NUTRITIONAL TREATMENT FOR BRAIN INJURY

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NUTRITIONAL TREATMENT FOR BRAIN INJURY

 

By David A. Steenblock, M.S., D.O.

 

http://www.strokedoctor.com

 

The following information represents research--in-progress and should not under

any circumstances be used as a substitute for physician supervision

 

 

 

I. Introduction

 

To understand how nutrition can be used to help in the prevention and treatment

of brain injury, we must understand some basic facts. Much like the engine of

your car, all cells of the body begin to " misfire " when deprived of oxygen or

sugar (glucose), or a combination of both. Without sufficient fuel, your car

will sputter and smoke, slow down, then quit. This is what happens to your brain

cells when they are deprived of the energy they need in the form of oxygen and

glucose. The lack of fuel and/or oxygen produces " biological sputtering and

smoke. "

 

A reduction in blood flow to the brain is a common occurrence as we grow older.

This slowing of the blood circulation decreases the oxygen and glucose supply to

the brain cells, causing biological smoke in much the same way that smoke is

produced when your car misfires.

 

Biological smoke (also known as free radicals) is produced when the energy

generators of the cell, called the mitochondria, are damaged by the inefficient

burning of glucose because of the lack of oxygen. As more and more biological

smoke is produced, the cells’ mitochondria no longer are able to make the

energy-storing molecule ATP. The cells no longer have the energy they need for

repair and they become more injured and die.

 

In summary, nutritional treatments for brain repair are based on the following:

 

 

 

 

Stroke, brain injury, cerebral palsy, multiple sclerosis, Parkinson’s

Disease, Alzheimer’s Disease, autism, and other forms of brain degeneration are

either caused by, or are associated with, a lack of oxygen supply to cells due

to a multitude of causes, including trauma, infections, inflammation,

irritations, and poisoning.

All forms of brain injury and degeneration cause stress. Stress produces a

variety of substances, such as adrenalin and cortisol, that trigger excitatory

neurotransmitters (glutamate and asparate) and subsequent cell injury. Neurons

in the hippocampus, the area of learning and memory, are especially vulnerable

and are either injured or killed by excess stress. There is therefore a direct

link between physical and emotional stress, the loss of neurons in the

hippocampus, and subsequent losses in learning and memory.

Brain injury and degeneration are produced by, or accompanied by

biological smoke (free radical damage), inflammation, edema, and cell injury.

Properly chosen and administered antioxidants are able to reduce the severity of

free radical damage.

Toxic elements such as mercury, lead, cadmium, and arsenic stimulate and

augment the " auto-immunity " of the body towards its own brain and spinal cord

tissues. Heavy metals also damage the inner lining of the blood vessels (the

endothelium), producing " spasticity " of the blood vessels, which narrows and

constricts them, reducing the flow of the blood. Other mechanisms of heavy metal

poisoning include microtubule alterations, free radical damage of important

enzymes, interference with calcium homeostasis, and increases in glutamate

toxicity to neurons.

Other essential elements such as iron, copper, calcium, potassium, and

zinc, become " decompartmentalized " causing " rusting " , calcification, oxidation,

demyelination, brain tissue damage or death.

The supporting cells of the brain called " glia " act as " mothers " to the

computer chip-like neuron cells. There are approximately 10 to 12 glia per

neuron that feed the neuron, detoxify the neuron and attend to its every need.

The health of these cells is critical to the health of the neurons. These glia

make up most of the white matter of the brain while the neurons make up the gray

matter.

 

 

 

 

The glia are filters. They filter the blood so that the neurons receive the very

purest of fuel. Any debris that gets through to the neurons will cause the them

to misfire or not fire at all. Autistic children suffer from this problem. Their

brain cells are constantly bombarded by toxins in the blood (from a " leaky gut "

syndrome) and immune defenses against the toxins. (see my lecture on Treating

Autism.) ).

 

In repairing brain injuries, " cleanliness is next to Godliness. " The brain is an

extremely complicated electrical device with billions of electrical connections,

any one of which will be affected by a tiny bit of debris, especially if it

affects one of the connections (synapses). According to a recent article in

Nature (Oct 14, 2003), the average gut is loaded with 1,200 different viruses,

half of which are unknown to science. In addition, chemicals such as PCB, MPTP

(1-methyl-4-phenyl-1,2,3,6 tetra hydropyridine), heavy metals, or tartaric acid

(from intestinal unfriendly bacteria and yeast), all increase damage to the

synaptic connections. The purity of the blood and glia cells is of paramount

importance in improving brain function. From this perspective, the importance of

diet cannot be underestimated. Keeping the air, beverages, food, and intestinal

tract clean and pure will go a long way in preventing " short circuits " in the

electrical pathways.

 

 

 

B. Nutrition and Brain Repair

 

a. Diet

 

" May your medicine be your food and drink and may your food and drink be your

medicine. "

 

-Adapted from Hippocrates

 

A. What nutritional program would you recommend for stroke and traumatic brain

injury?

 

The following is an application of the nutrition research to-date for treating

stroke and traumatic brain injury. While the focus is on brain repair, the same

nutrients are also important to cardiovascular health to promote better oxygen

and nutrient delivery to brain cells.

 

1. Clean, pure water: 6-8 glasses a day will help cells do their job more

efficiently. Water increases the transport of oxygen through damaged blood

vessels, prevents increased blood viscosity, and increases cell to cell

communication. Most strokes occur in the late evening and can be avoided by

drinking water before bed. However, most people want to avoid getting up to

urinate at night. One to two teaspoons of Epsom salts in the evening glass of

water will keep the water in the intestines (not the bladder), allowing a full

night’s sleep as well as the relief of any constipation in the morning. Avoid

carbonated water, coffee and soft drinks to help eliminate inflammation in the

body.

 

2. General Diet

 

The diet should be rich in fresh alkaline vegetables, moderate in poultry, deep

sea fish (unless suffering from heavy metal poisoning) and unprocessed almonds,

sesame and sunflower seeds, and low in saturated fat, total fat, salt and

cholesterol. The diet does not include red meat, fruit juices, sweets, salt,

alcohol, sugar-containing beverages, processed foods, or foods with additives,

hormones, colors, preservatives, monosodium glutamate/vegetable hydrolyzed

protein (MSG/VHP) or pesticides. Milk and wheat products are often associated

with allergies and inflammation and should also be eliminated.

 

There are many problems with the SAD diet (Standard American Diet), some of

which are that saturated fats and refined sugars:

 

Increase blood viscosity (thick blood)

Reduce the oxygen carrying capacity of the blood

Promote the growth of toxic bacteria and yeast in the intestines which causes

increased weight, " leaky gut " syndrome, and interference with the production of

brain growth factors.

 

For example, a high fat-high sucrose diet reduces Brain-Derived Neurotrophic

Factor (BDNF), important in stimulating the growth of new neurons. In a study

with laboratory animals, rats fed a high saturated fat-sucrose diet had lower

levels of BDNF and the lowest learning performance. The combination of a high

saturated fat-sucrose diet and brain injury resulted in lower BDNF levels and

greater learning impairment. (1)

 

3. Eat Organic as much as possible. Since environmental toxins can be harmful to

nerve cells, a maintenance and regenerative diet needs to be as non-toxic as

possible. While organic foods may still have some pesticide residues, certified

organic foods are usually preferable to conventionally grown foods. Fish farm

sources of salmon, halibut, bass and trout may have less heavy metal

contamination than fish from lakes and ocean sources. Fish (especially anchovies

and salmon) are an important source of omega-3 fatty acids that protect brain

cells from toxins and free radicals and make up most of the nerve’s insulating

material called myelin.

 

4. Eat fresh, whole foods as much as possible. If chewing is a problem, a

blender can be used. Fresh foods provide a variety of ingredients beneficial to

the intestines, blood, immune system and brain. Processed foods are made to last

on the shelf for long periods of time and may therefore have preservatives,

additives, colors, salts, and sugars. In addition, a variety of healthy foods

through the week helps reduce boredom and nutrient deficiencies. Good nutrition

is " teamwork. " Vitamin A is required for Vitamin D to function and zinc is

required for vitamin A. Vitamin D is required for magnesium, calcium and

phosphorus to do their job and magnesium is a cofactor for B complex, vitamin C

and vitamin E. The best organization of individual nutrients is found in natural

foods.

 

Green foods contain high amounts of vitamin K which has recently been shown

to have a profound effect on preventing brain injury that usually results from

oxygen deficiency. Vitamin K completely blocks free radical accumulation and

cell death. (2) Chlorella, a fresh water algae, and green barley are examples of

green foods that are also beneficial to the colon.

Home grown sprouts can be a non-toxic source of vitamins and minerals (use

pure water).

 

5. The Alkaline Diet: Improves immune function and protects against infection,

inflammation and disease.

 

80% of diet as raw vegetables: Asparagus, beets, carob, carrots, cauliflower,

celery, green beans, ripe olives, onions, parsnips, radishes, spinach, sprouts,

string beans, sweet potatoes, watercress, chard, mustard greens, kale, carrots,

leafy lettuce (no cabbage or iceberg lettuce) and fresh vegetables juices (no

tomato juice). Watercress, prunes and beet tops assist with elimination.

 

20% of the diet as: Avocado, almonds, fish, turkey, chicken or wild game

 

6. B vitamins and Homocysteine: Foods that contain natural folate, pyridoxine

(B6) and methylcobalamin (B12) help reduce the levels of homocysteine, which

injures neurons and blood vessel walls. Elevated levels of homocysteine (above

7.2 micromol/liter) are associated with an increased risk of heart disease,

stroke and Alzheimer’s.

 

Folic acid is in green leafy vegetables, lentils, chickpeas, asparagus, spinach

and most beans.

Pyridoxine (Vitamin B6) is in poultry, fish, fish oil, vegetables, eggs, dried

beans, tuna, and sunflower seeds.

Methylcobalamin (Vitamin B12) is in poultry, fish, and fish oil. In addition to

reducing homocysteine levels, large amounts of methycobalamin stimulate the

genes associated with neural regeneration.

 

7. Thiamine and energy metabolism: Foods that contain thiamine (vitamin B1) can

help prevent the loss of neurons. Thiamine deficiency is associated with

impairments in energy production in the mitochondria that lead to glucose

deficiency in the brain and subsequent free radical production and neuronal

death. In studies with mice, there was a 29% loss in neurons by the 9th day of

thiamine deficiency. By the 10th day, iron had accumulated in the microglia

(responsible for immune defense in the brain and associated with Parkinson’s and

Alzheimer’s), causing increased free radical damage and immune attacks on

surrounding neurons. By the 11th day, the loss in neurons had tripled to 90%.

(3) Thiamine is quickly depleted by cooking, processing and diets high in

refined sugar. Thiamine requirements are increased by sucrose, alcohol,

infection, diuretics, brain injury, hyperactivity and depression. Foods high in

thiamine include brewer’s yeast, wheat germ, millet, sunflower seeds, brazil

nuts, and rice bran.

 

8. Fiber and the Colon

 

According to the American Dietetic Association, the recommended daily intake of

fiber for healthy adults is 20-35 g/day, with good sources being fresh fruits

and vegetables, oats, green barley and legumes. Dietary fiber assists in

lowering blood cholesterol levels and helps to normalize blood sugar levels,

especially in patients with cardiovascular disease and Type 2 diabetes.(4) Fiber

also increases the transit of waste and toxins out of the system. Fresh fruits

and vegetables are an excellent source of fiber. Gluten foods such as wheat,

barley and rye should be avoided because they are associated with allergies,

inflammation, and increased gut permeability ( " leaky gut " ).

 

Colon cleansing with castor oil. In addition to fiber, castor oil can be used

periodically to help cleanse the intestines. Back in 1850, cathartics such as

castor oil were frequently used for stroke patients. The reasoning behind this

use is that a variety of toxic acids and amines are produced by certain bacteria

and yeast in the colon that proliferate by feeding on dietary sugars. These

acids and amines are absorbed into the blood, migrate to the brain and interfere

with synaptic transmission and neuron and glial cell function and regeneration.

We now know that cathartics such as castor oil also stimulate the vagus nerve

that innervates the small intestine and portions of the large intestine. This

stimulation moves the feces and toxins out of the body more rapidly, preventing

their poisoning the brain via intestinal absorption. The vagus nerve is also

associated with the parasympathetic nervous system and has been found to

increase memory and reduce seizure activity. (5)

 

9. Natural Sources of Insulin

 

Insulin and insulin-like growth factor are important factors in brain function

and repair. The Jerusalem artichoke creates a natural insulin effect on the body

and is available in health food stores. Vanadium and chromium also increase

insulin. If you are taking insulin, the dosages need to be monitored more

closely if these foods and supplements are utilized. One source of vanadium is

fish. Sources of chromium include Brewer’s Yeast, whole grains, beets, fish, and

chicken. Both vanadium and chromium can be obtained from a health food store.

The exact doses should be ascertained in partnership with a nutritionist or

nutrition oriented physician.

 

10. The Glycemic Index. Avoid foods that have a high glycemic index. These foods

raise the blood sugar levels too high, causing blood vessel wall damage, stress

to the nervous system and increased yeast and bacterial growth in the colon. The

following are examples of the glycemic index of foods (the lower the better):

 

Avoid:

 

Honey 75

Sucrose 60

Fructose 20

Applies 39

Raisins 69

Beets 64

Baked potato 98

White bread 69

Bran cereal 50

Cornflakes 80

Rice, puffed 95

 

Better:

 

Beans 31

Lentils 29

 

11. Foods that contain antioxidants can assist the activity of the cell’s power

generators (mitochondria) and protect neurons from free radical damage. It is

therefore important in brain repair to increase daily consumption of natural

sources of antioxidants and reduce as much as possible free radical damage from

alcohol, infection, allergies, pesticides, pollution, cigarettes, and stress.

 

Vegetables should be eaten in quantity since they are high in antioxidants.

These include kale, spinach, Brussels sprouts, alfalfa sprouts, broccoli, beets,

and onions. The best fruits are prunes, blackberries, raisins, strawberries,

raspberries, plums, oranges, red grapes, cherries and kiwi.

 

The highest food source of antioxidants is prunes. One serving of prunes every

night before bedtime provides fiber, antioxidants and a morning bowel movement.

 

12. Antioxidant Seasonings: Curcumin (curry), tumeric, ginger, natural vanilla

flavoring, garlic, Fenugreek, parsley, thyme, sage, rosemary, etc. can also be

used as antioxidant flavorings to increase the healing benefits of the meal.

However clove and cinnamon may interfere with energy production in the cells and

should be limited.

 

13. Antioxidant beverages include green tea and grape juice. Green Tea is an

antioxidant that can help protect nerve cells from severe damage and death.(6)

Grape Juice contains the antioxidant resveratrol. Wine also has resveratrol but

because of the alcohol content, wine can increase homocysteine levels that are

toxic to neurons. After a stroke or trauma, blood is deposited in the damaged

tissues. This blood contains red blood cells which contain iron rich hemoglobin.

As the body destroys the red blood cells, hemoglobin releases its iron. This

free iron reacts with oxygen to produce biological smoke (free radicals) and

damages the tissue more. This free iron-induced biological smoke may take months

or years to act. As the iron rusts in the wound, more and more tissue is

damaged. This is one of the mechanisms that causes Parkinson’s disease.

Resveratrol acts to reduce the free radicals as well as stimulate an enzyme

called heme oxygenase to rapidly degrade and reduce the heme.

Resveratrol has been shown to reduce the amount of brain damage after a stroke.

(7) Anyone with a stroke, early Parkinson’s or Alzheimer’s disease should put

Resveratrol on their list of daily supplements to take.

 

14. Garlic, selenium and chlorophyll can remove (chelate) heavy metals. Cilantro

(Chinese parsley) and chlorella are helpful mercury chelators. It is important

to reduce heavy metal levels which are toxic to the growth of new neurons. In

severe poisonings, oral DMSA (dimercaptosuccinic acid) is given for prolonged

periods as a chelation therapy.

 

15. Glutathione is one of the most important protectors of the body’s cells and

neurons against free radical damage. Free radicals play a significant role in

secondary brain injury in stroke, trauma, Parkinson’s, Alzheimer’s, amyotrophic

lateral sclerosis, multiple sclerosis, aging and other neurological

conditions.(8) Antioxidants, including glutathione peroxidase were measured for

several days in 38 patients admitted for acute stroke. Antioxidants in the

stroke patients were significantly reduced immediately after the stroke and

those with the lowest levels had the worst early outcome (functional decline and

death) while those with higher levels remained functionally stable. (9)

Intravenous injections of glutathione are associated with improvement in stroke,

Parkinson’s, Alzheimer’s, vascular dementia and brain injury by protecting

neurons against degeneration (necrosis) as well as preventing programmed cell

death (apoptosis) in the injured regions. Factors that increase and/or

have a sparing effect on glutathione include moderate sunlight (vitamin D3),

Fenugreek, riboflavin, aloe vera, ginger, garlic, vitamin E, Ginkgo biloba,

pycnogenol, green tea, succinate, citrate, and vitamin C. The B vitamin

riboflavin participates in energy production and is vital to the manufacture of

glutathione.(10) Various drugs, including Tylenol can deplete glutathione and

therefore their use is usually discouraged.

 

Glutathione is also important in protecting stem cells and new neurons. If taken

in high quantities (with physician supervision) after stem cell transplantation,

the stem cells are encouraged to multiply more before differentiating into other

cells such as neurons, blood cells, liver cells, etc. This longer period of cell

replication results in more stem cells to heal the damaged tissues and a much

better clinical response.

 

16. Foods that contain the amino acid tryptophan can help regulate mood and

support the nervous system. Tryptophan is necessary for the manufacture of the

neurotransmitter serotonin (important in the treatment of depression) and the

hormone melatonin, important for a good night’s sleep. Melatonin also prevents

free radical damage, has a sparing effect on glutathione (11) and promotes the

growth of new neurons. Tryptophan is found in turkey and cottage cheese.

Serotonin foods include tabbouleh, couscous, oats, millet, corn, amaranth,

squash, pumpkin, sweet potatoes, yams, carrots, onions, garlic, turnips, celery,

and radishes.

 

17. Eat smaller quantities more frequently to reduce insulin requirements and

maintain blood sugar levels. Reduced caloric intake can stimulate growth factors

that help protect nerve cells and promote the cell’s use of glucose and insulin.

 

18. Glutamine intake increases the levels of cell protective glutathione.

Glutamine has anti-inflammatory effects and reduces cravings for sweets.

Glutamine is in fish, beans, parsley, spinach, and dairy products.

 

19. Foods with calcium can help strengthen nerve and heart function, immune

defense and prevent bone loss. Calcium foods include dairy products (use low

fat), fish, tofu, broccoli, chard, and legumes.

 

20. Acidophilus and bifidobacteria are helpful for promoting healthy bacteria in

the bowel and for preventing constipation. These friendly bacteria are in plain

yogurt (no sugar). The integrity of the mucosal lining is important in the

prevention and treatment of " leaky gut syndrome " , in which toxins from the colon

pass easily through damaged intestinal walls and into the blood stream. Once in

the bloodstream, toxic chemicals and pathogens can wage war against the

blood-brain barrier, eventually leading to nerve cell damage.

 

21. Selenium assists with antioxidant activity and is found in abundance in

seafood and poultry. Excitotoxic neurotransmitters such as glutamate play a

major role in creating brain lesions in stroke, epilepsy, and traumatic brain

injury shortly after the insult. Selenium induces new protein synthesis that

inhibits glutamate’s destruction. Selenium deficiency results in a massive

increase in susceptibility to seizures and cell loss. (12)

 

22. In adults, growth hormone plays a vital role in bodily maintenance and

repair processes. Growth hormone rises during sleep between 10 pm and midnight,

which underscores the saying that " the best sleep is before midnight. " Growth

hormone can also be enhanced by garlic and red grape seeds (pycnogenol).

Lecithin, cabbage, cauliflower, Brussels sprouts, and savoy have also been found

to increase growth hormone and Nerve Growth Factor.

 

23. Fresh olives provide monosaturated fats that favorably influence energy

production. A combination of 4 parts olive oil, 1 part fish oil, and 1 part

vegetable oil is recommended (13) to reduce the levels of fats in the blood

vessels.

 

24. Prostacyclin enhancement: — Prostacyclin is manufactured by cells in blood

vessel walls to help open up the blood vessels and allow more oxygen-carrying

red blood cells to flow through. Nutrients and herbs that help increase

prostacyclin synthesis include Gamma linolenic acid (GLA), fish oil (EPA and

DHA), Gingko biloba, Vanadium, and ginger.

 

25. Reduce inflammation and blood coagulation. Elevated levels of a protein

called fibrinogen can cause blood cells to clump together, increasing the risk

of blood clots and subsequent oxygen deficiency. 6-8 glasses of pure water

through the day, vitamin C, Vitamin E, fish oil, flaxseed, green tea, garlic,

onion, ginkgo biloba, ginseng, ginger, yucca, aloe vera, wheat germ, cayenne,

sea cucumber, heparin and brown algae are helpful in reducing fibrinogen levels.

 

26. Energy Production in the mitochondria. Acetyl-L-carnitine, Lipoic acid,

vitamin E, Coenzyme Q10, nicotinamide and magnesium help the cell’s power

generators (mitochondria) do their job more efficiently. Acetyl-L-Carnitine is

found in white fish, chicken and milk (use low fat). Acetyl-L-carnitine and

lipoic acid work together to protect neurons from glutamate toxicity.

Nicotinamide and creatine also work in tandem to protect neurons. Octacosanol

also promotes energy production in cells and is found in wheat germ. Statin

(cholesterol-lowering) drugs can deplete Coenzyme Q10.

 

27. Phosphatidyl glycerol is a building block used to make cardiolipin, which

fuels the cell’s mitochondria to produce ATP. Oats and soy contain substances

used to make phosphatidyl glycerol. Magnesium helps create a geometry that

stabilizes the fat layers and helps protects them from injury (14).

 

28. Nutrients and supplements that provide protection against low oxygen and

lack of blood flow include ginkgo biloba, vitamin C (natural sources), garlic,

vitamin E, vitamin B6 (pyridoxine), nicotinamide, magnesium sulfate, and

cucumin/curry.

 

29. Foods containing creatine help to prevent energy loss in the neurons,

stimulate protein synthesis, reduce protein breakdown and stabilize cell

membranes. (15)

 

Foods to avoid:

 

1. Avoid red meats high in saturated fats. Diets high in animal fat or

cholesterol can bring about changes in cells that can lead to their death.

 

2. Avoid fish with high mercury content.

 

Mercury in Seafood - highest levels

SPECIESMEAN (PPM)

Shark.96

King Mackerel0.73

Tilefish1.45

 

Mercury in Seafood - Lower Levels

SPECIESMEAN (PPM)

Tuna (fresh or frozen).32

Halibut0.23

Sablefish.22

Pollock0.20

Tuna (canned)0.17

Crab Blue.17

Scallop0.05

Catfish0.07

SalmonND

OystersND

ShrimpND

 

 

 

3. Avoid processed foods. They are deficient in needed enzymes and may contain

additives, salt and sugar that can increase the production of cell-damaging free

radicals.

 

4. Avoid sweets and high glycemic index foods. Sugary foods can fuel the growth

of bacteria and lead to increased infections. Sugar also increases insulin

requirements, leading to high blood sugar levels (hyperglycemia) and an

increased risk of cell injury.

 

5. Avoid food additives that include the following: artificial coloring

(associated with cancer risk), aspartame (associated with nerve damaging

compounds - excitatory neurotransmitters), Brominated Vegetable Oil (potential

risk), BHA and BHT (potential risk), concentrated caffeine (associated with

fibrocystic breast disease), carrageenan (associated with colon problems), Corn

syrup, Dextrose, Invert sugar and Sucrose (interferes with blood sugar

regulation), Heptyl Paraben (potential risk), Hydrogenated Vegetable Oil

(associated with immune impairment), Hydrolyzed Vegetable Protein (HVP)

(contains MSG — associated with promotion of nerve damage, burning sensations,

headache), Phosphoric acid and Phosphates (associated with bone loss), Propyl

Gallate (potential cancer risk), Quinine (associated with birth defects),

Saccharin (associated with cancer risk), Sodium Chloride (associated with heart

disease), Sodium nitrite and sodium nitrate (associated with cancer risk),

Sulfur Dioxide,

Sodium Bisulfide (a bleach associated with allergies and B1 deficiency). (16)

 

6. Avoid cigarettes and alcohol. - Cigarettes and alcohol increase hypoxia (lack

of oxygen), free radical damage and homocysteine levels, which are toxic to

nerve cells. Alcohol inhibits the release of Nerve Growth Factor, which is

important to brain repair and the growth of new neurons.(17)

 

7. Avoid Stress. Stress can promote the production of hormones and nerve

damaging chemicals which increase cell damage, inflammation and tissue swelling.

High doses of antioxidants such as proanthocyanidins, resveratrol, Vitamin C and

E foods and supplements, exercise, humor, inspirational readings, and

meditation/contemplation can help reduce stress and its effects.

 

C. Nutritional Supplements and Brain Repair

 

The following are suggested nutritional supplements to be used only under a

physician’s supervision. The amounts prescribed will depend on the severity of

trauma and nutritional status of the patient. Individualized programs can be

designed to start with those nutrients most needed rather than trying to do

everything at once.

 

1. A natural, high potency amino acid/vitamin/mineral/antioxidant powder formula

is recommended for better absorption of the minimal daily requirements and to

minimize the irritation of the stomach and intestines that can occur with

tablets.

 

2. Methylcobalamin (Vitamin B12) is important to the regulation of the body’s

internal clock through the manufacture of melatonin. Methylcobalamin helps to

alleviate depression and supports the myelin sheaths that surround nerves and

promote rapid nerve conduction. Cyanocobalamin, a form of vitamin B12, has a

longer shelf life, but is not as effective in supporting and protecting brain

cells. In fact, in high doses, it’s cyanide molecule is toxic to neurons.

Methylcobalamin can also help reduce toxic glutamate levels and protect neurons

from free radical damage.(18) Methylcobalamin can be administered in high doses

(up to 20 milligrams) intravenously in combination with other nutrients. This is

especially helpful in the treatment of neuropathy and multiple sclerosis.

 

3. Omega-3 Fatty Acids

 

Cod liver oil provides the body with vitamins A and D, as well omega-3 fatty

acids (EPA, DHA) that are crucial players in brain repair and maintenance. EPA

and DHA reduce blood clumping and coagulation which promotes blood circulation

and better oxygen delivery to the cells. Omega fatty acids also reduce

inflammation, relieve depression, and can be used to prevent further strokes and

treat damaged white matter. 500 mg of EPA and 1300 mg of DHA daily from fish oil

are recommended, along with 400 IU daily of Vitamin E. I often prescribe 3

tablespoons of fish or cod liver oil as another method to prevent blood clots

from forming. In certain cases, and under a physician’s supervision, fish oil

can reduce and perhaps replace other anti-clotting medications.

 

4. Vitamin D plays a role in the manufacture of nerve cell growth factors such

as Brain Derived Neurotropic Factor (BDNF) and Nerve Growth Factor. These growth

factors can stimulate the production of new brain cells.(19) Vitamin D3 also

protects nerve cells by increasing glutathione levels, a compound that acts as a

quencher of cell-damaging free radicals(20). In addition, Vitamin D3 protects

cell proteins and their DNA from strand breaks and mutations.(21) Vitamin D

increases calcium absorption for stronger bones. This is especially important

for paralyzed patients who often develop osteoporosis on the paralyzed side.

This is why a paralyzed patient develops cramps and spasticity of the paralyzed

limbs. Primary sources of vitamin D are sunlight and diet. Normally we need

about 400 IU of natural vitamin D3 daily and cod liver oil is an excellent

supplemental source.

 

5. Calcium and Magnesium

 

Calcium is important in heart function, nerve transmission, muscle contraction,

and bone strength. Generally for an adult with leg cramps and spasticity, 500 mg

of a Corel Calcium powder can be taken three times a day mixed with water or

food due to its absorption and ease of administration.

 

Magnesium is important to energy production and can protect the cell against

calcium entry, inflammation, and leaky cell membranes caused by oxygen

deficiency. Magnesium deficiency is associated with heart disease, cardiac

arrhythmias, hypertension, depression, tremors, and diabetes mellitus. (22)

Magnesium is refined out of many foods through cooking and processing. Magnesium

is also depleted by excess carbohydrates, proteins, stress, " water pills "

(diuretics), and alcohol (even one drink will deplete magnesium to dangerous

levels). Food sources of magnesium include: fresh green vegetables

(chlorophyll), fish, figs, corn, apples, beans and almonds. Supplementation with

at least 500 mg of magnesium daily is recommended. I generally tell my patients

to take 200 mg three times a day and check the bowels. If the bowels do not

become looser, then increase the dose until the bowels just start to loosen and

stay on that dosage. The more magnesium, the more the blood vessels open up and

the

more oxygen flows.

 

6. Several hormones are important to brain repair, including DHEA, testosterone

and estrogen. These hormones help certain brain cells called astrocytes be less

reactive to injury in the surrounding area (23). DHEA and testosterone alleviate

depression and fatigue. Garlic supplementation has been shown to increase

testosterone and reduce the stress hormone corticosterone that can promote free

radical production and nerve cell injury.(24) Estrogen has antioxidant

properties and protects neurons from injury. (25) Take DHEA, estrogen, and/or

testosterone only if prescribed by a physician.

 

7. Thiamine promotes energy production in the mitochondria. Doses of up to six

grams (6000 milligrams) have been used without side effects to treat

Alzheimer’s. Use high doses of thiamine only with a physician’s supervision.

 

8. Depression can compromise recovery following a stroke or traumatic brain

injury. It takes physical and emotional strength to get up each morning, get out

of bed and move whatever muscles will move. Depression actually poisons the

mitochondria in the damaged brain tissue so they cannot produce the energy to

repair the brain cells. Antidepressants are not addictive and help the person

recover from brain injuries since they stimulate the mitochondria’s energy

production. This makes more ATP than otherwise possible and helps the cells

repair themselves.

 

Nutrients and medicinal plants that can help alleviate depression include:

Protein, B complex, Vitamin B12 (methylcobalamin), S-adenosyl methionine (SAMe),

moderate sunlight, ginseng, vitamin E, vitamin C, St. John’s Wort, calcium and

magnesium, and omega 3 fatty acids. Humorous books, caring friends and family,

cartoons, and movies and taking one day at a time are also helpful. A positive

focus brings positive results far more than thinking " what’s the use? " and

giving up. Above all remember that where there is life, there is hope!

 

9. Stroke and brain injured patients are more prone to seizures. In addition to

medications, the diet can be supplemented with nutrients that may be low. Cod

liver oil, phosphatidylserine, vitamin B1, nicotinamide, B6, B12, glycine,

dimethylglycine, melatonin, choline, vitamin C, D, and E, magnesium, taurine and

zinc have been shown to reduce seizures while low blood sugar (hypoglycemia),

aspartame (an artificial sweetener), caffeine and alcohol may increase seizures.

Intestinal bacteria and yeast infections may contribute to seizures and need to

be treated to help minimize seizure tendencies. Nutritional programs for

seizures need to be under the supervision of a physician.

 

10. Ginseng (100 mg a day), ginkgo biloba (100 mg a day) and melatonin (1 mg

before bedtime) promote the growth of new neurons, improve blood flow and

protect brain tissue against free radical damage. Ginkgo biloba should not be

taken if a patient is taking blood thinners (anticoagulants).

 

11. Alpha-lipoic acid — Protects neurons against free radical injury, reduces

blood clumping and clotting, increases cerebral blood flow and protects against

free radical injury. Alpha-lipoic acid (100 mg/kg injection) significantly

reduced the area of the stroke and improved neurologic function in an animal

study by Clark and associates (26). A maintenance dose is 150 mg a day, for

stroke, 300 mg 2-3 times a day, and for diabetic neuropathy — 600 mg three times

a day. Take with sources of biotin, vitamin B1 and B12 to prevent deficiencies.

Higher doses should be taken only with a physician’s supervision.

 

12. N-acetyl-cysteine (1500 mg/day) and/or Glutamine (8-20 grams a day):

Increases the production of glutathione.

 

13. Vitamin E, (natural sources) 400 IU a day (higher doses with a physician’s

supervision). Vitamin E and Vitamin C work together to reduce free radical

damage and neurodegenerative disease. Vitamin E levels are reduced by brain

injury. Caution should be taken with those on blood thinners or who have

bleeding disorders.

 

14. Vitamin C (natural sources such as rose hips) Antioxidant, protects neurons

and required for wound healing, including wounds within the brain. 500 mg 1-4

times a day (higher doses with physician supervision). Can be taken with grape

seed extract to increase its effectiveness. (150 mg daily of grape seed).

 

15. Coenzyme Q10 — increases energy production in the cells. 150 mg a day of

coenyzme Q10 can increase mitochondrial energy expenditure in the brain by 29%.

More energy means greater neuroprotection against cell injury and greater

potential for functional recovery. Those patients on blood thinners should use

with caution. The combination of Coenzyme Q10 and creatine have been shown to

offer substantial protection to brain cells against oxygen deficiencies, toxins,

trauma and free radicals. (27) Doses of 1200mg a day have been shown to be

helpful in the treatment of Parkinson’s.

 

16. Acetyl-L-carnitine — 500 mg twice a day. Can improve energy production.

Reduce dosage if there is nausea. Those patients on seizure medication should

use Acetyl-L-carnitine only under a physician’s supervision.

 

17. Niacin/Nicotinamide — Required for energy production. When mice were

deprived of oxygen, cell energy as ATP was reduced in the brain by 50%.

Nicotinamide provided NAD (+) to the cells and ATP levels were increased despite

the oxygen deficiency.(28) Nicotinamide prevents and reverses nerve and heart

cell injury. It promotes DNA integrity and reduces inflammation, blood clumping,

and auto-immune attack. In other animal studies (29), nicotinamide helped to

maintain blood circulation in the brain after a stroke and reduced the area of

injury by 36%. Nicotinamide is becoming an important tool in treating

neurodegenerative disease. Doses larger than 100 mg a day should not be taken

without physician supervision. Caution is advised for those with liver disease.

(30)

 

18. Chromium — Increases the efficiency of insulin. 200 mcg/daily.

 

19. Inosine — promotes rewiring in the brain that helps compensate for damaged

neurons Inosine should only be used under a physician’s supervision. Pregnant

and nursing mothers and patients with hyperuricemia should not take inosine.

 

Again, the doses for nutritional supplements will depend on the person’s

deficiencies, overall health, and the severity of injury or disease.

 

Diet Summary For Brain Injury

 

20 minutes of fresh air and sunlight daily; sleep by 10ish, 30 minutes of

exercise daily, 30 minutes of mental stimulation daily; and 30 minutes of acts

of loving kindness daily!

 

6-8 glasses daily of pure water and green tea and vegetable juices (except

tomato juice) two hours before or after meals (prevents diluting digestive

enzymes). Do not combine breads with meats; or vegetables with fruits; or meats

with fruits. Eat smaller servings.

 

The following foods as free of pesticides, preservatives and heavy metals as

possible (look for organic foods).

 

80 % Per Day

 

(4 out of 5 servings)

 

Chlorophyll foods

 

Wheat grass

 

Chlorella

 

Sprouts

 

Asparagus

 

Beets

 

Beans

 

Carob

 

Cauliflower

 

Celery

 

Chard

 

Cucumber

 

Green beans

 

Kale

 

Leafy lettuce

 

Mustard greens

 

Onions

 

Parsnips

 

Prunes (bedtime)

 

Radishes

 

Spinach

 

String beans

 

Sweet potatoes

 

Watercress

 

Vegetable Juices

 

(Green and Yellow)

 

Plain Yogurt/smoothies

 

 

 

Curcumin/Curry

 

Ginger

 

Ginseng

 

Garlic

 

Fenugreek

 

Rosemary

 

Parsley/Cilantro

 

Sage

 

Thyme

 

Natural vanilla flavoring

 

 

 

Knox Gelatin

 

20% Per Day

 

(1 out of 5 servings)

 

Artichoke

 

Avocado

 

Brussel Sprouts

 

Broccoli

 

Lentils

 

Chickpeas

 

Carrots

 

Carrot Juice (no more than _ glass)

 

Blueberries with plain yogurt

 

Red Grapes with plain yogurt

 

Grape Juice

 

Couscous, Taboulee

 

Almonds and filberts (not roasted or salted)

 

Sunflower seeds

 

Sesame seeds

 

Pumpkin seeds

 

Olives

 

Fish

 

Cod

 

Haddock

 

Flounder

 

Salmon

 

Scrod

 

Tuna

 

Sea Bass

 

Bass

 

Sardines

 

Herring

 

Anchovies

 

Turkey

 

Chicken

 

Eggs

 

Wild Game

 

0% Per Day

 

 

 

Cigarettes/Cigars

 

Beer

 

Wine

 

Other Alcoholic drinks

 

Sodas

 

Red Meats

 

White Potatoes

 

Wheat

 

Rice

 

Soybeans

 

 

 

Cloves

 

Cinnamon

 

Foods with

 

Artificial colors

 

Preservatives

 

Monosodium glutamate or Vegetable Hydrolyzed Protein

 

Processed foods/cereals with increased salt or sugar

 

Aspartame (Nutrasweet)

 

Fried Foods

 

Water with heavy metals

 

(fluoride water can increase the toxicity of aluminum)

 

Cocoa

 

Chocolate

 

Coffee (caffeinated)

 

 

 

 

 

 

 

 

 

 

 

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