting yourbell rung without losing
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consciousness is alsosignificant.
So if we put all of thistogether, maybe into some kind
of a hierarchy from worse tostill bad but not as worse would
look like this the most severewould be a major head impact
with loss of consciousness.
Then the longer you're out, theworse the impact on the brain.
Typically the next still badbut not as bad would be head
(10:12):
injury without loss ofconsciousness, but with
immediate post-concussivesymptoms, again feeling like you
had your bell rung, you'redizzy, you're woozy, you're kind
of out of it, you feel offkilter, you're fuzzy.
However, you might describethat A little bit less impactful
would be a post-concussivesymptom that lasts for weeks or
(10:35):
days, versus those that mightlast only for a few hours or
maybe a day or two.
So if you have post-concussivesymptoms, even though you might
not have lost consciousness, thelonger those post-concussive
symptoms last, typically theworse it is for the brain.
The next step down would be anylow-force injury that creates
(10:56):
immediate or prolonged symptomseven though there's no loss of
consciousness, and then thefinal step on that ladder, if
you will, would be mild injurythat doesn't create any
noticeable immediate orshort-term effects, and so we
have a wide range of possiblepresentations or manifestations
that factor in the magnitude ofthe impact the pre-existing
(11:20):
state of the brain, whether ornot you had post-concussive
symptoms that showed upimmediately or a little bit
later and how long thosepost-concussive symptoms lasted.
And of course, loss ofconsciousness is a critical
factor there as well.
And so you can look at whatever.
If you have had head injuriesin the past, you can look at
that spectrum or that continuum,if you will, and just kind of
(11:43):
gauge for yourself okay, howserious could this potentially
be?
And on this last note of youknow maybe you've had a head
injury, but it was a long timeago I want to address this idea
that or the reality in a commonoccurrence that people tend to
discount head injuries thatnumber one they didn't lose
(12:03):
consciousness, or that happenedyears in the past.
They just don't think it'srelevant or it doesn't apply to
them today.
To that I would say this About15 years or so ago I was a
co-author of a paper thatreviewed the current medical
literature on the metaboliceffects of head injury and
concussion, and one thing thatwe all learned from that was
(12:27):
that head injury always comeswith a price, even if that price
isn't paid until decades afterthe injury itself, repaid until
decades after the injury itself.
And one of the main reasons forthis is that any head injury
creates what we call microglialpriming.
Now, microglial cells areimmune cells in your brain that
create brain inflammation, andwe need them to be active at a
(12:50):
low level to keep the brainhealthy.
But when they become overactiveor primed would be the right
word they create sustainedneuroinflammation which makes
the brain sensitive to otherthings.
In fact, the low force headimpacts that translate into
major brain injury.
It's usually because the brainis already inflamed through this
(13:13):
process of microglial priming,and this makes the neurons of
the brain much more sensitive,not just to mechanical forces,
but also to changes in brainchemistry.
In fact, the neurologicalliterature talks about something
called chemical concussion orchemical reconcussion, which is
where someone has a history ofpast tannetry, has lived for
(13:34):
some time with an inflamed brain, and all it takes is a stress
event, an illness or a bad shiftin your hormones, among other
things, to recreate the effectsof the concussion through a
biochemical change Not throughhead impact, but through
biochemical change.
And again, it's called chemicalreconcussion.
And this leads me into the thirdmechanism of creating a bad
(13:56):
brain, and that is any metabolicimbalance that affects the
brain, and I'm not just talkingabout changes in the internal
chemistry of the brain, meaningthings that are happening in the
brain itself, like microglialpriming, or people.
When you talk about brainchemistry, they immediately
think about things likeneurotransmitters.
I mean to include anythingabout your body's metabolic
(14:20):
state that can affect the brain.
So I'm just going to give you aquick list.
We've talked about these overand over again in the course of
the podcast in the last coupleof years, but things like low
iron status or being anemic,deficiencies of key nutrients
like vitamin B or I should say Bvitamins, because it's more
than just one that's applicableto the brain omega-3, fatty
(14:42):
acids, vitamin D, for example,blood sugar problems, adrenal
dysfunction and the changes instress chemistry, whether or not
you have a leaky, infected gut,do you have things like
irritable bowel syndrome, areyour hormones screwed up, are
you sensitive to environmentalchemicals, and the list goes on
and on and on.
And so, while the brain'senvironment is supposed to be
(15:06):
protected by this thing calledthe blood-brain barrier, it is
permeable to many things,especially when poor health
breaks that barrier system downand things normally excluded
from the brain are allowed toget into the brain In reality,
again, pretty much everythingI've talked about for the last
two years or so on.
This podcast has the potentialto impact your brain in one way
(15:29):
or another.
So if the goal is to fix yourbrain or the brain of someone
you love, or if it is to protecta brain from going bad as you
age, then you are obligated tofind and fix any and everything
about your metabolic state.
And that leads me to the finalmechanism of creating a bad
(15:50):
brain, and that is simply time.
Time is the enemy of health,and it is true that most of your
major systems start to falterwith age.
But while we can see decline inmajor body systems starting
around the age of 40, the ratesof decline over time and what
you have left at the end of yourlife is dependent on how well
(16:12):
you take care of yourself beforeand after the age of 40.
The healthier you are, the morephysically and mentally active
you are before.
40 gives you an extra reserve.
It gives you a better startingpoint, so that any inevitable
changes are taking away from asurplus, which leaves you with
plenty left over by the timeyou're, say, 85 years old.
(16:35):
Here's an analogy.
It's probably an imperfect one,but if you're going out with
your friends and you know thenight is going to cost you $50,
isn't it better to have $100 inyour pocket so that if something
else comes up, you have thecash to handle it?
You're not going to go out with$50 when you know the night is
going to cost you $50 because itdoesn't leave you any reserve.
(16:58):
The more reserve you have, thebetter you can handle the aging
process.
And the people who end up intheir 80s and 90s with their
brains and bodies intact aretypically those who had only
acceptable asymmetries betweenleft and right brains, because
they develop properly and ontime.
These are typically people whomaintained physical activity.
(17:21):
They were metabolicallycontrolled through their young
adult lives and their youth.
They typically stayed activephysically through their lives
and especially took on newphysical and new mental
challenges on a routine basis.
They weren't just doing thesame thing, the same way all the
time.
They were typically also, ortypically also are fortunate
(17:43):
enough to not have had any headinjuries or perhaps did but
manage the injury process itselfto mitigate any long-term
effects.
And instead of reducing theiractivities and interest as the
age which is what most people doas they get older they start to
participate less in life.
People with good brains inthose later ages continue to
(18:05):
pursue physical, mental,emotional and social enrichment.
All of these have an impact onthe health of your brain.
Have an impact on the health ofyour brain.
The worst thing that you can dofor your brain is either
nothing or do the same thing dayin and day out.
The same way, your brain lovesand thrives on novelty and
(18:25):
things that challenge itscurrent capacity.
In other words, one of thepaths to a healthy brain starts
with birth, and it runs thegamut of all the things that you
can do to stay active, sharpand metabolically balanced.
Let me give you a final note onthings like genetics, because
you'll probably notice that Ididn't include genetics in bad
(18:48):
brain mechanisms, and that'sbecause I don't want to focus on
bad genes.
If you have them, yes, if youhave a family history of things
like anxiety, depression, othermental health issues, there is a
higher probability that youwill struggle with that too, and
with a rich family history,it's more likely that you have
genes involved.
But I know that you've heardthat genes are not your destiny.
(19:10):
In fact, we've said this on thepodcast.
For the most part, all thegenes can do is increase your
risk, and since you can't changeyour genes per se.
You focus instead on what youcan control, and how does that
affect how your genes arebehaving?
So that ends my introduction tothe interview series with Drs
(19:33):
Malillo and Skyer.
Hopefully that gives you enoughgrounding in how the brain
develops and some of the thingsthat can go wrong to create bad
brains.
I think you're really going toenjoy the next two.
We have at least three episodesplanned.
Don't forget to check out DrMelillo's new edition of his
bestselling book DisconnectedKids, and I will see you on the
(19:56):
next episode of the InflammationNation.
This podcast is for generalinformational and educational
purposes only and does notconstitute the practice of
medicine in any form or capacity.
No doctor patient relationshipis formed.
The use of the information inthis podcast or any materials
(20:18):
associated with or linked to thepodcast is at the listener's
own risk.
The content of this podcast isnot intended to be a substitute
for professional andpersonalized medical advice,
diagnosis or treatment, andlisteners should not disregard
or delay obtaining propermedical advice when a health
condition exists and warrantsthat.
(20:38):
And finally, functionalmedicine is not intended or
designed to treat disease, butrather is a natural approach to
support restoring health andwellness, the use of diet and
lifestyle modifications, andnutritional supplementation is
supportive for adjunctive care.
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