Protecting Your Central Nervous System

by Larry J. Sharp, D.O

One of the more serious complications CFIDS/FM/MCS patients are concerned with is that of the central nervous system, or the brain. Of all the perplexing symptoms, CNS related issues interfere most with activities of daily living. Most of my CFID/FM patients have been able to cope, to some extent, with the pain, sleep disorders, gut toxicity and fatigue; of greater concern is what these diseases are doing to their brain.

This is not surprising since our ability to maintain employment, interpersonal relationships, hope, joy and indeed daily functionality pertain to our ability to reason and remember. I have, therefor, spent a great deal of study and emphasis in learning to protect mental fitness. This article is written in an effort to share some of that knowledge in hopes that the reader may protect and heal their injured brain. There are four major biochemical pathways implicated as pathophysiologic mediators in aging and neurodegeneractive disorders. They are the four "Ms" leading to neurodegenerative disease.

1. Metabolic -- Endocrine dysfunction and dysglycemia - inability to regulate glucose.
   
2. Mitochondrial dysfunction -- Oxidative stress, loss of membrane potential and function, reduced enzyme activity, reduced ATP synthesis, and mutations in mitochondrial DNA.
   
3. Microglial activation -- Chronic inflammation. A rise in the body's free radical load (reactive oxygen and nitrogen species) accompanied by decrease in antioxidant reserve is a hallmark of aging.
   
4. Methylation defects -- The transfer of a methyl group (CH3) from one molecule to another is essential for numerous biochemical reactions required for good health. Homocysteine is an amino acid product of protein digestion which requires B vitamins to methylate. Accumulation has been associated with heart and brain disease.

The following are some of the techniques and supplements that seem to be the most useful in protecting the CNS.

1. Dietary modifications -- Table sugar combines with amino acids to form an unstable substance; a SCHIFF BASE. This problematic molecule OXIDIZES THE BRAIN causing "glycation" which eventually damages nerve cells ON A CELLULAR LEVEL. Knowing this process should make that sugary food much less appealing. Eat more fish and flax seeds to provide you with Omega 3 fatty acids. Also adding Omega-6 fatty acids from primrose, borage and other vegetable oils can be beneficial to the brain. Colorful fruits and vegetables contain flavanoid and carotene antioxidants. Avoid food additives such MSG, Aspartame and hydrolyzed vegetable protein-- all of these substances "fry the brain".
   
2. Supplementation --
   
   
   1. Ginko biloba - this is a most important antioxidant available to us. It also improves cerebral circulation which explains why German doctors prescribe huge doses for ear tinitus. Ginko increases brain ATP production, decreases platelet aggregation (clumping) and inhibits monoamine oxidase, the enzyme that breaks down certain brain neurotransmitters. It is synergistic when combined with rosemary.
      
   2. Essential fatty acids - Fish oil can profoundly affect the physical structure of brain cells. It can defeat free radicals and reduce inflammation as well as raise serotonin levels. Some medical authors claim that the greatest dietary deficiency facing western civilization is a lack of Omega-3 oils. In fact, Attention Deficit Disorder (ADD) and other neurologic diseases have been labeled as Omega-3 deficiencies by some diagnosticians.
      Omega 6 fatty acids (Evening Primrose oil, borage seed oil, etc.) can modify prostaglandin levels and are anti-inflammatory in the brain.
      
   3. Lecithin - Found in egg yolks, legumes and fish, lecithin is a fatty acid that promotes cell permiability. It is also a precursor to acetylcholine, the primary neurotransmitter for memory.
      
   4. Antioxidants - Act as free radical scavengers and reduce mitochondrial oxidative stress. The most beneficial ones include: melatonin, alpha lipoic acid, CoQ10, carotenoids, flavanoids (Quercitin, Anthrocyanidin), Vitamin A, C, E, bilberry, and green tea.
      
   5. Minerals - Magnesium (chelated, especially to Glycinate) supports neural and mitochondrial membrane function. It increases blood supply of nutrients (by acting as a calcium cannel blocker) thereby negating age-related reduced blood flow. Selenium prevents lipid oxidation, can detoxify heavy metals and is a catalyst in glutathione production. Zinc, the bodies' greatest concentration of this element is found in the hippocampus (the memory center). Zinc regulates neurotransmitter production. Calcium maximizes the electrical potential of nerve and muscle cells.
      Other important minerals documented to be beneficial to the brain include boron, chromium, copper, manganese and vanadium.
      
   6. Hormone therapy - A balanced endocrine system is essential to a feeling of well-being and correct physiologic responses. Estradiol (Estrogen) has multiple effects on the brain that act in similar ways as antidepressants, memory enhancers and nerve growth factors, and endorphin releasers. Progesterone is a CNS depressant producing sedative effects. It can decrease the production of CNS growth hormone, making its use difficult in CFID patients. Testosterone activates the brain's sexual drive in men and women. It also improves a woman's sense of well-being, energy level and stimulates bone and muscle growth. DHEA is considered a "mother hormone" and is a depository to convert to Progesterone, Estrogen, etc. Supplementation with 7-Keto DHEA offers some benefits since it is not converted to estrogen or testosterone.
      It is important to work with a health care provider willing to consider the hormone issues, but remember these are "dynamic chemicals" requiring frequent monitoring and dosage adjustments. Also it is better to monitor blood levels rather than saliva hormone levels, since saliva testing seems unreliable (the exception is salivary Melatonin level). Also insurance rarely reimburses for saliva testing.
      
   7. Amino Acid Support - The Great Smokies Laboratory can pinpoint specific amino acid deficiencies from a 24-hour urine collection. A supplementation schedule can be drawn up from these results. Short of this test there are several Amino acid supplements which are helpful.
      N-Acetyl Cysteine (NAC) enhances glutathione production in the brain, restores brain mitochondrial function, has intrinsic antioxidant properties.
      Acetyl L-Carnitine (ALC) readily crosses the blood-brain barrier to protect the brain from free radical damage. It enhances memory flow between the brain hemispheres, increases CNS CoQ10 and glutathione levels. It also increases cerebral blood flow and restores stability and fluidity of nerve cell membranes. ALC also works synergistically with phosphatidyl serine to promote the production of acetylcholine in the brain.
      Glutathione - A Tripeptide synthesized in the liver from the amino acids cysteine, glutamic acid and glycine. It is a powerful antioxidant that inhibits the production of free radicals. It defends the body from exposure to radiation, chemicals and heavy metals. A good source of glutathione is undenatured whey protein.
      
   8. Other substances - Dimethylaminoethanol (DMAE), once a prescription drug for treating ADD, now available over the counter. Its action is similar to choline in that it increases learning and memory capability. This should not be taken regularly even though it is found naturally occurring in the brain.
      Coenzyme A initiates manufacture of the neurotransmitter acetylcholine. It promotes fatty acid metabolism, supports the immune systems detox pathway, promotes DNA and RNA repair and contributes to red blood cell production. S-adenosyl methionine (SAMe), promotes cell detox and synthesizes neurotransmitters. It is a methyl donor meaning it gives up a methyl molecule- carbon plus 3 hydrogen atoms- which is a way the body protects itself on a cellular level to prevent cancer, and facilitates in the production of DNA. One interesting property is that it increases natural levels of glutathione. SAMe is active in more than 40 biochemical reactions in the body.
   
   
3. There are other natural, non-chemical treatments that can be utilized as well. These include meditation, light exercise, and stress reduction to "cool down" the adrenal glands. A good way to protect the brain is to "use it or lose it". In other words, continue to use your brain power. Take courses in music, art appreciation, read books, attend a play or symphony. Maintain your curiosity! To avoid further damage, reduce your activity levels that can lead to the "push-crash" phenomena. Avoid chemical, toxin exposure.

I have presented this as only a piece of the overall puzzle that plagues patients with these debilitating diseases which lead to neurologic disorders. We do know that all forms of brain related disorders are on the rise. The Fort Worth Star Telegram recently published an article noting the increase in Lou Gehrig disease cases among former employees at Kelly Air Force Base. Speculation is this was caused by exposure to chemical substances. Undoubtedly, many serious conditions are a result of environmental toxins--we just don't know the exact nature of these mechanisms yet. We do know that as our population continues to expect to live longer, finding solutions to neurologic aging will continue to be of increasing importance.