May 19, 2025 • 38 mins
The hormonal ripple effects of concussions are often overlooked in recovery, creating frustrating plateaus for patients despite their best rehabilitation efforts. These hidden disruptions in the endocrine system can dramatically impact recovery and require a nuanced approach to care.
• Dr. Tatiana Habanova brings together functional neurology and functional medicine to address post-concussion hormone disruption
• The hypothalamus is the only location in the brain where immune, hormonal and neurological systems all interconnect
• Recent research from 2023-2025 provides clearer evidence of specific hormonal disruptions following concussion
• Many concussion symptoms closely mirror hormone imbalance symptoms, making proper testing crucial
• Comprehensive testing, DUTCH tests and other important labs
• Tracking thyroid function, iron status (particularly ferritin), B12 and inflammatory markers
• Establishing baseline hormone levels when feeling well provides valuable reference points for future care
• Combining functional medicine with functional neurology addresses both neurological pathways and resulting hormonal imbalances
Join us next week for part two of this important conversation where we'll dive deeper into specific treatment approaches and protocols.
Dr. Tatiana Habanova Links:
Clinic: Palm Beach Brain Center
Instagram @palmbeachbraincenter
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Episode Transcript
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Speaker 1 (00:00):
Now, you know, doing a little more deeper research,
you can see, even recently,articles in, you know, 2023, 24,
25 are really coming out withsome real powerful statements
and delineating a lot moreclarity on what actually is
going on in the neuroendocrinesystem post-concussion, you know
, in the acute phase, and theneven months to years later.
Speaker 2 (00:23):
Welcome to Life After Impact, the concussion recovery
podcast.
I'm Dr Ayla Wolf and I will behosting today's episode, where
we help you navigate the oftenconfusing, frustrating and
overwhelming journey ofconcussion and brain injury
recovery.
This podcast is your go-toresource for actionable
information, whether you'redealing with a recent concussion
(00:45):
, struggling withpost-concussion syndrome or just
feeling stuck in your healingprocess.
In each episode, we dive deepinto the symptoms, testing,
treatments and neurologicalinsights that can help you move
forward with clarity andconfidence.
We bring you leading experts inthe world of brain health,
functional neurology andrehabilitation to share their
(01:06):
wisdom and strategies.
So if you're feeling lost,hopeless or like no one
understands what you're goingthrough, know that you are not
alone.
This podcast can be your guideand partner in recovery, helping
you build a better life afterimpact.
(01:27):
Life After Impact.
Today on Life After Impact,we're diving into one of the
most overlooked andmisunderstood aspects of
concussion recovery hormonedisruption.
And we're doing it with one ofthe most accomplished minds in
brain health.
Dr Tatiana Habanova is apowerhouse in both functional
neurology and functionalmedicine.
She is a board-certifiedchiropractic neurologist with
(01:48):
over 24 years of clinicalexperience and more than 1,800
hours of advanced trainingthrough the Carrick Institute, a
global leader in functionalneurology.
She is also a certifiedmenopause coach, a functional
medicine practitioner and aBredesen Protocol certified
clinician, bringing togethercutting-edge neuroscience and
(02:09):
hormone health in a way that fewpractitioners can.
She is an international speaker, a published researcher and an
award-winning co-author ofConcussion Discussions, a
groundbreaking book that bringstogether top experts in the
brain injury field.
(02:31):
In today's conversation, whichis part one of a two-part series
, we explore the hormonal rippleeffects of concussions, why
they're so often missed and howthey can dramatically impact
recovery.
We talk about what types oflabs and tests are most valuable
for assessing hormones.
So, whether you are a patient,practitioner or someone
supporting a loved one throughrecovery, this is a conversation
that everyone needs to behaving in the concussion
(02:52):
recovery landscape.
Please welcome the brilliant DrTatiana Habanova.
Welcome to Life After Impact.
In this episode, I am here withDr Tatiana Habanova and we are
going to talk about hormonalchanges that can happen after a
concussion or a brain injury,and I'm very excited to have you
(03:12):
on the show, dr Tatiana, and Ilove the work that you're doing
with brain health and thecognitive performance consulting
you do.
You're really shedding a lighton the importance of the brain
and, in a way where people feelcomfortable being able to come
in and open up and talk aboutsome of the cognitive symptoms
(03:33):
they may be having.
So I wanted to maybe have youstart out by giving a little bit
about your background.
You're the director of the PalmBeach Brain Center, and so tell
us a little bit about kind ofhow you got there and how you
started focusing on the brainspecifically.
Speaker 1 (03:51):
Oh great, thank you.
I so appreciate being a part ofyour podcast.
Thank you for this opportunityto have this conversation with
your audience and I agree it'san important topic and you know
it came really because of alittle bit of my own journey and
, I think, of many times.
People who are in theconcussion space generally have
had previous experiences.
I know you have as well, so youcan relate to this and and
(04:15):
through that, you know, we startlearning things and discovering
things.
So I have always beenfascinated with the brain and in
fact, my mom, embarrassingly,will still share the story.
If we're somewhere gatheringshe'll talk about how I had this
teddy bear called Charlie andhe was a stuffed teddy bear that
(04:36):
I absolutely adored.
I was, I don't know three, four, five, something like this, and
of course, charlie always hadto have some kind of brain
surgery, right?
so never never, never had abroken elbow or broken ankle or
broken wrist.
You know, it was always brainsurgery.
Now there's always bandages onhis head.
I love that I love that yeah, soI I'm, oh my gosh, my mom had
(04:58):
to wash charlie so many timesbecause I would not let charlie
go.
Um, so interesting enoughthough, like, even though you
know she mentions I was tryingto do surgery on on his brain.
I never wanted to get intobrain surgery.
I always was fascinated withneurology and I think that's
what led me into the world ofchiropractic, initially because
(05:18):
of the nervous system.
And I was also an athlete whenI was younger, in high school,
and, you know, played a lot ofvolleyball, paid for the
Canadian team and then went off,you know, and things like that.
So I loved, you know, sportsand athletes and musculoskeletal
injuries, but I was alwaysfascinated with the brain.
But again, you know, my gosh,over 40-ish years ago there
(05:42):
really wasn't much information,you know.
But I remember specifically oneday being in second, third year
university up in WesternUniversity of Western Ontario in
Canada.
I remember walking across theThames Bridge and walking to
class and thinking, oh, you know, we're learning about doing
physical therapy and stuff likethat.
(06:02):
You know, in some of thecourses I was taking and I was
like, oh, I wish I could do thisfor the brain, I wish we could
rehab the brain and of coursethat time I still didn't know
really much.
I was very focused intobiochemistry and molecular
biology and genetics and things.
So I was, you know, reallypigeonholed into going into a
PhD route and doing research andso that was kind of the
(06:23):
trajectory.
But again, being an athlete, Ijust really love that.
I was playing varsityvolleyball and of course we're
having all these injuries andeverything and I just keep
thinking about this.
Little did I know at the time.
Now I can look back and realizethat Dr Carrick you know, the
godfather of functionalneurology actually was already
speaking about functionalneurology and this ability to
(06:44):
rehab the brain in the world.
I just hadn't come across himyet so fast forward.
I finished school, you know, Iopened up practice, I moved here
to Florida, etc.
And I ended up developing viralmeningitis out of nowhere and
that was really earth shatteringfor me, really life altering.
(07:06):
Honestly.
It took me two and a halfmonths to just be able to get
back to work where I canliterally only work for one hour
and then that was it.
So it took about two and a halfyears to recover to a point
where I could somewhat do atypical 40-ish hour work week
and maintain the cognitive lowwithout crashing.
But I really didn't have muchmore of a life and then it still
(07:27):
took several more years.
I don't speak about this much,and I should probably because at
the time I was so confused ofwhat was going on and so I dove
deep into functional medicine.
I was always really into health, ate well and, being an athlete
, nutrition was always important.
My mom always grew a garden inher backyard so we were always
(07:49):
eating fresh vegetables andherbs and things.
So I kind of had thatbackground of that healthy
living.
So I was like, all right, it'sprobably again not thinking
functional neuro.
I was thinking, oh, I must havehad some kind of deficiency or
something.
So I went knee deep intofunctional medicine and I'm
(08:10):
really grateful I did.
I learned a ton, you know startto, you know support myself a
little bit more in variousthings.
But still some of thatcognitive piece for me I was
still struggling with and againnot realizing that could be a
phenotype of, you know, a postviral, even a post concussive.
You know, post concussion isvery similar to a post viral
manifestation with some of thosechanges in neuroplasticity and
inflammatory pathways that kickin.
(08:31):
So I really dug deep into thefunctional medicine side and I'm
grateful I did, because then Ireally just specialize in
neuroinflammation, neuroautoimmunity and things like
that.
But somehow, through a curiouspath, I luckily stumbled upon
the Carrick Institute and foundthe work of Dr Carrick and this
(08:53):
amazing community of functionalneurologists and it was just
like oh, this is exactly what Iwas looking for, this is what I
would thought about when I waswalking across that Thames River
.
You know, an undergraduate andand so I, you know, began the
process of the Carrick Instituteand that helped put the missing
(09:15):
pieces that I was stillstruggling with post viral
meningitis right.
So that was in 2004.
And I began the CarrickInstitute in 2018.
Meningitis right, so that wasin 2004.
And I began at the Care GoodInstitute in 2018.
So, again, you know, a lot oftime had passed.
I was better, but I stillwasn't great, still wasn't great
.
And so, finally, as I startedtaking the courses and began
(09:36):
learning and I, you know, I'mvery excited about learning
things so I dove knee deep andjust consuming everything and
the cognitive load wasincredible.
I don't know how I did it, butI just like, just, I guess, you
know, needed to learn and neededto understand and started
putting the pieces together andapplying things that I was
(09:58):
learning to myself and startedto see the improvements, um, and
then began working with peopleas well and that was it.
You know, I found.
I found my place, my love, mypassion, it all came together
and I'm grateful for the yearsof, you know, training and
muscle skeletal injuries andrehabbing the body,
understanding pain and variousthings, learning the functional
(10:19):
medicine side of things and, youknow, staying on top of new
developments today and thenbringing in that functional
neurology piece which, as youknow, is a constant, never
ending journey, yes, discoverywhich is phenomenal.
So that was really, and I didhave a couple of concussions in
there, in between those timeperiods which re rocked my world
(10:42):
.
And so, again, I think, from myown personal experiences of
understanding, you know, whenyou get to a good place and then
you have a little concussion, alittle like what's really a
little concussion, right?
How, you know, a small littlefender bender is what I'm trying
to say can just take the wheelsoff the apple cart and the
(11:02):
whole thing can start all overagain, right?
So I can appreciate thedelicacy, um, and the importance
of consistency and theimportance of a lifestyle
approach, especially of ahistory of any type of brain
injury.
Um, everyone's unique, everyoneneeds their unique approach,
right?
We're all literally uniquecellularly too, so we have to
really personalize it.
(11:23):
Um, but that's that's reallykind of now.
My mission, passion is to helpothers, you know, have a better
grasp and understanding ofwhat's going on.
I had wonderful medical care.
I I'm grateful for everythingthat has occurred to me, but
there were gaps and at the timeI didn't know that.
I just sort of somehow carriedon, like I think we all do.
We just somehow carry on.
(11:45):
But you know, as I look back nowwith the knowledge I have now,
I was like, oh, wow, so muchmore could have been done.
I wished more would have beendone for me.
I could have decreased thesuffering, the years of just
crawling to work every day andcrawling back home so fatigued,
just trying to treat people andtake care of people as best I
(12:08):
can.
But you know, it was.
It was difficult, you know, butsomehow, you know we, we get
here, we arrive to a new place,right, exactly so I feel like I
haven't walked in everyone'sshoes.
Who's had a concussion?
Obviously, but I feel like I'vestraddled it on both sides,
where I myself have had varioussituations that I've had to work
(12:29):
through, and I get to be on theother side as a clinician, you
know.
So I feel like I can bringcompassion and that's that's to
me very important as well, thatcompassionate approach to, to
helping patients, because manyare misunderstood when they're
seeking care and again,sometimes they're looking for a
particular symptom to resolve,so they go to a particular
(12:51):
physician and we're not gettingthat integrative, you know,
whole body approach or a wholesystems approach at looking at a
variety of things.
So that's sort of how I'vemolded myself into what I do now
at the Palm Beach Brain Center,where it's a very whole body,
integrated approach to brainhealth and longevity.
Speaker 2 (13:11):
Yeah, and such a powerful combination to be able
to blend functional medicinewith functional neurology.
I feel like I've had a lot ofsimilarities with my background
in the sense that I felt like Iwas able to use functional
medicine to get myself kind oflike 50% better from a lot of
the brain fog and cognitivesymptoms that I was having with
(13:35):
my concussions.
But I really needed thefunctional neurology to then
come in and get me that muchbetter, and so the two of them
were so powerful.
And what was funny was thatbefore I got into practicing
functional neurology and findingthe Carrick Institute, my
(13:56):
background was in fertility.
I was helping women getpregnant, and so, after
specializing in functionalendocrinology and restorative
endocrinology and diving intothe whole world of female
hormones for eight years, what Ifound was that a lot of my
concussion patients that werewomen, a lot of their hormonal
symptoms, would get worse aftertheir concussion, and so it
(14:18):
really opened my eyes to thefact that, okay, well, this
makes perfect sense you injureyour brain, and your brain is
the orchestrator of all of yourhormones and your endocrine
system and the wholeintersection between the
endocrine system and the immunesystem, and so there's so much
there and I didn't really haveany resources to lean on other
(14:39):
than my own personal experiencewith the fertility work that I
did, which ended up beingincredibly helpful.
But then, you know, as you and Iwere preparing for this, you
sent me this amazing researchpaper.
That just made me so happy thatpeople are finally looking at
the effects of, you know, thehormonal changes after a brain
injury, and so that's why Iwanted to bring you on the show
(15:02):
so that we could talk about this, because I think that, again, a
lot of people, it's very easyto not see the connection and to
just, you know, be experiencingthe symptoms and maybe think
that it's two separate things,when really it's all one system.
And, you know, our concussionsdon't occur in a vacuum.
They occur in the context ofwhat we already had going on our
(15:24):
entire lives.
Speaker 1 (15:26):
Yes, very true and I think it's so powerful that
you've had that background infunctional endocrinology and you
know, working with women on thefertility and probably seeing
those correlations, you know isso powerful.
And you're right, the world ofresearch in neuroendocrine
changes have significantlyadvanced in the last I'd say
(15:50):
about even five to seven yearsfrom my perspective.
I was asked to write a paperabout maybe seven years ago on
the exact topic of what are someof the neuroendocrine changes
that are experienced as asequelae to concussion and
basically at the time theconsensus was like well, we
think maybe there's going to besomething happening in the
(16:10):
pituitary and there could besome, you know, altered function
, but no, you know, likewhatever, like you know you
could get it looked at if youwant, but you know so it was
really just kind of like lowhanging.
You know they're just notreally putting it on the radar
to now.
You know, doing a little moredeeper research, you can see,
(16:30):
even recently, articles in youknow, 2023, 24, 25 are really
coming out with some realpowerful statements and
delineating a lot more clarityon what actually is going on in
the neuroendocrine system postconcussion, you know, in the
acute phase, and then evenmonths to years later concussion
(16:51):
, you know, in the acute phaseand then even months to years
later and giving more guidanceto physicians and clinicians on,
you know how best to approachcare.
Or if someone's come to youwho's had a post concussion that
maybe happened multiple yearsago, to realize, okay, hold on.
If no one has actually at thispoint, for whatever reason you
know, done a full workup on thehormonal side of things, maybe
(17:15):
that would be a goodrecommendation to do or to refer
out.
If you're, you know, not able todraw labs or whatever, but you
know, get that done again.
If you're working with someoneor someone's come with
post-concussive symptoms thatyou know happened years ago and
(17:35):
they're still having thosesymptoms, you know if neuro
rehab stagnates right, if all ofa sudden you hit a plateau and
you're not moving any further inthe abilities of the
neuroplasticity and the changes,because we know how rapid those
can be and how profound theycan be, right.
So it's really clear when thosethings occur appropriately in
that functional neuro side ofthings.
But if there's that stagnation,that should be a little green
(17:57):
light to say, hmm, maybe I needto be looking at those
neuroendocrine changes a littlebit more Again if it hasn't been
done or you know.
You don't overwhelm a patientin the beginning with oh my God,
let's get all of this assessed.
It could be a lot, so you cantake it in phases and stages.
right, that's totally fine, butagain just little, maybe gems of
recognition that this is animportant aspect and a major
(18:21):
piece of the puzzle.
Speaker 2 (18:22):
Yeah, one of the things I see a lot is that a
cycling woman who I'm workingwith in their concussion
recovery all of a sudden we'llfind that a lot of their
symptoms are improving, but nowthat when they do get worse
there's it's always at aspecific time in their cycle.
And so now we see, okay, well,maybe my headaches are now not
(18:42):
every single day, maybe they'reall just clustered right around
this particular like week of themonth, right.
And so now we start to see,like, okay, the symptoms are
improving, they're not thereconstantly, but they sure do get
worse in relationship tochanging hormone levels.
So now we really need to do adeeper dive into this piece of
it to get you that much better.
Speaker 1 (19:04):
Absolutely, absolutely.
And I see the same correlationas well, and as you mentioned
too earlier about with your ownjourney, saying that you felt
you were able to, throughfunctional medicine and herbs,
to get about 50% better and thenkind of stalled out.
And I see the same thinggenerally.
You know, when patients arecoming for some of these and
they want to come from thefunctional medicine side, then
(19:25):
they come to my office with thatin mind.
I'll honor their request of theapproach they want to take and
then again I generally will seeabout that 50% improvement mark
and then we don't seem to getfurther in that functional
medicine side of things.
That's the time to say, okay,let's get into some functional
medicine.
Speaker 2 (19:41):
So it really is the functional neurology.
Yeah, bring that.
Speaker 1 (19:46):
Excuse me, sorry.
Yeah, so the functionalmedicine, you know, just gets
you so far, which is fabulous.
I mean, that part is soimportant.
There's the other piece too, soit's almost like the yin and
the yang to be.
You know, the functionalmedicine, the functional neuro
are very important.
Yeah, yeah.
Speaker 2 (20:00):
And I think it's also like one of the ways I look at
it is what is the right tool forthe job?
And as you know someone whopractices Chinese medicine if I
have somebody with a lot ofbrain inflammation, you know
what.
There is animal research to saythat when you do acupuncture
you can modulate inflammatorypathways and potentially reduce
inflammation in the brain.
But personally, if someone'sonly coming to me once a week
(20:24):
for acupuncture, I would muchrather lean on my things that
people can do every single dayto decrease brain inflammation
and to improve the health ofthose inflammatory pathways and
regulate that through diet,lifestyle, maybe some different
supplements and herbs.
So it's like what is the righttool for the job is also kind of
(20:45):
the way that I'm looking at it.
It's like maybe I'm attemptingto change a system in one
particular way through myneurological rehab and then in
another way through my herbs,and so it's all working together
to just, like you said, not hita plateau.
Speaker 1 (21:00):
Absolutely.
And you know, as we kind ofalluded to or spoke about I
think you mentioned earlier thatin the hypothalamus
specifically, that is, you knowthe location and only location
in the brain that we'recurrently aware of where the
three major systems cross-talkor can have the opportunity to
interlink with each other, right.
(21:21):
So normally that immune systemis sort of a separate system,
the hormonal system is separateand the neurological system is
separate, but in thehypothalamus those three can
cross talk.
So now we're dealing withneuroinflammation that's an
immune side, right upregulationof the immune side, and we have
the endocrine.
The hormones are also nowinterlinking.
(21:43):
So a lot of teasing out ofneuroinflammation and
neuroendocrine changes.
And then the effects on thenervous system, because that's
the third piece I find when,when patients recognize that
that's like a three-legged stoolthere, um, and that those you
know neuroinflammatory processescan have an effect on the
neuroendocrine system and affectthe neurology, right.
(22:04):
So really untangling thosethree bits um become, you know,
a really important, maybe even astarting point perhaps of
patients understanding of like,okay, what trajectories and what
avenues do I need to considerand how can I all play into it?
You know, what gets confusingas a clinician is a lot of those
symptoms neuroendocrine changeshave the similar symptomology
(22:28):
as a concussion, and so it canbe sometimes challenging from a
clinician's point to try tountangle, which is which you
know what symptom is truly froma concussion, which is just a
neuroendocrine change, maybe anendocrine change due to a
concussion?
What is the person bringing tothe table prior to this
concussive event happening andwhat's their history and how
(22:51):
were they neurologically?
Most people are not gettingbaselines, a neurological
baseline, even some, maybefunctional medicine, blood work
baselines or hormonal panelbaselines, and that is something
that I've started to reallyreally implement.
I know in the moment it's notgoing to give me much help in
this current situation, but I'msetting people up for success
(23:12):
for the future.
So should there be futureevents, you know, at least you
have a hormonal baseline tostart with, for example, and
then we can use that, obviouslythrough treatment as well.
But I think this is a practicethat's starting to become more
prevalent, to be integrated alittle bit more, especially on
the hormonal side, to just evenfor, you know, a teenage gal to
(23:34):
have that hormonal panel, oreven for, you know, a young boy
like to have these hormonalpanels, and to just every so
often get documented like whereare you, you know hormonally and
what's going on there.
Speaker 2 (23:46):
Well, and what a great concept to to say you know
, right now I'm feeling reallygood.
Why don't I run a bunch of labsthat I know what labs equate to
me feeling really good?
I mean, I've had what a concept, right?
Yeah?
Speaker 1 (24:02):
benchmark it.
You know, benchmark it.
So if anything now dips orchanges, you know there's a
reference point.
Not that we're trying to chasesomething from the past, but at
least that's a guide, right?
It gives us a sense.
It's like a map, right?
Speaker 2 (24:16):
So, and when we talk about functional lab work.
We understand that you know anormal, you know TSH number,
like the reference range ispretty wide, and I've certainly
had patients that have said tome when my TSH is 1.0, I know
that I actually feel the best,and so I've also had people who
have had to pay lots of closeattention to their thyroid
(24:37):
numbers and really try tounderstand.
You know where do I fit on thisscale and what feels.
You know the best as far as myenergy levels and metabolism and
all the things.
So why don't you get into alittle bit of the testing that
you do?
I mean, are you doing bloodwork?
Are you doing like a Dutch test?
What types of hormone tests areyou running?
(24:58):
And then, are there certainpatterns or interesting things
that you're really paying closeattention to?
Speaker 1 (25:04):
Yes, absolutely so.
Definitely.
A person's history will dictatesome of that, course, obviously
.
So just asking you know alittle bit about menstrual cycle
and just do they?
You know they cramp a lot, youknow generally will indicate
some low progesterone, mostlikely in their history, if they
have a history of just reallypainful periods, for example.
(25:25):
I'm assuming we're just goingto mostly speak about women at
this moment.
Yeah, so I'm going to justframe it up from that.
Speaker 2 (25:30):
We'll do a different episode on men.
How does that sound?
Speaker 1 (25:33):
That sounds fabulous, good, good, good.
So that again gives you alittle clue of sort of maybe,
what their history was, a littlebit going in, because we know,
and I'm assuming this woman alsohas had a concussion, so we
know again at the time ofconcussion, for example, matters
in the woman's cycle if she iscycling right.
So definitely asking somereally good, pertinent history
(25:54):
questions are key.
So I always encourage women totry to keep a better log of
their monthly cycles andsymptoms and things like that.
So but the test that I reallylove to do, I'm a huge fan of
definitely the Dutch test, theurinary hormone test.
I've used that gosh, I don'tknow 15-ish plus years, so I do
(26:16):
love that over blood work.
I find the Dutch test gives us alittle more information,
especially if you add theadrenal component to it as well,
so we can get some of thecortisol levels and the
circadian rhythm of the adrenalstoo.
So it gives us a little bitmore information from that
perspective.
And the Dutch just gives us allthose metabolites and just the
way they lay out their report isvery useful and even with just
(26:40):
seeing how the estrogen aremetabolized and then COMT enzyme
.
So it gives us a lot ofwonderful markers that just
standalone, you know, let's testestrogen, let's test or esterol
, let's test progesterone,testosterone.
These are just such standalonetests in blood that I feel
that's limited and price pointwise it's actually a little
cheaper to do Dutch, so I think,for the value, that would be
(27:03):
the way to go.
I've also recently started usingVibrant Wellness Labs, or
Vibrant America is the parentcompany, and then Vibrant
Wellness would be thatlaboratory component, and they
actually have a little more dataon their urinary hormone tests.
They actually will also have aneurotransmitter panel that will
(27:24):
also pair up nicely with theurinary hormones and they go
into a little bit more detailthan the Dutch does.
So, um, you know one half dozenof the other there.
I think they're both pretty, um, um, amazing to use, you know.
So yeah so that is key there.
Uh, for the thyroid, definitelyWe'll just send out for blood
work there and I like to do afull thyroid panel.
(27:46):
So, beyond just TSH and T4, wereally want to do all seven
thyroid markers and especiallylooking at TPO antibodies and TG
antibodies Because, as we know,with a concussion, within 24
hours, research tells us thatwe're going to start to get like
a leaky gut syndrome.
We're going to get gutpermeability, and so we know if
(28:06):
we're going to start to get a um, um, like a leaky gut syndrome,
we're going to get gutpermeability, and so we know if
we're getting a gut permeability, we're getting probably a
breach of the blood brainbarrier, um, probably possibly
some of the other barriers sinusbarriers, inner ear barriers.
So we're um, wanting to lookbecause generally my experience
has been, within about a year aperson will develop some type of
(28:28):
autoimmune or foodsensitivities or something like
that down the road.
So if I'm seeing someone who'shad a concussion multiple years
ago and coming to me now becausethe symptoms have just gotten
so bad at this point, I'm alsoconsidering a gut panel as well.
So looking at what might begoing on on that level too.
So I know that takes a littlebit out of hormones, but know
looking at what might be goingon on that level too.
(28:49):
So I know that takes a littlebit out of hormones, but again,
it's all integrated.
But generally definitelythyroid panel, t7, very
important that's blood work.
So generally when I do sendpeople out for blood work I will
look for a few other things aswell.
I tend to do a bit of acomprehensive panel in that
sense, but some of the keythings I'm really interested
(29:10):
from a neural perspective islooking at the iron and not just
serum iron.
That's fine, that's a goodmarker, that's easy to look at,
but that's really just 1% ofstored iron in the body, so it's
not a great great marker.
Ideally we would want to addsaturation, iron saturation.
That is much better.
(29:30):
So sometimes you have to askfor that.
The pen of the light.
Thankfully it's included inthere.
But if people are listening tothis and taking some notes and
then going to their primary carephysician and saying, hey, next
time we do blood I'd like ironsaturation, I would like
ferritin.
Ferritin is another greatmarker, a surrogate marker for
iron.
It's 22% of stored iron, somuch better than just serum iron
(29:53):
alone.
It's also an inflammatorymarker.
So it allows us to take anotherpeek into the system and look
at maybe some levels ofinflammation.
So those are really key foriron, especially for
neurotransmitters.
I also like to look for B12.
Again, b12 serum, it's okay.
It's not the greatest, but it'sokay.
What I really ultimately liketo look at is methylmonic acid
(30:18):
and that gives us a much betterindication of B12 status.
Again, looking at that from aneurological perspective.
And of course, you know acomplete blood count, let's go
ahead and look at you know redblood cells, white blood cells,
you know how's the hemoglobin,how's our MCVs, the size of the
blood cell.
A lot of times people have anormal MCV, so the size of the
(30:40):
blood cell is good, but but ifyou have low iron, your red
blood cell will be small.
If you have not enough B12,your red blood cell will be too
big.
So actually it ends up lookingnormal.
Speaker 2 (30:53):
Yeah, and you have to get that whole complete picture
to understand all the pieces.
Speaker 1 (30:58):
You really do, and these aren't super expensive
tests.
The methylmalic acid might be alittle bit more on the pricier
side, but I think it's wellworth it.
So again, there's a few morethings that I do like to look at
, but just from some basics.
If we're looking at exactlywhat I'm looking for the iron,
the B12 is key and then what isthe red blood cell profile
(31:18):
looking like, and then also thewhite blood cells, I really do
like to, you know, look at thebreakdown, and a lot of times we
can maybe infer if we'regetting a little bit of
microglia activation going onthere as well.
So take a look at thosemacrophages, which is the in the
body.
These white blood cells willkind of be I kind of think of
(31:41):
them like Pac-Man and they goalong and they just sort of eat
up all the debris and thingslike this cellular debris and
viruses, bacteria, et cetera.
They're just like littlegobblers, um in our brain.
Uh, we have the cousins of themacrophages, which are called
the microglia, um, and so wehave cells in our brain that
also kind of do the cleanup, youknow, act as well.
(32:02):
So sometimes if I see reallyelevated macrophages, it just
gives me a Hmm, that is like hmm, could there be some microglia
activation which is going tocause neuroinflammation is what
I'm getting at which will affecthormone not just production,
but activity, right Receptorsite activity.
So that's why thatneuroinflammation piece is
(32:24):
important in this whole puzzle.
So, yeah, so those are kind ofsome of the tests the Dutch, the
vibrant wellness of the urinaryhormones, possibly a
neurotransmitter profile don'talways do that one but then the
blood work iron B12, red bloodcell panel.
So complete blood count, yeah,at the start.
Yeah there's so many to choosefrom.
I know right.
(32:44):
Yeah, that would be at leastthe bare minimum of what I'd
like to see Sure.
Speaker 2 (32:48):
And this might be getting into the weeds a little
bit, but as far as ferritin goes, you mentioned that it can be,
you know, like the technicalterm is an acute phase reactant,
right?
So if there is an inflammatorystate, I also know that a lot of
times the normal referencerange for ferritin is also
pretty wide and a lot of people,if they have very low ferritin,
it can maybe still be flaggedas normal.
(33:09):
But when it's on the low end ofnormal, are you also still
saying, eh, this is a littlelower than I'd like it to be?
Even if it's normal, this mightstill be something we have to
pay attention to.
Speaker 1 (33:19):
Absolutely, and actually I do look at the lab
values that come from.
Labcorp is the lab that Iprimarily use, or Quest is
another option.
But I transpose all the valuesthat the patient's receiving
into another document that Ihave that are functional ranges.
So I do look to see ifsomething is flagged lab high or
(33:40):
lab low, because those labranges are pretty broad.
So if they're flagged high orlow on lab, definitely red flag,
something really important toconsider.
But even if some of the valueson the LabCorp report are in
normal ranges according toLabCorp, I transpose everything
onto another document that hastighter ranges, which are more
(34:03):
physiological, functional rangesof the body, of the human body,
and I use those to, you know,see if something is in the high
or the low to get a much betterclinical picture.
So it is a little bit extrawork but it goes a long way.
So that's where, again, a kindof normal low ferritin actually
on the functional range it's lowand we can proceed forward from
(34:28):
that moment.
Speaker 2 (34:30):
Thank you for listening to part one of this
conversation with Dr TatianaHabanova.
Please make sure to subscribeto our show so you don't miss
part two, which will beavailable next week.
As always, you can email usquestions at lifeafterimpact at
gmailcom or send us a text byclicking on the text us link in
the show notes below.
Thanks again for listening.
(34:51):
We'll see you next week.
Medical disclaimer.
This video or podcast is forgeneral informational purposes
only and does not constitute thepractice of medicine or other
professional healthcare services.
And does not constitute thepractice of medicine or other
professional healthcare services, including the giving of
medical advice.
No doctor-patient relationshipis formed.
(35:13):
The use of this information andmaterials included is at the
user's own risk.
The content of this video orpodcast is not intended to be a
substitute for medical advice,diagnosis or treatment, and
consumers of this informationshould seek the advice of a
medical professional for any andall health-related issues.
A link to our full medicaldisclaimer is available in the
(35:36):
notes.
Now, you know, doing a little more deeper research,
you can see, even recently,articles in, you know, 2023, 24,
25 are really coming out withsome real powerful statements
and delineating a lot moreclarity on what actually is
going on in the neuroendocrinesystem post-concussion, you know
, in the acute phase, and theneven months to years later.
Speaker 2 (00:23):
Welcome to Life After Impact, the concussion recovery
podcast.
I'm Dr Ayla Wolf and I will behosting today's episode, where
we help you navigate the oftenconfusing, frustrating and
overwhelming journey ofconcussion and brain injury
recovery.
This podcast is your go-toresource for actionable
information, whether you'redealing with a recent concussion
(00:45):
, struggling withpost-concussion syndrome or just
feeling stuck in your healingprocess.
In each episode, we dive deepinto the symptoms, testing,
treatments and neurologicalinsights that can help you move
forward with clarity andconfidence.
We bring you leading experts inthe world of brain health,
functional neurology andrehabilitation to share their
(01:06):
wisdom and strategies.
So if you're feeling lost,hopeless or like no one
understands what you're goingthrough, know that you are not
alone.
This podcast can be your guideand partner in recovery, helping
you build a better life afterimpact.
(01:27):
Life After Impact.
Today on Life After Impact,we're diving into one of the
most overlooked andmisunderstood aspects of
concussion recovery hormonedisruption.
And we're doing it with one ofthe most accomplished minds in
brain health.
Dr Tatiana Habanova is apowerhouse in both functional
neurology and functionalmedicine.
She is a board-certifiedchiropractic neurologist with
(01:48):
over 24 years of clinicalexperience and more than 1,800
hours of advanced trainingthrough the Carrick Institute, a
global leader in functionalneurology.
She is also a certifiedmenopause coach, a functional
medicine practitioner and aBredesen Protocol certified
clinician, bringing togethercutting-edge neuroscience and
(02:09):
hormone health in a way that fewpractitioners can.
She is an international speaker, a published researcher and an
award-winning co-author ofConcussion Discussions, a
groundbreaking book that bringstogether top experts in the
brain injury field.
(02:31):
In today's conversation, whichis part one of a two-part series
, we explore the hormonal rippleeffects of concussions, why
they're so often missed and howthey can dramatically impact
recovery.
We talk about what types oflabs and tests are most valuable
for assessing hormones.
So, whether you are a patient,practitioner or someone
supporting a loved one throughrecovery, this is a conversation
that everyone needs to behaving in the concussion
(02:52):
recovery landscape.
Please welcome the brilliant DrTatiana Habanova.
Welcome to Life After Impact.
In this episode, I am here withDr Tatiana Habanova and we are
going to talk about hormonalchanges that can happen after a
concussion or a brain injury,and I'm very excited to have you
(03:12):
on the show, dr Tatiana, and Ilove the work that you're doing
with brain health and thecognitive performance consulting
you do.
You're really shedding a lighton the importance of the brain
and, in a way where people feelcomfortable being able to come
in and open up and talk aboutsome of the cognitive symptoms
(03:33):
they may be having.
So I wanted to maybe have youstart out by giving a little bit
about your background.
You're the director of the PalmBeach Brain Center, and so tell
us a little bit about kind ofhow you got there and how you
started focusing on the brainspecifically.
Speaker 1 (03:51):
Oh great, thank you.
I so appreciate being a part ofyour podcast.
Thank you for this opportunityto have this conversation with
your audience and I agree it'san important topic and you know
it came really because of alittle bit of my own journey and
, I think, of many times.
People who are in theconcussion space generally have
had previous experiences.
I know you have as well, so youcan relate to this and and
(04:15):
through that, you know, we startlearning things and discovering
things.
So I have always beenfascinated with the brain and in
fact, my mom, embarrassingly,will still share the story.
If we're somewhere gatheringshe'll talk about how I had this
teddy bear called Charlie andhe was a stuffed teddy bear that
(04:36):
I absolutely adored.
I was, I don't know three, four, five, something like this, and
of course, charlie always hadto have some kind of brain
surgery, right?
so never never, never had abroken elbow or broken ankle or
broken wrist.
You know, it was always brainsurgery.
Now there's always bandages onhis head.
I love that I love that yeah, soI I'm, oh my gosh, my mom had
(04:58):
to wash charlie so many timesbecause I would not let charlie
go.
Um, so interesting enoughthough, like, even though you
know she mentions I was tryingto do surgery on on his brain.
I never wanted to get intobrain surgery.
I always was fascinated withneurology and I think that's
what led me into the world ofchiropractic, initially because
(05:18):
of the nervous system.
And I was also an athlete whenI was younger, in high school,
and, you know, played a lot ofvolleyball, paid for the
Canadian team and then went off,you know, and things like that.
So I loved, you know, sportsand athletes and musculoskeletal
injuries, but I was alwaysfascinated with the brain.
But again, you know, my gosh,over 40-ish years ago there
(05:42):
really wasn't much information,you know.
But I remember specifically oneday being in second, third year
university up in WesternUniversity of Western Ontario in
Canada.
I remember walking across theThames Bridge and walking to
class and thinking, oh, you know, we're learning about doing
physical therapy and stuff likethat.
(06:02):
You know, in some of thecourses I was taking and I was
like, oh, I wish I could do thisfor the brain, I wish we could
rehab the brain and of coursethat time I still didn't know
really much.
I was very focused intobiochemistry and molecular
biology and genetics and things.
So I was, you know, reallypigeonholed into going into a
PhD route and doing research andso that was kind of the
(06:23):
trajectory.
But again, being an athlete, Ijust really love that.
I was playing varsityvolleyball and of course we're
having all these injuries andeverything and I just keep
thinking about this.
Little did I know at the time.
Now I can look back and realizethat Dr Carrick you know, the
godfather of functionalneurology actually was already
speaking about functionalneurology and this ability to
(06:44):
rehab the brain in the world.
I just hadn't come across himyet so fast forward.
I finished school, you know, Iopened up practice, I moved here
to Florida, etc.
And I ended up developing viralmeningitis out of nowhere and
that was really earth shatteringfor me, really life altering.
(07:06):
Honestly.
It took me two and a halfmonths to just be able to get
back to work where I canliterally only work for one hour
and then that was it.
So it took about two and a halfyears to recover to a point
where I could somewhat do atypical 40-ish hour work week
and maintain the cognitive lowwithout crashing.
But I really didn't have muchmore of a life and then it still
(07:27):
took several more years.
I don't speak about this much,and I should probably because at
the time I was so confused ofwhat was going on and so I dove
deep into functional medicine.
I was always really into health, ate well and, being an athlete
, nutrition was always important.
My mom always grew a garden inher backyard so we were always
(07:49):
eating fresh vegetables andherbs and things.
So I kind of had thatbackground of that healthy
living.
So I was like, all right, it'sprobably again not thinking
functional neuro.
I was thinking, oh, I must havehad some kind of deficiency or
something.
So I went knee deep intofunctional medicine and I'm
(08:10):
really grateful I did.
I learned a ton, you know startto, you know support myself a
little bit more in variousthings.
But still some of thatcognitive piece for me I was
still struggling with and againnot realizing that could be a
phenotype of, you know, a postviral, even a post concussive.
You know, post concussion isvery similar to a post viral
manifestation with some of thosechanges in neuroplasticity and
inflammatory pathways that kickin.
(08:31):
So I really dug deep into thefunctional medicine side and I'm
grateful I did, because then Ireally just specialize in
neuroinflammation, neuroautoimmunity and things like
that.
But somehow, through a curiouspath, I luckily stumbled upon
the Carrick Institute and foundthe work of Dr Carrick and this
(08:53):
amazing community of functionalneurologists and it was just
like oh, this is exactly what Iwas looking for, this is what I
would thought about when I waswalking across that Thames River
.
You know, an undergraduate andand so I, you know, began the
process of the Carrick Instituteand that helped put the missing
(09:15):
pieces that I was stillstruggling with post viral
meningitis right.
So that was in 2004.
And I began the CarrickInstitute in 2018.
Meningitis right, so that wasin 2004.
And I began at the Care GoodInstitute in 2018.
So, again, you know, a lot oftime had passed.
I was better, but I stillwasn't great, still wasn't great
.
And so, finally, as I startedtaking the courses and began
(09:36):
learning and I, you know, I'mvery excited about learning
things so I dove knee deep andjust consuming everything and
the cognitive load wasincredible.
I don't know how I did it, butI just like, just, I guess, you
know, needed to learn and neededto understand and started
putting the pieces together andapplying things that I was
(09:58):
learning to myself and startedto see the improvements, um, and
then began working with peopleas well and that was it.
You know, I found.
I found my place, my love, mypassion, it all came together
and I'm grateful for the yearsof, you know, training and
muscle skeletal injuries andrehabbing the body,
understanding pain and variousthings, learning the functional
(10:19):
medicine side of things and, youknow, staying on top of new
developments today and thenbringing in that functional
neurology piece which, as youknow, is a constant, never
ending journey, yes, discoverywhich is phenomenal.
So that was really, and I didhave a couple of concussions in
there, in between those timeperiods which re rocked my world
(10:42):
.
And so, again, I think, from myown personal experiences of
understanding, you know, whenyou get to a good place and then
you have a little concussion, alittle like what's really a
little concussion, right?
How, you know, a small littlefender bender is what I'm trying
to say can just take the wheelsoff the apple cart and the
(11:02):
whole thing can start all overagain, right?
So I can appreciate thedelicacy, um, and the importance
of consistency and theimportance of a lifestyle
approach, especially of ahistory of any type of brain
injury.
Um, everyone's unique, everyoneneeds their unique approach,
right?
We're all literally uniquecellularly too, so we have to
really personalize it.
(11:23):
Um, but that's that's reallykind of now.
My mission, passion is to helpothers, you know, have a better
grasp and understanding ofwhat's going on.
I had wonderful medical care.
I I'm grateful for everythingthat has occurred to me, but
there were gaps and at the timeI didn't know that.
I just sort of somehow carriedon, like I think we all do.
We just somehow carry on.
(11:45):
But you know, as I look back nowwith the knowledge I have now,
I was like, oh, wow, so muchmore could have been done.
I wished more would have beendone for me.
I could have decreased thesuffering, the years of just
crawling to work every day andcrawling back home so fatigued,
just trying to treat people andtake care of people as best I
(12:08):
can.
But you know, it was.
It was difficult, you know, butsomehow, you know we, we get
here, we arrive to a new place,right, exactly so I feel like I
haven't walked in everyone'sshoes.
Who's had a concussion?
Obviously, but I feel like I'vestraddled it on both sides,
where I myself have had varioussituations that I've had to work
(12:29):
through, and I get to be on theother side as a clinician, you
know.
So I feel like I can bringcompassion and that's that's to
me very important as well, thatcompassionate approach to, to
helping patients, because manyare misunderstood when they're
seeking care and again,sometimes they're looking for a
particular symptom to resolve,so they go to a particular
(12:51):
physician and we're not gettingthat integrative, you know,
whole body approach or a wholesystems approach at looking at a
variety of things.
So that's sort of how I'vemolded myself into what I do now
at the Palm Beach Brain Center,where it's a very whole body,
integrated approach to brainhealth and longevity.
Speaker 2 (13:11):
Yeah, and such a powerful combination to be able
to blend functional medicinewith functional neurology.
I feel like I've had a lot ofsimilarities with my background
in the sense that I felt like Iwas able to use functional
medicine to get myself kind oflike 50% better from a lot of
the brain fog and cognitivesymptoms that I was having with
(13:35):
my concussions.
But I really needed thefunctional neurology to then
come in and get me that muchbetter, and so the two of them
were so powerful.
And what was funny was thatbefore I got into practicing
functional neurology and findingthe Carrick Institute, my
(13:56):
background was in fertility.
I was helping women getpregnant, and so, after
specializing in functionalendocrinology and restorative
endocrinology and diving intothe whole world of female
hormones for eight years, what Ifound was that a lot of my
concussion patients that werewomen, a lot of their hormonal
symptoms, would get worse aftertheir concussion, and so it
(14:18):
really opened my eyes to thefact that, okay, well, this
makes perfect sense you injureyour brain, and your brain is
the orchestrator of all of yourhormones and your endocrine
system and the wholeintersection between the
endocrine system and the immunesystem, and so there's so much
there and I didn't really haveany resources to lean on other
(14:39):
than my own personal experiencewith the fertility work that I
did, which ended up beingincredibly helpful.
But then, you know, as you and Iwere preparing for this, you
sent me this amazing researchpaper.
That just made me so happy thatpeople are finally looking at
the effects of, you know, thehormonal changes after a brain
injury, and so that's why Iwanted to bring you on the show
(15:02):
so that we could talk about this, because I think that, again, a
lot of people, it's very easyto not see the connection and to
just, you know, be experiencingthe symptoms and maybe think
that it's two separate things,when really it's all one system.
And, you know, our concussionsdon't occur in a vacuum.
They occur in the context ofwhat we already had going on our
(15:24):
entire lives.
Speaker 1 (15:26):
Yes, very true and I think it's so powerful that
you've had that background infunctional endocrinology and you
know, working with women on thefertility and probably seeing
those correlations, you know isso powerful.
And you're right, the world ofresearch in neuroendocrine
changes have significantlyadvanced in the last I'd say
(15:50):
about even five to seven yearsfrom my perspective.
I was asked to write a paperabout maybe seven years ago on
the exact topic of what are someof the neuroendocrine changes
that are experienced as asequelae to concussion and
basically at the time theconsensus was like well, we
think maybe there's going to besomething happening in the
(16:10):
pituitary and there could besome, you know, altered function
, but no, you know, likewhatever, like you know you
could get it looked at if youwant, but you know so it was
really just kind of like lowhanging.
You know they're just notreally putting it on the radar
to now.
You know, doing a little moredeeper research, you can see,
(16:30):
even recently, articles in youknow, 2023, 24, 25 are really
coming out with some realpowerful statements and
delineating a lot more clarityon what actually is going on in
the neuroendocrine system postconcussion, you know, in the
acute phase, and then evenmonths to years later concussion
(16:51):
, you know, in the acute phaseand then even months to years
later and giving more guidanceto physicians and clinicians on,
you know how best to approachcare.
Or if someone's come to youwho's had a post concussion that
maybe happened multiple yearsago, to realize, okay, hold on.
If no one has actually at thispoint, for whatever reason you
know, done a full workup on thehormonal side of things, maybe
(17:15):
that would be a goodrecommendation to do or to refer
out.
If you're, you know, not able todraw labs or whatever, but you
know, get that done again.
If you're working with someoneor someone's come with
post-concussive symptoms thatyou know happened years ago and
(17:35):
they're still having thosesymptoms, you know if neuro
rehab stagnates right, if all ofa sudden you hit a plateau and
you're not moving any further inthe abilities of the
neuroplasticity and the changes,because we know how rapid those
can be and how profound theycan be, right.
So it's really clear when thosethings occur appropriately in
that functional neuro side ofthings.
But if there's that stagnation,that should be a little green
(17:57):
light to say, hmm, maybe I needto be looking at those
neuroendocrine changes a littlebit more Again if it hasn't been
done or you know.
You don't overwhelm a patientin the beginning with oh my God,
let's get all of this assessed.
It could be a lot, so you cantake it in phases and stages.
right, that's totally fine, butagain just little, maybe gems of
recognition that this is animportant aspect and a major
(18:21):
piece of the puzzle.
Speaker 2 (18:22):
Yeah, one of the things I see a lot is that a
cycling woman who I'm workingwith in their concussion
recovery all of a sudden we'llfind that a lot of their
symptoms are improving, but nowthat when they do get worse
there's it's always at aspecific time in their cycle.
And so now we see, okay, well,maybe my headaches are now not
(18:42):
every single day, maybe they'reall just clustered right around
this particular like week of themonth, right.
And so now we start to see,like, okay, the symptoms are
improving, they're not thereconstantly, but they sure do get
worse in relationship tochanging hormone levels.
So now we really need to do adeeper dive into this piece of
it to get you that much better.
Speaker 1 (19:04):
Absolutely, absolutely.
And I see the same correlationas well, and as you mentioned
too earlier about with your ownjourney, saying that you felt
you were able to, throughfunctional medicine and herbs,
to get about 50% better and thenkind of stalled out.
And I see the same thinggenerally.
You know, when patients arecoming for some of these and
they want to come from thefunctional medicine side, then
(19:25):
they come to my office with thatin mind.
I'll honor their request of theapproach they want to take and
then again I generally will seeabout that 50% improvement mark
and then we don't seem to getfurther in that functional
medicine side of things.
That's the time to say, okay,let's get into some functional
medicine.
Speaker 2 (19:41):
So it really is the functional neurology.
Yeah, bring that.
Speaker 1 (19:46):
Excuse me, sorry.
Yeah, so the functionalmedicine, you know, just gets
you so far, which is fabulous.
I mean, that part is soimportant.
There's the other piece too, soit's almost like the yin and
the yang to be.
You know, the functionalmedicine, the functional neuro
are very important.
Yeah, yeah.
Speaker 2 (20:00):
And I think it's also like one of the ways I look at
it is what is the right tool forthe job?
And as you know someone whopractices Chinese medicine if I
have somebody with a lot ofbrain inflammation, you know
what.
There is animal research to saythat when you do acupuncture
you can modulate inflammatorypathways and potentially reduce
inflammation in the brain.
But personally, if someone'sonly coming to me once a week
(20:24):
for acupuncture, I would muchrather lean on my things that
people can do every single dayto decrease brain inflammation
and to improve the health ofthose inflammatory pathways and
regulate that through diet,lifestyle, maybe some different
supplements and herbs.
So it's like what is the righttool for the job is also kind of
(20:45):
the way that I'm looking at it.
It's like maybe I'm attemptingto change a system in one
particular way through myneurological rehab and then in
another way through my herbs,and so it's all working together
to just, like you said, not hita plateau.
Speaker 1 (21:00):
Absolutely.
And you know, as we kind ofalluded to or spoke about I
think you mentioned earlier thatin the hypothalamus
specifically, that is, you knowthe location and only location
in the brain that we'recurrently aware of where the
three major systems cross-talkor can have the opportunity to
interlink with each other, right.
(21:21):
So normally that immune systemis sort of a separate system,
the hormonal system is separateand the neurological system is
separate, but in thehypothalamus those three can
cross talk.
So now we're dealing withneuroinflammation that's an
immune side, right upregulationof the immune side, and we have
the endocrine.
The hormones are also nowinterlinking.
(21:43):
So a lot of teasing out ofneuroinflammation and
neuroendocrine changes.
And then the effects on thenervous system, because that's
the third piece I find when,when patients recognize that
that's like a three-legged stoolthere, um, and that those you
know neuroinflammatory processescan have an effect on the
neuroendocrine system and affectthe neurology, right.
(22:04):
So really untangling thosethree bits um become, you know,
a really important, maybe even astarting point perhaps of
patients understanding of like,okay, what trajectories and what
avenues do I need to considerand how can I all play into it?
You know, what gets confusingas a clinician is a lot of those
symptoms neuroendocrine changeshave the similar symptomology
(22:28):
as a concussion, and so it canbe sometimes challenging from a
clinician's point to try tountangle, which is which you
know what symptom is truly froma concussion, which is just a
neuroendocrine change, maybe anendocrine change due to a
concussion?
What is the person bringing tothe table prior to this
concussive event happening andwhat's their history and how
(22:51):
were they neurologically?
Most people are not gettingbaselines, a neurological
baseline, even some, maybefunctional medicine, blood work
baselines or hormonal panelbaselines, and that is something
that I've started to reallyreally implement.
I know in the moment it's notgoing to give me much help in
this current situation, but I'msetting people up for success
(23:12):
for the future.
So should there be futureevents, you know, at least you
have a hormonal baseline tostart with, for example, and
then we can use that, obviouslythrough treatment as well.
But I think this is a practicethat's starting to become more
prevalent, to be integrated alittle bit more, especially on
the hormonal side, to just evenfor, you know, a teenage gal to
(23:34):
have that hormonal panel, oreven for, you know, a young boy
like to have these hormonalpanels, and to just every so
often get documented like whereare you, you know hormonally and
what's going on there.
Speaker 2 (23:46):
Well, and what a great concept to to say you know
, right now I'm feeling reallygood.
Why don't I run a bunch of labsthat I know what labs equate to
me feeling really good?
I mean, I've had what a concept, right?
Yeah?
Speaker 1 (24:02):
benchmark it.
You know, benchmark it.
So if anything now dips orchanges, you know there's a
reference point.
Not that we're trying to chasesomething from the past, but at
least that's a guide, right?
It gives us a sense.
It's like a map, right?
Speaker 2 (24:16):
So, and when we talk about functional lab work.
We understand that you know anormal, you know TSH number,
like the reference range ispretty wide, and I've certainly
had patients that have said tome when my TSH is 1.0, I know
that I actually feel the best,and so I've also had people who
have had to pay lots of closeattention to their thyroid
(24:37):
numbers and really try tounderstand.
You know where do I fit on thisscale and what feels.
You know the best as far as myenergy levels and metabolism and
all the things.
So why don't you get into alittle bit of the testing that
you do?
I mean, are you doing bloodwork?
Are you doing like a Dutch test?
What types of hormone tests areyou running?
(24:58):
And then, are there certainpatterns or interesting things
that you're really paying closeattention to?
Speaker 1 (25:04):
Yes, absolutely so.
Definitely.
A person's history will dictatesome of that, course, obviously
.
So just asking you know alittle bit about menstrual cycle
and just do they?
You know they cramp a lot, youknow generally will indicate
some low progesterone, mostlikely in their history, if they
have a history of just reallypainful periods, for example.
(25:25):
I'm assuming we're just goingto mostly speak about women at
this moment.
Yeah, so I'm going to justframe it up from that.
Speaker 2 (25:30):
We'll do a different episode on men.
How does that sound?
Speaker 1 (25:33):
That sounds fabulous, good, good, good.
So that again gives you alittle clue of sort of maybe,
what their history was, a littlebit going in, because we know,
and I'm assuming this woman alsohas had a concussion, so we
know again at the time ofconcussion, for example, matters
in the woman's cycle if she iscycling right.
So definitely asking somereally good, pertinent history
(25:54):
questions are key.
So I always encourage women totry to keep a better log of
their monthly cycles andsymptoms and things like that.
So but the test that I reallylove to do, I'm a huge fan of
definitely the Dutch test, theurinary hormone test.
I've used that gosh, I don'tknow 15-ish plus years, so I do
(26:16):
love that over blood work.
I find the Dutch test gives us alittle more information,
especially if you add theadrenal component to it as well,
so we can get some of thecortisol levels and the
circadian rhythm of the adrenalstoo.
So it gives us a little bitmore information from that
perspective.
And the Dutch just gives us allthose metabolites and just the
way they lay out their report isvery useful and even with just
(26:40):
seeing how the estrogen aremetabolized and then COMT enzyme
.
So it gives us a lot ofwonderful markers that just
standalone, you know, let's testestrogen, let's test or esterol
, let's test progesterone,testosterone.
These are just such standalonetests in blood that I feel
that's limited and price pointwise it's actually a little
cheaper to do Dutch, so I think,for the value, that would be
(27:03):
the way to go.
I've also recently started usingVibrant Wellness Labs, or
Vibrant America is the parentcompany, and then Vibrant
Wellness would be thatlaboratory component, and they
actually have a little more dataon their urinary hormone tests.
They actually will also have aneurotransmitter panel that will
(27:24):
also pair up nicely with theurinary hormones and they go
into a little bit more detailthan the Dutch does.
So, um, you know one half dozenof the other there.
I think they're both pretty, um, um, amazing to use, you know.
So yeah so that is key there.
Uh, for the thyroid, definitelyWe'll just send out for blood
work there and I like to do afull thyroid panel.
(27:46):
So, beyond just TSH and T4, wereally want to do all seven
thyroid markers and especiallylooking at TPO antibodies and TG
antibodies Because, as we know,with a concussion, within 24
hours, research tells us thatwe're going to start to get like
a leaky gut syndrome.
We're going to get gutpermeability, and so we know if
(28:06):
we're going to start to get a um, um, like a leaky gut syndrome,
we're going to get gutpermeability, and so we know if
we're getting a gut permeability, we're getting probably a
breach of the blood brainbarrier, um, probably possibly
some of the other barriers sinusbarriers, inner ear barriers.
So we're um, wanting to lookbecause generally my experience
has been, within about a year aperson will develop some type of
(28:28):
autoimmune or foodsensitivities or something like
that down the road.
So if I'm seeing someone who'shad a concussion multiple years
ago and coming to me now becausethe symptoms have just gotten
so bad at this point, I'm alsoconsidering a gut panel as well.
So looking at what might begoing on on that level too.
So I know that takes a littlebit out of hormones, but know
looking at what might be goingon on that level too.
(28:49):
So I know that takes a littlebit out of hormones, but again,
it's all integrated.
But generally definitelythyroid panel, t7, very
important that's blood work.
So generally when I do sendpeople out for blood work I will
look for a few other things aswell.
I tend to do a bit of acomprehensive panel in that
sense, but some of the keythings I'm really interested
(29:10):
from a neural perspective islooking at the iron and not just
serum iron.
That's fine, that's a goodmarker, that's easy to look at,
but that's really just 1% ofstored iron in the body, so it's
not a great great marker.
Ideally we would want to addsaturation, iron saturation.
That is much better.
(29:30):
So sometimes you have to askfor that.
The pen of the light.
Thankfully it's included inthere.
But if people are listening tothis and taking some notes and
then going to their primary carephysician and saying, hey, next
time we do blood I'd like ironsaturation, I would like
ferritin.
Ferritin is another greatmarker, a surrogate marker for
iron.
It's 22% of stored iron, somuch better than just serum iron
(29:53):
alone.
It's also an inflammatorymarker.
So it allows us to take anotherpeek into the system and look
at maybe some levels ofinflammation.
So those are really key foriron, especially for
neurotransmitters.
I also like to look for B12.
Again, b12 serum, it's okay.
It's not the greatest, but it'sokay.
What I really ultimately liketo look at is methylmonic acid
(30:18):
and that gives us a much betterindication of B12 status.
Again, looking at that from aneurological perspective.
And of course, you know acomplete blood count, let's go
ahead and look at you know redblood cells, white blood cells,
you know how's the hemoglobin,how's our MCVs, the size of the
blood cell.
A lot of times people have anormal MCV, so the size of the
(30:40):
blood cell is good, but but ifyou have low iron, your red
blood cell will be small.
If you have not enough B12,your red blood cell will be too
big.
So actually it ends up lookingnormal.
Speaker 2 (30:53):
Yeah, and you have to get that whole complete picture
to understand all the pieces.
Speaker 1 (30:58):
You really do, and these aren't super expensive
tests.
The methylmalic acid might be alittle bit more on the pricier
side, but I think it's wellworth it.
So again, there's a few morethings that I do like to look at
, but just from some basics.
If we're looking at exactlywhat I'm looking for the iron,
the B12 is key and then what isthe red blood cell profile
(31:18):
looking like, and then also thewhite blood cells, I really do
like to, you know, look at thebreakdown, and a lot of times we
can maybe infer if we'regetting a little bit of
microglia activation going onthere as well.
So take a look at thosemacrophages, which is the in the
body.
These white blood cells willkind of be I kind of think of
(31:41):
them like Pac-Man and they goalong and they just sort of eat
up all the debris and thingslike this cellular debris and
viruses, bacteria, et cetera.
They're just like littlegobblers, um in our brain.
Uh, we have the cousins of themacrophages, which are called
the microglia, um, and so wehave cells in our brain that
also kind of do the cleanup, youknow, act as well.
(32:02):
So sometimes if I see reallyelevated macrophages, it just
gives me a Hmm, that is like hmm, could there be some microglia
activation which is going tocause neuroinflammation is what
I'm getting at which will affecthormone not just production,
but activity, right Receptorsite activity.
So that's why thatneuroinflammation piece is
(32:24):
important in this whole puzzle.
So, yeah, so those are kind ofsome of the tests the Dutch, the
vibrant wellness of the urinaryhormones, possibly a
neurotransmitter profile don'talways do that one but then the
blood work iron B12, red bloodcell panel.
So complete blood count, yeah,at the start.
Yeah there's so many to choosefrom.
I know right.
(32:44):
Yeah, that would be at leastthe bare minimum of what I'd
like to see Sure.
Speaker 2 (32:48):
And this might be getting into the weeds a little
bit, but as far as ferritin goes, you mentioned that it can be,
you know, like the technicalterm is an acute phase reactant,
right?
So if there is an inflammatorystate, I also know that a lot of
times the normal referencerange for ferritin is also
pretty wide and a lot of people,if they have very low ferritin,
it can maybe still be flaggedas normal.
(33:09):
But when it's on the low end ofnormal, are you also still
saying, eh, this is a littlelower than I'd like it to be?
Even if it's normal, this mightstill be something we have to
pay attention to.
Speaker 1 (33:19):
Absolutely, and actually I do look at the lab
values that come from.
Labcorp is the lab that Iprimarily use, or Quest is
another option.
But I transpose all the valuesthat the patient's receiving
into another document that Ihave that are functional ranges.
So I do look to see ifsomething is flagged lab high or
(33:40):
lab low, because those labranges are pretty broad.
So if they're flagged high orlow on lab, definitely red flag,
something really important toconsider.
But even if some of the valueson the LabCorp report are in
normal ranges according toLabCorp, I transpose everything
onto another document that hastighter ranges, which are more
(34:03):
physiological, functional rangesof the body, of the human body,
and I use those to, you know,see if something is in the high
or the low to get a much betterclinical picture.
So it is a little bit extrawork but it goes a long way.
So that's where, again, a kindof normal low ferritin actually
on the functional range it's lowand we can proceed forward from
(34:28):
that moment.
Speaker 2 (34:30):
Thank you for listening to part one of this
conversation with Dr TatianaHabanova.
Please make sure to subscribeto our show so you don't miss
part two, which will beavailable next week.
As always, you can email usquestions at lifeafterimpact at
gmailcom or send us a text byclicking on the text us link in
the show notes below.
Thanks again for listening.
(34:51):
We'll see you next week.
Medical disclaimer.
This video or podcast is forgeneral informational purposes
only and does not constitute thepractice of medicine or other
professional healthcare services.
And does not constitute thepractice of medicine or other
professional healthcare services, including the giving of
medical advice.
No doctor-patient relationshipis formed.
(35:13):
The use of this information andmaterials included is at the
user's own risk.
The content of this video orpodcast is not intended to be a
substitute for medical advice,diagnosis or treatment, and
consumers of this informationshould seek the advice of a
medical professional for any andall health-related issues.
A link to our full medicaldisclaimer is available in the
(35:36):
notes.
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