The Dr. Hyman Show - Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Brain Inflammation In Chronic Fatigue And Depression

Episode Date: January 6, 2022

Hey podcast community, Dr. Mark here. My team and I are so excited to offer you a 7 Day Free trial of the Dr. Hyman+ subscription for Apple Podcast.  For 7 days, you get access to all this and more entirely for free!  It's so easy to sign up. Just go click the Try Free button on the Doctor’s Farmacy Podcast page in Apple Podcast.   In this teaser episode, you’ll hear a preview of our latest Dr. Hyman+ Functional Medicine Deep Dive on the role of brain inflammation in chronic fatigue and depression with Dr. Datis Kharrazian.  Want to hear the full episode? Subscribe now. With your 7 day free trial to Apple Podcast, you’ll gain access to audio versions of: - Ad-Free Doctor’s Farmacy Podcast episodes - Exclusive monthly Functional Medicine Deep Dives - Monthly Ask Mark Anything Episodes  - Bonus audio content exclusive to Dr. Hyman+ Trying to decide if the Dr. Hyman+ subscription for Apple Podcast is right for you?  Email my team at [e-mail] with any questions you have.   Please note, Dr. Hyman+ subscription for Apple Podcast does not include access to the Dr. Hyman+ site and only includes Dr. Hyman+ in audio content. 

Hey podcast community, Dr. Mark here. I'm so excited to offer you a seven-day free trial of my revolutionary new platform called Dr. Hyman Plus. For seven days you get special access to all the private content included in Dr. Hyman Plus entirely free. It's so easy to sign up. Just go to Apple Podcast on your phone and click try free button on the Doctors Pharmacy podcast. You'll get exclusive access to ad-free Doctors Pharmacy podcast episodes and functional medicine deep dives where a practitioner dives into topics like heart health, muscle health, insulin resistance, and more to help you understand the root cause of specific ailments and walk you through the steps to improve your health today. You'll also get access to all my Ask Mark Anything Q&As,

where I answer the community's biggest health and wellness questions. Because I'm so sure you're going to love this platform, I'm offering you free access to all of this content for seven days and a teaser of my brand new Functional Medicine Deep deep dive episode, diving deep into one of the most important topics in health. Head on over to the Doctors Pharmacy podcast on Apple Podcast and sign up for your free trial right now. Okay, here we go. Hi, I'm Dr. T. Scrozzi. In this presentation, what I want to do is talk to you about the role of neuroinflammation

in chronic fatigue and depression. And then I also want to talk about which nutraceuticals with applications you can do with diuretic lifestyle to help calm down brain inflammation. So when you look at depression, the most common model of depression is that you're low in some type of neurotransmitter, and then you take something, raise your neurotransmitter levels back up. And that model has really been questioned and shown to not be very effective over the past few years. And the emerging model of chronic depression and even aspects of chronic fatigue have really been associated with inflammation in the brain. So what inflammation does in the brain is that actually slows down all the neurotransmitter

pathways. So inflammation in the brain reduces what's called nerve conductance. And nerve conductance is how fast neurons synapse. So if there's lots of inflammation in the brain, then serotonin, dopamine, GABA, acetylcholine, all these different neurotransmitter pathways that impact our mood, that impact our cognitive thoughts, that impact our mental speed, all really become impaired. And one of the most common symptoms of neuroinflammation is brain fog. And people, you know, typically refer to the inability to think clearly, to get to their thoughts, to really figure out what's going on with them when they have brain inflammation, or so-called brain fog. Now, interestingly enough, you know, when you look at fatigue, fatigue and depression typically go hand in hand. And when

they do, it's very likely that the mechanism of fatigue linked with depression can also be neuroinflammation. So the other thing that inflammation does in the brain is that it shuts down the cells, energy producing cells called mitochondria. So mitochondria produce energy and in neurons, you have to have a constant supply of ATP to be able to have cognitive function and also to have healthy mood and to be able to be motivated and driven to do things. So what happens with a lot of people is they have mechanisms that turn on neuroinflammation. And I'm going to go through those mechanisms and explain to you the concept of neuroglia in this presentation. Then those neuroglia inflammatory based mechanisms shut down mitochondria, lead to chronic fatigue patterns and depression. Now, one of the

biggest clues that the fatigue that you have, or a person may have is related to a brain model is that anytime you try to use your brain, that's when you really get tired. So if you try to drive for a long distance, and that's really what fatigues you, if you're in exhausting conversations with people, and that's what fatigues you, if you're on a computer, and that's what fatigues you. If you're in exhausting conversations with people and that's what fatigues you. If you're on a computer and that's what fatigues you. Those are indications that you're trying to use your brain. Brain mitochondria is not working. Your brain gets fatigued and then you're pretty much done. So let's get into the topic. Let's talk about neuroinflammation. Let me show you the mechanism pathways and let me show you the research of

various nutraceuticals you can use. And then I'll talk to you about some dietary and lifestyle applications that may be helpful as well. And if you've been battling chronic fatigue and depression for a period of time, and you've really tried all the different protocols for depression, whether it's 5-HTP or St. John's Ward or various nutraceutical support and heart transfer pathways, and you try to deal with your fatigue by providing nutrients to the mitochondria or trying to support adrenal issues or blood sugar issues or other types of mechanisms, and maybe look for a subtle thyroid, none of those things have worked. It's very likely if you've gone through all those things and you have chronic fatigue and depression

at the same time, that you may have neuroinflammation and you may want to look at those types of strategies. I would also point out that all of us have some degree of neuroinflammation all the time. And those have had past head injuries. Some of us have autoimmune diseases. Some of us have chronic inflammatory conditions. Those things will cause some degree of inflammation in the brain. And the more inflammation we have in our brain over a lifetime, it then leads to the risk factor of neurodegenerative diseases. So let me switch the slide here. And by the way, I wrote a book called Why Isn't My Brain Working? If you want to learn more about that book and articles I've written on the brain, you can always go to drknews.com. I have lots of information on various topics that

are brain-related, autoimmune-related, functional medicine-related as well. Okay. So this is an important paper here. This paper titled Glia, More Than Just Brain Glue, is a reference to how the word neuroglia came in. And let me explain a really important concept. When you look at cells in the brain, there are two types of cells. There are neurons, and neurons are what we're all familiar with. Neurons are what fire and have neurotransmitters, and neurons work together to allow us to have function.

But then there's also glial cells and glial cells are immune cells in the brain. And these glial cells were named because they were initially thought to be only glue. They thought that the role of these glial cells, which are the immune cells in the brain, are really just to glue neurons together. And that's where the name glia came around. And there's different types of glial cells. There are microglial cells. You can see right here, microglial cells are like little Pac-Mans. They really go through the brain and get rid of debris. Over a period of time, we have some neurons that just degenerate, but those proteins need to be cleared out. That debris needs to be cleared out of the body. And that's what these microglia will do.

We also have different types of glia called astrocytes. And astrocytes are involved with maintaining blood-brain barrier. And they also help neurons synapse, which is very important. And then we have ligodendrocytes, which are glia that create a myelin sheath around neurons to allow things to work more effectively. And in conditions like multiple sclerosis, this myelin can be injured and traumatic brain injuries. These glial cells can become really activated and stay activated for many, many years. And these glial cells are immune cells and inflammation anywhere in the body can activate them and lead to brain inflammation. So like a classic example would be someone who eats a food

that they're sensitive to, they get an immune response, and then that immune response activates these glial cells in the brain. Now their nerve conduction in their brain is slowed. Now they have depression. Now they can't think, they can't focus focus they get brain fog that's the mechanism how an inflammatory response like a food protein may may be an issue and related to causing neurological and brain-related symptoms here's a video you can actually see a cell culture you can see microglia these pac-man cells these microgl, they actually go around and they get rid of debris in the brain. When we say debris, we also mean like beta amyloid. And if you have too much beta amyloid in your brain because you can't clear it out, then that's the mechanism for Alzheimer's disease.

There's another protein called alpha-synuclein. And these microglia get rid of this alpha-synuclein protein. And alpha-synuclein is a normal part of normal neurons. But over a period of time, as neurons die, they tend to accumulate and be promoted by inflammatory responses. And these microglia will go in there and get rid of that debris. So these microglial cells, these Pac-Man cells are really important for us because they help us get rid of the inflammatory cascade that we may be dealing with and so forth on a regular basis. Here you can see an image of a glial cell just going through and actually moving in the brain.

So we actually have these active movements in the brain with these glial cells, these microglial cells that are pretty amazing. Now, we got to get into pathways that activate these glial cells. Now, these glial cells do great things for us because one of the things that they do is they help us get rid of debris and clean up pathways in the brain. So we have healthy synapses, but these microglial cells can also injure the brain if they're over activated. And this is where, you know,

neuroinflammation is a problem. So just like we have inflammation in our body to help us heal after an injury, if you have too much inflammation, then we get joint degeneration and pain. It's the exact same thing. So we have some degree of brain inflammation to get rid of debris and clean up the brain.

But if we have too much brain inflammation, then we get neurodegeneration. Then we have our mitochondria shut down so we can get fatigue of the brain and then we can have too much brain inflammation, then we get neurodegeneration, then we have our mitochondria shut down so we can get fatigue of the brain, and then we can have too much inflammation, and we can shut down nerve conductance pathways of neurotransmitters, and then end up with mood disorders and depression and so forth. So this is a paper where they go into different pathways in which inflammation from the body directly impacts the brain. So one of the things they show here is the blood brain barrier. So just like we have an intestinal barrier called the gut barrier, and we have conditions like leaky gut, which we know as intestinal permeability,

we also all have a blood brain barrier, and we can get leaky brains or impaired blood-brain barrier permeability. And what happens in those states, as you can see here, is the illustration of the blood-brain barrier. And then the blood-brain barrier is injured. It opens up, and chronic inflammation, oxidative stress, chemical exposures can break down this blood-brain barrier. And even trauma to the brain, traumatic brain injuries actually open up the blood-brain barrier, allowing immune cells to come in to help clean the debris. But the blood-brain barrier can become hyperpermeable. And then inflammation and even pathogens and environmental compounds and particles can

then cross from the bloodstream into the brain. And this is a mechanism for neuroinflammation. So blood-brain barrier permeability is definitely a mechanism that can increase inflammatory responses in the brain and promote neurodegenerative changes and promote depression, promote poor endurance of the brain linked to fatigue and so forth. So that's one pathway. And then there's another pathway here. You can see through what I call the vagal afferent pathways. Afferent means to the brain.

And the vagus, vagal afferents are nerves. There's a bunch of nerves from the gut, the gastrointestinal sand, the microbiome. Here they're showing a picture of liver, but from all the different organs in the system that take input from the brain to the organs and from the organs to the brain and what they're showing in this study as a review is that they're showing that inflammatory mediators that are developed whether it's in the liver or whether it's in the gut the microbiome those inflammatory mediators can actually cross into the brain So there's a direct relationship with gut inflammation and brain inflammation. And there's like a saying in functional medicine is like, that is, you know,

fire in the gut is fire in the brain. And that's, that's a pretty accurate statement. So if there's lots of inflammation in the gastrointestinal tract, you can have lots of inflammation in the brain. That's very interesting is that the brain tissue itself doesn't have any nociceptors or pain fibers. So if the brain gets inflamed, you don't really perceive any pain. And the only thing that happens when the brain gets inflamed is neurological pathways become compromised, one being speed of neurotransmitter activity, again, leading to depression, and then mitochondria being impaired, leading to poor endurance of the brain or or

activities of the brain that then induce fatigue like driving reading and and so forth so this is another interesting pathway for the brain this bagel pathway through the microbiome through the liver directly into the brain and then there's another pathway of how inflammation gets into the brain and these are through the astrocytes so the astrocytes are part of the blood-brain barrier pathway and sometimes messenger pathways go directly through some of these astrocytes directly into the brain and there's also transport proteins and some particles can actually cross the brain through what they call active transport mechanisms in which there's like basically a tunnel

or canal designed for them to get through. So we have some inflammatory mediators that can easily cross the blood vein barrier through what are called active transport pathways. We have some transport into the brain via astrocytes in the blood-brain barrier. We have blood-brain barrier leakage. We have inputs from the gut and biggest soul getting to the brain.

But the bottom line is that there's multiple pathways in which inflammation anywhere throughout the body can then cause inflammation in the brain. And once inflammation takes place in the brain, then we can have a whole host of symptoms. This is also why some people go on an anti-inflammatory diet and all of a sudden their depression has dramatically changed or someone goes off gluten and they no longer have brain fog. Some of those clinical relationships are most likely these inflammatory pathways from the body into the brain. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode

and get access to ad-free podcast episodes, plus Ask Mark Anything episodes, plus monthly functional deep dive episodes, I guess that's why we call it Dr. Hyman Plus, then head on over to the doctor's pharmacy on Apple podcast and sign up for your seven day free trial. Hi, everyone. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical

professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.