174 | The Better-Brain Equation (Part 2): An Introduction to Functional Neurology, ADD and Autism

Unlock the secrets to maintaining a healthy brain and ward off the stealthy culprit of neuroinflammation in our latest episode of the Inflammation Nation podcast. We promise to guide you through the maze of factors leading to what we call a "bad brain," from early developmental challenges to the hidden aftermath of concussions and the silent effects of aging. Join us as we chat with experts Drs. Rob Melillo and Peter Scire, who lend their insights into how brain injuries and metabolic imbalances can set off a chain reaction of neurological issues. If you've ever wondered about the long-lasting impacts of seemingly minor knocks to the head or the subtle ways nutrient deficiencies can alter brain function, this episode could be eye-opening.

Our exploration doesn't stop there. We also tackle the concept of microglial priming and its role in prolonged brain inflammation, an often-overlooked aspect that might be key to protecting your mental faculties. For practitioners and listeners interested in functional medicine, glean practical tips on using natural methods like diet and lifestyle changes to support brain health, all while emphasizing the critical role of professional medical advice. Whether you're a parent, a practitioner, or simply curious about the intersection of brain health and overall wellness, this episode offers a treasure trove of knowledge and actionable insights to help you better understand and improve your brain's resilience.

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Transcript

Speaker 1 0:02

Hey everyone, welcome to the Inflammation Nation podcast. I'm your host, Dr Steve Noseworthy.

Speaker 2 0:08

One of the greatest obstacles to crafting health and wellness is identifying and controlling inflammation. It's at the core of all complex and chronic diseases and it's the driving mechanism that underlies the most common symptoms that people like you struggle to overcome. Join us as we explore cutting-edge science and research to give you the information and tools you need to create the quality of life you want and deserve. And now here is the host of Inflammation Nation, dr Stephen Nosworthy.

Speaker 1 0:37

Hey guys, welcome back to the podcast. This is part two of the Better Brain Equation, and this two-part series is really an introduction to a multi-part series of interviews that I'm doing with two amazing clinicians, researchers and educators, and they are Drs Rob Melillo and Peter Skier. So if you missed part one of this introduction, go back and listen to that. Today I'm simply going to continue on where I left off in part one, so it's important that you get the grounding of part one. The whole point of this series is to raise the bar on how you, as a healthcare consumer, understands your brain as an integral part of quality of life, and to understand how your brain is involved to one degree or another in all of the major health issues that we see very common in the world today. And since this interview is going to be on both of my podcasts, I also want to partner with Drs Malolo and Skyer to challenge our practitioner colleagues to develop their understanding of the brain so that we can all serve our communities better. And whether you are a parent of a child with ADD, adhd, developmental delays or even autism, or if you're an adult who yourself suffer with things like anxiety, depression, insomnia, ocd, perhaps balance issues, or if you are a functional medicine practitioner and you want to learn more about how the brain develops and works, then I highly recommend that you get Dr Melillo's book Disconnected Kids and make sure that you get the newly released third edition, since it actually has at least 30% new information over the second edition. That's how editions work In order to have a second edition, you have to have 30% new information over the first, and so on. And just so we're clear, I have no financial interest here. I'm making these recommendations based solely on the quality and the utility of the information in the Disconnected Kids book, as well as my personal and professional high regard for Dr Skyer and Malila.

Speaker 1 2:44

All right, so in the last episode I told you that in this episode we were going to talk about how brains go bad and in essence there are four core mechanisms. Of course there are others, but these are the main ones that we need to think about and talk about. The first mechanism of a bad brain is poor development. The second mechanism of a bad brain is head injury or concussion. Same thing, two different terms. The third mechanism of bad brain is a metabolic imbalance or disturbance that affects how the brain functions. And then the final mechanism of the bad brain is poor aging, and notice that I said poor aging and not just simply aging. Notice that I said poor aging and not just simply aging. Now, these are not mutually exclusive. You can have more than one, and having one tends to promote the others. For example, since the brain is in control of metabolism and even, to a certain extent, immune function, poor development of the brain tends to lead to metabolic issues and immune dysfunction, which then can have an impact on how the brain works. So it's a reciprocal relationship or two-way communication. But even if your brain developed in a perfectly symmetrical way and on time, meaning that you hit all of your developmental milestones as a child, injuring your brain with a concussion shifts the metabolic states of the brain, introduces this thing called neuroinflammation We've talked about that before on the podcast and this neuroinflammation then affects how the brain controls metabolism and even immunology again, to a certain extent. And so while I'm introducing you to a list of number one, two, three and four, they're not discrete entities, they all bleed into each other, so let's go over these one at a time. We're going to do this in summary form because, again, it's an introduction, it's not a full, detailed analysis.

Speaker 1 4:35

The first mechanism of bad brain is development. We talked a little bit about that in the first episode. In the interviews with Dr Skyer-Malilla we talk a lot more about that. But as far as development goes very quickly, your brain begins to develop within the first three weeks of conception. That's where we start to see the tissue changing, which eventually forms into a full human, fully functional human brain. And you'll remember that, even in utero.

Speaker 1 5:02

So baby's brains run some of these primitive reflexes that assist the birthing process but also which support survival via reflexive feeding behaviors once the baby's born. So when babies get hungry they cry. If you stroke the side of their cheek they will open their mouth and turn their head towards the side that you stroked so that they can latch onto a nipple to eat, and this is called the rooting reflex. Now there are other reflexes that have to do with feeding behaviors. There are others that relate to startle reflexes, with loud sounds, for example, others that relate to movement of the spine and limbs. But the key to remember here is that these are brainstem reflexes that, over the first few weeks and even months after birth, drive information into the cortex, into the higher brain, so that the higher brain can develop is all about survival, but the primitive survival reflexes drive sophistication of the cortex so that we eventually learn to move and to speak and to emote, or create and explore our world and connect with people and so on. So bad development or improper timing of development, asymmetrical development of the brain, is one way we can create a bad brain.

Speaker 1 6:25

The second mechanism of bad brain is injury and of course, at any point in life we can sustain an injury to our brain through concussion, whether that is mild or even all the way up to severe traumatic brain injury. For example, if a baby falls and hits their head, this could affect development of the injured regions, leading into an imbalance. Kids, teens, adults can sustain injuries in sports, during recreational activities, on the job, tripping and falling. I remember working many years ago with a woman who sustained a pretty nasty concussion standing up quickly in her kitchen. She was bent over getting something underneath the counter and she stood up and hit her head on an open cabinet door and caused a severe concussion. If I remember the details correctly, because it's been a while, she even lost consciousness for about 10 seconds or so.

Speaker 1 7:21

Car accidents are another common cause of head injury, and one thing that we know about head injury is that the effect on the brain itself isn't tied exclusively to the magnitude of the impact, because you would think, well, a small impact means no injury, and you have to have a certain magnitude of force to create an injury to the brain, and that's not necessarily true. Now, of course, the magnitude of impact matters, and it is easier to understand how hitting your head very hard could lead to a concussion, but even smaller forces can have major impacts, especially if the brain is unhealthy to begin with or there are multiple related low force injuries that accumulate over time. I spent many years of my chiropractic career early on working with people who were injured in a car accident, and many of them showed post-concussive symptoms despite not hitting their head when the accident happened. And it turns out that your brain floats on a thin cushion of fluid inside your skull. And when your head whips forward and back during a car accident, the brain literally sloshes up against the inside of your skull, and so a concussion in that sense can be from an internal impact rather than an external one. Obviously, if you hit your head on a steering wheel or the dashboard or a window, it's easy to see how you can get a concussion, but many people don't understand that there doesn't have to be an external impact to have a concussion in the brain in the context, for example, of a rear-end motor vehicle accident. So one of the factors determining the effects of a head injury is the magnitude of force, but don't discount these low-force injuries or even injuries without an external impact, and this is more likely to happen when the brain is already unhealthy. The pre-existing state of the brain is a major factor to consider, since unhealthy brains are more sensitive to lower-impact forces. It would be a mistake to think that a low-force impact wasn't an issue because it wasn't a high-force impact. And it would also be a mistake to think that a low force impact wasn't an issue because it wasn't a high force impact. And it would also be a mistake to think that a head injury without immediate effects or loss of consciousness is not a problem either.

Speaker 1 9:35

The neurology literature confirms that any head injury with loss of consciousness is very significant, and the longer you're out, the worse the effects will typically be. But just simply getting your bell rung without losing consciousness is also significant. So if we put all of this together, maybe into some kind of a hierarchy from worse to still bad but not as worse would look like this the most severe would be a major head impact with loss of consciousness. Then the longer you're out, the worse the impact on the brain. Typically the next still bad but not as bad would be head injury without loss of consciousness, but with immediate post-concussive symptoms, again feeling like you had your bell rung, you're dizzy, you're woozy, you're kind of out of it, you feel off kilter, you're fuzzy. However, you might describe that A little bit less impactful would be a post-concussive symptom that lasts for weeks or days, versus those that might last only for a few hours or maybe a day or two.

Speaker 1 10:40

So if you have post-concussive symptoms, even though you might not have lost consciousness, the longer those post-concussive symptoms last, typically the worse it is for the brain. The next step down would be any low-force injury that creates immediate or prolonged symptoms even though there's no loss of consciousness, and then the final step on that ladder, if you will, would be mild injury that doesn't create any noticeable immediate or short-term effects, and so we have a wide range of possible presentations or manifestations that factor in the magnitude of the impact the pre-existing state of the brain, whether or not you had post-concussive symptoms that showed up immediately or a little bit later and how long those post-concussive symptoms lasted. And of course, loss of consciousness is a critical factor there as well. And so you can look at whatever. If you have had head injuries in the past, you can look at that spectrum or that continuum, if you will, and just kind of gauge for yourself okay, how serious could this potentially be? And on this last note of you know maybe you've had a head injury, but it was a long time ago I want to address this idea that or the reality in a common occurrence that people tend to discount head injuries that number one they didn't lose consciousness, or that happened years in the past. They just don't think it's relevant or it doesn't apply to them today. To that I would say this About 15 years or so ago I was a co-author of a paper that reviewed the current medical literature on the metabolic effects of head injury and concussion, and one thing that we all learned from that was that head injury always comes with a price, even if that price isn't paid until decades after the injury itself, repaid until decades after the injury itself.

Speaker 1 12:40

And one of the main reasons for this is that any head injury creates what we call microglial priming. Now, microglial cells are immune cells in your brain that create brain inflammation, and we need them to be active at a low level to keep the brain healthy. But when they become overactive or primed would be the right word they create sustained neuroinflammation which makes the brain sensitive to other things. In fact, the low force head impacts that translate into major brain injury. It's usually because the brain is already inflamed through this process of microglial priming, and this makes the neurons of the brain much more sensitive, not just to mechanical forces, but also to changes in brain chemistry. In fact, the neurological literature talks about something called chemical concussion or chemical reconcussion, which is where someone has a history of past tannetry, has lived for some time with an inflamed brain, and all it takes is a stress event, an illness or a bad shift in your hormones, among other things, to recreate the effects of the concussion through a biochemical change Not through head impact, but through biochemical change. And again, it's called chemical reconcussion.

Speaker 1 13:54

And this leads me into the third mechanism of creating a bad brain, and that is any metabolic imbalance that affects the brain, and I'm not just talking about changes in the internal chemistry of the brain, meaning things that are happening in the brain itself, like microglial priming, or people. When you talk about brain chemistry, they immediately think about things like neurotransmitters. I mean to include anything about your body's metabolic state that can affect the brain. So I'm just going to give you a quick list. We've talked about these over and over again in the course of the podcast in the last couple of years, but things like low iron status or being anemic, deficiencies of key nutrients like vitamin B or I should say B vitamins, because it's more than just one that's applicable to the brain omega-3, fatty acids, vitamin D, for example, blood sugar problems, adrenal dysfunction and the changes in stress chemistry, whether or not you have a leaky, infected gut, do you have things like irritable bowel syndrome, are your hormones screwed up, are you sensitive to environmental chemicals, and the list goes on and on and on. And so, while the brain's environment is supposed to be protected by this thing called the blood-brain barrier, it is permeable to many things, especially when poor health breaks that barrier system down and things normally excluded from the brain are allowed to get into the brain In reality, again, pretty much everything I've talked about for the last two years or so on.

Speaker 1 15:25

This podcast has the potential to impact your brain in one way or another. So if the goal is to fix your brain or the brain of someone you love, or if it is to protect a brain from going bad as you age, then you are obligated to find and fix any and everything about your metabolic state. And that leads me to the final mechanism of creating a bad brain, and that is simply time. Time is the enemy of health, and it is true that most of your major systems start to falter with age. But while we can see decline in major body systems starting around the age of 40, the rates of decline over time and what you have left at the end of your life is dependent on how well you take care of yourself before and after the age of 40. The healthier you are, the more physically and mentally active you are before. 40 gives you an extra reserve. It gives you a better starting point, so that any inevitable changes are taking away from a surplus, which leaves you with plenty left over by the time you're, say, 85 years old. Here's an analogy. It's probably an imperfect one, but if you're going out with your friends and you know the night is going to cost you $50, isn't it better to have $100 in your pocket so that if something else comes up, you have the cash to handle it? You're not going to go out with $50 when you know the night is going to cost you $50 because it doesn't leave you any reserve. The more reserve you have, the better you can handle the aging process.

Speaker 1 17:04

And the people who end up in their 80s and 90s with their brains and bodies intact are typically those who had only acceptable asymmetries between left and right brains, because they develop properly and on time. These are typically people who maintained physical activity. They were metabolically controlled through their young adult lives and their youth. They typically stayed active physically through their lives and especially took on new physical and new mental challenges on a routine basis. They weren't just doing the same thing, the same way all the time. They were typically also, or typically also are fortunate enough to not have had any head injuries or perhaps did but manage the injury process itself to mitigate any long-term effects. And instead of reducing their activities and interest as the age which is what most people do as they get older they start to participate less in life. People with good brains in those later ages continue to pursue physical, mental, emotional and social enrichment.

Speaker 1 18:11

All of these have an impact on the health of your brain. Have an impact on the health of your brain. The worst thing that you can do for your brain is either nothing or do the same thing day in and day out. The same way, your brain loves and thrives on novelty and things that challenge its current capacity. In other words, one of the paths to a healthy brain starts with birth, and it runs the gamut of all the things that you can do to stay active, sharp and metabolically balanced.

Speaker 1 18:40

Let me give you a final note on things like genetics, because you'll probably notice that I didn't include genetics in bad brain mechanisms, and that's because I don't want to focus on bad genes. If you have them, yes, if you have a family history of things like anxiety, depression, other mental health issues, there is a higher probability that you will struggle with that too, and with a rich family history, it's more likely that you have genes involved. But I know that you've heard that genes are not your destiny. In fact, we've said this on the podcast. For the most part, all the genes can do is increase your risk, and since you can't change your genes per se. You focus instead on what you can control, and how does that affect how your genes are behaving? So that ends my introduction to the interview series with Drs Malillo and Skyer. Hopefully that gives you enough grounding in how the brain develops and some of the things that can go wrong to create bad brains. I think you're really going to enjoy the next two. We have at least three episodes planned. Don't forget to check out Dr Melillo's new edition of his bestselling book Disconnected Kids, and I will see you on the next episode of the Inflammation Nation.

Speaker 1 20:01

This podcast is for general informational and educational purposes only and does not constitute the practice of medicine in any form or capacity. No doctor patient relationship is formed. The use of the information in this podcast or any materials associated with or linked to the podcast is at the listener's own risk. The content of this podcast is not intended to be a substitute for professional and personalized medical advice, diagnosis or treatment, and listeners should not disregard or delay obtaining proper medical advice when a health condition exists and warrants that. And finally, functional medicine is not intended or designed to treat disease, but rather is a natural approach to support restoring health and wellness, the use of diet and lifestyle modifications, and nutritional supplementation is supportive for adjunctive care.