Concussion Rescue with Guest Dr Chapek

Transcript:

LEAH: Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness. We are a Minnesota company that specializes in real food nutrition education and counseling. My name is Leah Kleinschrodt and I've been a Registered and Licensed Dietitian with Nutritional Weight & Wellness for the last seven years.

We have been helping people connect what they eat to how they feel and perform for over 35 years. Believe it or not, food and nutrients can have a significant impact on how well our brains work. I have a quote from Dr. Daniel Amen here that I want to share to kick us off on this show. He says, “When your brain works right, you work right. When it is troubled for whatever reason, you are much more likely to have trouble in your life.”

We have used his information on our show for a long time. He is a psychiatrist, a New York Times bestselling author, Founder of Amen Clinics, and again, a regular resource on brains and brain health for us here at Nutritional Weight & Wellness. And Dr. Amen has put in a lot of work over the years using real food nutrition and specific nutrients to help support our troubled brains.

And today we have a very special show for our listeners. Because we have a physician with us who has worked with Amen Clinics for over a decade. He's going to talk about how our brains can get into trouble, specifically around concussions, and how we can rescue our brains and support their healing and improvement even years or decades after a brain injury.

This is a topic I am paying close attention to as I have a son who's just getting into the martial arts scene. I have a close family member who is an army veteran who is now unfortunately suffering from Alzheimer's disease. I have some nephews who play lacrosse and football, and I have another close family member who slipped on the ice here in Minnesota, hit the back of her head, and suffered a concussion.

And she still has some lingering effects from that injury almost a year later. So I just want the listeners to just take a moment and think, have I had a concussion or do I know someone who has suffered a concussion before? Or how many times have you had your bell rung in the past but just kind of brushed it off and walked off, walked away?

Or do you have kids or grandkids who play contact sports where their head could make contact with a ball or another player? Do you know a service member who's experienced the shock waves from gunshots or blasts while they were in training or in combat? Or do you know someone who has taken a tumble down the stairs or slipped on the ice and they saw stars when they fell?

Our brains are amazing organs, but they too are vulnerable to injury and insult just like any other body part. So our special guest today is going to take us through the ins and outs of what happens to a brain in a concussion, and also share actionable things we can do to protect our brains and help them recover quickly and more completely after an unexpected injury.

So without further ado, I'd love to introduce Dr. Kabran Chapek. Dr. Chapek is a naturopathic physician who has been working at Amen Clinics in the Seattle area since 2013. He is an expert in functional and integrative treatments of the brain, and he has special interests in the areas of Alzheimer's disease, dementia, traumatic brain injuries, PTSD, and anxiety disorders.

We're so excited that Dr. Chapek is joining us today to talk about his book, Concussion Rescue: A Comprehensive Program to Heal Traumatic Brain Injury, and to help us make the connections between nutrition and the healing brain or a hurting brain. So welcome to the show, Dr. Chapek.

DR. CHAPEK: It's a pleasure to be here, Leah; excited to talk with you about nutrition. I think some of the best results I've seen at Amen Clinics, I think our best reviews are those folks who have actually had nutritional intervention and our nutritionists work with them.

LEAH: Awesome. Yeah. Very good. Yeah. We're excited to dive into all things nutrition and nutrients with you because I know you're a wealth of information and you see this day in and day out in your practice.

Could you tell us a little bit more about your background? And I’m just kind of curious, did you always know you wanted to go into medicine? Did you always know you wanted to work with brains or was that just something that kind of unfolded as you went along?

DR. CHAPEK: I’m from Kansas originally, and, my parents had taught us how to eat healthily and take care of our bodies, because that's how you feel your best. And I, I'm still excited about that. And when I went to Bastyr, in Seattle, I studied nutrition, I studied supplements and exercises. I was asked as a doctor, you look at sort of the full person.

And I thought I was going to focus on environmental medicine, detox, gut health, things like that; graduated, I got my board result the same day my son was born. Very exciting role.

LEAH: Yeah.

DR. CHAPEK: They assured me to get a job and I found a job at a local partial hospital program that was treating eating disorders, mental health conditions, addiction issues. And, I found that I really loved the work. I worked there for about six years and worked with the holistic team, nutritionists and psychiatrists and other naturopathic physicians. And I found I was doing what I loved. I was helping people improve their bodies, which improved how they felt.

LEAH: Mm hmm. Yeah. Very cool. So it sounds like, like, you kind of had a great foundation laid in the beginning, but it was, again, like, your training and your education, and again, like, things just kind of landed in the, landed in the right order for you. And then, how did you end up with Amen Clinics? You said you, you worked, with the previous position, but how did you transition there?

DR. CHAPEK: Amen Clinics, so Dr. Amen's a brilliant psychiatrist. He's always looking at how he can help his patients, and that's where he's found SPECT imaging to look at the brain, because many other specialties don't look at, well, they look at the brain, but psychiatrists haven't, and so it's the left brain. This image into psychiatry, he's also looking for, you know, least toxic, most effective treatments.

And that's exactly what naturopathic medicine is. They had always wanted to have some more natural and holistic health care within Amen Clinics, but they hadn't found doctors which experienced psychs at, and the naturopathic doctors, but not with psychiatric experience. So based on my six years at the partial hospital program, I was a good match.

And so they recruited me and now we have five naturopathic doctors, and I think, you know, 30 some psychiatrists, so we have more naturopathic doctors there as well.

LEAH: Yeah, that's that's great. And I think what you said before is it the brain and the body are not separate entities. It is all and like your job is to kind of look at the whole the totality of everything and try to put the pieces of the puzzle together, which is so needed.

Details surrounding concussions

Tell us a little bit more about concussion. I'm going to toss a few questions out and you just answer in whatever logical sense it makes. But just tell us a little bit more about what happens to the brain in a concussion. How could someone tell if they've had a concussion or maybe their, if their kid has had a concussion or a teammate? And then sometimes we hear these terms, concussion and traumatic brain injury. So just kind of help us suss out like what's the difference.

DR. CHAPEK: Okay, so when someone had hits their head, there's a primary impact. This is in simple terms. So it can be damage, damage to blood vessels, damage to the underlying structure of the brain, and so that's the primary impact. And then there's a shockwave or secondary impact and through this cascade of inflammatory chemicals that happen secondarily.

So there's sort of an immune response, an inflammatory response, and there's this metabolic crisis where all of a sudden the brain doesn't have enough energy, it can't get enough glucose as well, it's a complicated effect and that cascades inflammation and excessive chemicals like glutamate can continue for weeks, months, and in post concussion syndrome, sometimes years.

And the term concussion, or mild traumatic brain injury, essentially a brain injury is a brain injury. A concussion is a form of a mild traumatic brain injury. So those terms could be used interchangeably. And typically we talk about traumatic brain injury if it's more severe, the symptoms, you know, loss of consciousness and, and such.

The symptoms can be varied. They're almost like subtypes of concussions. Some people have a little nausea. Some people have anger afterwards or depression. There can be light sensitivities, crown sensitivity, bowel problems, and some people will have a cluster of those symptoms. Some people will just have a post traumatic headache. It's persistent. It feels like pressure usually, but can be one sided.

So it can look different for different people and, you know, an acute brain injury should go away. We hope that it goes away after if a week or two, that's a little progression in about half the cases that last longer than that and can last for several months and then that's called post concussion syndrome if it lasts longer.

LEAH: I think that's so interesting. I think when people think about concussions, we think about the impact, the brain hitting the inside of the skull and like that's, it stops there. But what you're saying, especially with people who have lingering symptoms, it is actually a lot of inflammation that doesn't get resolved over time.

And then the brain, like you said, lacks energy. Like, there's things that kind of go haywire after that. And that's, I think that's the part that we don't, that's not like the typical things we think about with a concussion, right?

DR. CHAPEK: Exactly. And I think that's why people don't heal is because we don't think about those underlying mechanisms. And that's what I get excited to help people figure out and treat.

Who is at highest risk?

LEAH: Yes. Yes, absolutely. You know, we think about concussions with football players. Like that's the big population that's the most at risk. At the top of the show, I listed off several people in my own family who have either experienced concussions or like they're kind of more at risk. So I guess in your mind, who is at risk for having a concussion or who do you worry about the most?

DR. CHAPEK: The most common cause of concussion when people go into the emergency room is from falls. Football has popularized, hasn't really allowed us to study these NFL players and, figure out what's happening. But, most concussions are from car accidents, and so falling or getting attacked. It's people who fall, like you mentioned, on the ice. I have a lot of patients from Alaska, there's falls on the ice.

I think those people that are most vulnerable are those that may have some underlying issue. Maybe they already have some inflammation or they are low in vitamin D or they have poor diet or they're not getting enough sleep so they're drinking alcohol. Those put you at higher risk. You know, the study shows that if you had low vitamin D with the severe brain injury, those people died more than the patients who had normal vitamin D levels.

LEAH: Wow. Yeah, so even a simple nutrient like vitamin D could have some significant impact on how the brain reacts in a concussion or how it recovers.

DR. CHAPEK: Yeah, like a seatbelt, you know, it doesn't prevent the accident from happening, but it can help kind of protect.

LEAH: Hm hmm. Yes. And I think what you said, too, in terms of if we are already in a pre-inflamed state, like we have blood sugars that are running all over the place, if we have prediabetes or diabetes, or we have some underlying heart disease, or if we're already, again, in this inflammation state, it makes our brains a little bit more vulnerable if and when something does happen. So I think that's a huge takeaway, too.

When you're working with patients in the clinic, and so they're coming to you for some aspect of their brain, whether it is a post-concussion syndrome type of thing, or memory loss, or it's anxiety, or ADHD, or PTSD, personality changes, anything like that.

How long can effects from a concussion last?

When you're doing an intake with somebody or you're kind of getting to know them, how far back are you looking for a past concussion or trauma to the brain? And I guess another way to ask this is just like how long can these effects from a concussion go on for?

DR. CHAPEK: It's a really good question. So we do SPECT imaging where we're looking at the brain and it is a very sensitive and it's looking at a mild traumatic brain injury and any injury in the brain. And patients often ask, well, when does the scan show when I had this injury and, and it will basically show up many years later and they'll still see the image from at age seven or at age 10 or 18 or whenever it was.

And we know that injuries are cumulative, so, concussions to the head, such as in football or even soccer, with repeated headers or just football players crushing against each other and getting impacted, or the, veterans or the military with a lot of, concussive or blast type forces can accumulate over time and cause injury.

We always ask people, at least, we try and ask them, have you ever had a concussion because people kind of forget. They brush it off. Oh, I, I tossed stars for a second, I didn't lose consciousness, I must be fine. If it couldn't be that a damage to the brain where it was small bleed or, tissue impaired, temporarily, but over time those add up.

LEAH: Yeah. Yeah. I, that was one part from your book that I picked up too, is I get actually a lot of times you are having to ask many times over, going back even into childhood or into their teenage years of like, what did happen or did you play football? I was a soccer player, so I was never the person that was always like going for those big headers and stuff, but it's like those little things that add up over time that could lead to some of that inflammation that just can't resolve at some point.

DR. CHAPEK: Exactly.

LEAH: So, it definitely sounds like concussion prevention is ideal, as like prevention most of the time is kind of the ideal scenario, but we also want to, if something happens because we live in the real world and things happen, we bonk heads or we get into a car accident or we slip on the ice, intervening as soon as possible after the suspected concussion is also really important. How do we do currently, with the current standards and the current model, how do we do with treating concussions currently?

DR. CHAPEK: Well, I think that, the standards of care, is reasonable, you know, PT, OT, going to the ER if you suspect a brain bleed. You want to get a CT scan. I mean, all of that's really good. I think that's excellent, you know, and we're, people are much more sensitive to that than they used to be. The laws have changed around, you know, if you suspect a concussion, you got to take your kid out. They try and, you know, the trainer and the coach won't let them go back in until they're cleared. This is positive, positive changes that have happened.

How to start facilitating healing post concussion

But in my view, it's just the first step, because once we suspect that concussion, know that there's likely reclamation of sort of persisting and it's starting the process towards post concussion syndrome. That's when we could intervene and we should intervene to facilitate healing. We're not, none of the, the current standard of care is really facilitating healing.

It's allowing the body to heal if it has the resources to do so, and sometimes it just doesn't, and that's where I think is a true opportunity to intervene. There's a really interesting study done in 2013, in Stanford, an undergraduate student Theodore Roth, and he was doing this experiment where he had, he, and unfortunately we, we studied mice and he stuffed, he implanted an intracranial microscope into the mouse skull and then gave it a concussion basically and noticed, or we were able to see in real time what happened, sort of the macrophages gobbling up damaged tissue and this whole catheter event, we could actually see it happening.

And then he applied glutathione to the mouse skull, which needed strong antioxidants. It quenched, I believe 86 percent of the, it was a decreased cell death by 86%. If applied within three hours, it decreased cell death by 50%.

LEAH: Mm hmm.

DR. CHAPEK: But we know there's this window of time when we're watching the person taking them to ER, and then afterwards letting the rest when we could be sort of facilitating that healing, that's a real opportunity missed.

LEAH: Mm hmm. Yeah, I read that part in your book too and I was blown away by, like you said, just even some of these little things that it doesn't take much, a little glutathione cream or a little something to just kind of edge the inflammation response in the right direction and it can make a huge difference then with how people recover after that.

So you kind of gave us a picture of what the current model looks like or kind of how we currently treat concussions. In your book, there's a chapter called “First Aid for Your Brain”, where you kind of put on your hat and say, like, if I was concussion king for a day, this is how I would do it. Tell us a little bit more about, like, what your ideal protocol would look like when somebody has a concussion.

DR. CHAPEK: Yeah, Leah. So, this is where it comes back to naturopathic medicine and sort of holistic care and thinking about the whole, and that has pretty much failed in many areas that are related to the brain, especially complicated situations like dementia, and brain injury.

What we want to think about for a concussion or even many years later for healing from brain injuries is we want to have multifaceted approach that hits one multiple targets. So we want something that decreases inflammation. We want to think about nutrients that increase brain energy. We want nutrients that help with neurodegenerative generation and kind of stimulating healing.

And we want to make sure that the brain has the energy that it needs through nutrition and diet. And so since I wrote the book back in 2020, research continues to come out. And so I hope to, update the book in the next couple of years with the newest research, for example, with creatine, which we've thought of just for muscle, very helpful for the brain as well.

And I would add that to my, concussion protocol. I like nutrients like curcumin, curcumin from turmeric, but it's much more potent. And it's opens up osteoporins in the brain, which helped with decreasing swelling, because even if it's not a big amount of swelling, there are these micro swelling aspects that have, I mean, so it can kind of help with both inflammation and excess swelling because when there's swelling in the brain, there's nowhere for it to go eventually because of the skull.

I would use nutrients like of course, vitamin D or vitamin C is very useful as well as an antioxidant. I mentioned the glutathione with the study in Stanford, but, glutathione in the mouse skull, it's easily transmittable because the skull is so thin. But in the human skull where we have, it's much thicker skull, it's hard to penetrate through it.

There was a study, that they did with active duty military, double blind, retrieval controlled trial, also in 2013. And if these, active duty military, they would, if they had a concussion, they would go to the medic and they would give them huge amounts of NACs. They gave them immediately four grams of NAC and then twice a day you did two grams for four days.

And then the next three day they gave them 1500 twice a day. Mm-Hmm. And those, active duty military members, if they did the NAC, they had 86 percent recovery rate versus 42 percent recovery rate. So it's about, like we said earlier, most people who have a concussion, about half will recover within a week or two. But we want, if it was me, I want to be on the 86 percent side versus the 42 percent side.

LEAH: Yes, I'm glad you mentioned that. I was going to circle back around, like you said, like the glutathione was used in the mice study, but, you know, it's a little harder to get into the human brain because our brains are, our skulls are a little thicker, so the NAC, the N-acetyl-cysteine, is the precursor for glutathione, which is one way we could kind of get around that little snafu.

Yeah. So you mentioned vitamin D. I mean, our listeners who have been listening to us for a number of years know we talk a lot about vitamin D also. You know, you're kind of in the upper northwestern corner of the U.S. too, so you guys probably also don't get a ton of sunshine in the winter.

Like, we do the same thing here in Minnesota, so we often have clients on higher doses of vitamin D just to get those levels up, especially during the winter. Just because the creatine has been having a little bit of a moment in the spotlight, I'd say, like you said, we thought about it more for muscle recovery and things like that. Could you give us an idea, if you're able to, of what you might give somebody in terms of a dose of creatine?

DR. CHAPEK: I would give five grams twice a day. It's like kind of what you would do for muscle, isn't it? You know, it helps, it's just like we're thinking about muscular energy, instead of like brain energy. It's more in that kind of direction they get ATP for the brain. There's a little bit of evidence that it helps buster some of the calcium. That is, we think of calcium as a good nutrient, but it's also an inflammatory, mediator if released after injury and so it helps buffer that and helps with oxidative stress. So yeah, creatine is kind of awesome.

LEAH: Yeah. And I'd say that's right around kind of what we've used with clients also, like that three to five grams or so at a time, because it is a quick source of energy, right, and you said in a concussed brain, it might be lacking some of that energy, so it's a way to give that brain a little bit of energy to repair and start that process.

DR. CHAPEK: Yeah.

LEAH: So we do have to take a quick break, but we've been talking about a few nutrients that are helpful for the brain, and we will get into some eating strategies as to how can we help heal the brain. So stick with us. We'll be back in a moment.

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We're back to Dishing Up Nutrition, and we are talking with Dr. Chapek about how to rescue an injured brain, specifically around concussions. And before break, Dr. Chapek was sharing about some key nutrients that could be helpful for inflammation and helping to support a healing brain. And that included creatine, vitamin D, curcumin, vitamin C, and N-acetyl-cysteine, which turns into glutathione in the body.

The food connection to concussions/brain health

But now let's talk a little bit about the food. You mentioned, Dr. Chapek, many of your patients are meeting with a nutritionist or they're talking with you about food. So I guess how often or what do these conversations look like when you're talking with your patients about nutrition related to their brain? I know it's a big question.

DR. CHAPEK: It's an important question. And as you know, talking about nutrition with people is more than just about the food. It's about the relationship to it and, what it means to them. So, I always think about it as like a sort of a spectrum. There may be optimal, but we have to start with where they're at. So, for example, I find that if someone is eating very poorly, it's going to be very hard to heal.

And so we may just need to start with protein of every meal or cutting out some sugary drinks. And that can help significantly just removing the bad, you know. The one diet that's been studied for concussions and brain injury, if any, is a ketogenic diet. It is one of the most, helpful and well studies for a number of brain conditions from dementia, seizure disorder. That's how it was originally used was for seizures hundreds of years ago, and studied in the past centuries.

And now currently there's various versions of it, but it's still useful for seizure disorders, migraine headaches, Parkinson's, and, autism. Since the book came out, I wasn't able to include it. There's a phase one trial, 10 adults, in a ICU unit where they were given ketogenic diet. It was helpful. So hopefully we're going to see more trials come out, but personally I've seen it's very helpful, and it makes sense as it's anti-inflammatory, it's neurogenic, so it helps with healing.

The whole reason why I think it makes sense too is because a lot of the glucose transporters are damaged after a brain injury and your brain as you know, is your most metabolically active organ. You eat this 20 to 25 percent of the calories of your diet. A quarter of your plate is just your brain is losing that fuel. And so, if, if we have this deficit and you have the damage, what's your, you know, you're sort of at an impact. Your brain can't heal.

And this is where ketogenic diet comes in, where you're restricting glucose and carbohydrates to the point where your body has to produce ketones for fuel from fats, and the ketones can get right into the brain with less energy. They come in by osmosis almost. And, it takes many less steps. It's like three to six steps versus the 27 steps to produce fuel from, from glucose. And so it's more efficient in the end.

LEAH: Yes; ketogenic diet: you're right. It's like it becomes popularized in the typical media because it's, you know, out there for weight loss or it's the “new”, but like you said, it's it is actually an old way of eating like the new thing to help with weight loss and stuff.

But you're saying actually a ketogenic diet, which is very high fat way of eating, very low carb way of eating, that actually has some very specific healing potentials for the brain, which is great.

You know, I'm going to put you on the spot here. If you had to create the perfect or, like, your ideal ketogenic kind of feel, what might a meal like that look like?

DR. CHAPEK: Well, and I didn't mention omega-3s earlier, which really I would add to some whole protocol. But I would choose maybe some wild salmon, something like that, which is high in fat and protein. Maybe some vegetables, some broccoli or kale or something like that. And then for every keto meal, you kind of have to add extra fat. So I would add sort of, aioli or a bunch of extra olive oil or half an avocado or a full avocado, some olives, things like that. Fat, fat and more fat, basically.

LEAH: Yes. Absolutely. And you said too, like when the brain gets concussed or it has that injury, it might not be able to use the glucose, some of those carbohydrates or sugars as efficiently as it did before. And it might not be that way long term, but that could be why you made the point too of, you know, if we can reduce the added sugars, cut out the sodas or the high sugar coffee drinks or get some of those big players out too, which are things that create inflammation in the brain, that actually, pushes the brain in the right direction and pushes that inflammation response in the right direction, which I think is great.

DR. CHAPEK: One of the biggest symptoms or most common symptoms after concussion is fatigue. And for years, people were just so fatigued, energy is so low. And I just think keto can really help with that low energy state. Now, if someone's tired and they don't really have energy to cook, and we know keto takes a lot of energy and time and investment, and someone doesn't really like to cook, it might be too hard for them. But I do think, man, if you're low energy, it's worth to try, see if it helps.

LEAH: Yeah. If you're low energy or again, like you have months or years of these symptoms lingering and nothing is quite seemed to fit the bill yet, it is another option to try for sure. Yeah, you know, you've talked about some specific nutrition supplements both in the first aid kit.

Supplement support to consider for concussion/brain injury

You just mentioned the omega-3s. So like you have that kind of those, some of those nutrients as first aid strategies for the brain and then you have another chapter that extrapolates on some more nutrients, specific nutrients that are helpful for the for traumatic brain injury and concussions. If you had to pick, if you had to pick three to maybe four supplements that you would recommend for somebody who has had a concussion or an injury to their brain, I know it's probably kind of like picking your favorite children, but if you had to pick what would you prioritize?

DR. CHAPEK: Yeah, that's a great question. I liked the idea. Think about the, the first phase as sort of using higher doses of curcumin and vitamin C, and that if I had to do a study, I would do it for 30 days. Beyond that, we might choose a few different nutrients or additional things, especially if you're having problems with your memory.

I would choose citicholine, C I T I, choline, and citicholine is cool because it helps with producing acetylcholine, which helps with memory and learning. It's part of cell membranes; it's very safe. Well studied after strokes as well. But that's a very helpful cognitive nutrient.

Phosphatidylserine, I'm choosing one of these funny names, but, anyway, it's part of cell membranes, 10 percent of your brain is made out of phosphatidylserine. It's not a new, newer under a fad, but it's, well, it's one of the best studies, nutrients for your membrane.

Again, so I would certainly choose that one. I would do higher doses of omega-3. Some of us, we're in the range of two, two grams to three grams a day. But we're not on any blood thinners or anything like that. Some of the nutrients I would keep, like vitamin C, vitamin D. I might consider continuing the creatine.

I might have something specifically for brain injury, but really helps with brain inflammation and sort of long term cognitive healing are herbs like bacopa, and ginkgo biloba, probably heard of that for, for blood flow. Dr. Amen is a big fan of ginkgo biloba.

And so I would start to add some of the herbal supports as well as, continue some of the other nutrients and, and, I really want to highlight the point that, the first stage to it is the idea is to have a little packet of supplements ready to go on the sidelines, in your car, in your glove box, in your backpack, because we know there's that window of time.

And so what I have is a little Ziploc baggie. I like curcumin, vitamin C, vitamin D. I don't put fish oil in there because it, at first, they're going to have a huge mess and thing.

LEAH: Smelly mess too. Yeah.

DR. CHAPEK: And you can take it right away, you know?

LEAH: Mm hmm. Mm hmm. Yeah, that was part of, your, part of that chapter on first aid for your brain and kind of what you would do, you had a vision of like every trainer, every coach, or every sideline person who's out there supporting athletes or, like you said, packing a kit in your car, in a hiking bag or something like that.

So, just having some of these things on hand to kind of start that immediate process of healing or that immediate support of the inflammation versus, now we're a couple of weeks out and things aren't getting better. It's like, oh, now maybe I better think about doing something else. Not that these things wouldn't be helpful in a couple of weeks also, but like, hey, can we get it underway within even a few hours?

Ketogenic diet recommendations post concussion

What, when, I'm going to circle us back to the ketogenic diet also, because you also said for some of these nutrients and some of these supplements, you kind of think about some of them a little bit more short term in the first 30 days and then some a little bit more long term. So post 30 days.

What about that ketogenic way of eating? Is that something that you would say somebody does that for a couple of weeks, a couple of months? Or does it depend on the person and their situation?

DR. CHAPEK: Yeah, there's a couple of interesting studies like the animals right after concussion, and they showed better improvements in healing. So, assume it's due to the ketogenic diet or production of ketones. When someone's in a fasted phase, also those will be in a ketosis. So I think it's useful immediately. So sort of shift into a ketogenic diet or at least a low carb diet.

You know, the worst thing to do after an acute injury would be lots of sugar, lots of carbs. You want to do more proteins and fats. So, you know, if someone was playing lacrosse or football, probably that will be really important to do low carb, higher protein and fats just preventively.

I think I did a ketogenic diet for a couple of years a while ago. I found it very helpful for me the first three to six months. And then beyond that, I feel like I should have sort of rotated in and out just with my body type. Some people can do fine staying on it for years.

Other people need to cycle. So, I would do, you know, If I were to do it again for myself or for patients, I'll often recommend do three months. Get the mitochondrial going, get the brain energy. Take maybe a break for a couple of weeks, go and do it again. But, yeah, I think it's, you know, work with your nutritionist, the doctor, and figure out what's right for you.

Overviewing additional tips for general brain health, healing & protection

LEAH: Mm hmm. Yeah, I love that. It sounds like it is just another tool in the toolbox that can be brought in or maybe left out for a little while and just again kind of utilizes another anti-inflammatory healing aspect for the brain. Yeah. Yeah. Well as we're rounding out our show here, Dr. Chapek, do you have any parting wisdom or knowledge nuggets or anything specifically that you want our audience to walk away with? And this is whether we're talking about just protecting the brain in general or if we're talking about healing the brain. What would you want us to know?

DR. CHAPEK: Yeah. Well, in general, I would say remember that the brain is multifaceted. It's not this one nutrient or one diet that's usually going to help. I think so many patients who benefit it just from doing like the TBI first aid kit or do it a few nutrients and from the book, but some people really do need vision therapy, speech therapy, physical therapy.

They may need work on their neck because of structural problems with whiplash. If you have problems with the neck, if you had a car accident or even a fall, oftentimes you'll have impingement of the upper cervical spine and basically lack of blood flow.

That needs to be addressed through specialty chiropractic or cranial facial massage. So I just say, think about, do I need other therapies to help me heal more? Physical therapy, occupational therapy, speech therapy can be very helpful.

I would say that it's never too late to try to heal your brain, even if it's been many years later, you've struggled, been told you can't get better. Why not try some of the things you maybe haven't tried? You may not bring back your previous level of function, but we know the brain can heal. It's an amazing organ.

Even 20 years later, retired NFL football players can see it improve, when they had sort of dementia symptoms and depression symptoms. And they've been able to really become not depressed anymore, better memory in their 60s when they had injuries from their 20s and 30s.

LEAH: It's a message of hope, which is so important, especially when you don't feel well or you're not functioning well, just having hope that there are other things to try is so important. So thank you for sharing that. And like you said, there are, it's not super straightforward. The brain and the body are connected and there are lots of therapies out there that could help or lots of different angles that you could attack this from.

You've seen the progress, you've seen the improvements and so that message of hope is so important. So thank you for sharing that.

DR. CHAPEK: You're welcome.

LEAH: Yeah. Well, this has been a great conversation. It has a lot of impactful, useful, and like I said, hopeful information in it. Our special thanks and deepest gratitude to Dr. Chapek for sharing his wisdom and for taking the time out of this knowledge with our listeners.

So if you're in the Seattle, Washington area, you can look up Dr. Chapek and his practice at Amen Clinics. Otherwise, you can grab a copy of his book, Concussion Rescue: A Comprehensive Program to Heal Traumatic Brain Injury; especially if you're looking for a little bit more detail on some of the protocols that he uses and nutrients that he uses, it's a great book to pick up.

It takes a lot of the complexities of brain injury and healing and it translates it into an easy to read, easy to understand format so people can walk away with a clear plan on what to do. And Dr. Chapek, is there anywhere else listeners can find out more about you and your work?

DR. CHAPEK: I think Amen Clinics is the best and, yeah, it's been a pleasure to talk with you. Thanks so much.

LEAH: Yes, you're very welcome. Thank you again. And our goal at Nutritional Weight & Wellness is to provide each and every person with practical, real life solutions for everyday health through eating real food. It's a simple, yet powerful message that eating real food is life changing. Thank you for listening and have a great day.