Neuroinflammation of the Brain
After countless hours studying the topic, attending seminars on it, and treating hundreds of individuals in my own practice, I believe that neuroinflammation is one of the most overlooked problems affecting people with chronic health conditions
inflammation of the brain – is the activation of the brain's immune system in response to an inflammatory challenge, such as the use of fluoroquinolones. Research shows that fluoroquinolones love fat tissue, and that’s what makes up the human brain. Neuroinflammation can present as a variety of problems, and many people that come to me for help are in a dichotomy – meaning they have symptoms that seem opposing, or unrelated.
For example, they might have Achilles tendon pain accompanied by pain in their elbow. Others might report mood swings, anxiety, depression, intrusive thoughts, or simply not feeling or acting like themselves. However it manifests, it’s important to pinpoint this neuroinflammation and address it with a proper treatment plan in order to recover. If left untreated, a tendon tear will seem like nothing compared to the neurological problems that might lie ahead.
Your brain on fire
For someone with neuroinflammation, it’s almost like their brain is on fire.
t’s important to understand that the brain doesn’t have pain receptors like other parts of the body. If you hit your thumb with a hammer, pain receptors will let you know that something is wrong by causing you to feel pain in your thumb. But the brain doesn’t act the same way. If you could theoretically hit your brain with a hammer, it would not illicit that same pain response. Instead, the brain signals there’s something wrong using different methods, like brain fog, memory problems, anxiety, depression, thoughts of suicide, insomnia, reduced brain endurance, and chronic fatigue.
Chronic fatigue is a common symptom of neuroinflammation
I see in patients. It’s similar to driving your car around with the emergency brake on: the car has to work harder, requiring more energy and gas, just to complete the task it was meant for. That is your brain when it’s inflamed. It has to work ten to twenty times harder when neuroinflammation is present, which results in a spectrum of symptoms ranging from slight brain fog to full-blown chronic fatigue. In extreme cases, untreated neuroinflammation can lead to coma, seizures, difficulty speaking, and tremors. But how do we know if the brain is on fire so we can begin to treat it? Functional medicine can help.
Subtle, moderate, and severe symptoms
If you’ve read this far and thought, “This sounds like me,” then you’re not alone. Many people have some or all of these symptoms, but now we must determine which are present and how to classify them. I’ve broken down the list of possible neuroinflammation symptoms into three categories: subtle, moderate, and severe. It’s important to identify your symptoms so that they can be addressed properly with a treatment plan.
Part 2: Brain Neuroinflammation Timeline
Subtle symptoms: Brain fog, reduced mental speed, and reduced brain endurance are classified as subtle symptoms of neuroinflammation. Experiencing brain fatigue after a long drive, where you’re being exposed to strain and stressors over a period of time, is one example. Another is experiencing brain fatigue after exposure to certain chemicals or scents, or after eating certain foods.
Moderate symptoms: Mental health disorders like depression and anxiety fall into this category. Inability to concentrate on tasks, excessive sleepiness, lack of motivation or appetite, insomnia, and the inability to be physically active are also moderate symptoms of neuroinflammation.
Severe symptoms: Difficulty speaking, tremors, disorientation, and involuntary twitching can be signs of severe neuroinflammation. Shaking, or lack of balance when completing simple tasks like walking, can also be present. More serious symptoms like seizures, dementia, and even coma are possible if left untreated.
If these symptoms sound familiar to you, then it’s possible you are suffering from brain inflammation. In the next part of this blog series, I’ll go over the different tests available to determine whether you have neuroinflammation and how severe it might be.
The Blood Brain Barrier Permeability Screen measures whether the level of certain proteins in the blood is “in range” or “out of range.” When the level is out of range, it tells us that the blood brain barrier is leaking, or starting to break down. It may be an indication that fluoroquinolones have been tearing apart your blood brain barrier. Because fluoroquinolones love the fat tissue that makes up your brain, it is likely that this is the cause of the barrier’s deterioration. Without that barrier intact, particles can end up in your bloodstream where the immune system marks them as “foe” and attacks. This causes inflammation.
The blood brain barrier is only one cell thick
The skin on your fingertip is made up of tens of thousands of cells creating a barrier between the outside world and your blood. If you were to take a sharp blade cut your finger with it, all of these skin cells stand between that knife and your bloodstream. While it might not seem very difficult to draw blood this way, it’s even easier to permeate the blood brain barrier. That’s because the barrier between the bloodstream and your brain is only one cell thick. This is similar to the cells that make up the lining of your intestines, which is why “leaky gut” and “leaky brain” function in a similar way.
As you might imagine, the blood brain barrier is far more susceptible to damage than your skin. Just like food sensitivities, in which the proteins in food permeate the one-cell lining of the intestines, causing inflammation, the blood brain barrier can easily be impacted by foreign substances. Once the barrier is damaged it loses its impermeability, resulting in leaky brain.
The above graphic shows an impermeable blood brain barrier (left) compared to a leaky, permeable one (right). The one on the right may have been destroyed by fluoroquinolones, which can then pass directly into the brain once the barrier has deteriorated. Once these chemicals get in your brain, research shows they destroy the mitochondria – known as the “power packs” – of your neuronal cells. Without those mitochondria, your neuronal cells will not function.
Neurons do not regenerate like other cells in the body
The unfortunate truth about neurons is that they can’t rebuild themselves after they’ve been damaged. While your skin cells can heal, your liver cells can literally regenerate if a portion is removed, and even your digestive system can rebuild after an anomaly, the brain does not have this luxury. Once a neuron is gone, that neuron is dead forever. This is why addressing the symptoms of neuroinflammation is so critical.
However, it is also important to note that neurons only make up about 10 percent of your brain’s cells according to research. The rest, 90 percent, are called glial cells. Glial cells comprise many different types of brain cells, including Schwann cells, oligodendrocytes, microglial cells, ependymal cells, and astrocytes. Their essential function is to support and protect the neurons, acting as your brain’s immune system. But when this immune system is compromised by something like inflammation, the glial cells mistakenly attack the neurons, resulting in a range of symptoms. Imagine your glial cells are playing their own private game of Pac-man in your brain, eating away at your neurons.
Glia are the brain’s glue, and much more
The word “glia” means glue, and for a long time researchers believed that was the only function of these cells: to hold the neurons together. As it turns out, these cells do far more than that. Glial cells control the function of the body’s entire immune system, which is why restoring them to their proper function is so critical. Simply put, the goal of resolving neuroinflammation is to restore health to the glial cells in an effort to spare the brain’s neurons.
The above graphic shows just how closely these glial cells cling to the body’s blood vessels. This proximity means that if there’s an issue with the blood stream or if your brain is inflamed, the myelin sheath will also be inflamed. The myelin sheath is an insulating layer that forms around nerves, including those in the brain and spinal cord, and allows electrical impulses to transmit quickly and efficiently along the nerve cells. If the myelin sheath is inflamed, it causes your axons and your neurons to be inflamed as well, resulting in all of the symptoms we’ve discussed up to this point.
The above graphic represents your bloodstream. At the top of the graphic are healthy microglia, which contain tentacle-like arms. When healthy, the microglia move through the bloodstream freely, carrying out their normal processes like destroying anything that shouldn’t be there. But when unhealthy, those microglia are small and round without their signature tentacles. Unable to move freely, the unhealthy microglia sits in one spot, not doing its job. In fact, it’s simply become one of the causes of inflammation, as it becomes unrecognizable to the immune system.
This is just another way to illustrate the overall point: if your blood brain barrier is damaged, the result is inflammation in the brain. As leaking occurs in the blood brain barrier and cells begin to die off, the result can be such illnesses as dementia, Alzheimer's disease, or the development of beta amyloid plaques. Read on to the next blog in this series to learn more about the causes of neuroinflammation and how to treat it. And, as always, remember that where there is help, there is hope.
Part 3: Causes of Neuroinflammation
As much as I wish I could tell you there was only one cause of neuroinflammation, that is simply not the case. If you’ve been following along in this series of blogs about “brain on fire” symptoms and causes, you’ve learned that neuroinflammation can be caused by fluoroquinolones or other drugs breaking down the blood brain barrier. However common this may be, other causes of neuroinflammation do exist and I’ll break those down for you here. It is important to know which is the cause of your specific case of neuroinflammation so that it can be addressed in a treatment plan for your recovery.
What else can cause “brain on fire” symptoms?
Some causes of neuroinflammation include head trauma, concussions, micro strokes, and stress. These causes are even more significant when you consider that the damage they do is irreversible. Remember the glial cells we discussed in Part 2 of this blog series, which make up 90 percent of brain cells and act as the immune system for the brain? Think of those microglia as being an egg. Once an egg has been boiled, it can never return to its raw form. That’s why it is imperative to identify and stop neuroinflammation as quickly as possible: to preserve as many of the microglia as possible. This can be done through functional medicine, and is something I do in my practice on a regular basis.
The importance of barriers
The above graphic shows a cross-section of your bloodstream. Looking at the sections marked as “Early” and “Late” in the image, you can see ruptures in the artery surrounded by blood clotting proteins. As the figure demonstrates, the broken arteries can act like a garden hose that has been punctured. The pressure of the water inside the hose causes streams to shoot out through the punctures with some force. The same happens in your bloodstream, which can push unwanted substances through the blood brain barrier and into your brain. The attached astrocytes along with the inflammatory process in your brain will begin to cause damage, resulting in a range of symptoms.
Leaky gut can cause leaky brain?
Like the blood brain barrier, the gut also contains a one-cell-thick membrane separating the stomach contents from the bloodstream. The above graphic shows a comparison between a healthy, impermeable gut membrane (left) and an unhealthy, leaky gut (right). Because of inflammation caused by a number of sources, the gut on the right has had its one-cell lining broken down, creating gaps large enough for a variety of unwanted material to breach into the blood. Once in the blood, these unrecognizable intruders trigger the immune system, which brings on symptoms such as negative reactions to certain foods. This inflammation can also cause malabsorption, meaning the essential nutrients in your food are not absorbed by the body.
How do you know if you’ve got a leaky gut?
For the majority of people, having two to three bowel movements per day without gas, diarrhea, bloating, or heartburn are signs of a healthy gut. But many Floxed have leaky gut even if no gastrointestinal (GI) symptoms are present. This leaky gut allows trillions of bacteria in the intestines to leak into the bloodstream, making their way eventually to the brain through the blood brain barrier. The end result is always inflammation.
As the blood brain barrier begins to break down due to this leaky gut, a whole host of symptoms may appear. To make things even more frustrating, you may struggle to find someone who makes the connection between these new symptoms and GI or leaky gut issues. New research shows, though, how these issues relate, and it has to do with the vagus nerve.
What is the vagus nerve?
The vagus nerve extends up from the lower intestines to the back of the human head. You may recall famed Superman actor Christopher Reeve experiencing severe damage to his neck after falling from his horse. This fall considerably damaged his vagus nerve and, as a result, his gut was no longer able to function. For the remainder of his life he required tube feeding to stay properly nourished. This is just one example of how severely injuring the head and neck can affect the digestive system due to the connection of the vagus nerve
Research now suggests that in the reverse fashion, harmful bacteria from the gut can make its way to the brain through the vagus nerve. This happens in a similar way to how the shingles virus affects the skin. The shingles virus travels through the nerves to the skin causing discomfort in the same way bacteria and other microbes can travel up your vagus nerve and right to your brain. This direct access to your brain is what causes brain inflammation, and it’s the reason why 98 percent of people I treat for neuroinflammation are also experiencing GI issues..
Why aren’t doctors discussing this connection?
Now that we’ve seen the established link between GI issues and brain inflammation, you may be wondering why more healthcare professionals aren’t making this connection. In my experience, it’s because many of them aren’t continually taking time outside of their practice to read the new research and continue to learn. As a functional medicine practitioner, I can and do take the time to connect the dots with my patients to ensure that they get better.
Most people will ask about a “standard protocol” for treating these neuroinflammation symptoms, but since there are many possible causes, and everyone’s body is different, there’s no single protocol or magic pill to fix everyone. Protocols will vary from patient to patient, and I tailor an individualized plan for each of my patients to help them on the road to recovery. It is worth noting that all treatments take time, and all the money in the world can’t buy better health. To illustrate this point, look at former Apple CEO Steve Jobs. He had plenty of money to spend on his care, but he still lost his life at a rather young age. Time is more valuable than money, here. I encourage my patients to be sure to allow the body the time it needs to heal.
Stay tuned for the next blog in this series where I lay out a path to better health for those suffering with neuroinflammation.
If you’ve made it this far in my series of blogs on neuroinflammation, thank you for reading.
We’ve covered what neuroinflammation is, the related symptoms, and some causes behind it. In the last post, I went over the reason many medical professionals don’t make connections between leaky gut and brain inflammation and explained how I approach treating individuals in my practice. This post will go more in depth about my philosophy on treatment and provide some pathways to better health for those suffering from neuroinflammation.
As a practitioner of functional medicine, I want to get everyone on a path to better health. But since everyone is different, there are many things I need to address in order to tailor a plan to each specific individual. This often requires running tests, because without knowing what your labs show, it’s difficult to move forward. Unfortunately, most people will require polytherapy, meaning multiple therapies may be required to alleviate all of your symptoms. This is why I always provide an individualized, custom-tailored program for all of my patients.
General vs. Specific
Even before running tests, I can provide my patients with a general overview of some things to implement that will help manage neuroinflammation. For example, the above graphic shows certain polyphenols, essential fatty acids, short-chain fatty acids, antioxidants, and other nutrients that have been shown to reduce neuroinflammation in the human body. However, proper treatment will require some precision when it comes to figuring out exactly what to do next. This is why I set up 20-minute discovery calls with all potential patients to help me see exactly what is going on. There’s no need to continue suffering when there are plenty of answers out there.
There are many questions I may ask, and a variety of tests I might order to determine how to get you on the road to recovery. Those include checking your vitamin D level, discussing possible food sensitivities, checking your A1C levels, your fasting insulin levels, CRP markers, hormones, and levels of homocysteine in the body.
What is Homocysteine and Why is it Important?
Have you ever had your cholesterol levels checked? The odds are high that you have. But what about your homocysteine levels? Most people have not even heard of homocysteine, let alone been tested for it. That’s because these tests are rather expensive, but it’s important because it may tell you if you have inflammation, as well as whether or not your body is replicating DNA properly.
Homocysteine is an amino acid broken down by vitamins B12, B6, and folate to create other chemicals your body needs. The homocysteine level is a marker for DNA replication, and the range for homocysteine in standard labs is about four to fifteen. Proper DNA replications means that as your DNA copies itself over and over again, the thousandth copy of your DNA is just as crisp the original. When these homocysteine levels are high, it may mean that when you replicate your DNA, you are not ending up with a very crisp copy
Food Sensitivities and Inflammatory Markers
Most people have some type of food sensitivity, with gluten, dairy, and eggs being some of the worst offenders. Certain food sensitives lead to gut permeability, or leaky gut, as we’ve discussed earlier in this blog series. When testing for food sensitivities in my patients, I will also want to ensure that you have enough stomach acid to properly digest all the essential nutrients required for good health.
When I’m testing for inflammatory markers like CRP – a protein produced by the liver – I’m looking for the presence of something that has the ability to get into your brain and begin destroying your brain tissue. As I laid out in Part 2 of this blog series, once brain tissue is destroyed, the human body does not have the ability to regenerate it. Thus, once a neuron is dead, it is gone for good. This is exactly what happens in those patients who are suffering from Alzheimer's disease. It is likely there was permeability in the gut or blood brain barrier that caused their neurons to die. Unfortunately for many patients who fall victim to this horrible illness, no one ever addressed the root cause of the problem. In functional medicine, getting to that root cause is exactly what we aim to do.
The Role of Hormones
Another measure I use to assess the health of my patients is their hormone levels, paying special attention to testosterone, estrogen, progesterone, and cortisol. In women who have had a partial hysterectomy, it is sometimes the case that they are now more susceptible to the damage that can be caused by fluoroquinolones. Any changes to or irregularities in your menstrual cycle should be discussed at this stage to ensure that your hormone levels are adequate to support your neuronal tissue and decrease neuroinflammation.
Other Factors to Consider
As I speak with new patients, there are other issues to consider besides those mentioned above. As stated previously, it is normal to have one to two bowel movements each day with no gas, bloating, or diarrhea. If this is not the case for you, it might be an indication of something in the body that needs to be fixed. I also like to ensure that my patients are regularly doing exercises to strengthen their brains. There are plenty of neurological exercises that can be done to strengthen the brain through a process known as function neurology.
I hope that my words have brought both clarity and understanding to those suffering with brain inflammation. I want everyone to know that you are not alone, and perhaps more importantly, you are not crazy. You might have seen multiple healthcare professionals who’ve made you think these symptoms are all in your head, but you don’t have to believe them. I’m here to help, and I promise that I believe you. Even more than that, I believe that there is hope for you. As I often like to say, where there is help, there is hope.
If you would like to take the next step toward reducing symptoms and improving your health, I do all of my consultations via telemedicine with no need for an in-person office visit. After a telemedicine consultation, we can discuss the labs needed so that you may get these completed locally. I look forward to helping you, but most importantly, I look forward to giving you hope.