Perform with Dr. Andy Galpin: Nutrition to Support Brain Health & Offset Brain Injuries

Andy Galpin discusses the serious nature of traumatic brain injuries (TBIs) and their wide-ranging impacts, which can include symptoms often associated with dementia.

Differences between mild, moderate, and severe TBIs

TBIs vary in severity, with mild being the most common, and severe having the potential for lasting damage.

Mild TBIs (concussions) involve a brief loss of consciousness or amnesia, while moderate and severe TBIs involve longer periods of unconsciousness or amnesia

Mild TBIs, or concussions, are the most frequent brain injuries, accounting for over 90% of cases. They can result in a breve change in consciousness and may present with confusion and post-traumatic impact amnesia. Such cases might include a brief period of unconsciousness or memory loss of the incident, lasting a few hours to a day.

Moderate TBIs are marked by unconsciousness or amnesia that lasts between 30 minutes and up to 24 hours, while severe TBIs involve a duration stretching from 24 hours to over seven days.

Symptoms associated with different levels of TBI

Mild TBIs often involve acute symptoms like confusion, dizziness, and headaches, while moderate and severe TBIs can lead to longer-term issues like cognitive and behavioral changes

The symptoms of a mild TBI generally include acute conditions such as confusion, dizziness, nausea, vomiting, slurred speech, drowsiness, and difficulty co ...

Andy Galpin outlines the complex pathophysiology of brain injuries, explaining that understanding these mechanisms is vital for exploring how nutritional or micronutrient interventions might alleviate symptoms.

Disruption of cell homeostasis and excitotoxicity

Galpin discusses the 'accordion effect,' where brain tissue experiences intense pressure due to compression and expansion during brain injury, causing damage to brain structures.

Damage to brain tissue and blood vessels leads to imbalances in ion concentrations, excessive neurotransmitter release, and oxidative stress

Galpin explains that traumatic brain injury (TBI) results in numerous problems, including compromised excitotoxicity. A TBI can lead to ionic disturbances, where imbalances in ion concentrations disrupt the positive and negative charges within the brain. This issue is accentuated by the over-activation of neurons in the area of injury, leading to excitotoxicity due to an excess of communication between neurons. Glutamate, in particular, is a neurotransmitter that significantly contributes to excitotoxicity.

Injuries to the neurons can cause sodium and calcium ions in particular to become overly activated due to damage to the plasma membrane. This ionic imbalance advances cell death and degradation processes like the production of reactive oxygen species (ROS), linked with oxidative stress.

ROS activate cell-damaging enzymes such as proteases, lipases, nitric oxide synthases, and endonucleases. Calcium's destructive impact on mitochondrial health further diminishes cellular energy production.

As a consequence, mitochondrial dysfunction occurs due to increased membrane permeability, reducing the production of ATP. Galpin highlights the resulting negative energy balance in the brain, manifesting as brain fog, memory problems, and issues with executive decision-making.

Neuroinflammation and secondary injury

Galpin then focuses on the subsequent issues arising from a TBI, including persistent inflammation and further cell damage that can continue for extended periods, ranging from weeks to decades.

Persistent inflammation and further cell damage in the days and weeks following the initial injury

Galpin notes that damage from TBIs can result in edemas and swelli ...

Dr. Andy Galpin emphasizes the significant impact that nutrition and supplementation can have on reducing the risk of brain injuries as well as facilitating a quicker recovery from such injuries. Given his personal experience with concussions and his work with high-risk athletes, Galpin provides evidence-based options for supplementation and whole foods that can aid individuals in returning to health and minimizing symptoms of brain injuries.

Creatine

Creatine, a derivative of amino acids methionine, glycine, and arginine, is crucial for energy production in the brain. Studies reveal that a seasonal reduction in brain creatine levels is correlated with head impacts, increasing the risk for second impact syndrome injuries. Supplementing with creatine after a TBI has shown to reduce cortical damage by 35 to 50%. It may help prevent mitochondrial dysfunction, maintain membrane health, and fend off issues associated with ATP and calcium. Children with severe TBIs have benefitted from 0.4 grams per kilogram of creatine, with improvements in amnesia, ICU stays, and various cognitive and social skills. The treatment is cost-effective and devoid of reported side effects concerning the kidney, liver, or heart. For brain injuries, twenty grams of creatine per day, divided into five grams four times per day, is typical. Creatine also enhances cognition after sleep deprivation, starting from about three and a half hours up to nine hours after intake. Preventative daily dosages range from five to ten grams, with amounts increasing to 20 to 30 grams for seven days before high-risk events. Natural food sources like beef, chicken, and fish provide creatine, but supplementation may be necessary to achieve therapeutic doses.

Fish oil (DHA and EPA)

Omega-3s, particularly DHA and EPA, are critical for neurological function, prevention of neurodegeneration, and overall brain health. These fatty acids support cerebral blood flow, help with post-injury inflammation, and can improve learning and memory through their impact on the hippocampus. Daily dosages of two to four grams can aid recovery from brain injuries and are generally safe, save for some digestive issues. Prior to and after injury, relying on food sources such as salmon and mackerel can be beneficial, although supplementation could be necessary to reach therapeutic levels. An omega-3 index is an important measure of deficiency, which may worsen brain injury severity.

Vitamin B2 (riboflavin)

Vitamin B2 plays a key role in energy metabolism and antioxidant activity, reducing homocysteine levels, which can lead to cognitive decline. For post-brain injury and migraine relief, a dosage of 400 milligrams per day has shown to be effective. Achieving this through diet alone can be difficult, making supplementation a recommended approach.

Choline

Choline is essential for maintaining the blood-brain barrier, supporting neurotransmitter function, and performing cellular tasks after a TBI. It acts as a precursor to acetylcholine and aids in glutathione production. High dietary choline intake correlates with reductions in biomarkers of brain aging and dementia risks. Acetylcholine form has shown around a 20% likelihood of effectiveness for TBI treatment. Supplementation dosages range from 500 milligrams daily for prevention, to one to two grams post-injury. Choline is found in eggs, poultry, and beef ...