August 14, 2024 • 1hr 43min
Perform with Dr. Andy Galpin: Nutrition to Support Brain Health & Offset Brain Injuries
Huberman Lab
Key Takeaways
- Brain injuries are very common but often go undiagnosed as an "invisible disease" since there are no obvious external signs
- Nutrition and supplementation can play an important role in both reducing risk of brain injury and supporting recovery
- Key supplements with evidence for brain injury support include:
- Creatine monohydrate (5-10g daily, up to 20-30g around high-risk periods)
- Fish oil/omega-3s (2-4g daily)
- Vitamin B2/riboflavin (400mg daily)
- Choline (500mg daily, up to 1-2g after injury)
- Branched-chain amino acids (BCAAs) (up to 54g daily after injury)
- Magnesium (400mg daily)
- Blueberry anthocyanins (equivalent to ~1 cup blueberries daily)
- Caffeine should be avoided or limited after brain injury as it can impair recovery
- Getting adequate nutrients through whole foods is ideal, but supplementation may be necessary to reach therapeutic doses after injury
- Prevention is key - maintaining good nutrient status before potential injury is important
- More research is still needed, but current evidence suggests these nutrients are low-risk, potentially high-reward options for brain health
Introduction
In this episode, Dr. Andy Galpin discusses the science behind nutrition and supplementation for brain health, with a focus on traumatic brain injury (TBI) and concussion. He explains the physiology of brain injuries, reviews the evidence for various nutritional interventions, and provides practical recommendations for both prevention and recovery support.
Dr. Galpin emphasizes that while more research is still needed in this area, there is promising evidence that certain nutrients and supplements may help reduce risk and support recovery from brain injuries. He notes that these nutritional strategies are likely beneficial for overall brain health as well.
Topics Discussed
Brain Injury Overview (1:08)
Dr. Galpin begins by explaining that traumatic brain injuries (TBIs) are very common but often go undiagnosed. He describes TBIs as an "invisible disease" since there are no obvious external signs of injury. TBIs are typically categorized as mild, moderate, or severe:
- Mild TBI/concussion: Loss of consciousness <30 minutes, confusion/amnesia lasting <24 hours
- Moderate TBI: Loss of consciousness 30 minutes to 24 hours, confusion/amnesia lasting 24 hours to 7 days
- Severe TBI: Loss of consciousness/amnesia lasting >7 days
He notes that over 90% of TBIs are considered mild. Common symptoms can include headaches, dizziness, fatigue, memory issues, sleep disturbances, and mood changes.
Brain Injury Pathophysiology (17:09)
Dr. Galpin explains the physiological processes that occur during and after a brain injury:
- Initial response: Overactivation of neurons, release of excitatory neurotransmitters like glutamate, disruption of ion balance (sodium/calcium influx)
- Energy crisis: Mitochondrial dysfunction leads to reduced ATP production and an energy deficit in the brain
- Oxidative stress: Production of reactive oxygen species (ROS) that can damage cells
- Inflammation: Prolonged inflammatory response that can exacerbate damage
- Structural damage: Potential tearing of axons, damage to blood vessels and the blood-brain barrier
He emphasizes that understanding these processes helps explain why certain nutrients may be beneficial for prevention and recovery.
Creatine Monohydrate (36:52)
Dr. Galpin discusses creatine as one of the most well-studied supplements for brain health:
- Helps maintain energy production in the brain
- May reduce risk and severity of "second impact syndrome" from repeated head impacts
- Strength of evidence (SOE) score: 2 (strong)
- Dosage: 5-10g daily for maintenance, up to 20-30g for 7 days before high-risk periods
- Few side effects beyond potential mild GI distress
- Difficult to obtain therapeutic doses from food alone
"If you've had an injury, making sure your creatine stores are replenished as quickly as possible is really important if we're going to continue in that exposure."
Fish Oil / Omega-3s (56:05)
Dr. Galpin reviews the evidence for omega-3 fatty acids, particularly DHA and EPA:
- Help with cerebral blood flow, reduce inflammation, support cell membrane health
- Associated with larger hippocampal volume and better cognitive function
- SOE score: 3 (moderate)
- Dosage: 2-4g daily
- Can check omega-3 index via blood test (aim for 8-12%)
- Fatty fish like salmon are good food sources
"If you go into a brain injury with better omega-3 status, the brain injury will be less significant."
Vitamin B2 (Riboflavin) (1:04:46)
Dr. Galpin explains the importance of B vitamins, particularly riboflavin:
- Necessary for proper utilization of omega-3s in the brain
- Supports energy production and antioxidant function
- SOE score: 3 (moderate)
- Dosage: 400mg daily
- One study found it reduced TBI recovery time from 22 to 10 days
- Beef liver and fortified cereals are good food sources
Choline (1:11:25)
Dr. Galpin discusses the potential benefits of choline:
- Supports cell membrane health and neurotransmitter production
- May help preserve blood-brain barrier function
- SOE score: 3 (moderate)
- Dosage: 500mg daily for maintenance, up to 1-2g after injury
- Often supplemented as alpha-GPC or phosphatidylcholine
- Eggs and meat are good food sources
Branched-Chain Amino Acids (BCAAs) (1:21:30)
Dr. Galpin reviews the evidence for BCAAs (leucine, isoleucine, valine):
- Help regulate neurotransmitter balance in the brain
- May improve sleep quality after TBI
- SOE score: 2 (strong)
- Dosage: Up to 54g daily after injury showed benefits
- Dose-dependent effects observed
- Meat and dairy are good food sources, but high doses likely require supplementation
Magnesium (1:28:02)
Dr. Galpin emphasizes the importance of magnesium:
- Involved in over 600 reactions in the body
- Helps regulate brain excitability
- SOE score: 3 (moderate), but Dr. Galpin considers it very important
- Dosage: 400mg daily
- Various forms available (glycinate, threonate, etc.)
- Pumpkin seeds, almonds, and spinach are good food sources
"It is very, very safe, very little harm. It has so many other health and performance related benefits."
Blueberry Anthocyanins (1:33:09)
Dr. Galpin discusses the potential benefits of anthocyanins from blueberries:
- Powerful antioxidants that may protect against oxidative stress
- May improve memory and cognitive function
- SOE score: 3 (moderate)
- Dosage: Equivalent to about 1 cup of blueberries daily
- Easiest nutrient to obtain from whole foods
- Other berries likely provide similar benefits
Caffeine and Brain Injury Recovery (1:37:17)
Dr. Galpin notes that caffeine is the one substance with evidence suggesting it may be detrimental to brain injury recovery:
- Can cause blood vessel constriction and reduce blood flow
- Associated with worse emotional health, sleep quality, and depression after TBI
- Recommends avoiding or limiting caffeine intake after brain injury
Conclusion
Dr. Galpin concludes by emphasizing that while more research is still needed, the current evidence suggests these nutritional strategies are low-risk options that may provide significant benefits for brain health and injury recovery. He recommends focusing on obtaining nutrients through whole foods when possible, but notes that supplementation may be necessary to reach therapeutic doses, especially after injury.
He stresses the importance of prevention, maintaining good nutrient status before potential injury occurs. Dr. Galpin also notes that these strategies are likely beneficial for overall brain health and cognitive performance, not just injury recovery.
Finally, he encourages listeners to discuss any supplementation plans with their healthcare provider, especially in the case of diagnosed brain injury. While nutrition can play an important supportive role, it should be considered as part of a comprehensive treatment approach under medical supervision.
