Perform with Dr. Andy Galpin: Nutrition to Support Brain Health & Offset Brain Injuries
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Welcome to the huberman lab podcast, where we discuss science and science space tools for everyday life. I'm ander huberman and i'm a professor of neurobiology and optimal gy at stanford school of medicine. As some of you may know, our huberman lab team recently launched a new podcast called perform with doctor andy galen.

Andy is a professor of kane's ology at costa fern and is a world expert in exercise physiology and human performance. This new podcast perform with doctor andy galpin, explained all aspects of human performance, shares the latest science, and gives practical tools on things such as how to improve cardiovascular health, how to build strength and a muscle mass, how to maxim recovery with nutrition and supplementation, and much more. What follows is the final episode of season one of perform with doctor andy galen. If you enjoy IT, I encourage you to go and subscribe to IT wherever you're listening now, and to listen to the other nine episodes of season one. I'm certainly i'll really enjoy this first season from doctor andy gilpin and now episode ten of perform with doctor andy gilpin.

the science and practice of enhancing human performance for sport, play and life. Welcome to perform for the final time in this season. Welcome back, friends. I'm doctor, any gambling. I A professor of cannel gy in the center of the sport performance, I caa fulton.

So far, in the first season of perform, we've talked about everything from muscle to the mune system to liver and lungs, tables, m genetic sleep, lood work. And so I thought we have to end this thing on what I hate giving credit too, because i'm a muscle guy, but probably deserves IT. And that's the brain.

There are obvious ly many factors that going to getting your brain perform at its best. But today, I want to focus specifically on what you can do for my nutrition perspective to reduce your risk of as well as recover faster from brain injuries, concussions and T B S. I think it's worth reminding you though that if it's good for preventing and returning faster from a brain injury, it's probably safety soon.

It's also good for brain performance as well as long term health. Now i'm particularly passionate about the subject. Having dealt a lot personally, i've had a conclusion to myself, and i've spent much of my career working with athletes prone or a high risk of developing similar injuries.

This is includes football players, wrestlers, fighters, boxers and soft. That said, those are not the only people at risk of a brain entries. In fact, those things are quite common.

And not only in so i'm really excited about this topic because brain injuries are really common. They can be completely debilitating. And there's actually a lot of evidence that nutrition and supplementation can have a big effect.

And again, both reducing your risk of getting one as well as coming back faster once you've happened. And so I really want to make sure everyone knows what their options are from a supplementary as well as whole food perspective on getting back in, returning as fast possible and minimizing symptoms of brain injuries. Now I was saying traumatic brain injuries, or what were referred to S T, B S, are really common.

In fact, a lot of people in the field referred to them as the invisible disease because they don't come with a physical appearance. There is no cut, there's no Bruce or joint sticking the wrong way, bone poking out of the skin. And so these things can happen.

And you don't necessarily know that an injury occurred. Other problems include the fact that the symptoms that associated with A T V I or concussion are really similar to those generally associated with aging. So you talk about memory recall issues, mood, sleep and other things that people do not necessarily know are because of an injury they may think is just due to Normal aging.

In fact, we're going into this a lot as the episode progresses. But a lot of the research on rain in health with aging, alzheimer's dimension, other related topics come from the same data sets that we work on for T, B, S. And concussions and the inverse.

So there's a huge overlapped and diagram between the types of research, the study design, the actual papers themselves, the interventions, the models, whether we're talking about data from humans or animals and rats and fairs and things like that. There is a large overlap between these two bases. They're different.

Of course, I will try to highlight those, but these are some of the reasons why I want to get in today's episode, even if you're not an athlete, because many of you still at risk of getting A T V. I. In fact, the vast majority of concussions and tb I S do not come from sports.

They come from accidental slips and falls and other problems like that. In addition, they are still gona tell us a lot of indirect information about overall healthy brain aging. So the goal here will be to reduce our risk, of course, but if IT does occur, to minimize the symptoms and return back to a healthy brain as fast as possible.

Now before we go too much further, i'd like to take a quick brick and think our sponsors, because they make this show possible, not only are they on this list, because they offer great products and services, but because I actually personally love them and use them myself. Today's episode has brought you by element. Element is an elected like drink mix, that as an I O ratio of sodium, potassium and manius um but I was no sugar electoral zed are critical to proper migration, which i've been harding on for years.

But you can do that by only drinking water. In fact, many of you will probably remember that I featured element in my youtube series on optimizing hydration all way back in two thousand and twenty y, which is obviously long before this podcast even existed. So I gonna find an element for a long time.

In fact, a stute listeners will also realize these hydration videos with the genesis of the gale pon hydration equation named not by me about the legends neuroscientist doctor Andrew huberman. I featured element in these videos because they're blend of a thousand milligrams sodium, two hundred milgram potato um and sixty milligrams magnesium. Really is different than any other electorate on the market and has great scientific support.

I personally use the interest and automobile flavors a ton prehension before heading out on a full day of training or long hike hunt. Since I know you'll be losing a bunch fluid and won't have many opportunities to take things with me. Element has also just released a new line of can Sparkling element, which I am all about.

If you like to try element, you can go to drink L M N T dot com such perform to claim a free element sample pack with the purchase of any element drink mix. Again, that drink L M N T dot com flash perform to claim a free sample back. Today's episode is also brought you by continuum.

Continuum is a membership only wellness club designed to help high performers reach their finance performance goals continue just open its flagship club and manhattan quickly, making IT one of the most sought after memberships in the city. Its location and granted village is incredible. Fact is stunning. It's a twenty five thousand square for space with state of the art equipment, a beautiful design and everything you could possible want in this unique mix of a gym, welcome center and social club.

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To learn more, visit continuum dot club slash perform again, that's continuing with to use dot club slash perform. And before we get started on the details, I want to highlight gha couple of things. First, remember, I have A P.

H. D. I am a scientist. I have published in this area. In fact, I have recently submitted a literary review as a co author. I'll talk about that later, but i'm not a medical doctor.

If you think you have any risk of, or potentially have had or suffering consequences from any type of brain later injury, please see a medical professional in this area. I want to focus this episode on nutrition and supplementation related brain injury. But I also don't want anyone to think that I am suggesting this is all you should do for your brain injury.

I also don't want anyone to think that i'm suggesting this is enough to stop your chances of ever having a brain injure. So that being said, the landscape of the research and many the scientists area are on the same page in the fact that there is emerging evidence that several micrometers tries, and we will call biological compounds, really do have the ability to reduce the risk, hesitate to say, prevent, but can help prevent and treat brain injuries, concussions, T, B, S. And related events.

Now, over the course of today show, i'm going to walk you through a bunch of different macneil dream and new tacos al options. You will cover the evidence, how much to take the protocols, and soon as soft. But before we do that, you have to actually understand a little bit the terminology, because depending on what type of brain anger you have, you may want to take a different route with your nutrition.

So getting going with that point, what is a brain injury? You've heard me now say concussion, T, B, I, brain health and a bunch of different terms like that. What is actually the difference? In fact, do you even know the difference between A, T, B, I and a concussion? It's been my experience that most people don't.

And so what maybe to start right there now. So a brain injury can mean a lot of different things. Honest answer here.

There's not that much research in humans and random zed control trials on what to do to prevent or reduce synergy. In fact, if you think about research design, that's really hard to do. The only way to execute these kinds of studies in humans is to set up.

But enrolment center, said a hospital, probably around the area that has a lot of kids playing in sports, wait for people to show up with an injury, ask him if you're gonna them and study and go from that. We can go out and give humans head injuries and concussions. And so it's really chAllenging.

It's hard to get an adequate samples. Ze, and you are also relying upon those people coming into the study having the same type of brain injury, and we know that, that does not happen. And so brain injuries himself, there's a lot to learn and there's lots of different types that would be foolished to think.

That we know how to prevent all of them or recover from all of them. Some types of injuries we know more about, other types we know way less. And so there's not one type, which means there's not one solution.

And this is going to explain why almost always you'll see mixed results. Easy example here when I talk about one of major problems that associated with brain injuries is sleep. So supplements that help us sleep, therefore, are going to be helpful for folks who are experiencing sleep related problems with the brain injury.

However, we have a brain injury and were not suffered symptoms of sleep loss, then sleep aid mayor may not actually work. If both those individuals that say we are two people, one having issues with sleep, both enrolled in the same study, you're going to see the magnet, the effect of the supplement or the trial factor gets a little bit washed out. So those are common things you will see.

I won't bring this up again because honestly, I could do that with just about every single study. But as something for you really consider in the back of your mind right now, the goal then is to present to information that I think has a strength of evidence. I'll explain to what my criteria for strong evidence is a little bit later, and things that I think kind of justify what will call law risk and high potential reward.

I will typically break those down in the things you can do before the injury, during or immediately after the injury, as well as long term post recovery. So you can think about that as prey prior post or simply preventative, and then treatments post injury. So in terms of terminology, i'm going to try to be consistent with three basic phrases.

So I brain injuries often broken up in the three categories based on the severity. There's mild is the lowest, moderate and severe. Now fortunately, mild is by far the most common fact.

Some papers, when the kate, that over ninety plus percent a brain injuries are qualified as mild. What that means typically is there is a thirty minute or less change in state of consciousness, right? So if you were unconscious for a couple of minutes, you probably had a mild traumatic brain injury.

This is often associated with things like confusion or post traumatic impact amnesia. So you forgot what happened immediately afterwards, or a little bit of time travel, as I like to call IT. And this can occur for a couple of hours or even up to one day, is the general line that we cross there.

The overwhelming majority of recreational and sport related concussion ons fall this category. Therefore, almost always, though not always, but almost always, when you hear the word concussion, you can generally translate that into a mild T, B, I. Now, not all T, B, I, S are concussions, but all concussions are T, V S.

okay? So one more time in case I lost there, concussion is effectively a mild traumatic brain injury based on those category. If you had worse effects, so your unconscious for longer, or your amnesia will last longer, then you may be actually be considered to be a moderate category.

So moderate technically is to find as a loss of conscious ness or amnesia for somewhere between thirty minutes after twenty four hours. Symptoms associated with this are more severe. IT is headaches, confusion, dizen.

Ss, uh, notion of omits large speech douzen. Ss, difficulty concentrated so on and so for and so kind of back the envelope way to different ship between mild and moderate is mild and not always, but rough guidelines here. Mild is fairly acute, so in in immediately after the injury at symptoms, but then you're usually back to Normal.

Moderate often comes with downstream problems, not the injury themselves. So this is when you have behavioral changes because of the tvi you've got and difficulty with memory that last a long time. That's again back at the on globe kind of distinction.

If IT is worse than that, we call IT severe. That is technically a loss of consciousness or amnesia for someone between twenty four hours to update or more than seven days. And modern and severe also have similar dementia like symptoms.

Now I mentioned this earlier, but think about this severe T B S. Often times come with memory and attention problems, decision making problems, learning impairments, mood big, sleep services. And so you can imagine somebody who's in their fifty sixties or seventies who start experiencing things like that.

They may personally just think all this is, i'm getting old. Family members may think all now starting to show dimension science could be possible, can also be possible, that grama simply suffering from A, A severe tb. I, and so this is what I was referring earlier, when I said there is actually a big crossed over here.

It's a bit of a great area. They can actually be the same thing. They can clearly be different as well, but there is a large crossover between them. So hopefully, that helps you understand a little bit about what the difference in a concussion and tb I is, what a mild, moderate and severe traumatic brain injury are. And I started sneaking in some of the physiology at least.

What's the symptoms? What are the behavioral and actual consequences that is important to understand? Because now we'll tell us what we do in terms of a treatment or prevention strategy in order to finally connect that dot, though, we gotto walk through just a touch, and I promise this will be just a touch of the physiology or patrole physio gy of each one of these categories.

So we understand what we're trying to do with the or the micex trient, why they solve those problems and then ultimately, how that translates into reduction or elimination of these symptoms. So what's actually happening in the brain when we experience any of these three levels of a brain injury? There's a couple of resources I want to give you if you want to learn more about this right now.

I based a lot of episode heavily of these papers, so I want to give them their due credit. They will, of course, be linked and P, D, F will be available in the shown notes. You can find those that perform podcast 点 com， but for those who wants to write IT down right now, a paper that I found particularly helpful came out just last year, in two thousand twenty three, that has hired the optimization of nutrition after brain injury, mechanistic and therapeutic considerations.

In addition to that, my friend and colleague, dan garner, has a product available for purchase on amazon called the brain synergy protocol. Talk about a bit later. And then finally, honesty took the vast majority this episode of a paper that echo auth that's depending on when you're listen with either interview or potentially publish by now called mitigating traumatic brain injury, a narrative review of submitted and dietary protocols.

This was LED by Tommy wood, the fantastic neuroscientist at the university, washington, and was first authored by federico account, another tremendous neuroscientist in her own right. So they did the book of the work here, we contribute on newspaper together. And I thought I was honestly so perfect for a show that I thought i'm just gona take this entire thing and make a whole episode out of IT.

But nonetheless, let's get into the paper right now. So what's actually happening in your brain when you experience jury? Typically, we've been told that when you have some sort of injury, you have to go through this whip lash experience.

So you have to say, a sudden, stop your brain inside. Your school continues to travel, then smashes up against your score, and then therefore has A A brews on the brain. Well, that certainly can happen. That's actually probably pretty unlikely.

Generally, what's gona happen if that occurred, as you would see the injury site being on the outside, right? So you can imagine to say the front of your brain smashes in the front of your school, you would expect the injury to be right on the front, on the outside party. Your brain reality, that is, that's not where most concussions and T B S.

occur. IT generally happens more towards the the middle of the brain. Remember, the outside of the brain is where your gray matter is that mostly where your neurons are.

On the inside is the White matter that's made of mostly fat. And IT helps you conduct messages more quickly throughout the brain. See what typically happens in brain injuries.

If you get more of what I call the accordion effect. And so you have so much fluid in your brain that if you were to slashed around a little bit, there's not much room to slash. And so IT protects your brain from hitting the school.

But what can happen, though, is an intense pressure inside the tissue, because IT squeeze together and then get expanded back out. Picture, the accordion here may take my two hands, putting them close to together, smashing IT, pulling up back apart. And so you have this kind of egg looking oval of that, that I suppose you are a brain, and they get smashed down into a vertical piece of paper and an extended way back out and stretched and so on and so forth.

So is not the actual connection or contact to the school. That is always the issue. Sometimes it's that stretching and pulling in that pressure wave that caused the damage on the interior or various portions of the brain.

And so the injuries are highly varied. And the brain that can be everything from a cabuli or blood d flow supply that is damaged or torn, the acts on themselves, can be torn. This then causes a host of issues that will get into step by step but it's everything from temperature problems, energy problems, um metabolism problems, implementation and physical structural damage.

So many different options are going to occur but that's basically what happens for most but not all. This is obviously a complicated area. I don't mean to oversimplify IT depending on if you had a single event, say, a car crash or a single slip and fall or numerous sub concussive events.

Think of blast injuries in focus in the military. I'm small impacts with combat athletes or other people in professions that kind of banger had a little bit don't hear necessary, get huge symptoms. But I have a lot of these stack over time, all of the results in different problems.

I'm just trying to highlight a small example of of what I can look like as a quick overview. That being said, there are some generalities and commonalities between different forms of tbs, and i'll discover them broadly right now. The top of our list here is what's called comprised exit toxicity.

Explain what that means later, but this is arguably one of the bigger problems you will experience. There are ironic disturbances. You're positive and negative charges get all messed up. There are blood flow to the brain that's called survival blood flow, a demas and swellings oxide stress infection.

And then, as I mention before, even damaged or even death in the cells that are directly in the brain, or related to the brain, that can actually be going on acute for weeks or even months to decades throughout life. So I can go over. All of this would take me the entire show, if not many.

But I do want to cover a couple of very specific examples so you can start to grass what this could look like. The first one is just if you've had capitals, first, remember, you have capitals that surround all tissue in your body. And that's where all of your blood exchange is happen.

So you have this network in this bed of capitals that surround your brain. When those burst, you can't get nutrient and fuel in and you can't get waste products out. And so in the most fomenting problem here is you don't get auction to the brain.

So we lose river blood flow. We lose energy production because we're not getting you on the brain because we physically torn capillaries. This, if this was on your ARM, like IT is on mine right now, you might have a purple and black ARM.

Thank you camping. But in your brain you wouldn't see that goes right back to the invisible disease problem for earlier. More detailed example would be the following, that often times will break up.

T, B, S. And what we call the initial response, and then they delayed or face to response. So let's say you had some sort of direct hit, can pick your example.

You might look something like this. Your initial response would be an over activation of the neurons. That's right.

The nerves are associated with the injury area, become overly activated. Now this initial responses caused in large part by was called over activation of neighboring neurons. So you remember all the nerves connected one to one, one that are actually physically connected. There's a small space in between them, and they communicate by releasing what's called neural transmitters.

So what happens in this area is you have a damage to won IT over communicates the next one, and you get way too much neuron activity that's called over exciting or exciting toxic because you're excited so much that IT comes to the level of toxic and excited mean the neurons is being too active. Now this happens in large part because molecule can glutamate. You'll see this all over the T, P, T, I.

Literature sub marketing. Very common, we talked about because IT is very real and very important. It's the main neural transmitter that's responsible for this excitable activity.

okay. Now this gets released in response to that. We have a whole downstream casca of problems.

And this starts office, an initial response. And that i'll show you how this turns into that, the laid phase response later. So we have this over exit.

Now if you go back to our episode on muscle, you learn more about how nerves themselves contract, why sodium and calcium and paci um and lorde responsible for action potentials so on and so forth. For now, sodium and county um very specifically become overly activated. In fact, you literally often times have damage to the plasma membrane.

So the little thing that surrounds your cells gets damaged, gets broken. And so because of that, the things that are supposed to be in the cell and things that are not supposed to come in the cell start leaking everywhere. So sodium and calcium start coming in and out of the cell and inappropriate manners.

Now this causes things that eventually going to be self death and degradation. Because the production of what called ross ross is R O S A reactive occasion en species. So remember, auction is very reactive.

IT is good and bad. You have to have auction for fuel, allow you to create fuel, rather the byproduct needed to make a obie metabolite. At the same time, excessive amounts of IT are going to be damaging.

This is how we break down tissue. This is how we create and clean out dead and the breed cells. And so if were generating way too much to this reactive auction species, this is almost anonymous every time with oxide stress.

These, these kind of similar term, not the exact same thing, but pretty close. This also activate several enzymes that damage the cell structure of these, everything from what will call proteasome n asis in n time that breaks down a protein to light places. These are analyzes that breakdown fats, uh, matric oxides, synthesis and and and o nucleus and other like that.

A whole casi start breaking the thing down. You don't know exactly what's happening here, but the cell things that there is problems because there are. And so I just starts activating cell death.

So we're having issues with that. okay? In addition of that, that calcium specificity becomes a problem because IT alone harms metal onal health and efficiency.

And so the cells that do stay alive started getting really damaged medal contrat. Uh, this is again because of a membrane damage issue that allows too much premiership of things are now. And that, of course, eliminates or drastic reduces my economies ability to work, which means your ability to make ATP.

Remember, ATP is the solution. Currency is the only way any living cell can create energy. And so minor country is not the only way we can make A T.

P. Hold on to that. We're going to come back to that. But IT is a primary way, and this is the exclusive way in which we generate a robust metabolite.

The way that we create fuel with oxygen has to go for minor conry. So damage or interference, the minor conry is going to directly lead to reduce atp production. Reduced atp production simply means we have way more solar energy.

Our brain, this idea of brain fog or fatigue can remember things, recall, execute sion. If you don't have energy, your brain can't think that's quite litter. What's happening? This is why some of the supplements and Michael u.

Trians were going to talk about later have such positive effect is they help you restore what's called that energy baLance. The damage occurred, you are able to get transportation of auction and things in this allowed premiership of costume. This allowed too much exit, which means we're burning too much energy.

At the same time, we don't create enough energy, and we end up being in this really catabolic or negative energy state. And now we can't think well, are dealing with science and symptoms. And overall, more importantly, our brain is actually physically unhealthy.

And so because your brain is measuring energy production at all times, IT knows this imbaLance is occurring. It's gonna try to alleviate IT. And the best way to do that is to ramp up energy production.

But since I can't do IT, a robotically IT has to turn to anoroc c methods and specific. What we're talking about here is an erotic gay colosse. One more time we go back to our previous episode, I believe that was episode two on muscle.

And we talk about the physiology and by water jets of how we use carbon hydrate for fuel. It's the same. More in the brain here are not in muscle, but aneroid c lycos sis is still aneroid like closes is still a breakdown of carbon hydrate for the production of atp. So in this particular case, since the ability to store glucose in the brain is quite limited in the amount t that we can get into the brain, to the blood brain, berrier is also somewhat limited.

If we're only are mostly relying upon anthropic like collapses, you can quickly see or not going to be able to handle all the supply, because only does the brain takes enormous amount of energy, is, in fact, depending on the situation, our most energy cost the organ in the body and now was injured. And IT has more energy demands to recover, and that has less energy production. We're gonna be really running in the problems with our energy deficit.

So to summarize all that effectively, what's happening here is you've got this disrupted sell homeostasis. This leads to all kinds of problems like cell death or a potos A D, A fragmentation in the process, title scale degradation and a whole host of other things that are short and long term. And that's just the face one part that the initial response from there.

And once we've dealt with that, we now have to handle step two or the delayed or second phase, which is generally associated with neural information and prolonged Operative stress. So we're talking about here is this pervasive and film meta cascade that is in combination with our medical changes, specifically to the blood brain barrier. Now remember that the thing that keeps things add your brain and in your body in canto keeps the separation there.

If we've got a brain injury, weve potentially have damage to that membrane as well. And so we've got excessive information happening, not even talking about the acu response now we staying there and persisting for days, weeks, months or potentially even longer. This causes uh, migration of what's poor mune sales and the brain and released as a whole storm of cytokines.

These are communication tools that come out of your body from one organ to the next, not necessary good or bad, but in this case is so large and it's so extreme that IT continues to exacerbate. This implies mental problem. Uh this also causes activation of things that are called residual neural cells um there's a whole host of these things like extra sites, compliment proteins and swan um these things release reactive oxy of species.

They released that glutamate again and they released so sit kinds and so you can see how this circle just sort of perpetuate itself. It's not always a bad response. But in this particular case, and there's been so much structural damage one more time, the cycle just continues, this is going to a really harm the brains healing.

It's onna facilitate formation of water called membrane attack complexes. You could just hear from that term. That's probably not a good thing, again, where we're trying to clean out the damage, but it's going to come with a lot of problems.

Um this is gonna create like very specifically pores in the membranes of the the target cells, which means those you're gona often die. Now on the case of like a skeletal muscle from exercise, this is okay. It's pretty easy repair.

But when it's happening, your brain, it's a problem, right? So overall, we've got that oxy of stress, a response, and that's gonna start damaging fat protein and D N A. Remember, big portion of your brain made a fat.

So when we're typically not concerned about oxidative stress harming all the fat in ARM rest of our body, that represents serious damage to our brain and one that potentially is is not reversible. Now, I know I got pretty technical there, so I lost any of you to worry about IT. Just think about IT this way.

At the highest level, T, B, I is going to involve some likelihood of a physical injury or damage. This could be your capital ies, or any of your vessels, your blood brain barrier, your members of your cells, your astro sites, your neurons are actually physically torn. If you were a house, this would mean your windows are smashed, your doors broken, that you got a hold on the wall is not a functionality issue, as IT is an actual structure is broken and has to be repared.

Now in addition to that, we're going to be dealing with the secondary problem, which is now because we don't have the physical structure to get in nutrient and get waste out, we can make energy. So probably number two. Is a massive energy deficit.

Your brain is going to try to get around IT. It's going to start wrapping up our less effective methods of producing energy, but it's never going to catch up. And so physical damage number one, energy deficit number two, number three in response.

That number one in two is this prolonged in filamentation response. And so we're sending in molecules that let the inflation tion continue and they exacerbated and they start breaking down and killing and getting rid of actual tissue. So the ones that maybe were not injured initially will be injured or removed entirely in the week's to months because of this inflaming response.

So effectively, those are three big problems, which means now we can talk about what nutrition options we have to solve or mitigate, or at least a tanguay slightly reduce, some of those issues. I'd like to take a quick break and think our sponsors, today's episode brought you by moments momentous, make supplements are the absolute highest quality. For example, we've long known about the numerous health and performance benefits of fish.

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Again, that's mali eei I venoco dot com slash perform for twenty percent off. Let's jump right into IT with our very first neutral compound and that's creating model hydrate. You're probably sick of hearing me talk about IT because i've been doing IT for so many years, but it's for good reason there's so much data on IT.

IT is by far the most widely studies support supplement. And I studied and close. It's been studied in every population, healthy disease, Young, old band, women, kids, so on so forth.

And there is really very limited side effects, if any, that have been reported now. Creating itself is a naturally occurring derivation ative of three very specific and minae ds mEthane licence and argenton. These are really, really common a creating self.

I typically have talked about how it's stored in muscle and used as a great fuel source, but many people don't realize is actually also stored in your liver tests and brain. The last one, of course, is what we're going to pay our attention to today now is stored in the brain so that I can be used as a very quick fuel source. Your gear should be turning at this point.

Remember, one of the primary issues would have with the T. V. I. Is that energy demand problem. And so I made a tony sence to scientists very early on to say, okay, we know the way of energy issues. We know that the fastest way any of our tissues can make energies through the mystery.

And we always install in the brain ready IT makes sense to try that to both prevent, reduce the risk of, and then treat brain juries. So no surprise when we look at the researcher on both T, B, I as well as aging and Normal brain health research define that creating mono hydroid often improves cognitive unction in both brain injury and Normal healthy aging folks. Now it's not the world's most powerful new tropic, but IT is effective and when shown again in many models and many studies across many laboratories.

So because it's so effective at giving energy, especially low auction situations, you see evidence across injury and tb I papers, but also just Normal cognitive function and healthy individuals out to see benefit, right? So creatine is effective in all those populations. And the physiology about chemistry make total sense.

Now, specifically regarding T, B, S. And concussions, one of things you want to pay attention to a lot, as was called the second impact syndrome, many people have not heard this, but this is the basic idea of repeated head blows caused more damage as timbers on. And so one of things has been shown with creating is IT is really effective for that second impact syndrome.

More specifically, tes been shown that the repeated head blows cause more damage if the creating is depleted prior to the additional impacts OK. So imagine you had an one single impact. The more creating depletion, you have the worst damage you get if you have a secondary impact.

This is any athlete that's going to be inspiring our competitions. We were getting a lot of impact, theses military special forces, or anything like that, that is going to getting low impact, repeated exposure or blast. The more creative deep that happens, the worst the damage in your brain that occurs after the second or repeated impact.

So right there we can see that if you've hand injury, making sure your creaking stores are replenished as quick as possible as really important if we're going to continue in that exposure and how that's important because many people don't recognize, realize the first injury happened to begin with, most were unreported. Most don't realize IT harder diagnose. And so profile active ally IT, maybe makes some sense to make sure that you're taking here of business not necessarily just when you have an injury, but if you even think you're at risk or in high risk situations or prior to high risk exposure or or competitions, right?

Good example is there's a pretty famous study. I think he was a high school football players, high school or college. But unless football players, american foobar, that is, that didn't indicate the creating stores in their brain, like specifically in the motor and prefrontal cortex, reduced over the course of the season.

Now this is not a perfect study design, but you can see what this is alluding to. If you're in a situation, again with repeated him head impacts over the course of the season. The number of impacts, of fact, maybe all back up quickly in this particular study.

What they did, they film the games. And so what they they measured is for each individual player how many head contacts they had. But there was an association between those players that had more heading acts, not even necessary injuries, and the level of creating reduction in the brain of the course, the season.

So again, we're making some assumptions here, but I think it's fair fully say it's plausible. The more impacts on your brain, the more creating is reduced. Potentially the higher rescue are for second impacts and drome injuries.

Now before we go to be further with the creatine research, I need to do a quick poin explain to what I mean, what I say, strong evidence or weak evidence, there is no perfect way to do that. But an easy way to roughly understand is called the strength of evidence scale. So I will aggravate that.

And the rest of the is is episode by just calling IT the S O E. The strength of evidence. This takes into account research design, the quality of the relevant studies, the applicability to patient care and a number of other factors.

It's up to you ultimately to assign what is an actual level of evidence or not. Some people that there may be suffering from a brain injure considered a study in animals to be enough, and others want to see a analyzed control trial in humans. That's not for me to size that up to you, but I do want to share with you where the level of evidence is, and you can make your choice from there.

So the S O E is on a scale of one to five. A score of one is the best. That is the highest score possible.

This means we see consistent results across multiple studies. We've seen IT in both randomized control trials as well as systematic reviews and so on and so forth. A score of, say, four or five would be the opposite.

That would be our lowest score. Maybe there is evidence there, but it's from case studies or case control studies, maybe mechanism only, or some other model that's close. Maybe research from aging or dementia, not the same as rain injury, but shares some mechanisms.

You get the idea here. So for example, the S O E for creating on a hydrate is a too, my opinion. Personally, that's pretty good summarizing the collective evidence here.

There's been a lot of research on everything from kids to rugby players to mount bikers. And collectively you gna see its supports, cognitive health. It's been shown actually in psychiatric disorders.

There is I believe, two renomme zed control trials that i'm aware that I found five grams of creating per day um added in addition to entire present treatments, improve depressive symptoms might so take that for what you will and good regarding tb eyes and brain injuries, there is an argument we can make here for preventive use specifically for neural damage and injury. There has been shown to reduce critical damage following A T B I by anywhere between thirty five fifty percent. I'll be five zero pretty substantial amount.

There should catch your attention. They don't know exactly how IT works, but I thought to prevent some of that might conduct this function I was talking about a few minutes ago. I helps maintain the membrane health, certainly has a role in fending off that downstream reactive auction species, atp, calcium.

So a lot of those things we just got done covering, that's why we cover creatine, probably has a role. Again, we need more information here, but likely has a role in in neither eliminating or at least drastically reducing some of those issues. And finally, then what you care more about is the downstream T, B, I.

Effects have also been documented. What I mean here is sleep, cognition and actual mood seemed to be enhanced with the creating. Furthermore, there's actually some studies and specifically been done on kids.

There's one i'm thinking of in detail here that was everything from one eighteen year old that had severe tb s. In this particular paper that gave them zero point four grams per kilogram of body weight. If you do the math there, that ends up being up a pretty standard dose, but appropriate.

He was done based on body size. You have two year old and eighteen year olds. We can give them all just five grams.

So a relative, those who is given to them within four hours post injury and done so for six months. In that particular study, they found improvements in everything from amnesia to the length of stay in the I. C.

U. Improvements in communication, locomotion and social skills. And more importantly, what I one of things I loved most about this was that the researchers were clear in the fact that the treatment provided cost significantly less than the standard treatment protocol.

And this is something I felt was really important because I know supplements are not cheap and many of you can't afford any cost. What soever, but if you can, while creating, and I know I know I hear this all the time, has gotten more expensive in recent years, is still likely far cheaper than a standard hospital protocol. So if you can possible afford IT seems to be a pretty good option.

Now I think I want to point out here because that comes up all the time as well. In this study, I can remember kids six months of greeting. There were no signs of any kidney, liver or heart side effects. So overall, we would dem creating as a pretty strong chance of success in both the physiology as well as actual symptoms with a very low likelihood of injury or adverse effects.

For me personally, I wouldn't hesitate to get this to one of my kids if they have IT is entirely to you to make your choice and not advocating you do anything you don't want to do or uncomfortable with studying. You know, for me, when I look at the research as a parent myself of two Young kids, I would not hesitate at all to use this in my children. So how do you actually use creating? Well, you have a couple of options.

One, you can try to get this from whole foods, and i'll present you exactly what that would mean in amounts. Or you can use the supplementation around. I guess a third option would be to use a combination of boat.

So most of the data on creatine mono hydrate four brain injuries, they're typically using dosages of about twenty grams per day. Now that's four times the typical dose you'll see for performance benefits. So this is one of our major things we have to pay attention.

This is not a dosage that sister standard five grams, five grams, five grams IT is much higher for the the brain health benefits. Now often times, that's a little bit chAllenging. And so you'll see typical protocols instead of taking twenty grams at once, are things like five rams administered four times per day, right, so that the benefits are typically thought of as both acute and chronic.

I know I have said many, many, many years now that a creatine is not a cute thing. It's not caine. You don't take creating right now and feel this big stimulation effects.

IT takes weeks or months to build up. However, one paper that came out recently got a shook everyones world twenty four paper can just want paper here. So temper a little bit.

I'm tempering my own expectations, but a recent paper suggested that a very high dose, I think he was point three, five grams per kilogram of body way was enough to attend ua. The drop and cognitive performance after sleep deprivation. So you take people through sap the next day, you give this giant bulls of creating.

And those that took to cretins had less of a cognitive drop from the safe deprivation. Actually think the benefits started at about three and half hours and last after nine hours. So potentially say something bad happened and you didn't get a great night asleep.

You could take this, maybe twenty gramme those in the morning and by noon or so, or for us the day, you might have some improvements and targeted function. That's the first paper I ve ever seen that i'm aware of to show an a cute, effective of creating. But since that was so dramatic, I want to make sure I drew your attention.

So to me, you have an option there for brain health. And now if we consider this in context of the episode today, even getting this great team and immediately potentially has a brain impact. And that's why I wanted bring that study up.

As IT relates to the current topic, other studies have found that that twenty grams per day for seven days enhances cognitive unction. This is specific the mountain biker study are referring to. And so generally me personally, this is not the studies. This is me personally, based on the work that i've read, I think five to ten grams per day is probably plenty for most people as a propac's. So kind of an ongoing option to be at that number.

That said, and again, candidly, this is what I do for my seven days, is so prior to a high risk situation, a competition, something like that at a race or event, we're going to up that those to twenty to thirty grams for that seven days, right? Again, one more time when I do that IT is hard to choke down twenty grams at once. It's handful of scopes.

And so we will often try to get five, ten grams in the morning, five to ten, gramps and night, and split up the those throughout the day, simply for my practical perspective. Now, one of my favorite saying is there are no free passes in physiology, which is not perfect, is not a panache, and there are some potential risks. The biggest one is G I distress.

Some people have a gas or bloating or stomach crimes at even five grams a day, so taking them to twenty or thirty may cause some serious issues. It's not that frequently reported. I've never experienced IT.

I can't think of a situation where I ve never had an athlete client reported, but IT is a real thing that is preyed common but IT is reported. And so you will want to pay to that. Outside of that, there isn't really any documented problems associated even with high dosages, twenty pass grams a day.

For years there have been studies in kids, elderly, various will call risky or unhealthy populations for many, many years. You can start look across basic, all those studies. You just won't find really any other adverse events outside of the possible smile or moderate G I distress.

Now if the supplement does give U G I distress or you can't afford IT, don't have access to IT or for any other reason, just don't like supplements. You can theoretically get here with food. But IT is admittedly the very chAllenging, especially for those vegans and vegetarians, because the primary source of creating from food comes from muscle or meat.

The most common places of creating and meat are gonna things like beef, chicken, samantar, a cod. And they mostly have somewhere between four hundred to six hundred milligrams of creating per one hundred grams of meat. Now I know in amErica you're thinking what the hell hundred grams? The rest world knows exactly that means, but a hundred grams is about three and a half pounces.

okay? A typical serving size at a restaurant is seven answers or so. And so you can cut a double IT. Other words, beef specifically has six hundred milligrams of creating per hundred grams, but a typical serving is two other grams. See the beginning, twelve hundred milligrams to 2 hundred milligrams is also one point to grams。

Kay, now, the average american at least eats about three hundred and fifty grams or twelve vanes of me per day. So if you did some basic math there, which would mean you're out about two thousand milgram or two grams, a great team per day. So while IT is possible theoretically to get out your creating from food, it's honestly quite chAllenging.

So supplementation just might be the Better option. In this case, i'd like to take a quick break and thank our sponsors. Today's episode has brought to you by ag one. Ag one is a foundational nutrition Greens supplement. That means A G one provides a variety of vital minerals, promote s probos s and adaptations in an easy to drink Greens power.

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And it's been a big help pushing summer mi clients just in the right direction for eating more high quality foods because that helps them with cravings, digestion and many other benefits. Now not everyone needs to consume Greens powers, but if you're going to do so, you Better make sure that actually includes the ingredients that IT claims to and that those ingredients are of the best sourcing. If you like to try A G one, you can go to drink A G one dot com slice, perform to receive five free travel packs was a year supply of vitamin d three plus gatto again, that's drink A G one dom, like, perform to receive five free travel packs post a year supply of vitamin three plus k two.

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Again, that David protein dot com flash perform to purchase if possible or be notified when they are available. Our next topic is fish oil. More specifically, what I mean here is D H A and E P A.

D H A is accumulated. The brain, in fact, is about ten percent of your brain or so. So makes a lot of sense of distance. Be pretty important.

It's critical for everything from, uh, no logical function to injury risk, meta lic rate, prevention of neural generation, ageing and brain health and alzheimer mention so on and so forth. Incredibly important to actual structure. E P A is a little bit different.

It's mainly involved invest function information, auction and delivery, uh, nutrient delivery to the brain and so on. So for right, so these are typically tied together. So i'm not gonna differentiate them as most or make a three is come with both E P A N D H A.

Now when I said earlier, the created is by far the most study support supplement because IT is OMG. A series are by far the most studied. Regarding traumatic brain injury.

There are dozens and dozens of studies, systematic reviews, analyzed control trials on omega trees and brain related injuries and various head traumas. However, you might be surprised to know, i'm not aware of any direct evidence of mega s and T, B S. So this is a great example of me sing, hey, look, there's still a lot of good trial or indirect evidence so much.

I feel like it's overwhelming, but not necessarily that much directly on T V S for the reasons we described earlier. They are just heart studies Carry out in general what you're gonna is Frankly, they work. They work for both free and post impacts.

The S O E is technically three here, and you generally see main effects and benefits from liberal profusion. So this is getting that blood and oxygen and uh flow of nutrient and outs of the brain over the primary cause of injure there is that structural, that tissue that act on sharing, that that kind of ripping apart. So what that does cause that of secondary insults that miss matched the blood flow in the metabolite mand.

We talked about that earlier. Omega three land right on that problem for solutions. And the reason is IT helps dramatically with us called arterial liability and complaints. And so when we're having issues, getting blood in the arteries can either be broken or damaged or stiff. And omega three is really help to become more liable and open and closed more effectively.

As one way to think about IT also why you see so much evidence, research on the magazine for heart health and blood pressure and so on and so forth has the same effect essentially in the brain. Other thing that does that a huge benefit outside of that surreal profusion is IT modulates information post injury by regulating that ross active auction species and in interacts with all kinds of side of kinds, like going to look at one and T N F alpha if you're from me with, if not, don't worry about IT. Um even actually there's one particular called N F K B that brain folks will know if I going talking about here.

Um this actually functioning IT affects a uh gene expression that we want to be flaming ory things so I A cuts off information at the genetic level. So lots of ways that IT has an impact. To give you couple specific examples, one of most common issues associated A T B I long term is called atrocity of the hippo campus.

Now that's associated in one of the areas that mainly responsible for learning and memory. And we know that those are problems, right? We know that higher or make a three intake is associated with a bigger hippo campo volume, right? So we have cross national studies here on to two ones are suggested in people that consume more tend to have a larger hippo campus.

And we also see significant increase in these areas at the dosage of about two point two grams per day, two point two graphs official per day, associated the bigger hippo campus. Therefore, potential to improve hands are learning and memory similar of things have been done with memory specifically. In fact, one study looked at, I think he was a combination nine hundred milligrams of pa plus two hundred sixty milligrams of D H, A.

And that resulted in greater accuracy and speed of recall tasks. So mental recall memory E, P, A in general is often really associated with cogit function, and A D H A is associated with axial injuries. Um works on a thing called neuro filament enon light or nfl.

And that actually been specifically shown in called football, all players, I believe again at that two grams per day dosage of dh. And so in general, to get to the end here, the dosage for brain related injuries is somewhere between two to four grams per day. Though there is really little risk.

The only adverse issue you're going to typically have here is potentially some loose stool. Again, there's not that much Better. But if you have a you consume a bunches of oil that can kind of run you a little bit.

Probably I can see much happened there very often. The timing of IT doesn't matter that much. You certainly to be taking IT before the injury as well as after the injury and the timing of the day is honestly totally irrelevant. And so pretty easy, pretty fast when they go through very effective eyes personally will be totally honest. I take a lot more than foreground for other benefits. But very fairly, the available evidence are not necessary directly T B I R C ties, but the other associated areas of brain health and injury and damage pretty consistently show the effect happens that about two or so grams and studying es that have looked at higher dusties don't see the fit. So I think it's very fair to say two grams a day or so is affected those and more than that may not give you additional benefit.

What's that look like from food example where vegans and vegetarians really should honestly strongly consider supplementation here? We're going to give fish oil from fish pretty obviously salmon hearings, ordinance, micro stroud are generally the most highest concentration once salmon being the most obvious ous example that's got about two grams official per hundred grams of cooked meat and then i'll be three and half hands or so, which is not an outrageous dosage at all. Unfortunately, the standard american diet is typically about one hundred milligrams.

Have a mega three per day, and we need to get IT to two, right? So you gonna to up your any, if totally possible. But most people just don't do enough of IT.

This is a really important one to go after. I know I just covered information, but I want to also highlights fact. You can check what I mean, but that is unlike creating where it's gonna really hard to measure your creating mono hydrate, specially in your brain levels.

You, as a prevented strategy, should look at your omega three index and identify whether you have problems because there's a lot of evidence to suggest if you go into a brain injury with a Better or mega three, the brain injury will be less significant. So our starting place here is to actually not go into the injury with the problem. I mention this, but i'll be more clear.

The omega three index is not a perfect way to mature IT. But IT is an effective blood test. You can get done. And what that's an effective, we tell you, is the percent of E P A N D H A that's in the membrane of your red lood cells. And there is been a handful of studies on this that are quite impressive.

My opinion studies on football players and even, uh, a basketball players have found that the mash majority of them have an, I make a three index of less than five percent optimum is like eight to ten, maybe twelve. The overwhelming majority of these atis are less than five. In fact, I think the study is are taking right now, the two are combined basically none of the athletes higher than seven percent, again, eight to twelve as what we're looking for.

Fact, the reason we're doing that is because there's been known and shown document and cognitive benefits at ten percent plus, even as low as a percent plus. So in these studies, no athletes there. In fact, most of the over fifty percent are the athletes in these studies.

I do not make three index of lesson four percent. So IT is really, really, really common in our athletes to see omega three status being really insufficient. And the same thing is happening, the general population, so you can one hundred percent achieve, and not for brain health, through food, if you'd like.

You just need to make considered effort for IT. And you can see an angle back, tear the dosages, or you can use supplements or accommodation, but you absolutely want to make sure that you're doing this prophecy, ally, as well as if you do experience in injury getting right on the supplementation as quickly as you can. Next up is what's called vital b two or rival flavor.

We're going in the rival flave next because IT is a requirement for proper da utils ation here. What I mean, there's some really nice study showing that if you give people D H A, but they have insufficient b two, b six, b nine, twelve calling, they won't integrate that D H A into their brain. So it's really, really hard technically to get the D, H, A to integer into the fossil of membrane without these b vitals.

And so part and parcel to our appropriate to make a three satis is making sure we're not vital, be deficient. And specifically, in this case, we're talking about right of lemon. So IT is a coin zine for atp production, is a part of many of our energy production cycles, is also highly responsible for glue to find.

You will hear me bring us up again. But little fine is our chief and dodge's anti oxide. It's the big walter. okay. So going back to our problems associated with injury, rebel flame is gna play a role in two, those ones energy production, as well as information rock or antioxidant active.

So really helpful for that regard, right? Since we know T, B, I has metaverse problems, IT makes sense that these b two and b vitals are gonna probably play an important role. The S, O, E on rival flame is a.

Now personally, that's enough for me to take action. You're welcome to a, choose your own level of action on to the score here. But I have utilize and will probably continue utilize rebel ven for head related injuries.

There's great data in rat studies that have shown right flavin helps with some of the behavioral modification issues associated with downstream T, B, I problems. humans. There's not that most research kindly again, as why has an S O E score of three, not two or one.

And what we do know is there's kind of a two studies in particular that are classic, and they both use about four hundred milligrams per day. One of them is a bit older, one thousand eighty eight. And think he was published.

IT was actually migrants. And what a showed that I was safe and well tolerated. Now, interestingly, this was followed up in twenty twenty three, and they gave, again, foreign milligrams. I think they actually did twice per day instead of once per day starting twenty four hours after injury.

I think they had fifty plus people in the study, and they're all about twenty years old now in that they found a significant reduction in the number of days of recovery by about half. So the group that did not get the supplement, the typical recovery day, was twenty two days long. The summer group, he was cut down to ten.

So this was a very, very, very impressive result. And so IT seems to be a somewhat high reward, low risk option. Additionally, the other be vitals like b six and b twelve have probably more limited research, but they're really plausible.

They're also really safe. We've been studied a lot and a lot of unhealthier risky populations, and they just don't really have that many negative side effects. So sounds logical to try these ones.

Um there is a little bit of work here, particularly when thinking of some rat studies in cases of things like fully deficiency when that happens a little bit background there, when you are deficient and full late, you have higher levels of was called homo sist homa size is highly associated with additional occasion stress and a whole host of other negative health casques. So really high home assisting is is bad news, right? Home assisting is often also elevated when b vitamins are too low.

In general, that alone is associated with a neuropathy of tbs, brain atrophy, cognitive decline of aging and so on, a support. And so the clinical trials that have had done in this area where they combine these b vamps and make a trees, have been shown to reduce some system. And that is then also been associated with a reduction in cognitive decline.

So if you can pay tention all those b vitamins, trying to get them as high as reasonable, or at least not in those danger areas, take a look at homework, simple to pay attention to that. If you do that, that will give those a mega series a Better chance to work more effectively, and you should be in a Better spot. So what type of event look like in terms of supplementation and food?

One more time, the dosages that have been studied for migrants and headaches and brain health and things like that are four hundred milgram per day. More of the studies did that. Those such once per day, another day at twice per day.

But those are really, really common. Now you can look all over the internet, and you will generally find every multivariate house, river flavin, but it's not very much. So most evidence are not gonna the place you can go to, to get enough, be twelve or be too rather for this issue, you're gonna have to go to companies that may be too specifically in terms of timing.

Again, you want to take this after your brain injuries, certainly, but the Better option is, is to make sure your beast data status is high enough prior to going in. But if you didn't do that, don't know you would want to take this post injury time of day doesn't matter at all. Some people will feel a little bit of an energetic effects, so perhaps earlier in the morning, others don't.

But you might want to consider that i'm not aware of any risks associated IT. Obviously, thing has some risk of some dosage in some people, but for the most part there, there is very little harm here. B vd typically don't have many issues if you over consume them outside of pops, wasting your money, I guess if you want to think about that way.

But there's really very little consequences at reasonable dosages. So IT should be OK there if you want to get this from whole food sources. This is where things like liver come in handy or fortified serials way protein actually has a decent amount.

Uh, beef liver specifically has three point four milligrams. A rival flavin per hundred grams a way protein is about half that. I think it's about two actually.

So it's not a terrible source. So you can run the math very similar that we just sted IT before. I won't dragged you through IT again.

But if you have to eat something like fifteen times ish, the amount of the serving size I just listed to get to that four hundred seven grams per day, that's you know gonna a pound, a pound and a half, sorry, a kilo or a kilo and a half of beef liver per day. So again, theoretically possible, but just pretty unlikely, are pretty unrealistic for most people to get these at this dosage through just food. I remember, these are not daily amount you have to take.

We're talking about the dosages specifically for a brain injury. And so it's actually not that crazy to think you're taking IT if you've experiences something like this, it's not something that you need to do every day your entire life. Next on our list is calling.

Now this says a handful of functions. First, it's helpful and preserving the blood brain barrier because IT wards off membrane breakdown, it's critical to that cell membrane. So IT has a handful of fex.

The second big thing that does is IT is the primary precursor to the ural transport seal calling. You may remember that I see to calling is the primary neural transmitter, the signal molecular signal that goes from one neun on to the next. The actives, we talked about this some more detail in a previous episode, muscle, so you can go back to that to learn more.

But the third thing that does IT is a precursor to that important anio, xian ludivina. So a handful of functions here, both structural damage, cellar, communication activation as well as anti oxidation. We also know from a lot of research in area of brain aging, dementia, alzheimer is so forth, that higher dietary intake of Colin is strongly associated with decreases in several bio markers that are associated with that alzheimer's, dementia and other risk factors.

So from a dietary perspective, from a molecular and mechanistic perspective, starting the lineup is a pretty important molecule for both T, B, I, as well as long term brain health. To summarize the collective evidence, IT is well tolerated and safe. It's plausibly helpful, like I just described, and there is even some minor benefits in both physiological and cogniac domains following head trauma.

The most common form of Colin in the research is what's called seto Colin or C. D. P. Colin. As you will see, IT sometimes, and it's been tested in multiple tbi renaldo zed control trials.

In fact, a recent made analysis indicated that there's about a twenty percent likelihood of success or effectiveness with a see to calling for T, V, I treatment. So it's not perfect, but twenty percent pretty good in my opinion. Getting into the research is a little bit further.

There is a handful of animal and human studies that are worth talking about at a very high level. The animal research looked at one hundred milligrams per kilogram of body way per day. And i'm bringing up those numbers intentionally.

I want to put some contacts behind that honesty because I ve just heard people misinterpret this paper a lot. So one hundred million ms per kilogram per day immediately after an injury, which resulted in significant improvements in which called spatial memory performance. Now you can't simply equate body way here to humans.

You'll get an absurd number that what what makes sense, you IT doesn't actually work that way for details we don't want to talk about now, but this what this would equate to is something like sixty to seventy milligrams per kilogram and humans, and that is high. It's about three to five times the dosages used in human research, but it's not impossible either. So I do want acknowledged that those numbers are again, hi, but it's not completely crazy either.

In fact, some of the studies at two hundred fifty milgram helped with the blood brain barrier breakdown in a dema h were largely reduced in those trials, and also had benefits and hippo camp nero al death for the seven days following injury. So pretty good mechanisms from the rat studies. In terms of the human, you will see that the studies are mist.

Okay, one grand per day for thirty days has been found to at least mild tvi to produce statistically significant improvements in recognition. Memory, which is obviously important downstream behavioral problem, is associated tb s. And that study was actually repeated about twenty years after the initial one.

And they use IT, a pretty similar protocol design, and found actually no difference in T P I symptoms. I think that was a headaches, a sleeping is dies and concentration of things like that. However, what's really important to note here is in this study um the majority the participants had really minor T B S, meaning their colony gic pathways were probably not affected.

This is a classic case of something I warned out the beginning or earlier in our conversation. If you're not actually giving a supplement or taking the food that the mechanism of fact is not the mechanism injury, then you shouldn't expect a benefit. So I think this is really case of that.

I actually do feel like the strength the evidence for calling is okay reasonable. But that two thousand and twenty three follow up study to me is not indication that the original study was flaught er didn't work but simply you had mild or injuries that didn't result and damage to that pathway. M, so the benefit the supplement provided very limit or mixed benefits.

In addition, I know of two met analysis that reported generally positive benefits here regardless of tb I severity. So that's some more information of positive benefit. And the probably landmark study in this area came out fairly recently.

He was called the cobra study. I think he stands for like xy colleen brain injury treatment trial. You know how scientists always like to make these acronis for big studies? Again, honestly, I feel like this is being misinterpreted in my opinion and so what touching is just really briefly.

But in that they found um no evidence of benefit for cognitive function or cognitive status. Ninety days post injury with two grams a day of city calling. Now a lot of people have used that to say, we told you does work, does work and that's fine.

You going on, people going to turn out. Well, my personal opinion, the study though is at a highly flight. And i'm saying that because in IT, they considered a hearts to be seventy five percent, meaning if the people study took their seto calling seventy five percent of the time they were consider to be a hearing.

Only forty four percent of the participants met that seventy five percent mark, forty percent were consider to be non hearing. So that means they took at lesson seventy five percent. And the rest they don't even know.

So for me is it's hard to suggest that IT didn't work when the vast majority people didn't actually take IT most of the time. In those that did was still only seventy five percent of time. So cool study helped a add a lot information of my painting to the database, but I don't think IT should be interpreted as saying the calling then therefore doesn't work.

Words a myth or any of those other more extreme interpretations of these data more directly for the context of our show today been done on football players where brain coin, specifically the primary motor cortex, is known to diminish across the season. Similar what we saw earlier with creating probably as a result of this continues heading packs or couldn't be inferred directly from the study, but pretty easy to make a guess. It's likely scenario.

And this actually may contribute to the second impact syndrome and accumulation of damage. So simple idea here as creating, to me, prety strong case. So based on different study designs, mixed results and other limitations, the AOE for coin lands at a three.

So what are we looking at in terms of food and supplements? But first of all, you're not going to find Colin supplements on their own. Very commonly, it's almost always going to be in the form of what's called alpha G P C or in the more direct version of fos fitial calling. Now alphago gpc is immediately meta lizer into hospital coin or PC. Once you early adjust this so you can think of this as similar products, many companies make either PC straight or alpha G P C, or have a little bit built into often times like b complexes, dosages are usually little blower, twenty to thirty milligrams.

If you're getting the alpha gpc directly, moments course sponsor for the show as well as other companies, generally will make uh dosages three hundred and four and milligrams per serving。 So you need to take you know, three or so of those to get to this those double, but you will find that fairly commonly OK. Now in terms of timing, you probably want to take something like five hundred milligrams per day as a daily dosage.

practically. However, if you've had a direct head injure, this might be the time to ramp up to one, two grams. These generally do have any tropic effect. And so you would, anna, take this earlier in the day, see you soon. They don't have any problems.

Cognitive ly always sleep later on in terms of food, if you need to get up to that one of the two grams after you're accute injury, you're probably gonna wana use supplementation. But it's quite easy to get to that five hundred, that baseline profile active gosain straight out of food, a couple of eggs and some turkey will almost always kiss you right there. The most common places to get calling in food ARM, meat, poultry, fish, eggs, theory, beans, crisp, her's vegetables, a beef liver, for example, has around four hundred milligrams per hundred grams of liver.

Eggs is about a hot and fifty milligrams per egg. And so you can actually see r three or four eggs in a day gets you really close that five hundred number, most people, a couple of eggs, a bit of serving meat, you're gonna right there throughout the day, which again will put in a pretty spot. The average person though, doesn't get enough calling typical numbers.

And man is around four hundred milligrams. Women is about three hundred or so, which is well below the A I, or adequate intake, which is five hundred fifty four men and four hundred and twenty and sofa women. So you would have to probably do something in the nights hood of like twelve eggs to get you to that, you know two grams only per day.

So like I said, totally find you get this from food as your Normal baseline hel strategy. But if you did want to get those up or dosage with an acute injury, you probably have to use your time getting little bit supplementation rather than try to eat fourteen or fifteen eggs in a day. Alright, moving on to next one.

We're looking at branch chain and minal acts. To clarify, when I say B, C, A, M, almost always talking about three ema sets of particular, I saw losing Lucy and valley. Now Lucy e is the primary driver of muscle growth or muscle protein sentences, which is why there is so much steam behind B, C, A or musical growth.

Talk about those details later. But in general, if you get enough protein, B, C, A, or are not really needed from muscle grow. That said, there some different brain.

The human data do suggest that the severity of your T, B, I symptoms, correct. Well, with the degree of B, C, A, A suppression in the brain, bigger drop in B, C, A, S, more symptoms. The B, C, S have two big effects.

One of them, in effect, there was all night donor, and the other is that they help transportation interference across the blood brain barrier. So I mean, let me walk. You do what those mean really quickly, as is important, understand why they actually work in this case, but perhaps are not so important for muscle growth.

Now when I say nature en donor, what I mean is they're specifically used as then broken down to give off nitrogen, which can be used for glutamate and gaba. I already talked about glutamate earlier, and how that is a primary problem with extreme excitable taxi. So beginning, too excited to turning two in irons up.

Now, both gaba and glutamate are heavily involved in T, V, I. Pathology, like we just talked about from the transport perspective, when you eat protein, the amount are just as food, or supplement the amount of B, C, A, and your blood goes up. Make sense.

Put a bunch of proteins in your stomach, they have broken down in the acid mini s, in your blood. Go up if you want to complete protein. That will come up the bunch of B, C, S.

And of those go up in your bot. Now, as the B, C, A concentration goes up, two molecules called trip to fan and tiring. They happened to share the same transporters to get through the blood brain barrier.

So if you have this big rise in B, C S in your blood, the B, C, A, S will block up those transporters, which means the uptake of tyre acy and trip to fan are blocked. So they're not gna get across the rain berry, not going to get the brain ay. So the amount actually in your brain of t and t tyre sin and trip to find go down.

What that does is caused problems with things like serotonin, because T N T act as precursors for serota. Which of courses in a press or for military on and various economies, right? So this could be contributing to the T, B, I induced sleep problems.

As you can see the basic logic there, the current evidence does suggest that actually sleep is not compromised with B, C, S, but actually even potentially improved. I know of actually a study coming the mind right now that looked at thirty grams A B C S administer twice per day, found that actually improved in somalia and other latency related issues. This study, I think he was in veterans with chronic T B.

I. And so we know some about the mechanisms that I just outlined, has the potential to be influencing some of our sleeper later problems. And IT seems weak, causing a positive and beneficial effect for sleep, which is a huge concern and one of the biggest symptoms associated, the brain.

And the S, O, E. On B, C, A, A is surprisingly, a two. Remember, one is best, five is worst, and the scoring.

So the data are actually pretty strong here. IT is pretty clear that IT works as much as we can define work. There is extensive evidence in post impact for both mild and severe tb s. The benefits range from cognitive deficits, so reductions and cogan deficits.

But I just describe the somebody y's sleep wake abNormalities with the main effects probably been a correction of that excited toxic issue um that some of the gaba and other glue to mate problems that that we have just described. Ed, probably the most famous study in this area is called the hit heads trial. I do this came on twenty and twenty four actually.

So prety recent IT was a pilot raly zed control trial. They had, uh, I think like ten to thirty five gods. And there's so team three teens allow up to knowledge, and they follow them for three weeks or twenty one days post injury.

And this was really cool. They had fighting five arms in the study. So some of the participants got a preval, and then they broke up the rest of the intervention by dosage.

So they got fifteen grams a day, thirty grams, forty five or even fifty four, not surprise on fifty five. But they wanted to see is effect at all comparable placement. And if there is, what's the optimal dosage? And I gave five different dosage, from loads to more moderate to pretty high, and scaled all the up.

And one of things that they found was a pretty clear dose response, such that the most improvements were found in that fifty four grams per day decreased symptoms of concussions are faster and Better return to baseline. There were not benefits actually in most called processing speed, so that have been shown at some the earlier studies we talked about. But they didn't find that here for whatever reason.

But they had all those other benefits. One more time highlights the fact that not every supplement, not every food, not every neutral fixes, every problem ay. So benefits here in the concussion symptoms were not necessarily the process speed, but the facts.

One more time were those dependent, and one more time like we keep bringing up, there is no adverse effects reported the dated. So we currently have to suggest up to fifty five or fifty four grams per day. More specifically is the dosage.

You would want to make sure you're at that higher dosage past injury, you can be a much smaller one, just honestly, to make sure your protein intake is high enough, you can use whatever number you like, talk many times. So I personally like one gram of protein per pound of body weight. If you're APP that you're probably getting enough B, C, S.

At baseline. And then we would go to only the highest post brain injury to break this down. Food wise, B, C, A, S, its protein.

It's dairy products. Its meant poultry. Most meats gonna three to four grams of B, C, S per hundred grounds are serving. And so similar math we've done before, kay, this is going to result you having to have like forty or fifty answers of me per day, not something any baseline. But these small cases, again, I am don't what you feel like computer you to supplements.

But IT, is this significantly easier here for small times and for specific scenario of a brain injury? Go to supplement our next micex trine is magnesium. Oh, my goodness.

Could I go on and on and on about the physiological benefits of magnesium? IT is involved in well over six hundred actions in your body from celtic nal vascular function, a production protein sentences, a neural plasticity, learning memory. And I basically think of anything that happens in your body.

And magnesium central to that, I don't have to draw the southern. It's pretty easiest for you to assume that she's going to be an important role in your brain free and post century. We also have very strong data.

If you are deficient in magnesium, you have associations with a host of coal, mobilize health conditions, type to diabetes, metabolic rome, hypertension, headaches is another common one, migrants, heart disease, so on. And so for we know that IT probably inhibits receptors that are directly target a antia presence as well, and as a strong contributor to that brain exco toxic after injury. So you do not want to to be deficient in magnesium.

You can listen to read almost anything in the sports performance around, and you will see magnesium as a top tier supplementation. IT is really robust and A A strong line of evidence in and recommended by, again, many people on this field. But surprisingly, the S O is only three here.

There's a well document drop and magnesium, especially near central neurons after A T V I. Any extent of that drop is associated with the severity, the injury and the level of behavioral disturbances. So not only the injury, but your symptoms as well.

Animal and human research here from the animals, it's associates with a dema brain and blood concentrations, calcium problems like we talked about earlier. These are going to result in those behavioral modifications, memory cogit function, spac and working memory and zona sofa from the actual human stuff. Couple of studies that are worth draw attention to here.

One, look at a cute T, B, S. In kids. And saw a significant reduction in post concussion severity scores forty eight hours after injury, when they used four hundred milligrams of magnesium twice per day.

Now another study was used a similar design and didn't find a benefit, but this was actually using magnetism from an iv for five days. Now no one really actually knows why this one trial work. Another one didn't.

The obvious thought is maybe there's something that happens when you adjust IT through your stomach, AIDS in digesting or makes IT mobile available when you took on the I V. I didn't to me, it's onest ly, not a great answer, but I don't have any other reason to think that that happened. So really honest.

To summarize here, IT is very, very safe, is very little harm that has so many other health and performance related benefits. There are so many health consequences that are social magnetism deficiency. IT helps the symptoms and behaviors that are hallMarks of tb.

I like we've talked about. So I know the S O E is technically three, but personally it's about a high alist. As I could think one supplement could be the dosages we described, one more time, four hundred milgram per day.

The timing doesn't matter. You want to have some in their pre as well as post injury, and you can take at any point in the day. Now, depending on the type or form that you use, you might want to take IT later in the evening, some people report.

And depending on the type, magnesium helps you fall a sleep. I personally feel no effect at all, but most people do. I still then take my magnesium night just because just in case there are all kinds of forms.

You've heard of magnesium three at this point, license mal. And right now, I don't know any compelling evidence to suggest one of those forms is any Better than another. I will see magism three, eight has become more popular recently, and that may turn out to be more effective.

You may not i'm not sure that is not enough data for us to have a really an answer this point. And so you can take whatever form sits best to you. The obvious risk associated with my name um are the G I distress this click mal.

Three atter are generally pretty well handled. And so you shouldn't have too many cases with if you want to get a strickly from food you're looking at now at things like pumpking seeds, cheer seeds, Allen and spinach. Typically I think publican's es are about the highest.

You'll find they've got around two hundred milligrams a magnesium per hundred grams roasted. Again, you can do some math there and realize, alright, that at least two hundred grams of frosted pumpkinseed I have to get to get to my four hundred milligrams, which is honestly quite a lot, not impossible. Some people eat tons of women and managed and things like that, especially vegetarians and vegans.

But IT is quite a bit, given how cheap, effective and easy to handle, and how many other things are benefit with my museum as a supplement. Now we use IT pretty commonly. Our final food item discuss is was called Anthony ence.

Now this come almost always from bluebook ries. So hansford all all these blueberry anthers, it's tire, refer to IT. Now these are final chemicals in the flow and family as over seven hundred known antal molecules.

And we're honestly basically just learning about this stop. So we have a ton of improvements needed, a ton more analysis and understanding of mechanisms that so not so for, but there's enough here to go on at this point. We know that antos are involved in cardiac AR disease, meta x syndrome, typed to diabetes, cancer visions, skin health information, the general disorders, and probably fifty more.

thanks. Really ubiquitous, really robust and critical to a bunch of human functions. T, B, I, specifically, and a research here, blueberry supplements or blueberry extracts post injury have been shown to improve as called brain derived neotropical factor, or what you may have heard of, A, B, D, N, F, which is inversely correlated with indirect markers of memory performance in cognition.

Now, similar study has found that blueberries is also protected agains oxidative stress, which makes a ton of sense. You ve all probably heard about the ani oxide properties associated blueberries and blue ry extract. So this is no surprise for most people.

The soe francs is a three in terms of human data. Um I do not think there's a single R C T remixed control trial that exists for blueberries and tb I at this point. That said, there have been studies, many R C S um some of fact that are rain from developmental to ageing to clinical populations on brain health.

And so this is a classes example of where we can infer something from general brain health over to tbi at a pretty low risk, higher word possibility. The collective evidence um indicates that IT does help with attention, memory, executive function. There's a lot of evidence, specifically we use uh handle papers that have done looking at blueberries prior to gulf and enhancing brain performance in sport context.

So there's a lot out there. We know that works, but we also know we're missing a lot of details because of what I just described earlier. It's pretty new.

Couple of examples. One study in kids in particular, looked at fifteen or thirty grams of freeze dried wild blueberries and saw significant improvements in cogent function in a dose dependent fashion. Mobile barriers is Better. Other work has been done in.

And older adults looking at things like one hundred milligrams bull berry extract, seeing Better episodes, memory performance reduced, card of astar disease, uh and so on, a so or so um what this would look like from my whole food source to get something like five hundred milligrams of the and those you need a hundred grams a blueberries, which is I like a cup has honor and fifty. So i'll transaction that for A A little bit. You have a couple of blue ries and you probably your numbers.

It's really that easy. I'd actually say that of all the things we've discuss so far today, this is the easiest one to get out of straight food. You will be hard pressed to find a program that ever comes out of myself, a rapid health performance company.

What i've associated with that doesn't have a couple of blueberry in IT, and it's for these reasons that many more. So it's a pretty easy number to hit, pretty consistent and has a lot of benefits, right? I will also tell you, people love to give bilberry elles a credit here, but is not the only food item that's got the answer in IT, strawberries, crane berries, they have too.

It's not so much data. I don't actually know there's any data, but I imagine if they did those studies, you'd probably find the same benefit. So i'm actually not as particular on this one. I don't have evidence to support myself, but I don't think it's that big of stretch to think the same chemicals in this case that in blueberries probably also exist in razberries and straw ry other similar farms. So we will spread our barriers out.

But if you want to stick to giving all the love, the blueberries, you're not to hurt my feelings as far as I understand IT, that represents all the evidence on food related items one can take for brain held tbs in concussions. The only thing i'm aware of that's actually detrimental for brain healing is caffeine. And there's enough evidence here that this is probably pretty bad news when trying to heal from a brain injury.

IT cause is neural vascular construction at leads, the less blood flow. We know that caffeine consumers are more acceptable, ultimate to diminished emotional health, badly quality depression and tomato symptoms with brain injuries. And so what my recommendation here would be, over consumption is the problem.

Do not over consume caffeine. If you've experience to burn injury, I don't think there's any reason to think caffeine consumption is giving to give you more risk. Have a brain entry.

But if you have one, you you want to make sure you really careful, ask your doctor check in there. But that's the only one of our list that we have reason to think that you should avoid. That includes today's episode on nutrition for brain injury, T, B, S, in concussion. I think it's worth reminding you though that if it's good for preventing and returning faster from a brain injury, it's probably safe to assume it's also good for brain performance as well as long term health.

My goal of today, as always, was to provide you with a tone of information so that you can be excited, you can learn, you have some things to try, but to also be fair with the state of the data, and you can make your decision about what you want to do or not do based upon that. Given this was episode ten, not only are we done, but today's discussion, but we are done with season one, a perform with docker. And I happen I can't thank you all for the support.

I seriously was overwhelmed with comments from people I know don't know. I was blue past my expectations and so I really just cannot thank you all enough. If you're a new listener, this is maybe your first episode.

You can go back and check out all previous nine episodes on perform podcast dot com. You can check out the notes you know to youtube and you can see the exact sections of a particular video if you're interested. In that.

And we've made IT as easiest possible, hopefully, for you to go straight the information you're looking for and not spend time on things you are not. I can also share with you another phone announcement and that is that season to is officially been confirmed. It's going to be coming out pretty soon.

If you want to know more about when that does hit the radio waves, you can stay tune, of course, on my social media. But also I would recommend signing up for our newsletter, finishing us up here. I cannot conclude this in season without some very specific thank you.

First of all, to all the sponsors, a IT was overwhelming your support. The people jumped on board quickly and were really, really helpful. So the show would not have exist, ted, without them.

So I know at rats are a thing, but please do me a solid. If you enjoying doing part of any the episodes of the season, go check out the sponsors. They really are phenomenal products.

I got to think my push man, vin dog, you know who you are, helped me a ton and preparing for this. He's not the from of the camera kind of guy. So preciate events, the tosha, of course, my wife's super, super supportive.

And all the time I went to come up here and get this stuff done. My students, former and past current, could not have done any the stuff that allowed me to be up here without all of your support and truly doing all the work in the lab. Same thing for all of my colleagues and fellow scientists whom helped me directly with the show or indirectly, and that I told your research are ready at the least, and was able to have information to share with people.

So science is not easy. In a lot of times, people don't get to create ford. And I and I thank you all for your contribution.

All of my teammates and colleagues, my company's rapid health and performance biomolecular thy absent rest and vitality again, towns and tonnes of support for everyone. So appreciate that. And then finally, of course, my man hear my boys here, a psychotic and course doctor andreu man, love you all superperson ative of you.

Thank you all so much for joining on this ride, and i'll see you next season. Thank you for joining for today's episode. Our goals to share exciting scientific insight that helps you perform at your absolute best if the show resonates with you and you want to help ensure this information remains free and accessible to anyone in the world, there are a few ways you can support.

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I use my instagram and twitter also exclusively for scientific communication. So those are great places to follow along for more learning. My handle is doctor andy gapin on both platforms. Thank you for listening. And never forget in the famous words of bill barrowman, if you have a body, you're an athlete.

I hope you enjoyed this episode of perform with docker andy galpin. I encourage you to listen to the other episodes of season one wherever you are listening now. And last but certainly not least, thank you for your interest in science.