Low self-worth and no motivation? Check your dopamine

When a person has low self-esteem, low motivation, feelings of hopelessness and worthlessness, and is prone to temperamental outbursts, it’s common to pin that on some deep-rooted psychological issue. Although that is often the case, sometimes simply being low in the brain chemical, or neurotransmitter, dopamine can cause these symptoms.

Do you suffer from these symptoms of low dopamine?

• Inability to self-motivate
• Inability to start or finish tasks
• Feelings of worthlessness
• Feelings of hopelessness
• Lose temper for minor reasons
• Inability to handle stress
• Anger and aggression while under stress
• Desire to isolate oneself from others
• Unexplained lack of concern for family and friends

These symptoms not only make one’s life miserable, they also can lead to loss of relationships, jobs, and a sense of meaning in life.

Dopamine is linked with pleasure in the brain. We need dopamine to feel enjoyment, a sense of reward, and for motivation to get things done or even go do something fun. Dopamine is what enables us to focus and concentrate and see a task through to completion. It also helps with libido.

Dopamine also allows us to stay calm under pressure and not lose our temper. People with low dopamine snap or explode easily or become aggressive. Then they may feel bad about it later.

At the extreme end, chronically low dopamine is associated with Parkinson’s disease. Dopamine is also linked with addictions.

Dopamine and hormones

It’s common to see symptoms of low dopamine in aging men. This is because dopamine activity depends on sufficient testosterone in men. In women it’s linked with low progesterone.

In functional medicine we like to try to address the underlying factors of why hormones are low in the first place. However, some people may need bioidentical hormone replacement therapy to address chronically low hormones and thus low dopamine symptoms.

Nutritional compounds that support low dopamine

Although it’s important to address the causes of why dopamine may be low, the problem with people who are dopamine-deficient is they have poor motivation and follow-through. As a result, they are often terrible at complying with changes to their diet or lifestyle that would help them.

In these cases, some supplemental dopamine support can help boost their motivation to address their neurotransmitter imbalances.

Ingredients that have been shown to help support dopamine include mucuna pruriens, also known as cowhage, and the amino acids D, L-phenylalanine, beta-phenylethylamine, and N-acetyl L-tyrosine. Vitamin B-6 (P-5-P), selenium, blueberry extract, and alpha lipoic acid provide cofactors and additional support.

Foods that support dopamine contain high amounts of phenylalanine and include primarily animal products in addition to oats and chocolate. Phenylalanine is an essential amino acid, meaning our bodies can’t make it and it must come through diet. As such, vegans and vegetarians may need to make sure they are getting enough of this amino acid supplementally.

However, if you eat animal products and still have a dopamine deficiency, eating foods high in phenylalanine likely won’t do much.

The more important thing to do for many people is eat a diet that stabilizes blood sugar. Eating foods high in sugars and processed carbs on a regular basis will sabotage healthy dopamine activity.

Additionally, sufficient iron is necessary to make enough dopamine. If you are iron deficient this could explain your low dopamine symptoms. Many factors can cause iron deficiency, including anemia, gluten intolerance, and uterine fibroids.

Dosing dopamine support supplements

If you are trying to support dopamine activity, gradually increase the dose of dopamine precursors until you notice an effect. This takes trial and error. Then increase the dose again to see whether you experience even more improvement. Once you no longer feel any improvement, go back to the previous dose at which you felt improvement.

How often you take dopamine support also takes trial and error to see what works for you.

If dopamine support causes intense fatigue, those neurons affected by dopamine may already be overly fatigued even though you need dopamine support. In this case it’s more important to address issues of brain inflammation, oxygenation, and general support.

Dopamine clearance is important too

Just as making enough dopamine is important to feeling good, so is being able to clear dopamine out of your system. This makes dopamine activity more efficient. Proper clearance requires magnesium and methyl donors, such as betaine, folic acid, and methyl B-12.

The use of diuretics, over exercising, estrogen replacement therapies, low stomach acid, and long-time use of dopamine-based antidepressants can all hamper proper clearance of dopamine.

Ask my office for both nutritional and functional neurology support for your low dopamine pathways. One way to build dopamine is to pick something you have low motivation around and do one very small, positive thing in that direction regularly. For instance, if you want to build an exercise habit, start with one push up a day and build from there. The rewarding feeling of accomplishment is effective in building your dopamine pathways whereas beating yourself up for never getting around to that hour long intense Crossfit workout can further drive it down.

Sexual violence changes the shape of the female brain

Crazy, hysterical, overly sensitive, hyper sensitive — these are the labels often given to women. Although it’s true the female hormone estrogen is associated with feeling and being more emotional, research also shows that sexual violence, which is believed to affect about 30 percent of women, can change a woman’s brain in a way that may make her prone to PTSD-like symptoms.

A 2016 study on rats showed that pre-pubescent female rats paired with sexually experience older males showed higher stress hormones, an inability to learn as well, and reduced maternal behaviors.

Researchers said the study was significant because adolescent girls are more likely than the general public to be victims of sexual assault.

Despite the fact many women who experience sexual violence go on to suffer with depression, PTSD, anxiety, and other mood disorders, there is little research demonstrating the effects of sexual violence on the female brain.

This study was the first of its kind to observe the effects of stress on the female rat brain as males are usually used. It was also the first of its kind to observe changes in the developing female brain related to sexual violence.

Fortunately, the National Institutes of Health now requires that in order to receive federal funding, studies must observe the impacts on both male and female animals.

Women and PTSD

Sexual violence is estimated to be the most common cause of PTSD in women. As such, PTSD affects about twice as many women than men, women have more PTSD symptoms, and the condition lasts longer in women than men.

Studies also show this applies to various cultures and that the effects are worse in cultures where women have fewer rights and less safety.

It’s important to note that it isn’t women who are affected so much as people who fall into traditionally female roles. Therefore, it stands to reason that men who are victims of sexual violence would also fall victim to the same dynamics.

PTSD versus complex PTSD (CPTSD)

Both PTSD and complex PTSD (CPTSD) happen as a result of trauma, but both researchers and the World Health Organization acknowledge them as two distinct disorders.

While PTSD is more typically the result of an acute trauma, such as combat, witnessing a death, or being in an accident or natural disaster, CPTSD is the result of repetitive and prolonged trauma.

How functional neurology can help treat C/PTSD

The roots of the effects of PTSD can be traced to a part of the brain called the amygdala, a cluster of neurons that govern fear responses. Studies show a woman’s fear response lasts longer than a man’s, which may explain why women develop PTSD at higher numbers. Anger and threats also more activate the fear response in women than in men.

In functional neurology we help rewire the stress responses. We also address metabolic factors that can hinder recovery from PTSD, such as chronic inflammation, gut health, thyroid function, and hormone balance. These efforts, along with good counseling, can help people recover from PTSD and CPTSD.

For more information about how functional neurology can help you, contact my office.

Study links schizophrenia with specific gut bacteria

It’s the age of the gut microbiome — researchers are finding our gut bacteria influence multiple aspects of our personality, mood, and health. New research has now recently shown a connection between the gut microbiome and schizophrenia.

Researchers analyzed stool samples from three groups: Patients with schizophrenia taking medication, patients with schizophrenia not taking medication, and people who did not have schizophrenia.

The results showed that people with schizophrenia had gut bacteria the control group did not. Likewise, the control group had gut bacteria the patients with schizophrenia did not. In other words, researchers identified a schizophrenic-specific strain of gut bacteria.

To further test the connection, the researchers then inoculated mice with sterile guts with the gut bacteria from the patients with schizophrenia.

The mice then exhibited behavioral changes resulting in symptoms similar to schizophrenia.

Gut bacteria influence the brain and body health

Schizophrenia symptoms aren’t the only disorders scientists have been able to promote in mice through gut bacteria inoculations.

In other studies researchers have used gut bacteria inoculations to:

• Make fat mice thin
• Make thin mice fat
• Make anxious mice calm
• Make calm mice anxious

Human studies as well have shown gut bacteria influence obesity, diabetes, heart disease, high blood pressure, anxiety, depression, autism, irritable bowel disorders, and now schizophrenia.

Although researchers have not yet developed treatments based on gut bacteria, it’s clearly a promising path in treatment of chronic health and mood disorders with profound implications.

How to promote healthy gut bacteria in yourself

When it comes to a healthy gut microbiome, the key is diversity: both of your gut bacteria and the vegetables you eat.

Promote a brain-friendly gut microbiome in the following ways:

Eliminate foods and chemicals that kill good bacteria. Things that can kill your good bacteria and promote the bad include sugars, processed foods, alcohol, energy drinks, fast foods, food additives, excess salt, antibiotics, hand sanitizers, and household disinfectants.

Eat plenty of lots of different kinds of vegetables. Be sure and eat a large diversity of veggies on a regular basis. Avoid eating the same thing every day, your bacteria need constant diversity of plant fiber. Shoot for 25-30 grams of fiber a day.

Take probiotics. Taking a combination of pre- and probiotic support can help support your good gut bacteria. Try different probiotic strains to see if some help more than others.

Consume fermented foods. Sauerkraut, kimchee, kombucha, and yogurt contain live bacteria that can help boost your own populations.

Exercise your vagus nerve. The vagus nerve is a large communication nerve that runs between the brain and the gut. Brain injuries, aging, brain inflammation, or other factors that affect your brain health can impair function of the vagus nerve and thus communication between your brain and gut. This can impact gut function in a way that degrades the gut microbiome.

Ask my office for ways functional neurology and functional medicine can better support the health of your brain and gut microbiome.

Art: Lower stress and feed the right brain in a left-brain world

A new study shows that making art — sculpting, drawing, or collage-making — lowers stress hormones, even if you aren’t an artist. This is important for brain health as stress ravages the brain. We also know in functional neurology that our information-overload society hammers away at the left brain non-stop. Art is great way to exercise the right brain, thus improving overall brain function.

The study collected samples of stress hormones before and after the subjects spent 45 minutes drawing, sculpting, or making collages. Three quarters of the subjects showed lower levels of stress hormones after the art-making period. The results were similar regardless of whether the person had prior experience creating art regularly.

Subjects also reported feeling calmer, less anxious, and less obsessive.

What’s interesting is about a quarter of the subjects registered higher cortisol levels after the artistic experience. Researchers say this is not necessarily a bad thing as it may indicate increased excitement or engagement. The older subjects in the experiment exhibited the lower cortisol responses.

The study is important because stress is one of the most significant contributors to accelerated brain degeneration in our modern society. It is especially damaging to the hippocampus, and area of the brain that regulates stress and serves as the seat of learning and memory.

Chronically high levels of cortisol from chronic stress very quickly erode and degenerate the hippocampus. This not only makes the brain more conducive to experiencing stress, it also more quickly erodes learning and memory.

Taking adrenal adaptogens can help buffer the brain from the damages of high cortisol. But it’s also important to engage in more right-brained stress-relieving activities such as creating art.

Using art to support the right brain

The study shows another value in taking time to create art, even if you’re not an artist — exercising the right brain. For most of us, life is dominated by a left-brain existence as we navigate long hours at work, digital information overload, and the logistics of survival in modern America. Left brain characteristics include being analytical, logical, numerical, fact-oriented, very structured, and thinking with words.

However, optimal brain function requires that both sides of the brain work equally. For many of us, the right brain is sorely neglected. Consider these right-brain traits that may be going overlooked in your life:

• Visionary
• Big-picture thinker
• Intuitive
• Creative
• Free-thinking
• Think in terms of visuals more than words

In functional neurology we realize brain rehabilitation is more complex than simply left vs. right brain dominance. But if you find right-brain traits missing from your life, taking some time to engage them can not only lower stress, but also improve cognition, learning, and memory.

Ask my office how we can use functional neurology to help improve your brain performance, recover from brain injuries, or manage brain-based disorders.

Food reactions linked to MS and neuro-autoimmune diseases

A recent study by Brigham and Women’s Hospital found subjects with food allergies experienced a higher rate of multiple sclerosis (MS) disease activity than those without food allergies.

Researchers divided a group of 1,349 patients into four allergy groups: environmental, drug, food, and no known allergies. They assessed these groups in relation to:

• Number of MS attacks
• Expanded disability status scale (EDSS)
• MS severity score (MSSS)
• Radiological variables: presence of gadolinium-enhancing lesions and lesion count.

While the drug and environmental allergy groups did not show significant differences compared with the no-allergy group, the food allergy group showed a 1.38 times higher rate in the number of attacks, and more than twice the likelihood of having gadolinium-enhancing lesions on MRI. Gadolinium enhancement is a marker for blood-brain barrier breakdown and correlates with the inflammatory phase of MS lesion development.

According to study author Tanuja Chitnis, MD, "Food allergies perturb the immune system in ways that seem to increase MS inflammatory activity."

Researchers also suggested gut bacteria, or the microbiome, is an important factor. Further studies on the microbiome and diet may provide more information.

Food allergies vs. food sensitivities in MS and neurological autoimmune diseases

Unfortunately, the study did not differentiate between true food allergy and food sensitivities — more research is required to identify which is at the root of these reactions.

Distinguishing between food allergy and food sensitivity is key for grasping how your diet may affect your symptoms.

A true food allergy is an overreaction by your immune system to a protein it perceives as a threat. Within seconds or minutes, it mobilizes fighter proteins called immunoglobulin E (IgE) to drive the invader out, resulting in these immediate symptoms:

• Rash, hives, or itching
• Stomach pain
• Diarrhea
• Shortness of breath
• Chest pain
• Swelling in the airways
• Anaphylaxis

Food sensitivities begin in a similar fashion, but less aggressive immunoglobulin G (IgG) proteins are mobilized. They may not show their effects for hours or days (or even longer) after the pathogen has entered the body. Symptoms vary widely and include:

• Brain fog
• Systemic inflammation
• Mood disorders
• Gut disturbances
• Low energy
• Joint pain
• And many more

Because food sensitivity reactions are slower, not as obvious, and typically not potentially deadly, doctors tend to dismiss them. However, their slow-acting effects can still be extremely hazardous to someone with neurological autoimmunity such as MS.

Inflammation and the brain

If you are familiar with “leaky gut” you understand it occurs when the lining of the small intestine becomes overly porous. This allows toxins, undigested food molecules, and other pathogens into the bloodstream, triggering an immune cascade that raises your risk for food sensitivities, pain, systemic inflammation, and autoimmunity.

Like the gut lining, the blood-brain barrier is the protective layer around the brain that allows nutrients in while keeping pathogens out. The same factors that cause leaky gut can also cause the blood-brain barrier to become “leaky,” causing inflammation in the brain.

One of the worst consequences of food sensitivities and chronic inflammation in the brain is over activation of glial cells, the brain’s immune clean-up crew.

Under normal circumstances glial cells remove debris and dead cells from the brain and then the brain returns to normal. However, glial cells don’t have an easy off-switch, and when confronted by chronic inflammation, they go haywire, creating a further inflammatory cascade that can result in:

• Brain fog
• Depression and anxiety
• Schizophrenia and other severe psychological disorders\
• ADHD
• Headaches and migraines
• Cognitive impairment
• Alzheimer’s and Parkinson’s disease
• Neurological symptoms

Functional neurology for brain inflammation?

To manage your brain inflammation, you must determine if you have food sensitivities. This can be done either with sensitive lab testing by Cyrex Labs, or by an elimination and reintroduction diet that helps determine the offending foods. These are strategies we use in functional neurology to help guide you through the process.

Functional neurology offers many other ways to help reduce brain inflammation and associated symptoms:

Functional neurology rehabilitation. In functional neurology, we use comprehensive examinations and customized rehabilitation protocols to target the areas of your brain and nervous system that need support.

Regular exercise. Raising your heart rate floods your brain with oxygen, nutrients, and anti-inflammatory brain-derived neurotrophic factor (BDNF), which helps your neurons communicate better.

Blood sugar regulation. Keeping your blood sugar stable is one of the most important ways to reduce or prevent brain inflammation.

Look out for high blood sugar symptoms including:

• Constant sugar cravings, especially after eating
• Fatigue after meals
• Constant hunger
• Waist girth equal to or larger than hip girth
• Difficulty losing weight
• General fatigue
• Frequent urination

And low blood sugar symptoms including:

• Lack of appetite or nausea in the morning
• Eating to relieve fatigue
• Sugar cravings
• Irritability, light-headedness, or dizziness when you miss a meal
• Energy crashes in the afternoon
• The need for caffeine for energy

Ant-inflammatory diet. The Standard American Diet (SAD) is high in sugars, processed foods, allergens, and inflammatory foods such as gluten and nightshades. An anti-inflammatory elimination diet can help you determine which foods are causing inflammation.

Manage stress. Daily stress-reduction habits such as meditation, qi gong, walking, laughter, and play are anti-inflammatory and benefit brain health.

Improve brain circulation. The better the circulation to your brain, the more oxygen and other needed nutrients you give it. Ways to help include:

• Ginkgo biloba
• Don’t smoke
• Address hypothyroidism
• Address asthma and sleep apnea

Please contact my office for guidance on how functional neurology can help you with MS and other neurological autoimmune symptoms or diseases.

Beyond babymaking: Uterus and sex hormones vital to brain

It has long been thought the uterus’ only role was for housing a developing fetus, however, new research shows that the uterus may also play a vital role in the brain’s working memory. In functional neurology and functional medicine, we know how important female hormones and all the organs are to proper brain health.

The rat study divided rats into four groups:

• Had their ovaries and uterus removed
• Had only their uterus removed
• Had only their ovaries removed
• Underwent surgery but nothing was removed

Six weeks after the surgery, the researchers trained the rats to go through a maze. Then they gradually modified the maze. The researchers were surprised to discover the rats who underwent removal of the uterus performed more poorly than the other three groups, all of which performed about equally.

The rats who only had the uterus removed also showed a different hormone profile compared to the other three groups.

Although the rats who lost their ovaries performed as well on the test as those that didn’t, human studies paint a different picture: Removal of the ovaries (oophorectomy) is associated with memory lapses and an increased risk of dementia. It’s also associated with an increased risk of heart disease and osteoporosis.

This is because the ovaries make the reproductive hormones estrogen and progesterone, which are both vital to brain health.

As for the effect of a hysterectomy on brain function, the researchers cite the role of autonomic nervous system. We know the vagus nerve, a large nerve that connects the brain with the organs, plays a key role in the effect of diet and gut health on brain health. It stands to reason the back-and-forth communication between the uterus and the brain also affects brain health, especially if that communication is suddenly halted by removing the uterus.

This upends the conventional medical education that the uterus is a disposable organ with a “sole purpose.” The study’s authors remind us that nothing in the body acts in isolation, something we’ve long known in functional medicine and functional neurology.

The importance of the reproductive organs to the brain

Although an oophorectomy and/or hysterectomy may me medically necessary for conditions such as cancer, many oophorectomies and hysterectomies performed today are simply unnecessary and ignore the risks and side effects, which are severe for some women. Uterine fibroids, another common cause of hysterectomies, now have alternative treatments to removal.

Although women thankfully can use bioidentical hormone therapy to replace the loss of reproductive organ function in the case of ovary removal, an organ that communicates with the brain via the vagus nerve cannot be replaced when removed. However, functional neurology rehabilitation and vagus nerve exercises can help your brain compensate and find better function.

The importance of hormones to the brain

The female sex hormones estrogen and progesterone are vitally necessary to brain health. It’s important to use functional medicine strategies to balance your hormones for your brain’s sake.

If you are struggling with brain-based symptoms during perimenopause or after menopause, it’s important to determine whether an estrogen deficiency is the cause and to address that as low estrogen raises your risk of dementia and Alzheimer’s. Common brain-based symptoms linked to estrogen deficiency include memory loss, anxiety, depression, and insomnia.

Ask my office how functional neurology and functional medicine can help you protect your hormonal and brain health.

Sing your way to better brain health, ideally with others

Communal singing was once a regular part of life, and still is in some parts of the world. These days, however, we largely leave the singing to the stars, reality singing TV shows, and drunken karaoke nights. And it’s too bad — science shows singing is enormously beneficial to the brain.

Even though language is more of a left-brain task, singing activates the right temporal lobe of the brain, thanks to the rhythmic melodies that require the right brain’s involvement. In fact, some people who lose the ability to speak due to left brain damage are still able to sing.

Researchers have long been working with singing as a way to help rehabilitate speech. The areas of the right brain involved with singing are eventually able to compensate for the damaged left brain so that the person learns to speak again.

Singing also benefits people not suffering from brain injury. One study looked at the brains of singers versus non-singers and found singers had greater connections between different areas of the brain, especially on the left side. Researchers say this is because the left side of the brain is involved in language and articulation while the right side is involved in pitch and melody.

In our digital age of information overload, the left brain is beleaguered with non-stop evaluation, processing, and analyzing all the information thrown at us. Singing nurtures the right side of the brain, which governs intuition, imagination, and creativity, and can not only help improve overall brain health, but also simply make us feel better.

Studies show many benefits to singing, including:

• Releases serotonin, the brain chemical that keeps depression at bay
• Releases oxytocin, the love and bonding hormone
• Releases endorphins, our internal feel-good chemicals
• Lowers the stress hormone cortisol
• Communal singing even synchronizes people’s heartbeats, fostering connection and community. Singing is believed to have evolved in humans to enhance survival by fostering cooperation between people, building trust and loyalty, transmit information, and ward off enemies. Churches, choirs, and kirtans are examples where you can sing together with others.

Taken together these effects lower inflammation, elevate mood, calm anxiety and stress, strengthen bonds and trust between people, and reduce loneliness and depression.

Singing could be good for your gut

Singing has another potential benefit, especially if you do it really loudly in the shower or in your car — it can strengthen the vagus nerve, the “information highway” between the brain and the gut.

The vagus nerve is a large nerve that runs between the brain and the digestive organs. Information travels back and forth between the brain and the gut via the vagus. It explains why brain issues can cause gut issues and vice versa. For example, a poor diet or unhealthy gut bacteria can cause depression while a brain injury can suddenly cause irresolvable gut issues.

If brain health is poor or if the brain has suffered damage, the vagus nerve can under function, compromising communication between the gut and the brain. Exercises to strengthen the vagus nerve can be profoundly effective in improving this connection and overall function of both the brain and the gut.

Vagus nerve exercises include gargling vigorously several times a day, pressing on the back of your tongue with a tongue depressor, and, you guessed it, singing loudly. Take advantage of having the house or the car to yourself to really belt out some tunes so your vagus nerve is robustly activated.

The most important thing to know about singing is you don’t have to be good at it. Everyone’s voice has meaning and purpose, including yours.

Ask my office how singing and other forms of neurological rehabilitation and optimization can help improve your brain function.

Which area of your brain is failing? Look at your symptoms

Understanding some brain basics helps you understand symptoms when your brain isn’t working right. The brain is our heaviest and most complex organ, using most of the body’s oxygen and about 30 percent of its energy supply.

The brain is divided into sections, each in charge of different functions although all working together. In functional neurology, we can identify areas of poor brain function and help you get them working better again with customized therapy and rehabilitation.

Frontal lobe

The frontal lobe is the area of your forehead that stretches between the temples. The human frontal lobe distinguishes us from other animals and governs much of our personality, impulse control, and the ability to reason. A frontal lobe injury can completely change your personality and ADHD is understood to affect the frontal lobe.

The frontal lobe also governs emotional drive, motivation, and planning. Poor frontal lobe function can result in an inability to set goals or follow through on projects or plans. You may feel lazy, unmotivated, or depressed if so. In fact, depression is simply a frontal lobe impairment.

The frontal lobe activates the muscles. Poor frontal lobe function can result in moving more slowly or not swinging your arms when you walk.

Fine-motor coordination also falls under the frontal lobe’s duties. This is needed for handwriting, embroidery, and other detailed movements of the hands. As the frontal lobe degenerates it’s typical for handwriting to worsen.

Symptoms and signs of possible frontal lobe impairment

• Slower and less powerful muscle movements
• Depression
• Mental sluggishness and laziness
• Poor impulse control
• Poor social behavior and judgment
• Poor handwriting
• Poor cognitive function, such as poor math or planning skills
• Trouble learning complex things, such as math, new languages,
or philosophy
• Poor muscle-coordination

Temporal lobe

The temporal lobes are located on either side of the brain above the ears. They govern hearing, speech, memory, emotions, and distinguishing smells.

Tinnitus (ringing in the ear) is a common symptom of temporal lobe dysfunction, although not all tinnitus is due to temporal lobe degeneration, as is difficulty distinguishing between different tones.

Within the temporal lobes is the hippocampus, the seat of learning and memory. Degeneration of the hippocampus leads to poor memory and eventually Alzheimer’s disease.

It is also involved with spatial orientation, sense of direction, and circadian rhythm (sleep-wake cycle).

Symptoms and signs of possible temporal lobe impairment

• Poor memory
• Difficulty hearing with background noise
• Episodes of tinnitus
• Abnormal shifts of fatigue throughout the day
• Ongoing episodes of insomnia

Parietal lobe

The parietal lobes are located behind the ears and perceive and interpret sensations such as touch, pressure, texture, weight, size, or shape. The parietal lobe function also tells the body where it is in its environment. Reoccurring injuries are common with parietal lobe impairment.

Symptoms and signs of possible parietal lobe impairment

• Feeling unstable in darkness or with thick or high-heel shoes
• Misjudging where your body is in relation to your environment
• Unable to recognize objects through touch
• Difficulty perceiving where your limbs are and becoming prone to falls and sprains

Cerebellum

Your cerebellum is two lobes at the back of the head, directly above your neck. It calibrates muscle coordination and balance and filters information before sending it to the brain.

Symptoms and signs of possible cerebellum impairment

• Episodes of dizziness or vertigo
• Nausea from visual inputs (car sickness)
• Poor balance
• Subtle shakes at the end stage of hand movement

Occipital lobe

The occipital lobe is in the back of the brain and processes visual information.

Symptoms of possible occipital lobe impairment

• Difficulty processing visual information and recognizing shapes, colors, and motion
• Visual hallucinations
• Visual floaters
• Visual persistence or reoccurrence of the visual image after it has been removed

Any of the above symptoms in adults usually mean degeneration in those areas of the brain while in children it can signal poor brain development. If your overall brain function is declining, you may have many of these symptoms.

The good news is the brain is very receptive to improving with the right nutrients and input. Functional neurology excels in identifying areas of brain dysfunction and customizing brain rehabilitation specifically for your brain. Ask my office for more information.

Exercise soon to be prescribed for depression and dementia

We commonly think of exercise as important to lose weight, relieve stress, or improve heart health. But perhaps its best benefit is that it heals, protects, and supports the brain. In fact, the effects of exercise on the brain are so profound it may soon be prescribed for depression, dementia, Alzheimer's, and Parkinson's.

BDNF: The magic exercise brain chemical

A protein produced in the brain, brain-derived neurotrophic factor (BDNF), helps the brain perform important functions such as:

• Developing new connections between neurons
• Repairing failing neurons
• Protecting healthy neurons
• Protecting the brain from neurodegenerative diseases

Healthy BDNF levels are associated with memory and learning as well as a good, positive mood. When BDNF is low, however, learning suffers, you are more prone to depression, and the risk for brain degenerative disorders such as Parkinson's and Alzheimer's increase.

BDNF levels naturally decline with age — one reason complex tasks that were easy in our youth become more difficult. What's more, one in three Americans have a mutation in the gene responsible for producing BDNF.

If we want to maintain or even improve your brain function as you age, it's critically important to do everything possible to support BDNF production throughout life.

Exercise improves learning and memory

Scientists have known for decades that exercise improves cognition. Exercise triggers the release of proteins and other molecules from fat, muscle, and liver tissue that impact BDNF levels and that can initiate neurogenesis, the formation of neurons.

Exercise also promotes the growth of new blood vessels in the brain. And increase in blood flow to the brain increases the volume of the hippocampus, the brain's seat of learning and memory. It also improves plasticity, the brain's ability to learn by forming new connections between neurons.

Is exercise the new prescription for depression and brain degenerative disease?

Numerous studies are currently researching the potential benefits of exercise for Alzheimer's, Parkinson's symptoms, and depression, making it look like it a likely prescription for these conditions in the future.

But why wait? Try it yourself and see the profound effects it has on your own brain function.

Ask my office how to integrate functional neurology rehabilitation to not only super charge the great effects from regular physical activity, but also to help you develop the motivation and energy to start and maintain an exercise habit.

Parkinson's. Parkinson's patients who exercise show improvements in balance and gait, indicating their brains retained some plasticity (the ability of neurons to form new connections with each other) after their symptoms appeared.

A recent mouse study showed exercise in mice with Parkinson's-like disease increased dopamine receptors in the basal ganglia, brain structures important for learning, movement, and emotion.

Dopamine receptor loss is a hallmark of Parkinson's. In a human study, patients who walked on a treadmill three times a week for eight weeks increased the numbers of dopamine receptors on the basal ganglia.

Mouse studies also showed exercise maintained dendritic spines, the projections on neurons that branch to and connect with other neurons, thus modifying progression of the disease.

Alzheimer's. Studies suggest exercise can help prevent Alzheimer's in those who carry the APOE-ε4 allele, the gene variant most commonly linked with late-onset stage of the disease.

Other researchers are trying to mimic exercise's benefits to dementia by increasing BDNF genetically or pharmaceutically, which may one day offer an option for patients who can't exercise.

Added ways to boost BDNF

Below are some of the methods we suggest in functional neurology to support healthy BDNF levels and brain function:

Exercise. Moderate intensity exercise is linked to increased working memory and cognitive flexibility while high-intensity exercise improves the speed of information processing. However, low-intensity exercise does not have the same effects on BDNF compared to high intensity exercise, so push yourself and make your workouts count. However, don’t overdo it as this increases inflammation, which can inflame and degenerate the brain. Pay attention to the effect of exercise on your brain and find the sweet spot of duration and intensity.

One great way to boost your BDNF is to do the 7-minute workout first thing every morning.

Avoid excess sugars, processed foods, and high-fructose corn syrup because they drive systemic inflammation and can reduce BDNF in the brain.

Intermittent fasting. Studies show dietary restriction stimulates production of proteins such as BDNF that enhance brain plasticity and provide resistance to oxidative and metabolic harm.

Mental stimulation. The brain is like a muscle — use it or lose it.

Omega-3 fatty acids. A diet high in Omega-3 fats is shown to boost brain function. You can find high levels of these fats in cold water fish, walnuts, chia seeds, and flax seeds.

Social time. Animal models show that meaningful social connection improves BDNF levels in the brain.

Curcumin and resveratrol. Curcumin, the anti-inflammatory factor in the spice turmeric, and resveratrol, sourced mainly from red grapes, have been shown to increase BDNF. Taken together they are highly anti-inflammatory.

Stress-reduction habits. When we are under stress we produce less BDNF. Support BDNF with a daily routine that includes a stress-busting activity such as sitting meditation, chi gong, or a walk in the park.

Adequate sleep. Sleep deprivation drives down BDNF levels. Aim for about eight hours of sleep every night and avoid screen time in the evening to help your brain adjust to sleep mode.

Crawling is important for childhood brain development

A toddler's first steps are a milestone event parents eagerly await. However, early walking does not mean your child is advanced. In fact, it can mean your child’s brain has missed some vital developmental steps that will cause problems later.

Two main types of crawling

Experts have observed 25 unique combinations of body parts used by babies to move across the ground, however the two main types are belly crawling and criss-cross crawling on hands and knees.

Belly crawling. About half of babies begin crawling by keeping their belly against the floor. These children typically start crawling earlier than those who start out on hands and knees because belly crawling takes less strength and balance.

On occasion, babies use this method of crawling right up until the moment they walk. Others move to criss-cross crawling before walking.

Criss-cross crawling or hands and knees crawling requires limbs from opposite sides to coordinate with each other. A baby alternates arms and legs, getting the arm on one side to meet the floor at the same time the opposite leg does.

Also called contra-lateral, or cross-lateral crawling, this diagonal style of movement is vital in the development of an important pathway in the brain that belly crawling does not impact — the corpus callosum.

Criss-cross crawling is vitally important to brain development

The corpus callosum is a band of nerve fibers between the hemispheres of the brain. Criss-cross crawling stimulates the corpus callosum to develop in a balanced way, facilitating the hemispheres of the brain to communicate.

A baby’s cross lateral movements work both sides of the body evenly and involve coordinated movements of the eyes, ears, hands, feet, and core muscles. This helps support cognitive function, problem solving, and ease of learning.

Crawling helps hip sockets form

Crawling also serves as physiological stepping stone to walking. The crawling muscle actions start to reshape the hips, pulling them inward and forward. As the baby gets stronger she becomes better positioned to lift her body and balance for walking.

Crossing the midline of the body

In criss-cross crawling a baby can also move a limb to the opposite side of the body, such as touching the right hand to the left shoulder. This type of movement is key for developing vision, hearing, learning, and integration of reflexes.

Other ways crossing the midline helps babies:

• Increases lower back strength in preparation for upright positioning.
• Prepares the ankles for the flexion used in walking.
• Exercises spinal rotation.
• Strengthens hand-eye coordination.

What about other crawling methods?

You may notice your baby using other combinations of limbs and movements to move across the floor. Scooting on the bottom, using one foot or knee to push or pull, crab crawling, leapfrogging, or even repetitive rolling may indicate difficulty coordinating the cross-body movement necessary for hands and knees crawling.

This may occur for various reasons and it indicate your child is missing out on important developmental inputs.

If your baby doesn't seem to want to crawl, find a functional neurology practitioner who can help you learn fun, supportive, nonjudgmental ways to encourage crawling so your baby can gain all the brain benefits.

Be wary of pushing your baby to be upright

Some babies don't crawl on hands and knees and some recent parenting trends will tell you crawling isn't important, but that doesn't mean it isn't vital for development.

For instance, one popular trend that can inhibit development of reflexes and motor function is to prop babies in upright holding devices too often.

Placing a baby habitually into an upright position she otherwise couldn’t get into on her own, whether in a device or by hand, can make it harder for her to meet normal developmental milestones.

This doesn't mean you should never prop your baby up. It is fine to carry your baby upright, hold her at face level for interaction, or sit her in a high chair for eating, but make sure to give her plenty of time on the floor so she can develop her brain-body connections.

How can I help my baby learn to crawl?

The following suggestions can help encourage crawling:

• Give your baby as much floor time as possible. Exploration helps babies try new movements.
• Allow your baby to discover sitting and standing completely on her own. This way she will build strength and coordination necessary for crawling on hands and knees.
• Minimize holding or propping your baby upright to prevent her from developing excess muscle tension that makes crawling difficult.
• Avoid popular trends that tell you crawling is not important.

If your baby arches her back a lot, does not want to curl up and snuggle, does not use both arms and legs, uses rolling more often than crawling, or does not seem interested in moving, seek assistance from a functional neurology doctor.

Science has known for years that children who miss the vitally important crawling stage may exhibit learning difficulties later in life.

Crawling on hands and knees is vitally important for proper development of the brain and body.

Allow your baby to crawl for as long as she wants, and when she walks on her own she will take the benefits forward with her throughout life.

Contact our functional neurology office for more advice.

Functional neurology rehabs brain changes from chronic pain

For people with chronic pain, pain and limited mobility aren’t the only challenges. Long-term pain also affects the brain in ways that lead to chronic depression, anxiety, and cognitive difficulty. In functional neurology we look at not only how to treat chronic pain, but also how to protect the brain from the impacts of chronic pain. Addressing brain imbalances caused by chronic pain can actually help bring relief and begin to unwind the pain.

Scientists at Northwestern University found that in patients with chronic pain, depression and other brain-related symptoms may be triggered by a malfunction in a region of the brain called the cortex.

In a healthy brain, each region activates or deactivates according to its intended functions, creating a natural equilibrium between all the regions that ebbs and flows moment to moment in response to the environment and the body.

But with chronic pain, a part of the cortex "never shuts up," according to Dante Chialvo, lead author of the study.

Areas that ought to deactivate fail to do so, leading to a full-throttle activation that alters connections between neurons and can lead to permanent damage.

Chialvo's team used MRI technology to compare the brains of chronic pain subjects with the brains of pain-free people. When both groups took on the same task, the chronic pain group performed the task just as well as the pain-free group, but their brain functioned somewhat differently.

When certain parts of the cortex activated in the pain-free group, others deactivated, creating the expected equilibrium called the "resting state network."

In the chronic pain group, however, one of the nodes in this network stayed fired up instead of deactivating.

According to Chialvo, "We know when neurons fire too much they may change their connections with other neurons or even die because they can't sustain high activity for so long."

These changes may affect mood and make it more difficult to make decisions.

The findings indicate not only a need for better pain management options, but new ways to prevent the brain dysfunction that may lie behind these symptoms.

That’s why if you find yourself in a situation where you experience chronically it’s important to seek functional neurology rehabilitation not only to dampen or relieve the pain but also to protect your brain from the damages of chronic pain.

Chronic pain is learned by the body like a new skill

Chronic pain is similar to a learned memory such as typing — repetition enables you to learn something new by supporting transmission of the right signals between neurons. Persistent pain becomes chronic because the neurons involved become more efficient at transmitting pain signals.

A recent Canadian study that looked more deeply into this has identified a molecule that can reduce chronic pain-related anxiety by blocking the signals sent between neurons that create chronic pain.

This molecule, called NB001, has powerful pain-reducing effects in animal models and may lead to new medical interventions for chronic pain and anxiety.

Functional neurology methods to address chronic pain

Chronic pain can rob you of enjoyment in life and drain you of the energy to even take the steps to address it.

Conventional treatment relies heavily on quick fixes such as nonsteroidal anti-inflammatory drugs (NSAIDS), narcotics, and antidepressant pain modifiers. However, these substances can build dependencies and potentially cause hearing loss. Temporary fixes for chronic pain don't get to the root causes.

In functional neurology we look at chronic pain from a whole-body perspective, seeking the root causes and addressing them from the ground up. While medications are sometimes necessary, there are many things you can do to mediate pain in other ways.

Inflammation is one of the most common causes of chronic pain. The result of your body's immune response to harmful environmental toxins, allergies, food sensitivities, and stress, inflammation must be mediated in order to relieve chronic pain.

Following an anti-inflammatory diet is key for mediating inflammation. Many common foods are to blame for systemic inflammation, such as gluten, dairy, eggs, grains, legumes, and those in the nightshade family (white potatoes, eggplant, peppers, tomatoes, and more).

Many people experience profound pain relief by simply avoiding one of more of those food categories.

For those with autoimmunity, an anti-inflammatory diet is foundational for managing not only chronic pain, but many other associated symptoms.

A functional neurology practitioner can help determine what tests to run to find out if you have specific food sensitivities.

Avoiding excess sugars is important for quelling pain and inflammation. Blood sugar that is too low or too high, or that swings frequently from one extreme to the other, contributes to inflammation of the body and especially the brain.

Mild to moderate exercise can help reduce systemic inflammation and related pain. While an exercise-induced injury is of course the exception, moving your body helps circulate blood and oxygen, remove toxins, and motivate the immune system to function properly. Be cautious of over exercising, though, as over-doing it can flare up systemic inflammation and pain.

Sleep is one of the most powerful mediators for chronic pain. While sometimes it's the pain itself that keeps someone from sleep, there are ways you can support good sleep such as:

• Get 8-10 hours of sleep a day. If you can't get that much in one stretch, nap whenever possible.
• Go to bed and get up at the same time every day.
• Avoid screen time (blue light) in the hour before bed.
• If you must use a screen in the evening, use blue-blocker glasses, or an app such as F.lux on your computer to filter out the blue tones and allow in the brain-calming amber.
• Sleep in a cool room with plenty of covers to stay warm.
• Make your bedroom only for sleeping, no non-sleep activities allowed.

Stress management. High stress goes hand-in-hand with systemic inflammation. A daily stress-reduction practice such as meditation, tai chi, chi gong, yoga, or laughter and play goes a long way toward reducing pain and inflammation.

Your functional medicine practitioner may have other ways to help alleviate your chronic pain, including:

• Herbal and nutritional compounds to alleviate inflammation, promote sleep, and reduce stress
• Therapeutic body work
• Breathing techniques
• Other lifestyle adjustments

Chronic pain is hard to live with, and to remedy it you must take action. Contact my office for functional neurology help with your chronic pain condition.

Inability to handle rejection a troubling ADHD symptom

Most people automatically associate ADHD with hyperactivity, inattention, and impulsivity — all easily observed from the outside. However, for those who experience this disorder one of the most challenging aspects is invisible to the onlooker — a severe reaction to rejection.

The debilitating experience of rejection sensitive dysphoria

Nobody likes being rejected or falling short of expectations, but for those with ADHD, the response to these situations can be extreme.

Common to ADHD patients, rejection sensitive dysphoria (RSD) is intense sensitivity and emotional pain triggered by the perception — not necessarily the reality — of being rejected, teased, or criticized by those who are important to you.

Also triggered by a sense of falling short of one's own standards or of others' expectations, RSD is the most debilitating aspect for 30 percent of people with ADHD.

People with ADHD aren't weak or "too sensitive" — their brains actually perceive these situations as more painful than others do, and their emotional response hurts them much more than for those without the condition. Some even experience it as physical pain in the region of the chest.

When coping with RSD, a person may internalize or externalize their reaction — and sometimes both:

Internalized RSD can manifest as a major mood disorder, with sudden shifts from feeling fine to feeling intensely sad, even to the point of suicidal ideation. Often misdiagnosed as rapid cycling bipolar disorder, this aspect of RSD is frequently missed by healthcare practitioners.

Externalized RSD may look like a flash of rage at the person or situation at the source of the pain. Possibly related, half of the people assigned court-ordered anger-management treatment have previously unrecognized ADHD.

Those who suffer from RSD tend to anticipate rejection and cope in one or both of these ways:

• Becoming antisocial to avoid the expected rejection. Even the slight possibility of falling short in front of others is too painful and risky to consider. Meanwhile, these smart, capable people give up on social life, applying for jobs, or public engagements because of the fear. This social withdrawal can look like social phobia, which is a serious fear of being embarrassed in public, but they are not the same thing.
• Becoming an avid people-pleaser in an attempt to prevent the situations that cause so much pain. They scan those they interact with to try to determine what will make them happy, then become that person in an effort to be accepted. Some do this at the expense of their true personality. Others cope by becoming overachievers, but the search for perfection is never satisfied, leading to more effort at achievement.

While RSD episodes are intense and don't last very long, recovery can take some time.

Perceptions and self-fulfilling prophesies

RSD can affect relationships with friends, family, and romantic partners. The ongoing perception that you're being rejected can turn into a self-fulfilling prophecy.

Perception is the key word: Someone with RSD might feel they are being rejected or criticized, but the situation may not really exist.

This is also known as a self-fulfilling prophecy: An individual believes something is true, acts as if it was true, anticipates a particular outcome, and this expectation changes their emotional behavior.

As a result, they set themselves up to receive the feedback they expect, which only reinforces the belief.

Do I have RSD?

Some RSD symptoms are shared with other mental health conditions leading it to be confused with:

• Bipolar disorder
• Depression
• Social phobia
• Borderline personality disorder
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)

Because RSD can look like other disorders, it's important to get a proper diagnosis so you can get treatment and learn the right coping skills. If you have ADHD and experience any of these symptoms, see your mental health provider:

• Feel easily embarrassed in social situations.
• Feel instant rage or have an emotional outburst when you think someone has teased, criticized, or rejected you.
• Feel anxious in social settings.
• Set overly-high standards for yourself that you often can't meet.
• Have low self-esteem.
• Avoid social situations.
• Feel like a failure because you haven't lived up to your own or others' expectations.
• Think about hurting yourself.
• Constantly feel under pressure.
• Avoid trying new things due to fear of failure.
• In a constant state of panic in your relationships.
• Unbearable anxiety.
• Often feel depressed and alone.
• Feel constantly rejected by friends, family, or your partner.
• Generally good at hiding your sensitivities.

How do I manage rejection sensitivity?

Aside from getting a diagnosis, the following can help you cope with RSD:

Stay ahead of your emotions. If you feel an episode coming, try to process your emotions rationally. Realize your sense of perfectionism and let it go. Remember that what you perceive as the cause of the rejection may not actually exist.

Seek counseling. A mental health counselor can help you learn how to cope with the extreme reactions common to RSD. However, counseling isn't considered the first treatment option, because the fast reactions caused by RSD are in the moment and they overwhelm the mind.

Reduce your stress factors. Stress over-taxes your nervous and endocrine systems, making it harder for you to cope with situations where your RSD may flare up. In functional neurology we can help create a comprehensive diet and lifestyle plan to reduce and manage your stress level.

There are two possible medication options for RSD:

Alpha-agonist medications. Originally designed as blood pressure medications, guanfacine and clonidine can help. While only 30 percent of people experience relief from either medication alone, 60 percent experience better benefits when both are used.

Successfully treated patients report feeling at peace, as if they have "emotional armor," plus having fewer thoughts at one time.

Monoamine oxidase inhibitors (MAOI) used off-label (for a condition other than that for which it has been officially approved). Effective for both the emotional and attention/impulsivity components of ADHD, this is the traditional treatment of choice.

MAOIs are FDA-approved for mood and anxiety disorders, but patients must avoid the following:

• Foods that are aged instead of cooked
• First-line ADHD stimulants
• All antidepressant medications
• OTC cold, sinus, and hay fever medications
• OTC cough remedies
• Some forms of anesthesia

If you experience RSD, remember you aren't alone: it is experienced by a surprising 98 to 99 percent of adolescents and adults with ADHD and 1 in 3 say it's the hardest part of living with the condition.

For some people, just knowing that RSD is a common part of ADHD brings comfort. It's not your fault, you are not damaged, and there are ways you can improve your reactions to these painful situations to live a full and healthy life.

In functional neurology we have a variety of non-pharmaceutical brain rehabilitation techniques customized to your unique neurology that can help you better manage your ADHD, RSD, and other related symptoms. Ask our office for more advice.

Moss-like plant can act on brain’s cannibinoid receptors

Medicinal use of cannabis is a subject of debate in the US and around the world, however, discovery of the endocannabinoid system has been an important finding thanks to cannabis research. But not everyone who may benefit from the medicinal properties of cannabis wants to use the plant or can access it legally.

Turns out we have options. While it was previously thought that Cannabis sativa was the only plant to produce the medicinal cannabinoid compounds, a family of plants found in Japan, New Zealand, and Costa Rica has been found to offer similar benefits without the psychoactive effects of cannabis.

Patients seek less psychoactive cannabinoids

Cannabinoids are signaling chemicals produced naturally in our bodies. These molecules interact with the cannabinoid receptors found in the brain, immune system, connective tissues, and organs, playing a role in inflammation, pain, mood, appetite, memory, and more.

The Cannabis sativa plant also produces a wide variety of chemical compounds known as cannabinoids.

Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two of the most abundant and well-known cannabinoids. While THC is known for its anti-inflammatory and psychoactive properties, more and more patients are asking for CBD because it has less of a psychoactive effect while combating inflammation.

Cannabis-based cannabinoids are used for a wide range of therapeutic applications, including:

• Inflammation
• Chronic pain
• Loss of appetite
• Asthma
• Insomnia
• Anorexia
• HIV/AIDS
• Depression
• IBD
• Endometriosis
• Fibromyalgia
• Spasticity associated with MS
• Intractable seizures
• Nausea and vomiting associated with chemotherapy

Some states have legalized medical cannabis and even taken steps to legalize recreational use. At the same time, many patients are advocating for increased research due to its potential health benefits and smaller list of side effects compared to pharmaceutical options.

Perrottetinene less psychoactive than THC

In 1994, Japanese phytochemist Yoshinori Asakawa discovered perrottetinene (PET), a compound found in liverwort, but at the time nothing was known about its pharmacological effects.

Then Jürg Gertsch, a Swiss researcher, noticed the rare moss-like liverwort plant was being promoted online for its "legal high" and medicinal uses.

Gertsch and his team developed a new synthesis method to produce large amounts of PET without having to isolate it from the actual plant.

Using mouse and cell models the team found that PET has a molecular structure similar to THC, enabling it to easily attach to the brain’s cannabinoid receptors.

While PET reaches the brain relatively easily it activates cannabinoid receptors to a lesser degree than THC. As a result, PET is much less psychoactive than THC, making it more attractive for medicinal users or for those with moral objections to cannabis.

In another contrast to THC, PET more strongly inhibits prostaglandins in the brain, thus lowering inflammation in the brain.

“In a direct comparison I think PET is the better version of THC,” Gertsch concluded.

According to Ethan Russo M.D., a neurologist and cannabis researcher, this makes PET potentially useful medically because it provides effective anti-inflammatory and painkiller effects without the risk of intoxication, liver ulcers, heart attack, and stroke from NSAIDs and other pharmaceutical interventions.

Russo also noted that this new research should promote additional biochemical research into other liverwort species.

So far PET has only been studied on mice brains and further research is necessary for chronic and inflammatory pain.

It was previously believed that Cannabis Sativa was the only plant to produce cannabinoids. We now know three species of liverwort — Radula perrottetii, Radula marginata, and Radula laxiramea — produce the compound, although only in tiny quantities.

The potential of the liverwort family isn't a total surprise. The Maori people of New Zealand have used the liverwort plant for centuries to treat disorders of the liver and digestive system, and it has long been used in traditional western herbal medicine.

Functional neurology and functional medicine offer effective alternatives to the opiates that have turned into an addiction crisis. In functional neurology we often see chronic pain stem from dysfunctions in the brain, negative feedback loops, and negative plasticity — or a brain that has become highly efficient at producing pain so it happens too easily.

Ask our office how functional neurology and functional medicine can help you relieve your chronic pain.

The cerebellum’s role is greater than we knew

The cerebellum is located at the base of the skull where the spinal cord meets the brain. For years, scientists have believed its only roles were in helping to coordinate and regulate voluntary movement such as walking or writing. However, we've learned it plays a much larger role acting as the brain's “quality control unit.”

An ancient brain structure

Evolutionarily speaking, the cerebellum is an ancient brain structure common to humans, lizards, and fish. It takes up a relatively small portion of the human brain — about 10 percent by weight — but it contains about half of the brain's neurons, specialized brain cells that transmit signals.

More well-protected than other areas of the brain because it sits at the base of the back of the head, we've long known that the cerebellum coordinates voluntary movement.

Any time you shift your balance, coordinate multiple muscle groups, move your eyes, speak, or learn a new movement such as playing a musical instrument or riding a bike, you are using your cerebellum.

The primary integrator of information

The cerebellum is a primary integrator of information for the brain. The body's hundreds of thousands of receptors for vision, motion, and positioning constantly send information to the brain where the cerebellum condenses it and "gates" it on its way to the brain's cortex. The cortex then decides what the cerebellum will tell the body to do about the information.

The brain's ultimate quality control unit

Only a handful of researchers have explored cerebellum functions that might reach beyond motor control. Exciting new research out of Washington University has revealed that the cerebellum isn't only involved in sensory-motor function.

"It's involved in everything we do," says Dr. Jeremy Schmahmann, a neurology professor at Harvard and director of the ataxia unit at Massachusetts General Hospital who was not involved in the study.

It turns out that what the cerebellum does for motor control it also does for cognition and emotion.

The team found that only 20 percent of the cerebellum is dedicated to physical motion while a surprising 80 percent is dedicated to other functions such as:

• Emotion
• Memory
• Language
• Planning
• Abstract thinking

The cerebellum isn't directly responsible for those tasks. Instead, it appears to monitor those brain areas doing the work and helps them perform better by constantly reviewing and improving them.

"We already thought that the cerebellum was cooler than most people thought, but these results were way more exciting and clear than I could have ever dreamt," says Dr. Nico Dosenbach, a professor of neurology at Washington University whose lab conducted the study.

A compromised cerebellum results in poor balance and worse

When the cerebellum loses function, it starts to fail at this job of gating information to the cortex. This provides the cortex with more information than it can manage, causing a form of sensory overload resulting in symptoms such as:

• Anxiety
• Irritability
• Emotional reactivity
• Insomnia due to a racing mind
• Light sensitivity
• Blood pressure changes
• Digestive issues

Common signs of a damaged cerebellum also involve disturbances in muscle control such as:

• Loss of coordination of motor movement
• Inability to judge distance and know when to stop
• Inability to perform rapid alternating movements
• Staggering, wide-based walking
• Movement tremors
• Tendency toward falling
• Slurred speech
• Weak muscles
• Abnormal eye movements

In addition, the cerebellum easily falls prey to environmental toxins, oxidative stress, and food sensitivities — especially gluten.

It also commonly degenerates with age, which is why so many seniors seem to have trouble with balance.

Schmahmann also says that a poorly functioning cerebellum can lead to brain disorders such as depression, schizophrenia, autism, and obsessive-compulsive disorder. He and others will attempt to treat patients by improving their cerebellum function.

Is my cerebellum compromised?

One way to test if your cerebellum is not functioning optimally is to stand with your feet together and close your eyes. If you sway more to one side, it may indicate that side of your cerebellum is more compromised.

Other tests we can use to determine your cerebellum function include:

• Finger to nose with eyes closed
• Walking heel-to-heel in a straight line
• Complex alternating movements
• Ocular tracking

Other signs your cerebellum is not responding properly to its environment may include dizziness, nausea in cars or on boats, or nausea or dizziness when seeing things move swiftly such as in movies.

It's not uncommon for Hashimoto’s hypothyroidism patients to have autoimmunity against their cerebellum. If you have Hashimoto’s and also have symptoms pertaining to balance, dizziness, or nausea, ask our office about screening for brain autoimmunity.

Our busy lives present many challenges when it comes to healthy brain function, such as non-stop stress, inflammatory diets, lack of exercise, unstable blood sugar, and sleep deprivation.

Functional neurology and functional medicine offer ways to improve cerebellar function through diet, lifestyle, and customized brain rehabilitation exercises to improve various areas of the brain. Ask my office for information about how we can use functional neurology to improve yours.

Women react differently to cannabis than men

The use of cannabis for both medical and recreational purposes is increasing along with the growing trend of legalization in many states. As new studies abound regarding its health benefits, we are also learning that men and women can respond very differently to cannabis. This information may lead to improved methods for coping with addiction and other health issues.

The endocannabinoid system, or the body’s own production of “cannabis”

In school we learn about eleven major systems in the body — the respiratory, circulatory, urinary, reproductive, integumentary, skeletal, muscular, nervous, endocrine, lymphatic and digestive systems.

Twenty-five years ago, a scientist researching the effect of THC, the primary intoxicant in cannabis, discovered a twelfth system, the endocannabinoid system (ECS).

He found a highly complex network of receptors in the body’s nervous system now called cannabinoid receptors.

This discovery sent researchers on a hunt for the chemicals naturally produced in our bodies designed to interact with these receptors, now called cannabinoids.

Cannabinoids are endogenous (produced within the body) signaling molecules that bind to and activate the cannabinoid receptors found in the brain, organs, connective tissues, glands, and immune system.

The ECS has complex actions in our immune system, nervous system, and all of the body’s organs, and plays a role in:

• Inflammation
• Appetite
• Pain
• Mood
• Memory
• Reproduction
• Cancer prevention

The ECS also plays a role in how exercise affects the brain and body. Because endocannabinoids can cross the blood–brain barrier, it has been suggested that the endocannabinoid anandamide contributes to the development of the exercise-induced euphoria commonly called "runner's high."

Women and men react differently to cannabis

A new review of animal studies revealed that sex differences in response to cannabis are both socio-cultural and biological, which contributes to our understanding of the different ways women and men respond to cannabis. This invites questions on how addiction treatment strategies may differ between the sexes.

Men are four times more likely to try cannabis than women. They are also more likely to use higher doses and use it more frequently. Researchers say this may be because the male sex hormone testosterone increases risk-taking behavior and suppresses the reward system in their brains.

But while women try cannabis less often and use lower doses than men, a study showed women seem to be more neurochemically vulnerable to developing addiction to cannabis.

Studies in rats show the female hormone estradiol (the most active form of estrogen) affects movement, social behavior, and sensory input to the brain through its effect on the ECS.

It also showed that the female rats had more sensitive endocannabinoid receptors in these areas of the brain compared to the male rats. The female rats also showed more significant hormone changes during the menstrual cycle that affect the female response to cannabinoids.

Research on humans shows that in women blood levels of enzymes that break down cannabinoids fluctuate during the menstrual cycle and brain levels of cannabinoid receptors increase with aging. Both of these factors mirror changes in estradiol.

As research into the interactions between cannabinoids and sex hormones evolves, we'll be able to better assess the impact of cannabis use on women and men and how to better address addiction.

Creating gender-based addiction rehabilitation, detoxification treatments, and relapse prevention strategies for patients with cannabis addiction can improve success rates.

The endocannabinoid system is vital to good health

A functioning ECS produces its own cannabinoids and is vital to good health. The ECS helps bring balance to the body, and may even be effective for restoring balance in relation to many health conditions such as neurodegenerative disorders, autoimmune diseases such as rheumatoid arthritis, and cancer.

Scientists have found that the ECS is dysfunctional in certain conditions associated with hypersensitivity to pain or stimulus such as fibromyalgia, migraines, and IBS.

The existence of the ECS explains why cannabinoids in hemp and other plants are therapeutic for some people by supporting and enhancing the ECS.

The cannabis plant contains more than 100 different cannabinoids with THC being perhaps the most well-known due to its psychoactive qualities. However, with the legalization of cannabis in many states, supplement producers are focused on cannabidiol (CBD) and terpenes, which are not psychoactive — and more frequently allowed by law.

CBD is now widely recognized as the compound responsible for many of the medicinal effects of hemp-based cannabis. Terpenes are the medicinal compounds that give cannabis its distinctive aroma.

There is debate over whether CBD and terpenes are individually therapeutic or whether they work better together in whole plant formulations. Some CBD producers offer both options.

Controversy also exists around whether CBD from non-psychoactive industrial hemp is as effective as CBD from cannabis, which has higher THC levels. Many CBD producers use hemp in order to comply with state and federal rules and to appeal to medical users who don't want to dabble in the psychoactive realm.

Support your cannabinoid system naturally

To boost your endocannabinoid system, adopt these easy lifestyle and dietary habits:

• Avoid alcohol and the associated inflammation.
• Get bodywork such as massage to increase anandamide, the "bliss" cannabinoid.
• Eat plenty of leafy greens; they contain a terpene that activates cannabinoid receptors.
• Eat plenty of Omega 3 essential fatty acids.
• Exercise regularly (but don't over do it) to naturally maximize your "runner's high."

Gum disease has been shown to lead to Alzheimer’s

It has long been known that periodontal disease — a common but preventable gum infection — is linked with health issues such as heart disease, mood disorders, and Type 2 diabetes. While periodontal disease has previously been associated with dementia and cognitive impairment, a recent study is the first to reveal that exposure to periodontal bacteria supports development of plaques that promote the neuropathology found in Alzheimer's disease.

Poor mouth care leads to periodontal disease

Our mouths naturally host many bacteria. Along with mucus and other particles, bacteria form a colorless plaque on the teeth. Regular brushing and flossing help remove plaque, yet when it is not removed it can harden into tartar that brushing won't remove. This can lead to periodontal disease and higher risk for a variety of associated health problems.

Look for the following symptoms of periodontal disease:

• Red or swollen gums
• Tender or bleeding gums
• Receding gums or teeth that appear longer than before
• Bad breath that won't go away
• Loose teeth
• Painful chewing
• Loss of teeth

Risk factors for gum disease include:

• Smoking
• Diabetes
• Hormonal changes in women (pregnancy, contraceptives, menopause)
• Medications that reduce the flow of saliva
• AIDS and other illnesses (and their medications)
• Genetic susceptibility
• Stress
• Fillings that have become defective and leave gaps
• Dental bridges that no longer fit
• Poor diet

Periodontal bacteria linked to Alzheimer's-like plaques in the brain

A team at the University of Illinois recently found that long-term exposure to periodontal disease bacteria in mice causes inflammation and degeneration of neurons (brain cells) similar to the effects of Alzheimer's in humans.

In a comparison to mice who were not exposed to the bacteria, the exposed mice were found to have:

• Significantly higher levels of accumulated amyloid plaque, also found in the brain tissue of patients with Alzheimer's disease.
• Fewer intact neurons and more brain inflammation.
• DNA from the periodontal bacteria found in their brain tissue.
• A bacterial protein found inside their neurons.

While much of Alzheimer's research is done on mice that are specially bred to be prone to the disease, the results of this study were reinforced by the fact that the mice were "wild-type," or not genetically primed to develop Alzheimer's.

Alzheimer's accounts for 60 to 80 percent of dementia cases

Dementia is a general term applied to multiple conditions causing memory loss and other cognitive issues that interfere with one's ability to cope with daily life.

Alzheimer's is a progressive dementia, generally worsening over a period of years.

In the early stages a person may still function independently, driving, working, and engaging in social life. One might notice memory lapses, and difficulty with word recall and location of objects, but symptoms are subtle and not always recognized by the patient or their family and friends.

Moderate Alzheimer's tends to be the longest phase. A person may have more difficulty coping with daily tasks that require mental focus, and memory continues to decline. Mood issues may arise, as well as changes in sleep patterns and increased risk of wandering and getting lost.

In late stage Alzheimer's, individuals lose the ability to have a conversation, respond to their surroundings, and even control their own movements.

Optimize your oral health

While we still have a lot to learn about how oral health relates to Alzheimer's and other diseases, we do know it's wise to take the best care possible of our teeth and gums by adopting these habits:

Brush twice a day for two minutes each time. Make sure to vary the movements and get to all the hard-to-reach places.

Floss daily to remove food and plaque from the spaces between teeth, using regular floss, a special brush, or a water flosser.

Oil pulling. This ancient practice of swishing coconut oil through the teeth has shown to whiten teeth and reduce bacterial counts in the mouth.

Inspect your mouth regularly for gaps between the teeth and gums, redness, bleeding, or teeth that seem to be getting longer.

Visit your dentist regularly for cleanings.

Don't smoke. Smokers have significantly more risk for gum disease than non-smokers. Smoking also reduces chances for successful treatment of gum disease.

Eat a diet low in sugars and rich in vegetables, fruits, legumes, nuts, and fatty fish to provide essential nutrients and help quell inflammation. Some evidence shows omega-3 fatty acids help reduce the risk of periodontal disease.

Functional neurology helps prevent Alzheimer’s

Understanding the causes and risk factors for Alzheimer's is key for developing successful treatment protocols, especially since more than 95 percent of cases are late-onset with largely unknown causes.

If you are suffering from early stages of memory loss and other early warning signs of dementia, it’s important to take action right away.

In functional neurology we perform a comprehensive brain exam to see which areas of your brain are under active, over active, or degenerating too quickly. Customized brain rehabilitation exercises can help restore your brain function and health and stop the accelerated degeneration associated with dementia and Alzheimer’s.

Additionally, in addition to considering your oral health, we also use functional medicine strategies to evaluate and address your overall health so your brain has an optimal chemical environment in which to operate. This includes looking at your diet, lifestyle, supplementation, gut and immune health, blood sugar stability, chronic infections, and exposure to toxins.

Please contact my office for more information about how functional medicine can help you protect your long-term health.

If your insurance doesn't offer dental coverage and you can't afford it on your own, you may be able to find help via these resources:

• The Health Resources and Services Administration supports a network of clinics for people who qualify for reduced-cost care (toll free: 1-888-275-4772).
• Most dental schools have a training clinic staffed by professors and students, and care is provided based on your ability to pay.
• Your state dental organization may be able to refer you to dentists in your area who provide dental care at a reduced rate.

Autism linked to DDT exposure in the womb

A recent Finnish study found a link between DDT, the banned insecticide that is still prevalent in the environment, and autism. Pregnant women with elevated blood serum levels of a breakdown product of DDT showed increased risk of having children who went on to develop autism. The study is the first to connect an insecticide with increased autism risk.

Maternal DDT exposure raises autism risk in children

In a study of more than 1 million pregnancies, researchers identified almost children with autism and compared them to mother-child pairs without autism.

Maternal blood taken during early pregnancy was analyzed for DDE, a metabolite (breakdown product) of DDT. They also evaluated PCBs, another long- banned toxin that nevertheless remains in the environment.

They found that:

• The odds of autism were nearly one-third higher among children whose mothers had elevated DDE levels.
• The odds of autism more than twice as high among children whose mother's DDE levels were in the top 25 percent. 

These findings persisted after adjusting for maternal age, psychiatric history, and other factors.

While the study showed a strong link between maternal DDT and autism risk, it showed no association between PCBs and autism. The researchers propose two reasons. First, maternal DDE is associated with low birth weight, a well-researched risk factor for autism, whereas maternal PCB has not been linked to low birth weight.

Second, they propose a connection with hormone function in which DDE has more of an impact than PCB.

The study is the first of its kind to link a pregnant woman’s blood levels of an insecticide to an increased risk of autism in her offspring. Previous studies have looked at pregnant women’s proximity to sites contaminated with pollutants.

Wasn't DDT banned decades ago?

DDT has not only been linked to autism, but also to the following:

• Breast cancer
• Reproductive difficulties
• Changes to the nervous system
• Impaired immune system function
• Liver damage

DDT and PCBs were banned in many countries more than 30 years ago. However, they remain in soils and elsewhere in the environment because they take decades to break down.

Exposure happens in small increments, mostly from eating foods that contain minute levels, in particular fish, poultry, and meat.

DDT attaches to the roots of plants, but it does not easily move to other parts of the plants. However, DDT in the air can be deposited on to the surfaces of plants, making them carriers as well.

In addition, not all countries have banned DDT, so it is possible to ingest it via imported food products or while traveling.

When we ingest DDT, the amount we actually absorb depends on what it was attached to when ingested.

As a result, a pregnant women passes on DDT metabolites to unborn baby.

DDT and DDE are more soluble in fats and oils, and more bioavailable when mixed with them. Because they are more fat-soluble than water-soluble, they tend to concentrate in our fatty tissue — in fact, they can be found in fat at levels several hundred times that of found in the blood.

Over time, the liver metabolizes DDT/DDE and makes it water-soluble for removal, but the process is very slow. According to the University of Nevada, it has a half-life of 8 years, meaning an amount you ingested 8 years ago is now only reduced by half.

How do I avoid DDT?

DDT and DDE can be found in root crops, leafy crops, grains, fatty meats, fish, poultry, milk, cheese, and oil. They may be found in small amounts on US food but can be found in larger amounts in or on imported food products.

Below are ways to reduce your DDT exposure:

• Wash your produce to remove DDT residues.
• When cooking fish, remove the skin and visible fat, then broil, grill, or bake the fish so the fat drips off.
• Support liver health and detox capabilities.
• Be aware of health advisories for imported foods source where DDT is applied.
• If you fish local waterholes, check your state website for DDT advisories.
• Supplement with curcumin, which has anti-carcinogenic and anti-inflammatory properties. Curcumin also inhibits the estrogenic effects of DDT and is synergistic with phytoestrogens.

For more information about how to support your body's ability to cope with DDT in the environment, contact my office.

Nutrients to help repair your leaky blood-brain barrier

The brain is surrounded by a thin lining called the blood brain barrier, which prevents harmful compounds from entering the brain while allowing helpful nutrients in and cellular debris out. However, for a lot of people the blood brain barrier degrades, allowing harmful toxins and compounds into the brain. This causes inflammation in the brain and symptoms such as depression, brain fog, memory loss, and other brain-based symptoms and disorders.

The strategies for repairing a leaky blood brain barrier are similar to the strategies for repairing a leaky gut because the causes are similar. Some of the more foundations include balancing your blood sugar, removing inflammatory foods and chemicals from your diet and environment, and focusing on a whole foods diet that is abundant in produce.

However, beyond that certain nutritional compounds have been shown to help repair a leaky blood brain barrier:

Resveratrol. Resveratrol is a potent anti-inflammatory and antioxidant (protects against damaging free radicals) known to help prevent development of neurodegenerative diseases.

Resveratrol can increase your brain's growth hormone, support mitochondria, and protect and restore the blood-brain barrier.

Curcumin. Often used in conjunction with resveratrol, curcumin is the anti-inflammatory component of the spice turmeric. Heavily researched, curcumin can:

• Lower stress hormones
• Increase the brain's growth hormone
• Reduce hyper-permeability of the blood-brain barrier
• Reverse blood-brain barrier dysfunction
• Improve integrity of the blood-brain barrier
• Reduce inflammation and oxidative stress
• Sulforaphane. A phytochemical found in cruciferous vegetables such as broccoli, cabbage, and Brussels sprouts, this antioxidant has anti-inflammatory qualities similar to curcumin.

Studies show it can prevent breakdown of the blood-brain barrier, reduce its permeability, and improve brain function after traumatic brain injuries and stroke.

If you take sulforaphane in supplement form, make sure it contains the co-factor myrosinase.

Vitamin D. Vitamin D is a powerful tool in managing inflammation and autoimmunity. Every tissue in your body has vitamin D receptors. Studies show it can help prevent leaky brain by reducing inflammation and reducing blood-brain barrier disruption.

Ways our modern lifestyle contributes to a lack of vitamin D:

• Modern diets lack vitamin D-rich foods such as liver and organ meats, seafood, butter, and egg yolks
• Chronic stress and elevated cortisol (stress hormone) depletes vitamin D
• Gut inflammation reduces absorption of vitamin D
• Obesity contributes to vitamin D deficiency

While we think of direct sunlight as the best way to get vitamin D, not everyone can make enough this way. To maximize your vitamin D levels, get 15 minutes of sun on your skin every day and take care of your gut health to optimize absorption of dietary vitamin D.

In the absence of exposure to enough sunlight, it's recommended to supplement with a minimum of 1000 IU of vitamin D3 (not D2) daily to maintain proper blood levels.

Some people need much higher doses, from 5,000 to 25,000 IU per day. If you take higher doses, have your blood levels tested periodically to avoid toxicity.

Emulsified vitamin D is best for those with poor digestion.

B vitamins. Several B vitamins support the health of the blood-brain barrier:

• Vitamin B1 (thiamine) deficiency disrupts the blood-brain barrier and supplementation can restore it.
• Vitamins B12, B5, and B9 (folate) can restore blood-brain barrier integrity.

Magnesium. A vital mineral for more than 300 biochemical processes in your body, magnesium affects brain neurotransmitters, enzymes, and hormones. Many people are deficient, so ask your healthcare practitioner of you should be tested.

Magnesium protects the brain by:

• Protecting the blood-brain barrier
• Supporting mitochondria
• Increasing the brain's growth hormone
• Assisting in overcoming addiction and withdrawal

Strong dietary sources of magnesium include:

• Spinach
• Chard
• Almonds
• Avocado
• Banana
• Pumpkin seeds
• Dark chocolate

Omega 3 fatty acids. Essential fatty acids (EFA) are fats our bodies need but can't produce on their own, so they must come from food sources or supplementation.

EFAs are critical for:

• Dampening inflammation and autoimmunity
• Supporting blood vessel and skin health
• Production of hormones

It's estimated that up to 80 percent of the US population is deficient in EFAs.

Primarily found in fish, Omega 3s are EFAS that support your mitochondria, increase brain growth hormone, and support the blood-brain barrier.

When consuming EFAs, it's important to consume the proper ratio of Omega 3 to Omega 6. Omega 6 is a necessary EFA but taken in the wrong ratio to Omega 3 it is highly inflammatory.

The average American consumes a shocking ratio of Omega 6 to Omega 3 of 25:1, contributing to the epidemic of inflammation-related health disorders.

Researchers recommend a ratio of Omega-6 to Omega-3 that ranges from 1:1 to 4:1. A recommended dose is 3,500 mg for a person eating a diet of 2,000 calories per day.

As you now know, it's important to take great care of your precious blood-brain barrier. Many of the above suggestions also benefit other health issues, so by adopting them you are hitting more than one target at a time. For more information on how to fix your leaky brain, please contact my office.

Brain inflammation can be at the root of your suicidality

If your antidepressants aren’t helping your severe depression or suicidal thoughts, you’re not alone — but an alternative could be the key. New research shows brain inflammation plays a key role in depression, pointing the way to new treatments for depression and suicidal ideation.

For decades, depression has been treated as a chemical imbalance in the brain’s neurotransmitters — most often serotonin, norepinephrine, and dopamine.

Commonly prescribed medications such as SSRIs (selective serotonin reuptake inhibitors) and NDRIs (norepinephrine and dopamine reuptake inhibitors), attempt to resolve depression by changing how the brain stores, transports, and reabsorbs these key brain chemicals.

While this treatment helps some, it proves inadequate for many others. For those with severe depression and suicidal thoughts it can strand them in the danger zone with nowhere to turn.

The inflammatory model of depression: Microglial over-activation

New research reveals the root of depression may not be chemical imbalance but instead chronic inflammation that disrupts brain function. This can lead to malfunctions in how the brain manages not only its neurotransmitters, but other key functions such as fighting inflammation, immune response, and communication with the rest of the body, including the gut.

A team at the University of Manchester has found a strong correlation between major depressive episodes and increased neuroinflammation — inflammation of the brain's neurons.

At the root of this relationship is increased activity of microglia cells (glial cells), the immune cells of the brain and nervous system.

Glial cells outnumber other neurons in the brain and are responsible for removing debris from the brain. As neurons die, the glial cells chew off the dead portions so that communication between remaining cells is not impaired.

Under normal circumstances, glial cells do their cleanup and the brain returns to normal. However, processed foods, environmental toxins, sleep deprivation, and chronic stress spikes inflammation in the brain.

Unlike other immune cells in the body, glial cells don't have an easy off-switch. When brain inflammation continues unabated, glial cells become over activated, creating an inflammatory cascade that damages neighboring neurons and destroys their ability to communicate with each other. This can result in brain fog, depression, and worse.

Glial cell over activation is fueled by:

• Chronic systemic inflammation
• A diet high in sugars, carbs, processed foods, and industrial seed oils
• Poorly regulated blood sugar
• Food sensitivities
• Autoimmunity and other chronic health conditions
• Chronic viral infections
• Traumatic brain injuries (even minor concussions)
• Gluten sensitivity

Glial cell over activation linked to suicidal thoughts

The study compared subjects with moderate to severe depression and suicidal thoughts to a control group of healthy subjects with no depression. In the depressed group, brain scans showed increased microglial activity.

The most significant increase was observed in the part of the brain responsible for mood regulation, pointing to a link between suicidal thoughts and increased brain inflammation. The control group showed no elevated glial activity.

Prior studies of post-mortem suicide subjects also showed similar inflammation in these brain regions.

Do I have glial cell over activation?

Look for these clues your brain is inflamed:

• Brain fog
• Depression
• Anxiety
• Poor memory
• Physical or mental fatigue
• Difficulty finding words
• Gut inflammation (the gut is connected to the brain via the vagus nerve)
• Food sensitivities
• Leaky gut

Lowering brain inflammation to relieve depression and suicidality

Many functional neurology patients have relieved depression by addressing brain inflammation.

Below are ways you can minimize inflammation and protect your brain.

Exercise regularly. Exercise can literally save your brain. Raising your heart rate a few times a week positively impacts your brain by flooding it with healthy brain compounds such as brain derived neurotrophic factor (BDNF), which helps neurons communicate better. It only requires a few minutes of high intensity exercise to increase BDNF levels. The more coordination required for the exercise, the better it is for your brain.

Control blood sugar. Whether you have chronic high blood sugar (insulin resistance) or low blood sugar (hypoglycemia), imbalanced blood sugar is inflammatory to the brain. Left unmanaged, it can be one of the most damaging factors for the brain. In fact, chronic high blood sugar is so damaging to the brain, neurologists call Alzheimer’s disease “Type 3 diabetes.”

Symptoms of chronic high blood sugar (insulin resistance):

• Constant sugar cravings, especially after meals
• Fatigue after meals
• Constant hunger
• Waist girth equal to or larger than hip girth
• Frequent urination
• Increased appetite and thirst
• Difficulty losing weight
• General fatigue

Symptoms of chronic low blood sugar (hypoglycemia):

• Lack of appetite or nausea in the morning
• Sugar cravings
• Eating to relieve fatigue
• Irritability, light-headedness, or dizziness when you miss a meal
• The need for caffeine for energy
• Energy crashes in the afternoon

Adopt an anti-inflammatory diet. American diets are high in sugars, processed foods, allergens such as corn, soy, and wheat, and inflammatory foods such as gluten and nightshades. An anti-inflammatory elimination and reintroduction diet can help determine what foods may be causing you undue inflammation. Contact my office for guidance on how to manage this protocol.

Fix leaky gut and leaky brain. Leaky gut happens when the lining of the small intestine becomes inflamed, damaged, and over-porous, allowing undigested food particles, toxins, and other pathogens into the bloodstream. These pathogens trigger an immune cascade that leads to systemic inflammation, increasing your risk for more inflammation, food sensitivities, and autoimmune disease.

The brain is surrounded by a protective layer called the blood-brain barrier (BBB), meant to allow nutrients in and keep pathogens out. Similar to leaky gut, inflammation can disrupt the integrity of the BBB, making it over-permeable.

This allows inflammatory pathogens into the brain, firing up the immune response and glial over activation. Once the BBB is leaky, many other immune triggers can feed the inflammatory fire.

Avoid gluten. Gluten exposure opens the lining of the blood-brain barrier, allowing inflammatory pathogens into the brain and contributing to glial over activation and damage to brain cells and function.

For those with celiac disease, gluten exposure activates zonulin, which opens the lining of both the gut and the BBB, leading to more brain inflammation.

Manage stress. Regular stress-reduction practices are anti-inflammatory and provide great benefits for brain health. Even a few minutes a day of one of the following can make a difference:

• Meditation
• Deep breathing
• Yoga
• Tai Chi
• Dance
• Laughter
• Hug a tree
• Walk in nature
• Gratitude journaling

Improve circulation to the brain. In addition to exercise, look for other ways to increase brain circulation such as:

• Gingko biloba
• Eliminate smoking
• Address asthma
• Address hypothyroidism (and associated anemia)

Address head injuries. If you have a head injury, you need to address it no matter how mild or severe. Even a mild head injury can initiate glial cell-over activation, and many with old untreated head injuries have an inflammatory fire smoldering in the brain that can erupt years later in the form of mood issues, brain dysfunction, and worse. Those with multiple head impacts over time are especially at risk — even if the injuries have all been minor.

While it was previously thought that the intensity of the head trauma mattered most, we now know that other factors such as an inflammatory diet, lack of exercise, toxic overload, and chronic stress set the stage for how well your brain and immune system will respond to trauma, regardless of the intensity.

An exciting future for depression treatment

Ongoing research will offer more answers to how inflammation relates to depression. Meanwhile, functional neurology offers numerous tools to reduce its impacts on the body and brain. For more guidance into how you can use the above tools to minimize brain inflammation and reduce your depression, contact my office.

Exercise your vagus nerve for better gut health

Are you following the right diet and taking all the right supplements yet still struggling with irresolvable gut problems? The problem could be in your head, or more exactly, in the large nerve that runs between your brain and your digestive system.

Called the vagus nerve, this large nerve sends communication back and forth between the brain and the organs, including the digestive organs. If your gut problems are accompanied by poor memory, brain fog, problems with cognition, or other brain symptoms, then you know you might have a sluggish vagus nerve.

Indigestion, acid reflux, constipation, burping, gas, bloating, diarrhea, pain, and irritable bowel disorders are some of the common problems that result from an insufficiently active vagus nerve. A problematic vagus nerve is also evidence that your brain is degenerating, or aging, too quickly.

The brain delivers commands to the gut via the vagus nerve. This function executes digestion, gut repair and regeneration, moves food through the intestines (motility), secretes digestive enzymes and juices, triggers digestive hormones, and more.

When brain function deteriorates or the brain degenerations, the vagus nerve does not receive sufficient communication from the brain to deliver to the gut. This poor communication between the gut and the brain causes constipation, leaky gut, food sensitivities, irritable bowel disorders, and other gut problems.

This is one reason gut problems are common among people with brain injuries, the elderly, or people struggling with poor brain function.

Exercise the vagus nerve to improve gut function

A functional neurologist conducts a thorough exam of your brain health and function and then customizes a rehabilitation program unique to your brain. This rehabilitation may include activating your vagus nerve to improve your gut function.

The good news is you can also activate your vagus nerve on your own at home with some simple exercises.

How to exercise and improve your vagus nerve

First, how do you know if you need vagus nerve activation?

• Look at the back of your throat in the mirror when you say “ahhhh.” If the uvula (the little punching bag at the back of your throat) does not rise much, that’s an indication of a sluggish vagus nerve.
• You don’t have much of a gag reflex; you can test this by pressing on the back of your tongue with a tongue depressor. It should make you gag.
• If possible, listen to your abdomen with a stethoscope. You should hear intermittent rumbling noises. If you hear virtually nothing, this indicates sluggish bowel and vagal activity.

So, it looks like you have a sluggish vagus nerve, now what? Here are some exercises to activate the vagus nerve, taken from Dr. Kharrazian’s book, Why Isn’t My Brain Working?. You can also contact my office regarding some other methods of activation. It is a growing field with many innovations.

Robustly gargle several times a day. Gargle each sip of a glass of water several times a day hard enough to make your eyes tear up.

Sing loudly. Sing as loudly as you can several times a day if you are in a place where you can do this, like the car.

Gag. Use a tongue depressor to gently press on the back of your tongue and make yourself gag several times a day until your eyes tear. This is one of the stronger approaches; just be careful not to poke the back of your throat.

Coffee enemas. Google coffee enemas and hold the enema solution as long as you can.

This is a very simple summary of how to activate the vagus nerve. For more advice unique to your brain’s needs, please contact my office.