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Daggers to the brain and how to assess brain health

It is imperative to remember that what is happening in one vascular bed is most likely happening in another. In other words, the cardiovascular risk daggers are just as important risk markers for the blood vessel health of the brain as for the heart, and stroke risk parallels cardiovascular disease risk as a result. The attached 17 daggers of arterial disease are thus also important for the assessment of brain health, neurodegenerative disease risk and cognitive decline risk.

There is however a subset of tests that can be done to assess the risk for neurodegenerative diseases such as cognitive or memory decline associated with aging. The rationale for the testing reflects the common mechanisms underlying the aging of the human brain. As we age, we burn up and swell up due to inflammation,  dry out, due to dehydration (and loss of acetylcholine and memory results),  and turn to stone, as it were, with bone mineral density loss and calcification of our arterial plaques instead.

So what testing is at our disposal ?

1.  C-reactive protein

C-reactive protein (CRP) synthesis in the liver increases in response to infection or inflammation.  Unfortunately crp lacks specificity for any given disorder. There is also no absolute criterion for distinguishing active infection from chronic inflammation or even acute trauma. It is however now recognized that chronically elevated crp can be predictive of neurological disorders, including dementia and stroke.  (1)

2. Homocysteine

Methionine is the essential precursor of the methylation cycle. Transfer of a methyl group to S-adenosyl methionine (SAMe) results in the production of homocysteine, which occurs throughout the body. Homocysteine can then be transmethylated (vit b12 and folate dependent) to regenerate methionine, or alternatively, by trans-sulfuration  (B6 dependent) cystathionine can be produced, which is necessary to regenerate glutathione. (2) Oxidative stress appears to shift these pathways towards formation of reduced glutathione, which is most likely the single most important antioxidant for the brain. While elevated homocysteine has long been recognized as a risk factor in cardiac disease, it is now clearly associated with central nervous system (CNS) disorders including retardation, autism, seizures, stroke, memory loss and altzheimers disease. (3) Abnormal elevations of homocysteine can be considered to reflect a backing up of substrate, reflecting inadequate production of glutathione and/or methionine. This most frequently occurs in the setting of B vitamin deficiency states.  Optimal levels of homocysteine should be less than 7.

3. Free radical markers like malondialdehyde (lipid peroxides)

Lipid peroxides are the products of damage to the lipid layer of cell membranes mediated by reactive oxygen species (ROS). (4)  Levels of lipid peroxides can be measured in either urine or serum.    Serum has a greater sensitivity to subtle increases and is now considered a standard measure of the body’s oxidative stress state (5).  Elevated lipid peroxides have been demonstrated in schizophrenia, mild cognitive impairment (MCI) and even methamphetamine abuse. (6)(7)

4. Vitamin d3

It is becoming increasingly evident that vitamin d deficiency is much more prevalent than previously believed.    Sunlight exposure alone is frequently insufficient as a vit d source, and recommendations for supplementation have historically been far too low (8).  Low levels of vitamin d are now implicated in a broad spectrum of diseases , including dementias and MCI. (9)

5. Apoe4 genotype

The apo e proteins are involved in cholesterol metabolism and transport. Subsequent research has shown significant effects on brain oxidative stress and risk for altzheimer’s disease.     Two alleles, Apo e2 and apo e3 actually appear to improve antioxidant function in the brain (10). Apo e4, however, has been shown to be an independent risk factor for altzheimer’s disease (11).  Heterozygotes for the E4 allele have an approximately 45% increase in risk, and tend to develop symptoms 5 to 10 years sooner than the general population.      Individuals who are homozygous have an increased risk approaching 90%, and may see symptoms 10-20 years sooner. It could be argued that at least patients with a family history of Altzheimer’s disease should be tested for the presence of Apo E4. This information can be used to positively motivate those patients who test positive to initiate the most aggressive preventative measures possible.

Other diagnostic testing for the assessment of brain health include brain electrical activity mapping (the beam scan).  This is a scan developed by dr eric braverman in new York.       There are 4 key measures of brain bioelectrical function: voltage, rhythm, speed and synchrony

Further testing could include:

(a) Transcranial Doppler: this measures blood flow in the cerebral arteries.    It can be used to detect changes in the blood flow due to vascular spasm or stenosis, detect blood flow changes due to aneurysm, and provides information regarding migraines

(b) Carotid ultrasound: this measures blood flow in the carotid arteries and can be used to detect early changes in carotid arteries (intimal thickening) and to detect tortuous arteries, aneurysms, turbulent blood flow, and carotid dissection

(c ) MRI brain

(d) CT angiography

(e) PET scan

(f) whole body ultrasound

Integrative Approach to Enhancing Brain Function

Aging healthily really begins if we increase the level of our brain functioning. A healthy brain controls the health of the rest of the body. Age related diseases such as arthritis, osteoporosis, heart disease, high blood pressure, loss of skin tone, dementia, weight issues, mood disorders, memory loss all can be prevented or controlled by ensuring the healthy functioning of the brain, which after all is connected to the rest of the human body. The brain can be taught to break the aging code and actually resurrect an aging body. The brain’s functioning can be balanced with nutrient supplements, proper dietary choices, natural hormones, medications, and lifestyle changes.

There are chiefly four measurements that determine the relationship between brain function and the creation and delivery of human electricity, which unlocks the aging code and restores a more youthful, vibrant healthy body:

1.        VOLTAGE (dopamine).  Voltage measures power: the intensity at which the brain responds to a stimulus, and the effectiveness of the brain’s ability to process information. This information can be both cognitive and physical. Voltage determines metabolsim and how one’s body processes food.     Voltage also determines the state of consciousness (ranging from fully alert to deep sleep) and how one chooses to meet one’s emotional and physical needs.

Low dopamine levels accelerate aging by causing a number of pauses in the body:

a)       Cardiopause: an aging heart, raised blood pressure, weight gain, fatigue, high cholesterol, vascular system aging

b)       Immunopause: increased incidence of infections, obesity accelerates every form of cancer in every organ as well

c)       Menopause: menopause can be accelerated by lack of dopamine, hormonal loss is a major age accelarator

d)       Andropause: loss of genital size, prostate disease, loss of libido, heart disease are all accelerated by dopamine deficiency

e)       Osteopause: fat seeps into one’s bones, replacing normal bone.    Lack of dopamine accelerates arthritis and osteoporosis

f)        Dermatopause: low dopamine equals weight gain, stretch marks and aging of the skin

The following hormonal treatments enhance weight loss and dopaminergic functioning (consult the Compounding Pharmacy of South Africa 0114630310 and Dr Golding at 0114630036):

a)       Testosterone transdermally preferably... symptom clue: low sex drive

b)       Estrogen transdermally… symptom clues : skin aging, poor circulation, menopause, poor hair and teeth health, menopause

c)       DHEA (dehydroepiandrosterone)… symptom clues: fatigue, poor inner strength

d)       Thyroid… symptom clues: low mood, all day fatigue, weight gain

e)       Human growth hormone… symptom clues: loss of bone mass, muscle tone and skin aging

f)        Erythropoeitin… symptom clue: anemia due to ailing kidney function

g)       Calcitonin… symptom clue: bone loss

h)       Insulin, incretin… symptom clue: blood sugar regulation problems

i)         Cholecystokinin… symptom clue: digestive tract problems

Natural treatments that help against the fat battle: (increasing dopamine levels is essential but   nutrient supplements, exercise and the correct dietary choices helps to restore a lean, healthy body)

a)       Conjugated linoleic acid (CLA): facilatates weight loss and reduces additional fat cell deposition

b)       HCA (garcinia cambogia/hydroxycitric acid) with chromium reduces the conversion of carbohydrates into stored fats ; also suppresses appetite and induces weight loss

c)       5HTP (5-hydroxytroptophan) reduces appetite and promotes weight loss

d)       Phenylalanine: stimulates the body’s brown adipose tissue to burn up regular adipose/fat tissue.  It also assists in releasing cholecystokinin, a hormone that increases the sensation of fullness.

e)       7-keto DHEA is a bioidentical metabolite of DHEA and promotes weight loss

f)        EFA (essential fatty acids), such as GLA (gamma-linoleic acid) facilitate weight loss

g)       Fish oils facilitate weight loss, raise serotonin, and decrease appetite

h)       Vitamin d and magnesium control the metabolic syndrome and aid in losing weight

i)         Increasing calcium metabolism results in better fat metabolism and speeds up weight loss

Dopamine levels can be boosted with natural supplements:

a)       Tyrosine (regulates mood) 2g/d

b)       Phenylalanine (helps reduce fatigue and is a natural pain reliever) 500-2000mg/d

c)       L-dopa (for the treatment of Parkinson’s disease) 100-500mg/d

d)       Rhodiola Rosea (herb that fights depression and fatigue) 75-375mg/d

e)       Thiamine (B vitamins that helps convert carbohydrates to glucose; helps with addictions) 50-500mg/d

f)        Chromium (fight fatigue) 200-600mg/d

g)       Folic acid (enhances dopamine transmission) 1-2g/d

h)       Ginkgo Biloba (enhances blood flow, glucose utilization, enhances dopamine)

i)         Yohimbine (enhances sex drive) 5,4mg/d

j)        Methionine (enhances production of dopamine and adrenaline) 60mg/d

k)       Guarana (works like caffeine and helps fight fatigue and raises ATP) 100-500mg/d

Leptin producing, appetite suppressing foods:

Apples, salmon, broccoli (the best dopamine enhancing food), pomegranate juice, carrots, spinach,  egg whites and unsalted almonds.

Dopamine enhancing foods:

Apples, avocado, broccoli, canola oil, carrots, chicken, chocolate, duck, eggs, game meat, granola,  lean beef, low fat dairy, mackerel, oat flakes, olives, pomegranate, salmon, soy beans, spinach, tofu,  tuna, turkey, unsalted nuts, wheat germ and yoghurt.

2.       SPEED (Acetylcholine). Speed measures how fast we think or process information. The electrical signal speed processing is governed by acetylcholine. By increasing brain speed one can increase attention, IQ, and even one’s behaviour. Slowing of brain speed leads to forgetfulness, dementia, mental quickness, attention and memory. Loss of acetylcholine in the brain results in messages being sent to the body causing other aging related pauses:

a)       Osteopause: arthritis, muscle atrophy and osteoporosis

b)       Menopause: decline in sexual activity due to vaginal dryness

c)       Andropause: erectile dysfunction and related complications

d)       Vasculopause: diabetes and eye disorders

e)       Cardiopause: elevated cholesterol

f)        Somatopause: multiple sclerosis related to loss of growth hormone, which also affects memory, neuromuscular quickness, and strength

The following are acetylcholine promoting hormones:

a)       Human growth hormone

b)       Vasopressin 5-60 units/d

c)       DHEA 5-200mg

d)       Calcitonin 200Iu/d

e)       Parathyroid hormone 20-40ug/d

Nutraceuticals to promote acetylcholine function:

a)       Choline 200-3000mg/d

b)       Deanol Dimethylaminoethanol (DMAE) 100-3000mg/d

c)       Acetylcarnitine 500-5000mg/d

d)       Phosphatidylserine 1—300mg/d

e)       Lipoic acid 25-1000mg/d

f)        Fish oils (omega 3) 500-3000mg/d

g)       Glycerol phosphocholine (GPC) 125-1000mg/d

h)       Manganese 2-10mg/d

i)         CLA 1-6g/d

j)         Piracetam (derivative of GABA) 2000-4800mg/d
Herbal treatments to enhance Acetylcholine:

a)       Huperzine A 50-400ug/d

b)       Vinpocetine 5-20mg/d

c)       Ginkgo Biloba 50-300mg/d

d)       Bacopa monnieri 100-400mg/d

e)       Gotu Kola 500-1000mg/d

Low acetylcholine signals send signals to your body that you are drying up and as a result fatty food cravings occur which elevate choline. A better choice of fats here is essential to boost brain speed, but breaking the fat code at the same time:

a)       Replace whole or condensed milk with skim milk or non- fat milk

b)       Replace bacon with Canadian bacon

c)       Replace bologna and sausages with turkey, chicken thinly and leanly sliced

d)       Replace creamy cheeses with low fat cheeses, cottage cheeses, or frozen low fat yoghurt

e)       Replace ice cream with ice milk or low fat yoghurt

f)        Replace beef and fatty meats with lean meats that are fat trimmed

g)       Replace sour cream with low fat yoghurt

h)       Replace salad dressings with reduced calorie salad dressings, vinegar and lemon juice

i)         Replace cream with skim milk

j)         Replace fried eggs with poached, boiled or baked eggs

k)       Replace marbled meats with fish

The following herbs and spices can improve brain speed :

Basil, sage, salvia, black pepper, turmeric, lemon rosemary, mint

Asparagus blocks acetylcholinesterase and boosts acetylcholine as well.

3.       RHYTHYM (gaba).  Rhythm measures the balance between the two hemispheres of the brain. A smooth,even flow of electrical  conduction  results in a balanced brain. The beginning of brain dysfunction is signified by bursts of electrical activity called arrythmias. Rhyththm determines one’s ability to cope with stress. Abnormal rhythm results in anxiety, nervousness and irritability. When you are out of rhythm, you can be irregular anywhere, such as your bowels, lungs or joints.

Gaba enhancing foods are high in vitamin b (especially if you are in pain or emotionally stressed).  Glutamine is an amino acid that is a precursor to GABA. In particular bananas, brocolli, and brown rice are all packed with inositol, another B complex vitamin that boosts GABA production.  Whole grain breads and cereals, figs, spinach and kale all contain magnesium – great for calming down nervousness and irritabilty. Good foods to incorporate into your diet for good rhythm of the brain include : almonds, bananas, beef liver, brocolli, brown rice, figs, grapefruits, halibut, kale, lentils, oats, oranges, potatoes, rice bran, spinach, walnuts, whole grains.

Hormonal treatments to enhance GABA:

a)       Progesterone 100-200mg/d by mouth preferably

b)       Pregnenolone 10-25mg/d

c)       DHEA 25-200mg/d

Natural gaba enhancers include:

a)       Inositol 100-10000ug/d

b)       Kava 200-700mg/d

c)       Vitamin b3 50-3000mg/d

d)       Branched chain amino acids 5-20g/d

e)       Taurine 500-10000mg/d

f)        Glycine 500-5000mg/d

g)       Magnesium 300-1000mg/d

h)       Theanine 100-500mg/d

i)         Tryptophan 500-2000mg/d

j)         Phenylalanine 500-2000mg

k)       St. john’s wart

Other techniques to improve brain rhythm:

a)       A good night’s rest

b)       Exercise and yoga

c)       Meditation

d)       Alternative therapies such as touch, accupuncture, physiotherapy and manipulation

e)       Peer support

f)        Take a break from stresful situations

g)       Avoid caffeine…good choices include nutrient rich and antioxidant rich caffeines like green tea, oolong tea, white tea and rooibos tea

h)       Be more assertive (express your feelings in a polite, firm and not aggressively or in a passive way and ask for what you want)!

4.        SYNCHRONICITY (serotonin). Synchronicity of the brain balances the movement of the 4 brain wave (alpha, beta, theta and delta) across the hemispheres of the brain.  When synchronicity is out of balance you experience sleep disorders, depression and fear during the day. Lack of sleep exacerbates all diseases and triggers the cycle of inflammation.  Brain serenity can be augmented through dietary choices, especially with foods that are high in tryptophan.  Turkey is a rich source of tryptophan, hence the reason feeling tired after eating turkey. Other foods to enhance serotonin include: blueberries, bananas, bran cereal, salmon, yoghurt, poached eggs, cottage cheese, avocado, tofu and broccoli. Herbs and spices to enhance serotonin include: basil, black pepper, borage, cayenne pepper, cumin, nutmeg, peppermint, rosemary, sage, thyme, turmeric.

A lack of serotonin can cause:

a)       Depression

b)       Accelarate calcification, leading to osteopause

c)       Lower your sex drive, triggering menopause and andropause

d)       Lower your estrogen and and progesterone triggering menopause

e)       Lower your testosterone triggering andropause

f)        Weaken your immune system, leading to immunopause

g)       Accelarate skin aging or wrinkles and frown lines, accelarating dermatopause

Serotonin boosting hormones include:

a)       Progesterone 100-300mg/d

b)       Human growth hormone

c)       Pregnenolone 10-25mg/d

Natural synchronicity boosters include:

a)       Melatonin 0.3-10mg/d

b)       Tryptophan 500-2000mg/d

c)       Vitamin b6 10-50mg/d

d)       Fish oils (epa/dha) 500-3000mg/d

e)       Magnesium 300-1000mg/d

f)        Vitamin b3/niacinamide 500-1000mg/d


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