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Dr. Magryta: Concussions

Concussions: otherwise known as TBI, traumatic brain injury

We have discussed TBI many times, however, some hot-off-the-press cutting edge data needs to be added to the discussion.

What we know about TBI is evolving rapidly. In the latest edition of Neuroscience news, the authors discuss new animal data, proving that there is a cross-talk between the brain and the gut, post- injury.

They looked at the research from a group of scientists at the University of Maryland who wanted to know the effects of trauma to the brain on the gut flora/microbiome post-injury. What they found was truly remarkable and a first.

The research was published in the November 2017 edition of the Journal Brain, Behavior and Immunity. The findings are staggering. The results show that post- injury, people develop a classic leaky gut, allowing intestinal bacterial pathogens to travel out of the gut to other sites in the body. Subsequently, they develop significant systemic bacterial infections which can kill, or at least hurt, the injured person.

Statistically, post-TBI humans are much more more likely to die from bacterial infections than non-TBI patients in the hospital.

In the animal model, the mice underwent a traumatic brain injury which caused a period of intestinal leakage that lasted for greater than 30 days.

The second part of the study proved the cross-bidirectional talk of the brain and the gut bacteria. They infected the mice with a pathogen known to cause infection in the gut. The animals that had TBI had significantly greater brain inflammation if they were co-infected with this pathogen. The infected animals lost more memory cells and suffered significantly more.

Why is this significant?

If you have a dysfunctional gut micro biome prior to suffering a TBI, you a likely to have a significantly worse outcome. We know by in- clinic testing that most of our children are on the dysfunctional side of the balance point — yet another piece of evidence in a long line of data teaching us that we are negatively affected by a dysfunctional diets and micro biome.

As with all things in nature, prevention would be ideal. One is easier to protect against than the other. The “easy” one is to have a robust and healthy fiber-based diet for years prior to the event, to prevent this inflammatory worsening.

The “hard” part is to choose it. Preventing TBI itself is also important, but harder to do if you are an athlete.

What to do:

1) Fiber will protect you by providing food for the good microbes to consume and proliferate. Eats lots of vegetables, nuts, seeds and fruits for the rest of your life!

2) Gluten is known to worsen intestinal permeability in certain individuals. See the research of Alessio Fasano. Avoid gluten post-injury for a month.

3) Avoid all pro-inflammatory foods including vegetable oils, fried food, processed white foods (bread, pasta, crackers, chips, cookies, etc.), corn fed meats, farmed fish, diet- and sugar-based beverages.

4) Omega 3 fatty acids in fish oil can protect against some of the inflammatory damage by balancing the inflammatory fatty acid system. Take provider recommended fish oil.

5) Control the variables that are controllable. Wear a helmet or specialized protective gear to lessen the impact in sports. Wear seat belts and use car seats appropriately to prevent car wreck-induced head injuries. Offensive and defensive linemen in football and rugby are at particular risk based on the repetitive ram-like hits. I am in favor of contact-minimized practice, especially for these linemen.

6) Take high quality refrigerated multi-species probiotics.

Fiber is key,

Dr. M

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

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