The standard concussion protocol has evolved over the years and greatly improved outcomes for people who suffer head injuries. Sadly, however, many of the long-term effects of such injuries are never addressed, and many of these brains eventually regress. In the second episode of a series with “Concussion Rescue” author Dr. Kabran Chapek, he and the Amens reveal the nutrients and supplements that will keep your brain in a healing state for the long term.
Dr Daniel Amen: We are going to start your new year, your new decade off with a bang. Tana and I are going to do a six week live class, so starting January 21st, every Tuesday we're going to be with you for an hour. At the end we're going to give away over $20,000 in prizes. We look forward to helping you kick off this new year by becoming brain health revolutionaries. Welcome to The Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast we provide you with the tools you need to become a warrior for the health of your brain and body.
Dr Daniel Amen: The Brain Warrior's Way Podcast is brought to you by Amen Clinics where we have been transforming lives for 30 years using tools like brain SPECT imaging to personalize treatment to your brain. For more information, visit amenclinics.com.
Tana Amen: The Brain Warrior's Way Podcast is also brought to you by BrainMD where we produce the highest quality nutraceuticals to support the health of your brain and body. To learn more, go to brainmd.com. Welcome back. We are still here with our friend and colleague, Dr. Kabran Chapek. We were having so much fun and we're talking about something really serious though. Your new book, Concussion Rescue, which really outlines how you treat patients through our protocols at Amen Clinics. Really excited about that. I also am really excited about the course you're going to put together with that, Concussion Rescue. So that's just fantastic to be able to hold people's hand through this process, educate them on what it really means to have a brain injury, because we talked about how so many people don't actually know. So thank you for being here with us and talking about your new book and the new course.
Dr Daniel Amen: So when someone has a concussion, what's the first thing they should do?
Dr Kabran Chapek: Well, if it's severe, of course the standard protocol, go to the ER. Get CT scan, MRI, check for brain bleed. The standard protocol is fine. In fact, we've reduced the death rate from 40 to 50% down to 20 to 30% in the past 30 years, so that's huge. We don't want to minimize good work of the neurosurgeons and their teams, miracle workers. However, the death rate has gone down over the past even five years, but we've seen a rise actually in patients going to the ER. There's now nearly 3 million people going to the ER with a head injury. We'll see kids zero to four and then older adults, but also many people in the middle. Sports teams, standard protocol, watch and wait, rest, progressive exercise, both schoolwork, going to work, using your brain and also physical exercise.
Dr Kabran Chapek: But then that's kind of it. It just leaves so many people without enough help. And 20% to 50% will go on to have post concussion syndrome or chronic symptoms from their brain injury. Could be memory problems, could be depression. Like we were talking about earlier, depression can come out of the blue. I don't know why I'm depressed. When you think back, it could be due to an injury. We need to do more to actually help the body and the brain to heal and facilitate that healing. Specifically it's that quenching of inflammation. The chronic, it's like a fire that hasn't been put out and it continues to smolder. There's excess glutamate, this excitatory neurotransmitter, there's excess calcium, there's swelling.
Dr Kabran Chapek: Also, there's a metabolic deficiency. The brain is very hungry organ. It uses a lot of energy and it's damaged so that it can't use the energy as well. So the brain needs a lot of help and a lot of support. Part of why I wrote this book is that there's actually thousands of studies that tell us and clue us into some of the mechanisms that are really helpful at healing the brain, yet the standard protocol is very basic and doesn't utilizing any of this. So I would like to see a big change in the standard concussion protocol in schools and physical therapists' offices. They're doing great work, but it's just we need to do more.
Dr Daniel Amen: So early on, there's way more things people can do than they're typically told.
Dr Kabran Chapek: Mm-hmm (affirmative).
Dr Daniel Amen: So yes, you should go to the emergency room and have a neurological exam. If the neurological exam shows trouble, you should have a CT scan to rule out a bleed. But unfortunately that's where it stops for virtually everyone. The emergency room doctor says, "You're fine. Go home. Rest." Maybe they'll go, "See your primary care doctor." There's this one study from UCLA where they gave rats a head injury and one group they gave their standard healthy diet to. The other group they gave their standard healthy diet and fructose. They put fruit sugar in there, which just think of Gatorade on the sidelines of games.
Dr Daniel Amen: The rats that had the healthy diet in three weeks could run the mazes that they knew how to run. The ones that got the fructose, the excess sugar, couldn't. They were still confused. So immediately want all of our brain warriors to change their diet to a low sugar anti-inflammatory diet, which you talk about in the book. So right away eating better can be helpful. Then you actually, you and I've been talking about nutrient support. So if you've had a concussion acutely, that there are some nutrients that can be helpful to prevent the damage that is occurring from the excess release of calcium and glutamate and inflammation. So talk about that for a minute.
Dr Kabran Chapek: Yeah, so the way to really quench the inflammation in addition to, like you said, I love that. See, that's the evidence we have, the research, the higher sugar diet is perpetuating that inflammation, but taking targeted nutrients. Vitamin C doesn't get enough respect. We need more vitamin C. The brain uses a ton of vitamin C as an antioxidant, quenches inflammation. Simple vitamin C right after a brain injury is something very simple. Vitamin D. So there was a study out of Iran in 2013 where they had, for acute brain injury, they had a placebo group, a progesterone and vitamin D group, and then a just progesterone group. They found that those who were given progesterone and vitamin D right after, and these were acute, I mean Glasgow Coma Score less than eight. So some of these patients didn't survive. Some of them died. Sixty-five percent had good recovery, which meant either they were sort of back to "normal" or had minor disability.
Dr Kabran Chapek: The folks who had the progesterone and vitamin D. Whereas 45% who had just progesterone and 20% who they did standard procedures. So vitamin D is a real key and in this study they used about 13,000 international units a day, which is a higher dose, but it's not, you get 10,000 international units when you go out into the sun, not maybe where we're at in Seattle, but maybe down where you are. You get a lot of sunshine and 10,000 international units on a sunny day. So that's something is vitamin D. Another thing is that if folks are deficient in vitamin D prior to a brain injury, it's been shown they have poorer outcomes.
Dr Daniel Amen: So just stop you there. Those of you that are listening, vitamin D is a universal risk factor for trouble. Cancer, depression, Alzheimer's disease, diabetes, heart disease. All of you should know your vitamin D level now. Normal's between 30 and 100. We think optimal's more or like 60 to 100 and you should optimize it because what Dr. Chapek just said is if you get a head injury and you have lower vitamin D level, you're at more risk. This is so stinking easy to fix. NeuroVite Plus, which is the multiple vitamin mineral supplement we create directed toward your brain actually has 2000 units of vitamin D. Why did I do that? Because there's actually a study that said that decreased cancer risk by 30%, that level.
Tana Amen: Speaking of cancer, so I go to a doctor who is, he's a research specialist up at UCSF. He's not a functional medicine doctor technically.
Dr Daniel Amen: [inaudible 00:09:42].
Tana Amen: He actually gets a lot of criticism because he practices more like a functional medicine doctor. So when I first started seeing him, my vitamin D, and I take a lot of vitamin D because I know it's good, right? But I think it was around the 60 mark and he was like, "No, we need to increase that." I was like, "What?" I've never heard a doctor tell me that, ever. Usually my doctors say your vitamin D is either really good or it's a little too high. So in his case he's like, "No, I want it actually closer to 100." I was like, "Wow." It's because of the cancer, so.
Dr Daniel Amen: And look at you, you're just so amazing. It's probably vitamin D [crosstalk 00:10:16]. Omega 3 fatty acids ...
Dr Kabran Chapek: Critical.
Dr Daniel Amen: ... is another thing that you recommend.
Dr Kabran Chapek: It's critical. Absolutely.
Dr Daniel Amen: It's anti-inflammatory. It provides support for the membranes that have often been torn or ripped.
Tana Amen: How much do you recommend for someone with a concussion? It's higher, correct, than the regular, what you'd recommend on a daily maintenance basis for individuals?
Dr Kabran Chapek: There's a lot of research. Some say you need very high doses, five grams a day, nine grams a day. I don't think it needs to be that high. I think three grams a day is sufficient. I think we want to target a lot of different mechanisms. Cell membrane stability, anti-inflammatory, that's the Omega 3 captures that. Vitamin D, anti-inflammatory, immune modulation, vitamin C, water soluble antioxidant. Another one I'd like to mention is NAC or N-acetyl cystine. This is a supplement. It is a precursor to glutathione, our bodies', one of our main antioxidants. They did this really cool study with humans. So often these are animal studies, but this was a human study in the field, so at war, these active military. Eighty-one of them double blind placebo-controlled trial in 2013.
Dr Kabran Chapek: If they were suspected of having an injury, they would go to the medic and they would give them a large dose of NAC and then follow them over the course of that week. At the end of the week, 84% of them had improvement in their concussion symptoms and only 42% who didn't have NAC. So both groups got better, but significantly better with NAC as this antioxidant. That's just NAC.
Dr Daniel Amen: What was the dose? Do you remember? Was it a gram of NAC?
Dr Kabran Chapek: Yeah, they actually gave them, immediately they gave them four grams and then days one through four, they gave them two grams twice daily, and then days five through seven, one and a half grams twice daily. So it's fairly heavy doses.
Dr Daniel Amen: But you can but it at the health food store. These are not outrageous doses ...
Dr Kabran Chapek: No.
Dr Daniel Amen: ... that you could buy. NAC usually comes in 600 milligrams and so you load it for the first week and you talk about this in Concussion Rescue, what are the dosages. It's just such important information for you ...
Dr Kabran Chapek: It makes sense.
Dr Daniel Amen: ... to have.
Dr Kabran Chapek: I wish it was on the sideline of football games, you know? Some of these treatments, high school football, these kids are having concussions and watching and waiting. My own son plays basketball and when I see a concussion happen, I'll go and offer some help. If they need to be seen, there'll be evaluated, but the parents are just so grateful because they feel helpless. It's like what can I do to help? Nice.
Dr Daniel Amen: Well, and this rest and see if you get better is just stupidity as far as I'm concerned. It's like you put the brain in a healing environment immediately. If you break your leg, they don't go, "Well, let's see." They work on rehabilitation immediately. I think this is just, it's a discussion we have to have which is why I'm so pleased you have written this book. When we come back, we're going to talk about more strategies that you write about in Concussion Rescue.
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