Tag Archives: neurological health

What’s that sound?

This is a transaxial slice of the brain of a 5...

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Tinnitus, or ringing in the ears, is an exceptionally common problem.  As many as 2 million Americans experience this on a daily basis.  It can range from very minor to annoying to debilitating.

Tinnitus is often associated with hearing loss.  Prolonged exposure to loud noises is the most common cause of hearing loss.  It is this loss of hearing that is actually causing the tinnitus.  Say what? Hearing loss actually causes people to hear sounds that don’t really exist? Yes!

People often describe tinnitus as ringing in the ears.  However, the list of sounds that are considered tinnitus is very long.  Other sounds that people might perceive include ticking, clicking, whooshing and buzzing to name a few.

Recent research, published online in the journal Proceedings of the National Academy of Sciences, suggest several new approaches to treatment, including retraining the brain, and new avenues for developing drugs to suppress the ringing.

As a chiropractic neurologist the above statement about retraining the brain got my attention.  This is something that is near and dear to the heart of all chiropractic neurologists.  We use techniques that retrain the brain every day.  We use these techniques to help people with a wide variety of conditions ranging from anxiety to muscular imbalances and pain.

Traditionally, patients with tinnitus are told the problem stems from damaged hair cells inside of the ear.  They are told it is these hair cells that are sending the wrong signals into the brain which interprets them as noise. Turns out, this is not true.

Because each hair cell is tuned to a different frequency, damaged or lost cells leave a gap in hearing, typically a specific frequency and anything higher in pitch.  It is this gap which causes problems for the brain.

Chiropractic neurologists have been saying for a very long time that ringing in the ears is actually brain based.  This new research supports this assertion. Below is information from coauthor of the recent study Shaowen Bao, adjunct assistant professor in the Helen Wills Neuroscience Institute at UC Berkeley

Experiments in the past few years have shown that the ringing doesn’t originate in the inner ear, though, but rather in regions of the brain — including the auditory cortex — that receives input from the ear.

Bao’s experiments in rats with induced hearing loss explain why the neurons in the auditory cortex generate these phantom perceptions. They showed that neurons that have lost sensory input from the ear become more excitable and fire spontaneously, primarily because these nerves have “homeostatic” mechanisms to keep their overall firing rate constant no matter what.

“With the loss of hearing, you have phantom sounds,” said Bao, who himself has tinnitus. In this respect, tinnitus resembles phantom limb pain experienced by many amputees. (From sciencedaily.com)

The neurons that have lost sensory input in the brain are the neurons that are responsible for the perceived noise that people hear.  These neurons have undergone a process called transneural degeneration.  To stabilize these neurons they need more input.  But because they cannot receive it from the hair cells in the ear that are damaged, other areas of the auditory cortex must take over.  This retraining of the brain takes time, but if performed diligently, the results can be phenomenal.

We know this is a possibility because the brain is plastic.  That is, it changes in response to the stress and environmental input it receives. When a finger is amputated, for example, the region of the brain receiving input from that finger may start handling input from neighboring fingers.

Drug therapy is aimed at increasing the levels of the neurotransmitter GABA in the brain.  GABA is the primary inhibitory neurotransmitter.  In order to slow down the firing rate of these over excited cells, we must increase the levels of this inhibitory neurotransmitter.  The good news is there are lots of natural therapies that work to raise GABA levels or drive GABA receptors in the brain.

One way is to use the amino acid taurine.  I use it frequently.  Another is a product called phenibut (Phen-i-bute).  It is a natural GABA derivative that crosses the blood brain barrier and binds to GABA receptors.  I also use this frequently in my practice. These supplements, however, I believe are temporary solutions.  The permanent solution is to retrain the brain.

Tinnitus is a complicated and elusive condition, but we appear to be headed in the right direction in terms of research.  Always remember, the brain holds the key!

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Anxiety or Depression? Test the levels of your neurotransmitters to guide therapy.

Depression

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Happy New Year!  A new era began at the Vreeland Clinic on January 1st this year.  Dr. Carrie and I would like to thank all of our friends and family for their well wishes.  We looked forward to continuing to serve the community for years to come!

Today I’d like to touch on something that has revolutionized the way I practice.

People come to me for many reasons.  Some people come to my clinic for weight loss or to get more energy.  Others for help with a chronic condition that hasn’t responded to traditional care.  Still others come to see me for a wide range of neurologic conditions.  These include things like Parkinson’s disease, multiple sclerosis, depression or anxiety.  It is the last two that I’d like to focus on today.

Anxiety and depression are extremely common in America.  Millions of Americans suffer from anxiety, depression or both.  These conditions may have many etiologies but one theory is a chemical imbalance in the brain.

Just what is this chemical imbalance?  When someone states that they have a chemical imbalance they are referring to an imbalance in the neurotransmitter system of the brain.  These neurotransmitters are really just proteins that each nerve in the brain uses to communicate with its neighbors.  Sometimes people can have too little of a certain neurotransmitter or too much of another.  This is problematic because it alters the way the brain functions.  It may cause anxiety and/or depression.

The pharmaceutical industry has figured that out and makes a large class of drugs that alters neurotransmitter function in the brain.  These are drugs like Prozac, Zoloft, Wellbutrin and Lorazepam to name a few.

Neurotransmitters are broken down into two categories – they are either excitatory or inhibitory.  That means they either tell the brain to go or tell the brain to stop.  The complexities of the neurotransmitter system are extensive and there is much more to it than “go” and “stop” but that basic principle holds true in most cases.

Examples of neurotransmitters include serotonin, GABA, epinephrine, norepinephrine, glutamate and dopamine.  Serotonin and GABA are inhibitory while epinephrine, norepinephrine, glutamate and dopamine are excitatory.

If you have anxiety and depression often times an imbalance exists in the levels of these neurotransmitters.

For example, high levels of glutamate may cause anxiety or seizures.  Low levels of GABA may cause anxiety.  Low levels of serotonin may cause depression.  Same goes for norepinephrine.

So how do you tell which neurotransmitters are low or which are too high?

Measuring Neurotransmitters

Measuring your neurotransmitters with a urine test is the best way to estimate your levels of neurotransmitters.  We do this routinely in our office for many patients.  It is incredibly insightful and directs our care for patients with anxiety, depression and many other conditions.

The measurement of neurotransmitters in the urine has been around for many years.  I’ve read studies dating to the 1960’s of scientists using similar methods to evaluate neurotransmitter levels.

Until relatively recently, perhaps the last 10-15 years, it has not been used frequently in clinical practice.  Now, through specialized laboratories, it is available to the general public and it is very affordable.

The knock on urinary neurotransmitter testing is that it does not correlate with brain levels of these hormones because the urine test is in fact testing whole body levels of neurotransmitters.

The very neurotransmitters that exist in our brain to make us happy exist outside the brain to serve the body in other ways.  So, yes, it is true that checking urinary neurotransmitter levels is technically a check of the entire body’s store of neurotransmitters.  But, through hundreds of thousands of tests these specialized labs have shown with high correlation that when neurotransmitter levels are abnormal certain psychiatric and neurological conditions are much more common.

Clinically, I have seen an almost one to one correlation in my patients with certain conditions an alteration in their neurotransmitter system.

The lab that I use will test all of the basic neurotransmitters plus a slew of metabolites of these neurotransmitters.  It provides a wonderful window into the neurological system.

If I find that serotonin is low, I supplement with something called 5-HTP.  If dopamine is low, I like to use L-tyrosine or an herb called mucuna pruriens.  The list can go on and on.

Once someone has been on a program for 6-8 weeks we recheck their neurotransmitter profile to gauge our therapy and adjust it if necessary.  We find that once a person’s profile returns to normal, their symptoms resolve.

If you have anxiety or depression, consider seeking out someone who does this kind of testing to improve your outcomes.  The brain is incredibly complex.  It never hurts to have a little extra information to guide your therapy.

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1 in 100 Children have Autism…Find Out Why

My recent studies have focused very much on vitamin D and all of its wonderful benefits.  A quick perusal of the other articles on our blog will confirm this!  Recently, I came across information that was too good not to share with all of you.  A link between Autism and vitamin D deficiency has been established.  As some of you know, we see many children at The Vreeland Clinic for interventions with autism.  We provide nutritional and neurological rehabilitation programs to further assist in the development of the brains of these children.  In this article I would like to share with you groundbreaking information regarding vitamin D and autism.

Autism now affects 1 in 100 children in the U.S.

Autism statistics are staggering.  Twenty-five years ago an autism diagnosis was a 1 in 10,000 chance.  Today, 1 in 100 children will be diagnosed with autism.  Many researchers point to the increase in diagnosis as nothing more than more accurate methods and increased awareness.  They believe that the number was always about 1 in 100, but it was not reported.  Although there is some truth to more accurate diagnosis, it does not account for such a meteoric rise.  What’s more likely is that there has been some change in our environment over the last 20 to 25 years that, in combination with a more accurate system of diagnosis, has caused the number of autistic children to rise to epidemic proportions.

Autism involves poor social and verbal functioning accompanied by a host of other issues that range from poor digestion to fixed and repetitive behaviors.  Also included in the Autistic Spectrum Disorders is a series of problems with fine or gross motor control, all of which can have a devastating effect on a family.  The range is so broad in fact that many scientists and healthcare professionals often do not agree on a diagnosis.  What is presently known is that this condition can cause subtle developmental delays or profound issues that can require long-term care is specialized facilities.  The dichotomy is obvious, but there seems to be a link between the two.  This link is vitamin D.

There are many proposed causes of autism.  Most agree that there is some genetic predisposition.  This has been suggested because of the increased frequency of autism that tends to occur in families and in studies of identical twins.  Although there is a genetic link, it is also accepted that some environmental trigger must occur to cause autism.  The majority of scientists have come to a consensus that identifies both genetic and environmental factors as being relevant in the cause of autism.  Many theories have focused on environmental toxins, especially heavy metals, as a culprit in autism.  Another theory is low levels of vitamin D during pregnancy and infancy.

Many times when speaking about autism people are very confused by the recent rise in autism diagnoses.  Most times,

A link between Autism and vitamin D deficiency has been found

people rightly point out that a purely genetic theory makes no sense because our genes certainly are not any different than they were 20 years ago.  They also make the point that our environment, while different, is not significantly different than it was 20 years ago.  If both of these previous statements are true, and I believe they are, then what could possibly be causing the rise in the diagnosis of autism?  Dr. John Cannell, a leading researcher in vitamin D has a theory.  He agrees that genetically we are the same today as we were 20 years ago and that the environment, while altered, is not so significantly altered to cause an epidemic of autism.  He argues that our behavior with regard to our environment has changed.  He states that these changes have had an effect on our nervous systems that can and does account for a rapid rise in autism diagnoses.

Our understanding of what vitamin D does in our body has exploded in recent years.  Although most physicians know that vitamin D is critical for healthy bones, most do not know about its other benefits.  Vitamin D is critical for a healthy heart.  It has been shown that it is critical in preventing many forms of cancer.  We know that it regulates the immune system by keeping it prepared but also keeping it from overreacting.  Vitamin D is a potent anti-inflammatory.  It has also been shown that the active form of vitamin D, called calcitriol, is an important neurosteroid hormone.  A neurosteroid hormone is a compound that is extremely important for brain development and behavior.  Calcitriol is a potent neurosteroid that controls brain cell growth and acts on brain cells from the time of conception.  Recent research has suggested that vitamin D offers “neuroprotection, antiepileptic effects [antiseizure effects], immunomodulation, impact on several brain neurotransmitter systems and hormones as well as regulation of behaviors.”  The last statement makes it very obvious that vitamin D is critical for pregnant mothers, newborns and children alike.

The question remains, however.  What could have possibly changed so greatly in the past 20 years that it would account for the rapid rise in autistic cases?  Dr. Cannell believes it is a simple answer.  He believes that in an effort to reduce our risk for skin cancer we have created a very serious deficiency in vitamin D.  Remember, it is through the sun’s UV rays that most of our vitamin D is produced in the body.  By lathering up with sunscreen every time we go out side, we block those UV rays from ever reaching our skin, thus preventing synthesis of the all important vitamin D.  Dr. Cannell also believes that because we have become a much more sedentary society that we do not get outside nearly as much as we used to.  And is this so hard to believe?  Twenty years ago marks the real beginning of home video game systems.  Cable television was still in its infancy 20 years ago.  The iPod did not exist and hand held electronic games were not nearly as popular and complex as they are today.  So this, in combination with sunscreen, creates a dangerous, yet easily overlooked scenario.

Our unfounded fear of the sun has lead to an epidemic of low vitamin D levels - even in sunny climates.

So what evidence links autism with vitamin D deficiency?  Is it more that just a coincidence?  Calcitriol acts as a molecular switch in brain tissue that turns on favorable genes that facilitate brain development.  In fact, there are about 1,000 genes already known that are targets of calcitriol.  Vitamin D is unique in that is it the only vitamin that relies on the sun for its production rather than dietary intake.  Because pregnant women are getting into the sun less and less they require more and more to be taken orally.  Unfortunately, the prenatal vitamins that most women take are far too low in vitamin D to be of any benefit.  From an evolutionary perspective, our bodies are not used to getting the majority of our vitamin D from a pill.  It is used to getting massive amount from the sun.  The skin’s production of vitamin D is far more effective than ingesting it orally.  Take the following into consideration; in just 10-40 minutes of sunbathing by a fair skinned adult about 20,000 IUs of vitamin D will be produced over the next 24 hours.  It is important to note that the FDA claims 400 IUs per day through diet is sufficient for health.  There is quite a difference between 20,000 and 400.  Now consider this; in order to get 20,000 IUs from diet, one would have to drink 200 glasses of milk or take 50 prenatal multivitamins.  Obviously neither of those is a viable option.

Dr. Cannell points out that people have been avoiding the sun for the past 20 years.  It is exactly in the last 20 years that we have noticed a rapid rise in the diagnosis of autism.  Now, just because the rise in autism parallels a decrease in sun exposure in industrialized nations does not necessarily mean it is a cause and effect relationship.  There are other astounding biochemical reasons this theory makes sense.  A very large amount of animal studies have shown just how crucial calcitriol is to brain health.  In rats, it has been shown that the offspring of vitamin D deficient mothers had abnormal cell growth, structure and functions in their brains and alterations in learning and memory.  A group of French researchers found that 36 important brain proteins are disrupted when vitamin D is deficient during fetal development.  We discussed earlier that vitamin D is a potent anti-inflammatory.  Often in autism, children have problems with immune function similar to those affected by vitamin D – including increased inflammatory cytokine levels.  These high levels of inflammatory cytokines cause oxidative stress in the brain and are known to cause cognitive impairment.  Vitamin D reduces this oxidative stress on the brain.  Calcitriol also helps increase levels of glutathione in the brain.  Glutathione is a critical antioxidant for detoxification.  This may explain the link between heavy metals and autism.  Without the calcitriol, children cannot actively detoxify the small amounts of heavy metals that accumulate in their body on a daily basis.  In time, this results in a toxic load that retards brain development.  As we can see, there are many reasons why vitamin D is important for proper brain function.  It serves to regulate nerve cell growth, it regulates protein structure, it regulates the immune system and it regulates oxidative stress that may damage brain cells.

So now the question is, how much vitamin D do I need?  This is a good question.  Most people cannot obtain enough vitamin D through diet.  Ideally, a good blood level of vitamin D is 50-60 ng/mL.  This can be measured through a simple test.  In order to get to that number most people will have to supplement their diet with a quality form of vitamin D.  Generally speaking, we start adults on at least 2,000 – 4,000 IUs per day and recheck the levels in 2-3 months.  Recent research indicates that even that might not be enough (remember we are told the standard for Americans for adequate health is 400 IUs).  Children over 1 year of age can safely take at least 1,000 IUs but we usually start at 800 IUs and check the levels in 2-3 months.  Vitamin D is very safe to take and as a matter of fact, the risk of not having enough far out weighs the risk of vitamin D toxicity.  In fact, if vitamin D is taken responsibly, the risk of toxicity is virtually zero.  Should you have any questions regarding vitamin D supplementation, please contact you health care professional and talk to them about vitamin D.

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How to get better brain function!

In the study of neurology, there are many theories and formulas that can be applied in order to better help our understanding of how we as humans experience the world around us.  Scientists, researchers and other doctors break them down, analyze them and apply them to different areas of the brain, mostly for academic value.  That is extremely valuable, especially for me as a functional neurologist.  While helpful for me, this is usually not the case for many of you.  One of the most common questions I get is “How can I better understand the way my brain functions so I can feel better?”

There is one principle that applies to the entire brain that is very easy to understand and is indispensable for me when considering my treatments.  It is also very simple; input equals output.  That’s it.  And it really is as simple as it sounds.

Our brains are completely dependent upon the input coming in from all around us to generate its output.  Let me give you a simple example of correct input resulting in correct output and then just the opposite.  Picture yourself at a restaurant and you are ordering a wonderful organic, grass-fed New York strip steak.  When you place your order the waiter asks, “How would you like that done?”  You reply, “Medium, please.”  You responded appropriately because the input (the waiter’s question) was interpreted by your brain correctly and it quickly formed the correct output (your response to his question).  But what if the scenario unfolded as follows; the waiter asks the same question, but you hear, “Would you like a bun?”  You might reply, “No thank you,” but of course the waiter would look at you funny because that is not the answer to his question.  The problem in the second scenario is that the input was interpreted incorrectly, so your brain had no choice but to formulate incorrect output.

This is a very simple set of circumstances, but in fact, this is happening millions of times per day in our own brains.  And input comes from everywhere!  Input comes from the outside world in the form of hearing, sight, touch, taste and smell among others.  This is called external input.  Input is also internally generated.  This input comes from within the brain from other circuits that communicate with each other to maintain the high output of the human brain.

Both internally and externally generated input is critical.  In functional neurology, we use a combination of these two inputs to change the way the brain fires.  First we establish where the problem is.  A person might say they have headaches, high blood pressure or depression, all of which could be from aberrant output of the brain.  The symptoms are being caused from this aberrant output, but as illustrated earlier, the brain is actually just responding or interpreting the input it is receiving incorrectly.  Once we discover the part of the brain that is not working correctly, we recommend specific exercises to retrain the brain.

It is through these corrective exercises that we are able to change the input, which changes the output and reduces the symptoms of many conditions.  It is a cutting edge treatment for many conditions and is gaining momentum as research mounts on brain function.

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