Archive for Protecting and healing your brain
Physical Activity May Modulate Effects of ApoE Genotype on Lipids
Jump up and down for joy with this one. Since its initial discovery and seeming death sentence in heart disease and Alzheimer’s almost 20 years ago, we are just now finding that these are NOT death sentences, but rather instructions for how these genes should be treated for a healthy lifestyle. In this case, high intensity exercise can improve lipid profile of patients with the ApoE4 genotype.
Arteriosclerosis, Thrombosis, and Vascular Biology — Abstracts: Bernstein et al. 22 (1): 133
As I’m sure you’re well aware, drugs to lower cholesterol are among the most successful in history. But the list of side effects is quite long, and it just got longer.
I have covered many of the common cholesterol lowering drug side effects in a previous article that can be read by clicking here. Many of these side effects can be predicted based on the fact that statins, while lowering your cholesterol number (and let’s face it–that’s pretty much all they do is lower the number of a single marker in your bloodstream) they also block the production of a compound called Coenzyme Q10, or CoQ10.
Another name for CoQ10 is ubiquinone is because it is present everywhere in our cells. And it’s there because it’s important for every single cell to generate energy for that cell to function the way it was supposed to function. Kind of makes you wonder why Mother Nature put the path to create cholesterol on the same path as something as critically important as CoQ10, huh?
So basically, when a cholesterol lowering drug lowers CoQ10 in the cell, all kinds of bad things can happen to pretty much every cell in the body, the worst side effect being death from fatal rhabdomyolosis, a condition where your muscle essentially melt away from the massive damage. The debris that gets kicked into your circulation essentially shuts down the kidneys.
Most notably, any cell with a high metabolic activity that requires lots of energy (in the form of ATP) can suffer from the statin class of drugs. That is why the heart can be damaged by statins (kind of ironic, don’t you think) and why muscle aches and pains are the greatest problems with statin use.
However, the largest utilizer of glucose in the human body at rest is the central nervous system. Yes–your brain.
So, could this class of drugs to lower cholesterol lead to brain damage? It certainly makes sense and is supported by the results in this particular study.
Granted, the group of patients studied were patients who had pre-existing cardiovascular disease (and would almost all be put on statins) and had an implantable cardioverter defibrillator (ICD) put in as a result. So maybe not your average population and probably doesn’t apply to you directly. However, it is highly likely that the brain cells of these patients with the ICD function pretty darn close to the way your brain cells function, so don’t dismiss the results too quickly.
For those of you in the mental health field, researchers used both the Hospital Anxiety and Depression Scale and the Medical Outcomes Study Short Form 36-item Health Survey. Overall, of 409 patients in this study, 60% were on statins.
Here’s what they found on statin use (regardless of the type of statin used or the dosage):
- Associated with poorer physical role limitations (basically–physical things were more challenging).
- Poorer social functioning
- Poorer emotional role limitations
- There was an association with depression and physical functioning as well, but the relationship was not as strong.
- Overall, statin therapy was associated with impaired health status on 3 of the 8 on the SF36-item Health Survey (Tweet this).
Overall, it was clear that, at least in this specific population, statin drugs led to a deterioration in health and mental health status as a result of taking drugs to lower cholesterol. To be fair, the benefits of the statin class of drugs IS better in secondary preventation (preventing a second heart attack) so the risk / benefit ratio may be different than in primary prevention (preventing that first heart attack).
However, remember that lifestyle changes (my recommendations can be found by clicking here) do NOT worsen cognitive function or damage muscles or increase the risk of arthritis or make your eyeballs pop out and dangle by the optic nerve.
Brain health involves conditions such as migraines & seizures, dementia & Parkinson’s, depression & anxiety. Self help for depression centers on good brain health.
This is certainly not the first time I’ve discussed the research as it relates to functional medicine and depression and / or anxiety. While many may think that depression is what it is and there is little that we can do to effect it (either positively or negatively), this is far from reality.
As I have mentioned before, exercise is arguably one of the most potent brain tonics on the planet. Unfortunately, when you’re in the throes of depression, exercise is likely the last thing you’re going to be able to pull off. I have argued that, in this case, there are clearly lifestyle changes that can be done to improve your mood that even someone in severe depression can adopt. These can be as simple as avoiding artificial sweeteners and diet soda, as I have covered in a recent article that can be read by clicking here.
Much like everything else when it comes to chronic disease, prevention is always infinitely easier than a cure. Incidentally, for pancreatic cancer, prevention really is the only answer…
Well, depression is no different. You need to adopt and maintain the optimal lifestyle to lower your risk of developing depression in the first place. But it’s all family history and situational, isn’t it? There’s nothing you can really do to change whether clinical depression will strike or no.
Not according to researchers in this particular study.
Here are the details that researchers put together:
- 4215 participants in the Whitehall II Study (an ongoing study done in UK civil service employees).
- Healthy diet scores were computed in 1991–1993 and then again in 2003–2004.
- For the detail oriented, recurrent depressive symptoms were defined as having a Center for Epidemiologic Studies Depression Scale score ≥16 or self-reported use of antidepressants in 2003–2004 and 2008–2009.
Basically, the participants were evaluated according to accepted scales of depression or by his or her use of antidepressant medications over a period of 5 years and compared this to how healthy his or her lifestyle was. Here are the results:
- Better lifestyle was related to a 59% lower risk of recurrent depressive symptoms in women, but not in men (Tweet this).
- Women who maintained high lifestyle scores or during the 10-y measurement period had 65% lower odds of subsequent recurrent depressive symptoms.
- Women who improved their scores had a 68% lower risk of another depressive episode within the study timeframes.
- Specifically, vegetable, fruit, trans fat, and the ratio of polyunsaturated fat (such as olive oil and nuts) to saturated fat components were associated with recurrent depressive symptoms.
Overall, this study suggests that, at least in women, lifestyle choices (in this case exclusively dietary choices) play a very strong role in preventing depressive episodes and, even more importantly, preventing a second depressive episode.
One could argue that ANY patient who experiences depression and manages some degree of recovery
Cardiovascular Risk Assessment and Triptans
I was not aware that there was concern with triptan use (in this case when used for the treatment of headaches–in my opinion, not a very good use) in patients with cardiovascular disease. Live and learn. However, what makes this VERY interesting is the following article….
Cardiovascular Risk Assessment and Triptans – Headache, Vol 44, Issue s1, pp. S31-S39 (Abstract)
I’ve covered many of the risk factors for depression over the years in this blog. Of course, top of the list of powerful tools to manage depression is exercise, but I understand that when you’re depressed, getting the motivation to exercise is just short of impossible. That is why making the right lifestyle choices becomes critical to lower your risk of depression in the first place. Or, once you’re there, there are simple changes you can make to begin to turn your brain health around.
I have covered simple, natural approaches to depression in a prior article that can be read by clicking here. These are simple changes you can make that do not require the motivation that exercise does. That same article covered the long list of potential side effects associated with antidepressant use as well.
Despite all of this, as with everything else, prevention is key. This includes all the same lifestyle choicees that you need to adhere to in order to lower your risk of heart disease, diabetes and cancer. My recommendations can be found by clicking here. It makes sense, though–treat your body right and your brain health will follow. And at least you don’t need to remember a different lifestyle list for each disease you want to prevent. Makes it much easier, right?
So what hidden factor are we talking about in this particular article? Before we go any further, I do need to clarify something. This study has not been published in a peer reviewed journal (yet). Rather, it is a presentation of a completed study that will be given during the 2013 annual American Academy of Neurology meeting. It was also a study looking at seniors, not the general population. However, since a senior’s brain works pretty much the same as everone else’s brain (albeit with maybe a little more clutter), I feel that making the jump to everyone else is not a big one.
No regular reader of this blog will have any doubt that I absolutely despise the use of any form of artificial sweeteners and the bulk of the research suggests that they do nothing good and contribute to diabetes and weight gain. But despite the research, society is firmly entrenched in the use of these substances. So much so that the newest USDA recommendations for food in schools allows diet sodas to be sold in high schools.
Here are the summaries of the findings of a review of 263,295 adults, aged 50-70, (that’s a lot, in case you were wondering):
- 4 cans or cups of sweetened soft drinks each day had a 30% increase in risk of depression.
- The increased risk with diet soda was 31%.
- Regular soda was 22% (yes-diet soda was worse for your brain than regular).
- Diet iced tea upped risk 25%.
- Fruit punch was implicated as well at 38% increased risk.
- Diet fruit punch ramped up risk a massive 51%.
- Regular fruit punch “only” increased risk 8%.
- Overall, aspartame (Nutrisweet) showed a 36% increase risk of depression (Tweet this).
- On the other hand, 4 cups of coffee daily lowered risk 9%.
Clearly, artificially sweeteners are NOT good for the brain. Period. And don’t think that, because you use Splenda instead of Nutrisweet, that you are safe. Don’t count on it.
If you do still consume artificial sweeteners (consider your gum, your drinks, even your mouthwash), would you like to share why?? Inquiring minds want to know…
You want to protect your brain . We send our kids onto the field with a helmet. The Tour de France riders wear helmets. So why do we destroy it from the inside out?
Clearly we value the role of our brain in our everyday lives. This is the reasoning for the aforementioned protective headgear and all of the hubub focused on protecting out collective brains from outside-in trauma. Anyone who has ever spent some time in a neurological rehab hospital will tell you it’s not a pretty sight when the brain gets damaged.
As we age and become more thoughtful of protecting our brains, we begin to try to see what we can do to lower our risk of stroke such as lowering our blood pressure and eating more dark chocolate. A stroke, much like head trauma, is an instantaneous event. These seem to scare us into some type of action, whether it is wearing that helmet, passing up on the sparring match with worked up, 225 pound, 5% body fat Golden Gloves boxer or getting to the ER when your blood pressure spikes to 200/130.
But what about the more insidious, but equally destructive, slower paced damage to your brain? The type of damage that ends up in Parkinson’s or Alzheimers dementia.
I have gone over ways to protect your brain in a previous blog post that can be read here.
But have I mentioned how damaging stress is to the brain? Only a few hundred times, so I figure a little reminder is not a bad idea. This particular study looked at how stress changed inflammation in the brains of mice. Here’s what they found:
- Increased activation of nuclear factor κB.
- Upregulation of the proinflammatory enzyme nitric oxide synthase.
- Increased activity of the enzyme cyclooxygenase 2 (you know–COX-2– the one Vioxx and Celebrex block).
- Increased cellular oxidative/nitrosative damage.
Now, either your eyes have glazed over or you’re salivating at the thought of all this detailed biochemistry. Either way, you need to understand that saying that stress is bad for us is some tongue-in-cheek comment that we can all laugh about.
Rather, it begins to destroy your brain, biochemical piece by biochemical piece, from the inside out. So you would never think about sending your child out onto that football field without a helmet, but are you teaching them stress management tools so that they can protect their brain from the inside out as well?
Vitamin D intake and incidence of multiple sclerosis
Vitamin D formation in the human body is a complex and interesting process. Sunlight exposure on the skin converts a pro-hormone Vit D to it’s next form which is then converted in the kidneys and liver to the active form 1,25 hydroxyvitamin D3. This process is severely blunted in patients using sunscreen and obviously those staying out of the sun. Considering that every cell in the body has a receptor for 1,25 hydroxyvitamin D3, the effects on every aspect of our health cannot be understated. It has been well accepted that Vitamin D metabolism being reduced the farther you go from the equator is one of the risk factors for MS.
Neurology — Abstracts: Munger et al. 62 (1): 60 -
Celiac disease and schizophrenia
I firmly believe that schizophrenia has a strong physiological component that can be responsive to natural approaches. Mauve factor is one marker that may result from increased oxidative stress on fatty acids. In this study we see a relationship with celiac disease. With evidence of other neurological effects (such as ataxia and increased risk of Alzheimer’s) this should not be a big stretch for many. However, I do disagree with the author’s conclusion that celiac disease is rare–it has been estimated to be upwards of 1-2% of the general population. That is not rare.
bmj.com Eaton et al. 328 (7437): 438 -
Morning Light Therapy for Treatment of Antepartum Depression
Now we must be very careful instituting therapy such as this. While we know that many antidepressants are approved by the FDA for use in nursing mothers, this light therapy thing should be avoided until proper studies are done identifying the risks. All kidding aside this small study showed a tremendous benefit for a condition that can be problematic to treat, especially if the mother is nursing. With a therapy like being exposed to light in the morning, why wouldn’t anyone try this as a first line of attack? Couple that with exercise and proper diet and I’m sure response will skyrocket.
American Journal of Psychiatry — Abstracts: Oren et al. 159 (4): 666 -
Addition of Omega-3 Fatty Acid to Meds for Depressive Disorder
While this is only a small study, I feel that it is incredibly important. I know that in my office I see many patients on pschoactive drugs. Many of these patients experience weight gain as a side effect, and are frequently bounced around between meds to see which “works best.”
This study uses fish oil as an adjunct to pharmaceutical intervention. How about using fish oil as one tool in the package to include dietary changes and exercise? I think we would find management of depression in this way much more effective with little or no adverse effects.
American Journal of Psychiatry — Abstracts: Nemets et al. 159 (3): 477 -