brain health handout slides2

8/2/2019 Brain Health Handout Slides2

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Brain Health: A

Functional ApproachMichael Montico, MD

Holland Biomedical ClinicMarch 24, 2012


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Current State of Health Care

Expensive

Ineffective

Dangerous Interdependence

Unsustainable


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What is wrong with medicine

One size fits all

Doctor centered

Drug centered Treat the symptoms not the problem

Evidence based medicine


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Treating Pneumonia

Signs/symptoms

Cough

Fever

Body Aches

Disease

Chest X-ray

Sputum culture

Antibiotics


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Redefining Medicine

New paradigm

Function vs.. Pathology

Physiologic systems vs. Diseases New measuring stick Optimal Health

Continuum

Optimal function Disease state


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Functional Medicine

Biochemical individuality

Genetic predisposition

Environmental stressors Patient centered approach

Indentify the imbalances that cause the

disease


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Functional Medicine: Imbalances

Digestion, absorption, barrier integrity

Methylation/Detoxification

Immune dysregulation/Inflammation Hormone/Neurotransmitter regulation

Psychological/Spiritual equilibrium


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Traditional Approach

Name it

Blame it

Tame it


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What is Functional Medicine

Science-based, personalized healthcareapproach that assesses and treatsunderlying causes of illness through

individually tailored therapies to restorehealth and improve function.


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Functional Approach

Get rid of what is hurting them!

Give them more of what they need!

Break the vicious cycles!


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Brain Disease

Not inevitable

Minimize cell damage

Brain aging not detiorating, constantlyadapting

Lifestyle factors affect cognitive aging


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Brain Basics

Organ

Network of neurons

Brain cells communication Synapse

Neurotransmitters

Receptors


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Methylation

Biochemical balance

Methyl groups: CH3

Methylation affects: Serotonin

Melatonin

Creatine

Gene expression

Detoxification


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SAM

SAH

Homocysteine

THF

CBS

B12BHMT

Choline

Betaine

Methylation Cycle/Oxidative Stress

TranssulfurationPathway

THF: tetrahydrofolateCystathionine

Cysteine

Glutathione

Methionine

AK

ADA

Inosine

AMP

B6

Methylation of DNA, RNA,Proteins, Catecholamines,Phospholipids, Creatine

Enzymes

MS

5-CH3THFAdenosine

GSSG


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Impaired Detoxification

Oxidative stress

Methylation/sulfation abnormalities

Environmental toxins Increased inflammation

Dysfunctional mitochondria

Brain cell damage death


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Homocysteine

High levels of homocysteine:

Methylation imbalance

Detoxification issues

Increased risk of heart disease

Mental health issues

Genetics


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Oxidative Stress

Brain is over 50% fat

Trans fats/damaged fats cause problems

Oxidative stress = fire Antioxidants:

Vitamin C

Selenium Glutathione


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Bad for the Brain

Oxidants

Smoking

Alcohol

Sugar

Stimulants

Stress

Toxins

Allergens


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Vicious Cycles

Gut inflammation

Abnormal intestinal permeability

Food sensitivitiesMalabsorption

Dysfunctionalenzymes

AbnormalMethylationbiochemistry

Increasedoxidative

stress

Environmentaltoxins

Impaireddetoxification

Increaseddamage from

toxins

TH1 to TH2shift

Increasedautoimmunityand aller

Chronic viraland fungalinfections


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Memory Problems with Aging

Age related memory decline

Digestion issues with age

Circulation changes: gut to brain Brain aging: neurons/synapses decrease

with age


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The Human Brain

Reptilian Brain

Instinctual

Survival

Regulates autonomic functions

Limbic System

Neocortex

Prefrontal cortex


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Limbic System

Brain of instinct and emotion Amygdala

Hypothalamus

Hippocampus Decoding signals

Fear

Feeding Fighting

Fornication


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Limbic System cont.

Processes info from environment

Relies on emotion/instinct

Memory storage

Damaged in brain dz

Free radicals

Oxidative stress

Hippocampus damaged Memory affected

Emotions blunted


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Neocortex

Higher-order thinking

Interprets our environment

Creates messages Functions:

Logic

Planning


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Prefrontal Cortex

Higher brain function

Reasoning

Invention

Creative thinking

When brain functions well

Develop intelligence

Creative

We thrive


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Mitochondria

Powerhouses

Cell regulation

Provide fuel to build cells: ATP Create reactive oxygen species (ROS)

Free radicals - apoptosis


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Free Radicals

Apoptosiscell death

Necessary process avoid cancer

System is flawed when mitochondriabecome impaired

Free radical >>> oxidative stress

Damaged tissue >>> aging


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Stress

Amount of resistance a material offers tobeing reshaped

Structure of a building

Psychological stress

Stress bucket

No longer resist the forces collapse!

Cant cope


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Acute Stress

Short lived

Encountered in new learning environment

Creates imprint Causes positive hormonal changes


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Chronic Stress

Long lasting

HPA axis

Hypothalamus

Pituitary

Adrenal glands

Hormones

Cortisol

Adrenaline


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Acute vs. Chronic

Acute stress: Appropriate hormone release

Ready energy

Appropriate action fight or flight Chronic stress:

Adrenal stuck on

Increased affect of free radicals Damaged mitochondria

Cell death >>> brain damage


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Stress = Brain Dysfunction

Higher brain function stops

Primitive brain takes over:

Cant learn

Avoid pain

Take risks

Adrenal fatigue exhaustion

Im in a rut wiring of neural networks

Structure of building


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Our Thermostat

Hippocampus regulates adrenal glands Healthy brain normal cortisol levels

Damaged brain triggers excessive cortisol

Hippocampal set point Determines amount of cortisol released

Trauma/stressturns down thermostat

Positive experienceturns up thermostat Genetic factors involved

Life experiences reset sensitivity


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Neuroplasticity

Brains ability to create new networks

Neuroplasticity = adaptability

Attention + focus = new neuralconnections

Stop feeding the negative circuits and

start feeding the new ones!


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Balancing our Brains

Shifting from the emotional brain:

1. Take away what harms toxins, allergens,negative emotions

2. Give what heals fix the physiology

3. Build new positive neural networks


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Neurogenesis

Ability of the brain to grow new neurons

The brains own . stem cell therapy

BDNF brain derived neurotrophic factor Protects neurons

Stimulates creation of new neurons


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Activating BDNF

Physical Exercise

Reduced calorie intake: Sugar

Obesity Fasting

Intellectual stimulation

Brain supplements Omega 3s

Curcumin (Nrf2 pathway)


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Benefits of Fasting

Reduces free radicals

Reduces inflammation

Enhances mitochondrial function Increased BDNF production

Reduces apoptosis

Activates the Nrf2 pathway


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The Brain and Nutrition

Cell communication: fats

Neurotransmitters: amino acids/proteins

Energy: carbohydrates Work

Vitamins

Minerals Energy


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Carbohydrates

Glucose is brain fuel

Carbohydrates are not created equally Complex carbohydrates

Refined carbohydrates Glycemic index

Blood glucose stability

What about fruit??? Fiber

Vitamins


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Carbohydrates cont.

No sugar substitutes

Avoid processed carbs

Eat whole grains: rice, oats, quinoa Fruits: apples, pears, berries

Stop eating sugar!


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Fats

60% of brains mass

Essential fats: thru the diet

Omega 3s: EPA/DHA

Omega 6s: GLA

Cell communication

Synapses

Myelin sheath insulates the nerve cell


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Omega 3s

Unsaturated fats

Damaged by cooking

Functions of Omega 3s Relax blood vessels

Anti-inflammatory

Balance blood sugar

Regulate neurotransmitters


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Fats cont.

Eat nuts/seeds

Eat fish

Use oil on food (after cooking) Take fish oil


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Phospholipids

Cell membranes

Myelin sheaths: insulators

Neurotransmitters

Methylation

Homocysteine

Source: Eggs

Fish


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Proteins

Amino acids: building blocks

Neurotransmitters made of amino acids

Adrenalin/dopamine feel good

GABA calming

Serotoningood mood

Acetycholine memory/communication

Essential amino acids


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Eat Protein

Grains: quinoa, brown rice

Beans

Nuts/seeds

Fish

Poultry

Eggs


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Brain Nutrients

Vitamin B 12 methylation

Folic Acid 100mcg

B6 (P5P) 50mg

B vitamins 25mg

Vitamin C 500mg

Magnesium 250-500mg

Zinc 10-20mg


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Defining HBOT

A treatment in which a patient breathesoxygen while inside a pressurizedtreatment chamber @ a pressure that is

greater than the atmospheric pressure atsea level


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O2 and Respiration

Human respiratory system: designed tosupply O2 to tissues

Oxygen travels:

Lungs

Blood

Circulation

Delivery of O2 >>> Tissues


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Oxygen and Energy

Respiratory system series ofcompartments linked by circulation

O2 transferred from gas >>> cells

In cell O2 consumed by mitochondria

Powerhouse of the cell makes energy!

Energy = work!!!


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Oxygen Transport

O2 travels from lung >>> vessel

RBC carries O2 via hemoglobin (Hgb)

Blood has large carrying capacity

Good circulation + adequate Hgb = goodoxygenation


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Oxygen Transport cont

Blood transports O2 via

Hgb

Plasma

Hgb saturated

How do we increase O2 content???


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Oxygen and Plasma

Increase O2 content via increasing O2dissolved in PLASMA!!!

Amount of O2 in plasma ~ O2 partial

pressure

Increase pressure = increased O2 in thetissues


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O2 Transport and HBOT

At atmospheric pressure oxygen transportlimited by oxygen binding capacity ofhemoglobin (hgb is already saturated)

Plasma carries oxygen to areas thatRBCs can not reach!!!


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HBOT and the Brain

Increases cerebral glucose levels

Improves neuron function

Recovers neurons injured by:

Ischemia

Hypoxia


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Oxidative Stress

Electrons passed along ETC to create nrg

Electrons leak >>> free radicals

(Reactive O2 species ROS)

Free radicals can lead to damage of:

Lipids

Proteins

Mito DNA


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Oxidative Stress cont

Occurs when ROS cant be quenched

Increased in most chronic diseases

Oxidative stress leads to mitochondrial

dysfunction

Effects of HBOT on


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Effects of HBOT onMitochondria

Increase function of normal mitochondria

Mitochondria:

Weaker apoptosis

Stronger multiply

Aging result of accumulatedmitochondrial damage from ROS


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Mechanism of HBOT in ASD

1. O2 causing angioneogenesis

2. Increased blood flow independent of newblood vessel formation

3. Decrease in inflammatory markers

4. Up-regulation of key antioxidant enzymes

5. Increasing O2 to mitochondria6. Increase production of new mitochondria


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Mechanisms of HBOT cont.

7. Improvements in immune system function

8. Decreasing bacterial load in the GIsystem

9. Decreasing yeast load in the GI system

10.Decreasing viral load in the GI system

11.Increased production of stem cells


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HBOT and ASD

Problem Autism Finding HBOT Effect

Cerebral perfusion Reduced Increased

Inflammation Increased Reduced

Immune function Reduced Increased

Oxidative stress Increased Reduced

Mitochondrial function Reduced Increased

Neurotransmitterabnormalities

Increased Reduced

Dysbiosis Increased Reduced


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Effects of HBOT in TBI

1. Reduce cerebral edema

2. Stabilized the blood brain barrier

3. Decrease intracranial pressure

4. Improve aerobic metabolism


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The Injured Brain

Injured brain needs more:

Blood flow

Oxygen

Injured brain has cerebral edema

causing:

Less blood flow

Less oxygen


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Effects of HBOT in TBI

Increase blood flow

Increase oxygenation to tissues

Increase O2 utilization efficiency s/pHBOT

Improve mitochondrial function/recovery


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Off label uses of HBOT

Traumatic brain injury

Inflammatory boweldisease

Cerebral Palsy Ischemic stroke

Myocardial infarction

Autism

Parkinsons Disease

Multiple Sclerosis

Osteoarthritis

Cancer

Lyme Disease

Dementia

CFS/Fibromyalgia

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