Broken Brains with Bruce Parkman
Broken Brains with Bruce Parkman is presented by The Mac Parkman Foundation
The mission of this show and the foundation is To serve as a source of information, resources, and communications to the community of parents, coaches/Athletic trainers, medical staff, and athletes that are affected by sports-related concussions and to raise awareness of the long-term implications of concussive and sub-concussive trauma to our children.
Broken Brains will also explore how Concussive Trauma impacts our Service Members and Veterans.
Join us every week as Bruce interviews leaders and experts in various Medical fields, as well as survivors of Concussive trauma.
Produced by Security Halt Media
Broken Brains with Bruce Parkman
Broken Brains: Integrative Neurology, Trauma, and the Future of Brain Health
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Dr. Ken Sharlin joins Broken Brains to explain how integrative neurology and functional medicine redefine mental health by treating the brain’s root causes—trauma, inflammation, and injury.
Topics Covered:
• Brain trauma and mental health
• Chronic inflammation and neurology
• Childhood trauma and brain development
• CTE and repetitive head injury
• Functional medicine for brain health
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Broken Brains with Bruce Parkman is sponsored by The Mac Parkman Foundation
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Chapters
00:00 Brain Trauma and Mental Health Explained
02:16 Dr. Ken Sharlin’s Path to Integrative Neurology
05:16 Why Traditional Neurology Falls Short
08:00 Integrative Neurology and Whole-Brain Healing
11:52 Limbic System Dysfunction and Hypervigilance
15:15 Chronic Inflammation and Neurological Decline
19:57 CTE and Repetitive Brain Trauma
25:50 Childhood Trauma and Brain Development
29:49 Functional Medicine Tools for Brain Health
33:23 Medication vs Root-Cause Treatment
39:05 Rethinking Mental Health Care
44:24 Emerging Brain Diagnostic Technologies
49:07 The Future of Neurology
54:06 Resources for Brain Health
Connect with Dr. Sharlin:
LinkedIn: https://www.linkedin.com/in/drkensharlin/
Website: https://functionalmedicine.doctor/
Produced by Security Halt Media
Mission: Repetitive Brain Trauma
SPEAKER_00Hey folks, welcome to another episode of Broken Brains with your host, Bruce Parkman, sponsored by the Mac Parkman Foundation, where we look at the issue of repetitive brain trauma from two aspects: repetitive head impacts from contact sports, and repetitive blast exposure from our veterans, uh veteran population, and how these conditions are impacting the brains, well-being, and mental health of our children, athletes, and veterans. And why is this important? Because the connection between repetitive brain trauma, brain damage, and mental health is not taught in any nursing, a medical, psychological, or a suicide prevention course in this country at this time, making you the front line of defense for you and that for you that love that you love and those that you identify may be suffering. So we bring on authors and researchers and science and patients and veterans and athletes and all types of folks to give you that 360-degree per degree perspective on this issue because you have to be informed.
Meet Dr. Ken Charlin
SPEAKER_00On our show today, another amazing guest, a Dr. Ken Charlin, who is a board-certified neurologist, functional medicine practitioner, researcher, and author, trained at Emory University, the University of Virginia, and Vanderbilt University. He holds certifications through the Institute for Functional Medicine and is the author of the best-selling book, The Brain Healthy Toolbox and the peer-reviewed publication, Reversal of Cognitive Decline, 100 patients. And I hope to be one of them one of these days. I'm there. Dr. Charlin leads a clinical clinical trials research center as the primary investigator, investigator for multiple pharma-sponsored studies and directs the Brain Tune-Up Functional Medicine Program in Ozark, Missouri. His practice includes the diagnosis and treatment of Alzheimer's disease, Parkinson's disease, multiple sclerosis, ALS epilepsy, migraine, neuropathy, sleep disorders, and complex neurological symptoms. He has experienced in vagal nerve stimulation therapy and performs comprehensive neurodiagnostic testing. With a multiple dictionary care team, Dr. Charlotte integrates neurology, functional medicine, and lifestyle-based interventions to deliver personalized evidence, uh, evidence-informed based treatment. Dr. Charlotte, welcome to the show, sir. Appreciate it. Thank you. Thank you for having me. No issue, sir. No problems there. So tell us, I mean, nobody's born a board-certified neurologist. How did you get into the field, sir?
SPEAKER_01You know, in an odd sort of way, like probably and I'm 61, but probably the narrative doesn't hadn't changed in generations younger than me. That, you know, there's sort of this idea that you have to be really into the science, you have to be a math, chemistry, biology geek, which is, by the way, wonderful if that's what you know turns you on. But I was a kid who's trying to figure out uh things like why I love to read books and write you know poetry and short stories and uh learn about people who are publishing their work today. And that seems like an odd combination uh for somebody who eventually became a doctor. But uh, in fact, when I was in college in Ohio, somebody turned me on to the books of Dr. Oliver Sachs. And uh Dr. Sachs is uh world-renowned, he's passed away, but he was a world-renowned neurologist and author. And I started to really embrace this interface between the physician uh and and the pursuits, the traditional pursuits of the physician and the writer, and and found a tremendous amount of overlap. And then ultimately, because of his work, Dr. Oliver Stone's work, uh uh Dr. Oliver Sachs's work, not the director, Dr. Oliver Sachs's work, I knew that neurology sort of led me to these the great questions that we ask about life and the meaning of life and consciousness and awareness. And it just seemed like a great fit for me.
SPEAKER_00That's amazing, sir, because you know it becomes apparent now, I think more and more people are becoming aware of a universal consciousness, right? And what is out there and you know, and who and who is our creator and all these conversations that lead to really, you know, the uh amazing, well, or mind-blowing, you know, or you know, precepts, you know, whatever. But no, I mean it it's uh and then from there, from neurology, did you specialize in neuropathology or or neuroscience?
Neurology’s Toolbox Feels Too Small
SPEAKER_01And and um did you where did you start practicing at the Yeah, I I finished my training in neurology at Vanderbilt University in 1998 and uh then uh joined a practice in Nashville for a couple of years before moving to the southwest Missouri area. So I practiced general neurology. I see people with Alzheimer's, Parkinson's MS, traumatic brain injury, migraine, the full measure. But what really turned the tide for me was realizing that by the time uh it was about 10 years or 12 years into practice, that I felt like the toolbox that I had was way too small. It was a sort of a paradigm and a paradigm shift for me when I realized that what I was doing was focusing on making a diagnosis and then largely giving a, you know, and by the way, I should say that neurologists for a long time had a reputation that followed the phrase diagnose and adios, so meaning we were great diagnosticians, but not very good at, you know, having solutions to treat our patients. And and even in 2012 or so, when the tide turned for me, things were, they were better, they were getting better. There were more drugs for MS, things like that, nothing for Parkinson's beyond, you know, symptomatic management, nothing for Alzheimer's beyond symptomatic management. And I realized that I had to do more for my patients, and that's when I learned a lot more about systems biology and root-cause medicine, that the information was really out there, but it was, you know, sort of my responsibility to go out there and grab that information and internalize it and figure out how I could integrate that into my clinic.
SPEAKER_00And with a lot of the conditions that you just mentioned right now, we usually find accompanying mental illness disorders as well. Was that did you notice that in your practice?
SPEAKER_01Well, most definitely. Uh you know, pick any big name diagnosis, and there's often an emotional or mental component. We're studying now agitation and Alzheimer's disease, big problem in Parkinson's disease, can be depression, but can also be apathy, which you could look at as a sort of a dimension of the overall depression uh spectrum, certainly traumatic brain injury. Even migraine has migraine is very interesting to me because it's really just an expression of what I call a hyper-vigilant brain. In other words, if you're being chased by the saber-toothed tiger, you're going to hear everything around you, you're going to see everything around you, and your metabolism shifts from digestion or your gut to your skeletal muscles to make you strong and fast. And if you talk to somebody with migraine, well, they have light sensitivity and they have sound sensitivity and they have nausea and vomiting, and they're worse, you know, it's all worsened if they, if they move, so they try to lay down into a dark, you know, in a dark, cold, quiet room where they can bring that nervous system back into that parasympathetic sort of rest and digest mode.
SPEAKER_00Now, uh, we know that hypervigilance is also highly prevalent in our you know, veteran and professional athlete um populations. You know, uh running down that path a little bit, you know, what you know, number one, have you have you seen it and then you know, you know, where where what were the treatments for it that either you were set weren't satisfied or a finding now can better treat that? Because you know, we we we do have a significant having suffered from that myself. You know, you get done with four different combat zones, you see people everywhere. So um, you know, what um you know, how knowing that that's out there, how are you dealing with that as you know part of the diagnostic and treatment protocols that you are you're using?
SPEAKER_01Absolutely. You know, and it's so I'm so glad you asked that question because it's so central to really what I call integrative neurology. And and I uh there's certain I want to give credit where credit's due. There are people out there who who are a generation older or have just been doing it longer uh and have paved the way, but really there was not a universal playbook. And so as I learned about these aspects of what we call functional medicine, it it's kind of been my job to figure out how the pieces of those puzzle fit into the neurology framework. And here's the way I see it that, and I teach a lot of this. I teach at major conferences where people want to learn more about how they can integrate these tools into their own practices. And I've come to the point where I start off talking about what I call the limbic system. The limbic system of the brain is a collection of structures that includes things like the hippocampus, the amygdala, the cingulate gyrus, the olfactory area, the prefrontal cortex. And ultimately, this part of the brain operates largely unconsciously. Uh, and it is sort of at times called the reptile brain or primordial brain. But its sole job is
Mental Health Through A Neurology Lens
SPEAKER_01really to take in data from our senses to have learned. Learning, it turns out, is a big part of the role of the limbic system. Because I always say, you know, if, you know, we have we've all most of us have been parents at one point or another, or grandparents, and you have a young child, and maybe you're cooking in the kitchen, you say, well, don't touch that honey, don't touch that oven, don't touch the stove, it's hot, right? And and they don't necessarily know that, but we know that as adults. And imagine if you touch something hot, you get burned, but you never learn. So you just keep touching it, you know, over and over and over and over again. So the point being that learning and memory and what ultimately becomes signals that tell your conscious brain and unconscious functions of the brain simultaneously, are you in danger or is it safe? If you're in danger, it's going to activate a couple of different pathways, one of which involves things like epinephrine and adrenaline or adrenaline, and that will make your blood pressure go up or your pupils dilate and your heart race, all the things that you actually need from a physiological perspective to run from that saber-toothed tiger, right? And you need those, you know, a little more cardiovascular oomph, if you will. On the other hand, in the context of uh nutrition, of digestion, of intimacy, of rest, you know, if your brain thinks that you're still being chased by the saber-toothed tiger, none of that's going to happen, right? Can't fall asleep. So that's, you know, some of what we describe as hypervigilance. People don't sleep well at all. And in fact, they also don't remember things well because, you know, things that distract you from your own survival will not serve you in that context, right? So in the end, really understanding the role of the limbic system, how it grows, how it evolves, and how it evolves from a young age and then gets very hardwired at a young age. It's by seven or eight years old, it's kind of locked in, which is a very important concept, both for our own survival as human beings on the planet, but to also understand hypervigilance dates later in life and how these early childhood experiences actually impacted and imprinted upon this part of the brain. And all the other functions of the brain, all the other aspects of life kind of fall second to whether or not we're alive. And really that's what hypervigilance or vigilance is all about. It's are we, are we in a safe place or do we need to defend ourselves?
SPEAKER_00And when you, and I think there, you know, we know this has been a lot of research on the impact of negative childhood experiences on adults as they grow older. But when you compound that, or even if you didn't have, you know, a negative childhood, when you start throwing repetitive brain trauma in in the mix, like repetitive impacts or repetitive last exposure, what's the impact on this primordial blurring of the limbic system? What what what do you uh you know, what are you uh seeing or or or what uh I mean obviously it'd probably make things worse.
SPEAKER_01It would make things worse. And of course, I'm sure you've talked about this before in the show, but the catchphrase
Hypervigilance And The Limbic System
SPEAKER_01is inflammation, chronic inflammation, neuroinflammation. And we kind of tend to think almost by word association that inflammation is a bad thing, but really in the acute situation, an inflammatory response is actually a protective response of the brain and the body, right? If we didn't have that, we'd we'd probably die or we'd get a terrible infection. I always tell people, look, if you get a cut and you do all the right things and you wash it with soap and water and you put a band-aid and all that stuff on it, and it's fine, it's healing, but a couple days later it's gonna be a little red around the edges of that cut, and that's a normal inflammatory response because your skin is a protective layer, right? And that layer has been violated by whatever caused the cut, and you don't want bacteria to get down into that, the muscles and the fascia and the connective tissue, and eventually, potentially even to the bone, right? Which does happen. Call that osteomyelitis, and then people lose entire limbs. The problem isn't the inflammatory response, although it can in some cases be an issue, meaning that the magnitude of the response can be a problem acutely, as in uh, you know, COVID and the pulmonary, say, reaction to a COVID infection. But the problem in the grander scheme of things is the duration. These low levels of persistent inflammation go from being protective to detrimental. And the body has and the cells and the brain all have built-in mechanisms of defense, if you will. And if this system is turned on long enough, eventually there are adaptive responses of the cell to try to restore what is called homeostasis, but it ultimately means balance. And those adaptive changes can result in all kinds of problems for the whole person, the person who's experiencing that, including, you know, what we call chronic traumatic encephalop.
SPEAKER_00Yes, sir. And I would like to dive in that a little bit for our audience because you know, we're becoming aware that it's, you know, in my opinion, it's the long-term chronicl neuroinflammation that is the most serious risk to the health of the brain. And there becomes a time when, you know, the the brain's response, as you so well mentioned, from all those hits starts overwhelming the actual brain itself. You know, the you know, glial cells become in macrophages, start consuming, you know, pretty soon they start consuming, you know, they they've consumed the injured part of the brain, they start consuming the actual, you know, the brain itself, like resulting in synaptic death demyelination. Can you dial into this for um our audience a little bit of you know how this process starts and why it is so degrading to the brain, or why is it such a risk to the brain health of our population, especially a child's brain that is developing continuously almost every day? And you know, could you elaborate on that a bit, sir?
SPEAKER_01Yeah, I mean, there are certainly many layers of understanding and complexity to this. As we talked about earlier, the limbic system is critical. We want to have a limbic system and it can and we want to have it largely dialed in from a fairly young age. So especially uh, and we call it a young age, but if we go back, you know, 100,000 years, you know, children who are what we call children, a 12-year-old may have been considered an adult at that time and had to sort of fend for themselves or even start that process of reproduction. I'm not endorsing that today, of course. But I'm saying that, you know, really our perspective shifts based on a lot of other things. So the brain has to has to defend us, the brain has to protect us. This work has been studied at many different levels from the work of Celier, Hans Celyer, who is an Austrian by birth, but did his most of his research in Montreal, Quebec, where he looked at uh laboratory rodents and would expose them to a predator over a long period of time and then take hormonal measurements and ultimately frame something that he called the general adaptation syndrome. It went from an alarm phase, the initial exposure, the heart rate goes up, the pupils dilate, right? All that stuff, the blood pressure goes up, to what he called a resistance phase. I often call it a resilience phase. It's sort of how long can you can you push through these inflammatory, you know, these threatening challenges. And then finally, as a as an adaptive response of the cell and of the body and the brain, he there was the exhaustion phase where all of the resources that keep us going and really give us our sort of joie de vive, you know, the joy
Chronic Inflammation’s Long Game
SPEAKER_01of getting up in the morning and engaging with other people and going for a run and enjoying food, they really sort of collapse, they become secondary to survival itself. You know, if if all else fails and you're still alive, maybe, you know, that's okay. It wouldn't be okay to any of us as a human being, but sort of at the cellular level, it becomes a sacrifice worth making. And if we look at that from other perspectives, there's a so-called cell danger response. It's really more or less the same thing where the mitochondria, the energy-producing portion of the cell, says, okay, that's enough. I'm gonna go into an arrest state and shut things down because there's too much input that that creates a threat at that level. Walter Cannon was a Harvard physiologist who gave us terms like homeostasis or balance. And so ultimately what this is saying is there are a variety of systems that govern how we work as human beings. And when one system is thrown out of balance, say the inflammatory or defense system of the body for long enough, the other systems have to figure out, okay, what are we going to do to return that harmony or return that balance? And Cellier's exhaustion phase is a kind of maladaptive or non-productive form of restoring homeostasis. It's okay for cell survival for a period of time, but not okay for us as human beings. So we have to understand that there is this biological stress response, that it is normal, and that even small doses of stress are very good for us. They teach us, they make us more resilient, they allow us to adapt. In effect, that's part of what boot camp is, right? In a sense, right? Make you a little more tough so that when you actually are deployed, you don't fall apart the minute you go out on your first mission or whatever. There are a lot of other things, and I'm not a veteran, so I can't speak on that, that happen that test that resilience, of course, but that is part of why we put our our young soldiers through through boot camp. So I'm making the point that this balance is critical. What the brain learns along the way is critical, and how it ultimately responds to what it learns and it predicts things. It tends to predict future events. It's not just reactionary. It's learned long enough to say, oh, I've seen that before. This is what I'm supposed to do, right? And then we have things that become maladaptive, like the accumulation of tau protein in the brain, leading to diseases like chronic traumatic encephalopathy.
SPEAKER_00And so uh diving uh just uh staying on that point for a second, when the brain is subjected to a large amount of trauma, subconcussive trauma, or not just, you know, you know, not just uh, you know, uh a car accident, right? You know, but also you know, the the kind of trauma we're seeing for CTE, where you have years and years of you know continuous subconcussive exposure. What what what happens to the brain? What is going on in the brain?
SPEAKER_01Well, again, uh it triggers these defense responses of the brain. Probably, uh, and I would say I have not reviewed the specific literature on this as I mention it. If we look at folks, there are probably hundreds of thousands of soldiers who who get deployed or who are exposed to percussive injury even in in the mainland and training. And my son went through SEAL school and all kinds of things. There are many ways that we get exposed to these and on the football field or heading the soccer ball, right? But obviously, not everyone develops CTE. That's not to say you want to tempt, you know, tempt the devil, as it were, and go and have your head banged around. But I think it also begs the question of why is it that some people will develop this and yet others don't? And I think it goes back to this idea that we as human beings kind of accumulate these hits and these experiences as we go through the journey that is life. And it's not just a hit on the head. It could be poor quality sleep. It could be, you know, eating a lot of, you know, fast food, junk food, processed food. We I always talk about the guy who did that movie super size me and nearly killed himself in a month. It could be, uh, and it's probably not true of a veteran, but relatively sedentary lifestyle, although that is something that veterans can settle into after they come back, right? And and we see a lot of diabetes and obesity among veterans. Veterans, we have to understand these as pro-inflammatory states. When we add this equation of percussive injury, whether it's a direct hit to the head with a physical strike to the head or it's sound waves that get
Subconcussive Hits, CTE, And Proteins
SPEAKER_01through the skull to the hypothalamus and pituitary gland, it disrupts hormonal function, it sends out danger signals, and again, a cascade that can, in some cases, okay, you got hit once, we'd say rest, right? But how many times are you going to do it before that cascade becomes a domino effect? And this, the brain or the brain cells, whether it's the astrocytes, the microglia, the neurons themselves, have built-in defense systems. ALS, a disease that has a close tie to traumatic brain injury. You know, what's very interesting to me is outside of the tau protein of traumatic encephalopathy, you have a protein called TDP43 that accumulates in the brains of people who have ALS. And we tend to think of these proteins as being somehow abnormal. But in fact, TDP43 or even tau protein can be a normal part of cellular function. And so it's not whether the protein itself is normal or not normal, it's why is it behaving this way? Why is it accumulating? Why is it forming, you know, tangles in the brains of, say, people who have Alzheimer's disease? So in TDP43, it's very interesting if in the normal cell, if the cell, and this is not somebody who has ALS, again, we all make this protein, it protects our RNA, among other things. But what the cell will do, say if that you get exposed to a virus, is it will package your genetic information into something called a stress granule with TDP43, and it will send it out into the cellular cytoplasm, away from the nucleus, away from the rest of the genetic information of the cell. And I often think of that as sort of lifeboats, right? Or I'm an old Star Trek fan, so I think of the enterprise under attack. And if all else fails, right? If all else fails, we put people in those pods, we send them out, and we'd rather press that button and destroy the ship than let you know the enemy get a hold of the dialithium crystals or whatever technology or whatever reason, right? We need more power, Captain. Right. And this is real. I mean, this is happening in our brains all the time. The issue, the reality is that, you know, if we just have acute cellular stress and it resolves and homeostasis or balance is restored, those stress granules kind of poof and disappear and they go away and everything returns back to normal. But if it doesn't, that's the big question, right? Why is there this persistent stress, and I don't necessarily mean emotional stress. That's certainly not good for any of us on a long-term basis. But then it leads to these adaptive responses that Cellier and all these other people have described in their own way that lead us down the road to disease. I think it's interesting that, first of all, can't we recommend, of course, limiting blows to the head, right? Prevention is the best medicine. But on the other hand, if somebody comes to me and says, you know, I've had been around lots of IED explosions and, you know, other things and, you know, shoulder launch rockets or whatever, you know, I can't undo that fact of their medical history. But what I can do is teach them to address all the other things that drive chronic inflammation in the brain, kind of like taking things off your scale and with the idea that perhaps we can then get the brain out of this pro-inflammatory response and restore function.
SPEAKER_00Yeah, it's those are all good points. Now, just for our parents out there, you know, yeah, now we have a child, a child's brain who's we've got a helmet on at six, and a brain that's barely developed. And are these defense mechanisms even developed in that brain at this time yet? Or, you know, I mean, obviously, you know, we're in and we're talking about a brain that's developing. And so are these hits also laying the foundation for you know improper development or maladaptive development where we have, and what we see now is you know, mental illness. Mental illness has been directly tied to damage to the prefrontal cortex temporal lobes for a long time. So, you know, you know, go run it down that path a little bit from a developing brain perspective. What uh what are the risks to our children when we put helmets on them and they head soccer balls for extended periods of time? And we know that you know now parents are so sport crazy they think pee is for plenty is all right, now we're gonna play football all year round, right? Or we're gonna play football and like me, dumbass, you know, all right, now we're gonna, you know, yeah, you know, my son wanted these sports, I just never stopped them because I didn't know. And that's what I'm trying to get across these parents is that from a child's perspective, while the risk is high or for is serious for adults, I I think it's more pronounced for our children.
SPEAKER_01It really on many levels, we have a developing brain, we have a limbic system that maybe may depends on the age, may or not be sort of fully formed. And then we have other issues. You know, certainly I endorse wearing helmets, don't get me wrong, but you know, what what is a helmet going to do or not do? It doesn't have any real effect on deceleration injuries, right? You're going high speed and then you suddenly stop and the brain rocks inside the cranial vault and in some cases slams against the inner table of the skull and causes direct injury to the brain. So we certainly have to be very conscious of those things. And there is something that it's more at the cellular level where those microglia, which are the brain's immune cells, are learning, quote unquote, at a young age. We know that they can shift back and forth between a pro-inflammatory and an anti-inflammatory state. And there's something called sort of the one-two-hit hypothesis, whereby if we have these early traumas, it could be physical traumas, you know, the football or
Kids’ Brains And Early Exposures
SPEAKER_01soccer player, what have you. It could be other factors that activate inflammatory signals in the brain. That again becomes, I'll put in quotation marks, a learning phenomenon for the brain or for those cells in the brain. And so that becomes sort of hypervigilance at the individual cellular level. You're you're more likely to flip into that pro-inflammatory M1 state than someone who's not had those earlier hits, and the brain hasn't necessarily learned that pattern and hardwired that pattern early.
SPEAKER_00Which we can also all agree is not exactly what our children's brain should be exposed to or should be responding to at any time. And that's what we're learning. And your point on how these helmets do not stop any deceleration event at all. I mean, it goes against all this hype about these concussion caps and these cue collars and all these gizmos out there when we know that the brain's suspended in fluid and nothing is going to prevent that that brain from bouncing. Pretty stop, pretty much stop, you know, this advertising or a misadvertising or, you know, whatever approach out there. Let's talk about some of your publications here, because obviously you've been a very busy man. And I wanted I would like to know you know more about these and dive into there. What was the um the rationale beh beside behind um your first uh book, The Healthy Brain Toolbox? What drove you to write that, sir?
SPEAKER_01Well, uh I had started to formulate, I well, I had already formulated an approach to this framework called functional medicine, which is really based on something called systems biology. I had trained through the Institute for Functional Medicine, and I wanted to put on paper a guide that anyone could read, but also for my patients in particular, because, you know, medicine is sort of a language. You know, if you go to the doctor with a problem and you're not sure what it is, you want to know what's the name of it, right? What's the name? I'm having trouble with my memory. Do I have Alzheimer's? I notice that my left hand is shaking when I'm sitting in a chair at rest. Do I have Parkinson's disease? And that has been the framework of medicine for so long that it is both the expectation of the patient to give the name to the problem for which there is value, but also for the physician in terms of how they're going to approach the problem. Because without a name, the doctor may say, Well, I'm sorry, but I, you know, you can take some ibuprofen, but I really don't know what's going on. So I don't have any treatment for you. And we want to break that paradigm. I am not in any way against traditional medicine. I still practice plenty of traditional medicine. I just integrate or bring in these other principles for those who are open to it. And so the book was a way to lay out the roadmap for people to understand what I call systems biology and the things that really govern how our bodies truly work, which, you know, we do have brains, we do have lungs, we do have a heart and all that. And yes, if you have a brain problem, you see a neurologist, if you have a heart problem, you see the cardiologist. But that's a very siloed way of seeing things. You know, holistic medicine, as as we, again, by word association, shouldn't be, if I say holistic, you think a supplement or an herb or acupuncture or yoga. And by the way, I love all that stuff, but that's not to me what holistic means. Holistic means understanding the whole the person as a whole, sort of mentally, physically, spiritually, emotionally, and then realizing that disease, these disease names that we have are convenient and they give us a bit of a roadmap, but everyone with these diagnoses is different. And we have to understand the biochemical individuality of each person, what drove, what were the underlying processes that created this thing that we call Alzheimer's or CTE or Parkinson's. And then ultimately it creates also a roadmap for how we can help our patients get better. We understand the root causes, we can address the root causes.
SPEAKER_00And you and you're you're you're saying a lot of you know, a lot of great stuff there, Doc, because you know, we're what we're seeing out there now is that you know, we deal with a lot with mental illness as a result of brain trauma. And the mental illness uh protocols to date is pharmaceutical intervention and therapy. And when we have a damaged brain, we're really not, number one, treating the causality of the problem. But number two, we're also messing with the endocrine
Systems Biology And The Toolbox
SPEAKER_00system, the hormonal system, we're messing with these systems that you're talking about that are are controlled by the brain. So what's your perspective on, you know, uh there's a place where obviously, you know, you know, pharmaceutical intervention, like i.e. suicide, suicidal ideation is a requirement, right? We we have to protect these people from harming themselves, harming others. I I got it. But this long-term approach to, you know, pills and chasing symptoms and with more pills is just, I don't know, it's just another way for people to make money, I guess, but it doesn't do the patient any good. And I think this is going back to your point, is how do we look at a patient and what is out there? What are what are some of the you mentioned yoga and all this other stuff, but talk about this more functional approach to medicine and how it it's it just appears to be much more beneficial to our patients, especially in terms of brain health, if we can prevent them from being medicated in the first place.
SPEAKER_01Yes, and and by the way, there are varying degrees of urgency when it comes to medication. If somebody is seriously depressed and suicidal, let me be clear that I do believe that medication is an important first line of defense. But ideally, and this does happen in in inpatient uh mental health facilities to a degree, at least the ones that are a little more holistic and open-minded, that the dialogue is this we're gonna put you on the medication to kind of get things stabilized and get you on your feet, but then we're also gonna do the work that it takes to get you better. And when you get better, and we'll define what that work is and what better is, then ideally you don't need the medication anymore, right? It shouldn't be the long-term solution to the problem in the ideal perfect world. I'm not saying it is in some cases, people do need the medicine lifelong, but in the ideal perfect world, it shouldn't be that way. Where does it come from? What do we do? The framework, and I talk about this in the book, is really sitting down, first of all, with someone and getting them to tell their story from pre-birth. What was your mother's pregnancy like and what is your family history? Because we learn a lot from that. There are things that there's something called uh transgenerational epigenetic expression, meaning, for example, women who survived the Dutch famine after World War II were more likely to have children that were diabetic and obese. There was something that their G these mothers' genes learned that were passed on to their progeny that then got expressed as food was scarce for my mother, so I better preserve energy, which just becomes body fat. There's altered energy management, which becomes diabetes. So that aspect of the history is very important. But then, you know, everything from early life development and, you know, were you born by cesarean section? Were you breastfed or bottle fed? Did you have allergies as a kid? Did you have your tonsils or your appendix out? You know, did you have a bunch of head injuries growing up? Have you had any uh situations where you had surgery, general anesthesia? All of these things are critical to understanding these smaller hits, these little sort of perturbations in the pond of life that eventually, as they accumulate, can lead to this tipping point that's referred to as the allostatic overload. I didn't make that term up. It's often, you know, but uh I will quote Lisa Feldman Barrett, a great neuroscientist and psychologist, for that the that tipping point then that that then leads to the expression of the disease. And then we ask questions like what are the mediators, what are the perpetuators, what's keeping you on that trajectory? That's purely historical, but it's still important to helping create that roadmap of where the imbalances occur. We can then layer in uh, you know, specific tests that are done. Some of them are blood tests, some of them could be spinal flow tests, some of them could be poop tests, believe it or not, some of them could be very fancy brain scans that look at brain volumes or functional brain imaging, whether that's fMRI or PET scans or quantified EEG. But all of this ultimately informs us about the uniqueness of that individual and allows us then to tell that story back, right? To present to Bruce, hey, here's what's going on, here's how you got here, here's what's kind of keeping you on the trajectory. And based on this, here's a plan that we can work together to correct these imbalances, even in the face of head injuries that I can't undo what happened, I can't undo the fact that you hit your head, you know, multiple times.
SPEAKER_00And and Doc, I mean, this all sounds great, but you know, I'm aware right now of certain practices that unless they prescribe pills, they can't get their patients to do anything else because they don't get reimbursed. You know, and it's horrific that, you
Beyond Pills: Root-Cause Care
SPEAKER_00know, you know, people in the mental health industry that are trying to get people off medications or to pursue, as you said, other alternative modalities that can help their patients at a holistic area. None of these are covered. These are not treatments that are FDA approved, right? I mean, look how long it took for chiropractors or chiropractors to be accepted into our medical system, right? I mean, I used to have to go find these underground guys back in my days to get my neck fixed from parachute jumps or whatever, and and nobody paid for them. I was out of pocket every time. So I think you know, we have to shift the paradigm. We have to open up the aperture that approaches like yours to medicine are what's necessary, not only the cost savings alone, just you know, uh advice, the traditional forms of siloed medicine that keep people locked into medications or therapy forever when there's other ways to address their health issues, or when these you know pills cause problems. I mean, we all know the horror stories of our veterans that have a bag of you know 15 different medications because a pill causes a symptom. And let's I got a pill for that, and I got a pill for that, and and then they're they're they're going crazy. So yeah, I mean it's a problem.
SPEAKER_01It's a problem on both sides. We have to change the culture a little bit, and we have to educate people, like through this podcast show, that there is more to you have a diagnosis, therefore you take this pill. We have to change the way doctors think about medicine and yes, how they're reimbursed, what the system truly values. There is something called a trans theoretical model of change. There are many or several, and I uh this other people could speak in a more expert way on this, but in a sense, uh Prochowska's trans theoretical model of change really looks at or asks the question of why do we make decisions to do what we do? Right? If you come from a very traditional medical background and you have certain expectations, you go to the doctor for the doctor to fix you. Give me a prescription and go home and I'll see you in six months. And we might call that pre-contemplation. But then you've heard a little bit, maybe you caught this podcast, maybe you read a book by someone. It's kind of inspiring, and it tickled your imagination. You're not necessarily ready to make any changes, but you have a heightened awareness that there's other things out there that really could make a big difference. And then, you know, you get to a point where, you know what? I think I I'm ready to do something myself, and that's called the preparation phase, right? Maybe you buy the books, you get you go, you go through your cupboard, you get rid of all the ultra-processed food, you go to the farmer's market, you start stocking up, et cetera. You buy some recipe books, whatever, you're preparing for a change. And then there's the action phase where you're actually doing the things that create health. And I think as long as we're waiting for our health insurance companies or our public health system to do that for us, I think we're unfortunately sorely mistaken. Probably not gonna happen. I don't I think, you know, I time tend to stay out of talking a lot about politics, but I do think that some of the some of the intent, if you will, of make America healthy again is kind of welcome in a system that, you know, it's a it's a push back against the traditional paradigm. Yes, we need to change the food we eat. Yes, we do need to move our bodies. And Robert Kenney is not the first person to talk about that. There's an immense political machine and lobbyists. You know, Michelle Obama tried to do the same thing and went from promoting healthy food to standing side by side with the processed food injury and saying ketchup is a vegetable. So, you know, it's a complex discussion. Oh, it is. But definitely we have to get people listening to podcast shows like this to realize that there's more out there for them. And then we have to get them feeling that, not just believing that, because when you feel it in your heart, so to speak, that's when the action steps tend to happen.
SPEAKER_00And that's what we're hoping right now is that you know, I'm I'm not a political guy at all, really, anymore. I don't like anybody. But yeah, I will say that opening up the aperture to more non-traditional approaches, but yet proven approaches. I mean, nobody's talking about, you know, things that cause cancer or that, you know, hurt you. I mean, the modalities that, you know, that are out there just on the brain side alone, from the electronic modalities to psychedelics to stellar, you know, outpatient procedures and brain supplementation programs, unless you lie and go take ayahuasca and you're on SSRIs, you cannot die from any of these. Nobody's ever died from these HPOT, right? So why are we so scared of introducing them into our healthcare system when we have a huge amount of testing, population, testimonials saying this helped me? And is is this term, this the statement, this helped me, more important than that's not covered by insurance? And that's where I think we have the problem that exists today. But like you said, that's a multiple, that's a case of wine or you know, and a whole bunch of chicken wings to get through that one. But you know, that's where it's at.
SPEAKER_01And yeah, and and there are there are ways to
Changing Medicine And Incentives
SPEAKER_01act. I mean, you can have things that are FDA cleared, you can have things that are promoted as health products, and and the companies that make them are very cautious about the language they use, but in reality, the science is there. For example, on my own podcast show, I interviewed the chief medical officer with a uh with a company. It's a complicated uh situation because it got bought out, but basically it's called a Halo device, H-A-L-O, Halo Neuroscience. They're now owned by another company, but they have a device, it's a very user friendly transcranial direct current stimulator. And the leads on this are are easy for the general person to use. If we get it more into discussing TDCS, I can explain why that is, but it's very user friendly. It's it's it is not presently FDA approved for. Treatment of any disease. But if you look at what it is and what it does, and you go to the medical literature, you'd say, well, the only difference between being approved to treat a disease and approved and able to be sold as a wellness device is a lot of regulatory red tape that they have to go through to get that designation. And if you look at TDCS for TBI as an example, it's quite remarkable.
SPEAKER_00Can you tell us what TDCS means, uh? Because I haven't heard of that one.
SPEAKER_01Yes, it means transcranial direct current stimulation, TDCS. And uh the company that owns the Halo device is called Flow, I believe, but they used to be a separate company as Halo. At any rate, it's based on the principle that if you take, say, a nine-volt battery, which puts out a little electrical charge, but not a huge amount, you can't get electrocuted from a nine-volt battery. The reality is that brain cells, which essentially run on electricity, right? They're always firing what we call action potentials, but there's something called a resting state. It's a long way, you know, how low can you get on your resting potential? I think it's about minus 70 microvolts or something like that, but it's basically the low end, the nerve cell's not going to fire. That potential goes higher and higher and higher and higher and higher until it reaches zero. That's the the level required fire in action potential, right? But if you think about, I always think about a turbulent uh body of water where the water is kind of going up and down at different places, different little waves and things like that, right? So the brain, nerve, the nerve cells of the brain are not firing synchronously. That would be an epileptic seizure, by the way. They're in fact at different points in their threshold for firing their action potentials. So if you take a small electric current, like two millivolts, and you apply it to specific areas of the brain, a direct current, you can catch those nerve cells that are really close to their firing thresholds. And there's an expression sometimes called Hebe's law, I believe, which is that nerve cells that fire together wire together. It's based on the whole concept that we broadly call neuroplasticity. How do you rewire your brain? You want to learn a musical instrument, you gotta practice. You want to calm your brain and get out of that fight or flight mode into that parasympathetic rest and digest, you gotta practice, right? So if you repetitively stimulate these nerve cells in specific brain areas, it makes it easier to achieve the outcome that you want to achieve, whether that's less stress, improved sleep, et cetera, improve mood, maybe walk. Maybe you've had a TBI and you're not walking well. Well, use a TDCS device that stimulates the primary motor area of the brain and it sort of warms up the brain. Still got to do the exercises, but it primes the brain and it readies it for the action that you want and then the ability of the brain to redo the wiring.
SPEAKER_00That sounds amazing because um I don't know how it compares to you know any of the uh M E R T or TMS modalities that are out there, but um, you know, a lot of our veterans and football players have damaged wiring, right? So now they've gotta either re-reprogram their brains to to you know to either erase old habits or pick up better ones and and so on and so forth. Yeah, I'd love to know more about that. And and how far are we away from a technology? And I've run into a couple of them over the years, I think Quantum X, something out of Israeli, where I mean, you know, we go to a doctor and they look at your heart, you know, they listen, and then they uh you know they you they you breathe in, they listen to your lungs, and they crack you on your knee with the hammer and make your foot move and and then they check out all this, but they never ever ask you, how's your brain? You know, because they don't have anything yet. How close are we to a technology? And I know there's other ones out there where, you know, there could be
Brain Stimulation: TDCS Explained
SPEAKER_00a helmet or something that can, you know, you know, we we've got DTI scans, functional MRI scans, QEG scans, uh, you know, and and and and uh there's another one out there I can't remember, but uh spec scans. And these are all, you know, scans of the brains that can see things that we haven't been able to see before, at least, at least look at and find abnormalities where based on a patient's history, did you have a lot of TBIs? Were you in a car wreck? Could say, look, we've got to see Ken Charling because you, you, you know, you're I'm a general practitioner, but we have a problem here. How close are we to possibly having some kind of diagnostic tool in a doc in a doctor's office that could indicate that, hey, we gotta we gotta we gotta go see a neurologist?
SPEAKER_01Well, I would say we're there. Medicare does actually have a CPT code for for a cognitive screening that unfortunately is probably not used nearly enough. I want to credit uh my colleague, Dr. Dale Bredison, for coining the term cognoscopy, like a colonoscopy. I think that's really important. And uh I certainly applaud that and use that all the time. But, you know, I know all of those things that you just mentioned, whether QEG and diffuser tensor imaging and functional MRI and SPECT and so forth, they're they're really important because the other piece that's very much hardwired in our present medical culture is anatomy, meaning your standard MRI, nothing fancy, no 3D volumetric analysis, no nothing. You know, standard MRI has limited value because it's just really looking at structure, and we're much, much more interested in function. How is the brain working? But we are in the age of biological markers, and I think that's really key. When we talk about neuroinflammation, we can measure interleukin 6, we can measure tumor necrosis alpha, we can measure phosphorylated tau or fragments, the P tau 217 and 181 in the blood and learn a lot about what's going on in the brain. So I think the key and the reason to, you know, come and see me is I've worked out what that framework is, what should we be doing? And certainly it's my goal to share it with as many practitioners as possible and hope that they will adopt that in their practices. But I would say the technology is there.
SPEAKER_00That's good to hear, Doc. That's I mean, that's great because uh we we we need a lot more awareness, uh especially with the issues that we're talking about, repetitive brain trauma, because you know, it's hard to see in the brain, and then these questions don't ask. You know, Tommy's got a concussion. How long has been Tommy been playing sports? Or Susie's having, you know, some form of depression, anxiety, as has Susie been playing a lot of contact sports. And these children, they get overlooked because we're not asking the right questions, we're misdiagnosing the mental illness, and then we're mistreating it with pharmaceuticals instead of addressing the true issue, which is you got to stop playing contact sports, right? And give your brain a rest.
SPEAKER_01Give your brain a rest and and take care of some other things. Get your vitamin D levels up. That's really, really critical. In the case of our veterans, I can't tell you, and I'm sure you're quite aware, how many of them get placed on antidepressants when, in fact, their testosterone was in the tank. And uh, I'll tell you, I got a call one day. We see a lot of veterans here, and the way that bureaucracy works is the veteran is sent to see me with a specific diagnostic code that I am to evaluate. But I'll say, you know, while you're here, did you know that many veterans have low testosterone and it will manifest as things like depression, anxiety, insomnia. Um, you know, and and these guys are, these are, I'm gonna call them GI, I mean, they're G.I. Joe's. I mean, these are buffed, muscular. They eat red meat for breakfast still, you know. You can't look at a guy and say, well, you're super muscular and toned up and all that stuff, and obviously you don't have low testosterone. Very often they have, you know, some degree of sexual function. They don't have complete ED. There may be fewer morning erections or may take a lot more to kind of get them going. But a lot of times it's sort of the last thing. They may have less interest in sex. But when you look at this, I mean, it is a fact that veterans are disproportionately affected by low testosterone. I can't, I mean, I identify it all the time and they'll come back and go, I didn't need my deloxetine, I didn't need my Prozac, I didn't need my Xanax. What I needed was testosterone. Surprising thing is we got a call from the VA saying, what are you doing testing all these veterans for low testosterone? I'm like, you're kidding me, aren't you, right?
SPEAKER_00Yeah, dude. It's so it's so bad. I mean, that they yeah, and they and they question every exam that you provide these kids yet, you know, they haven't changed their approach to mental health, they haven't changed their approach to anything, and we've still got the same suicide rate that we have. And something's got to break. There has got to be something that breaks when we talk to you know experienced people like yourself, and we're finding out that the VA is gonna question you because, again, they're stuck in this 1980s by the book, by the code, you know, regimen where they will not, you know, you know, look outside, step outside the box. I got into it with a highly ranked VA rep at a conference who wanted to know why I had a bottle of booze next to a military helmet and a football helmet. And I said, that bottle of booze gets more veterans over here to put their business card or come talk to us so we can make them aware of repetitive blast exposure and repetitive brain trauma. And after a conversation, she admitted that, yeah, we we have an extreme problem with diagnosing this problem, and I'm sorry I bothered you. And she walked away. But we have, you know, a very you know, we have a major amount of work to do uh with that when it comes down to this. So, Doc, as we close out, I mean you mentioned you have a podcast. I'd love to give my guests uh some time to talk about themselves. How do people find you? What do you have going on? You know, where's
Diagnostics: From QEEG To Biomarkers
SPEAKER_00your book out there on the internet? And what's next for Ken Charlotte, MD?
SPEAKER_01Well, thank you. Yeah, the podcast is called the Healthy Brain Toolbox Podcast. It's relatively new. So we're excited. We're still learning. I've done lots of podcasts, but it's my first opportunity to be the host of a podcast show. Uh I have a brick and mortar clinic in Ozark, Missouri, where we see people from all over the world. Uh, we have ways where you can engage with us remotely. Uh it's a little more coaching oriented because I am only licensed in Missouri, but we can get people some really good information, get them to make a few changes, and get, you know, these days it's sort of the wham-bam, thank you, ma'am, when you go to the doctor, and what people want is really an opportunity to sit down with a board-certified neurologist and ask questions. And so we can do that, but we see people in person for our brain tune-up program. If you go to the website, our my website, which is functionalmedicine.doctor, all spelled out, functionalmedicine.doctor, you can go to the link where it says, you know, have a free consultation, speak with my coordinator. She spends a tremendous amount of time with you, gives you a lot of value, uh, and ultimately hope to see you in the clinic itself.
SPEAKER_00Dr. Charlotte, thank you so much for your time to come on the show today. This has been an eye-opener, and I really appreciate what you're doing, not only for your uh your patients, but for your veterans. And you're truly a servant that is given back. And I thank you and bless you for that.
SPEAKER_01Thank you for having me.
SPEAKER_00No problem, sir. Folks, another great episode of uh Broken Brains. As we close out, remember, go find Dr. Charlotte, look up that tool, look up that podcast, look up his book, become informed. Because these are approaches to medicine that, while they might seem new, they're not. They've been around for a long time. They're just not out there. Become an advocate for yourself. If you got children, go on our website, get the book. It's for free. Download it. Broken Brains Youth Contact Sports, become involved. Look at our app on the Google and Apple Store, ahead smart. It's got the only concussion app with repetitive head impact information. If you like this episode, please be sure to follow us on Instagram at Broken Brains Podcast, on YouTube at Broken Brains with Bruce Parkman. Uh, please relieve a review on Apple, Spotify, wherever you listen, it helps us get the word out. And of course, that helps us get the word that uh that is necessary out there. If you have children and for yourself, you only got one melon, please take care of that. Become informed and please stay safe. If you are a veteran or you know anybody that is struggling and needs help, please reach out to us uh at the Mac Parkman Foundation, BW.mpfact.org. We have a national network of people. We're gonna add Dr. Charlotte to our list of people that you can talk to and and take care of those that you know are suffering in silence or yourselves. So until the next episode of Broken Brains, thank you so much. God bless you all, and we'll see you next time. Take care.