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Host: Welcome to the Lifelong Wellness podcast, where we talk to wellness professionals from around the world to gain their insights into healthier living. I’m your host, Wes Malik. Our guest today is Dr. Kabran Chapek. In Dr. Chapek's last 12 years spent in the mental health field, the number one thing he has learned is that mild traumatic brain injuries (concussions) are a major cause of mental illness. No one knows more about this than Dr. Chapek, and today he will share what he has learned with all of us. Dr. Chapek is an expert in the use of functional and integrative treatments. He has a special interest in the assessment and treatment of Alzheimer’s and Dementia and traumatic brain injuries, PTSD (Post-Traumatic Stress Disorder), and anxiety disorders. Let’s welcome him to the show. Dr. Chapek, welcome to the Lifelong Wellness podcast. How are you doing today?
Dr. Chapek: Great, Wes. Great to meet you. Great to talk with you.
Host: Alright, tell us a little bit about yourself, what do you do for work? How did you get into the research that you are involved in? Give us a brief history of your timeline.
Dr. Chapek: Sure. So, I'm a naturopathic physician with primary experience in mental health, brain health, and psychiatry. I graduated from Bastyr University in the Seattle area, and I've been working in this field for about the past 12 years. I work at Amen Clinics where we do SPECT imaging, which is a type of blood flow study, functional study of the brain. Because it helps us understand what's going on ‘under the hood', how to help people with different problems, such as brain injuries and tension problems. And I just love doing this work because your brain is… runs everything you do. If your brain works right, you work much better and more efficiently and can make better decisions, and I think it comes down to that. If you can make good decisions in your life, that equals a better life for you.
Host: Over the past 45 episodes that we've recorded of this podcast, we have focused a lot on physical health. We focused somewhat on mental health, somewhat on spiritual health as well, but I don't think we've gone into the details and specifics of mental health in terms of the brain.
Dr. Chapek: Oh, cool. Well, I’m excited to talk with you more. There’s a lot to talk about there.
Host: So, when did you start researching or focusing on just the brain?
Dr. Chapek: You know, when I graduated from school I didn't think this was something I was going to focus on initially. I was more interested in detoxification, cleansing, digestive health, and that's because I grew up in a family that was really focused on that, and helping me learn how to live a healthier life with diet and exercise. So, I was always studying that and that's how I got into natural medicine in the first place. I just love it. And what I think I love the most about it is if you can improve the health of your body, you feel better, and then you kind become your best self. Like, you feel good and so that's a mental health connection between body and brain that I think when I started working… I started working at a treatment center for addiction and mental health problems. It was a partial hospital program so severe mental illness. And I just loved helping people improve how they felt through natural means. And that's what really got me into it. It was about 12 years ago and I’ve been doing it ever since.
Host: Do you think you’re going to continue for the long-term?
Dr. Chapek: I love this work. This is my life-long passion for sure, and there’s just so many different facets. It’s always changing, the research is coming out each year. There's something different, whether it's with brain injuries or Alzheimer's, Dementia, or even depression and anxiety. There are new treatments, new therapies. This is like the next frontier. So I'm so excited to continue this work as long as I'm still upright, my brain working well. I’ll be doing this work. (laughing)
Host: Okay, we can usually tell when our brain is not functioning properly. Sometimes we can't tell. Are there cases where, you know, people can go unaware that their brain might not be functioning optimally?
Dr. Chapek: You know what, my first thought to that question is mostly we have symptoms of brain fog, confusion. But the thing is, sometimes it's insidious and the people around us are noticing more than we’re noticing. There can be depression and anger problems. It depends on your level of insight to your own self. So some people are very in tune with how the brain and body are functioning, some people are not. Not so in tune and they need their spouse or their friends to tell them, “Hey, you're not acting the same. How are you feeling? Are you feeling a little depressed?” or “Why aren’t you speaking in the same way? You seem to be forgetting things”. And some people don't really don't notice and they just, we tend to compensate for these things like, oh, it’s slow and gradual as we get older especially. We may start making more lists or start using our phone to set reminders more often. And some of that, that's normal with aging but some of that can be the start of another neurodegenerative process like Dementia, Alzheimer's, Parkinson's, different neurodegenerative conditions. So once you or a friend or loved one tells you, “There might be something different about you”, I would suggest not taking the ostrich approach with the head in the sand to pay attention. Let’s check it out.
Host: Yes, pay attention to what other people are saying even if they come across very subtly. Because usually, people aren't that direct because they care for you or, you know if they don't straight up tell you to your face, “There's something wrong with you, buddy”. (laughing)
Dr. Chapek: That’s right.
Host: Now, we don't appreciate those kinds of people that much, but although they are very truthful. I'd like to ask you what is… Now your work revolves around brain injuries and mental illness. First, I’d like to ask you to define, for our listeners and myself so I can learn a little bit, what is mental illness? What are the mental illnesses?
Dr. Chapek: Mental illness is when you’ve kind of diverge from normal sadness, grief, and loss. Those are all normal human processes. And depression, anxiety, those are probably the most common mental illnesses. And it's when… The keys to depression are essential when you feel like you're not enjoying things that you used to enjoy. Like just that lack of enjoyment in life. So the colors are muted and you just don’t feel as motivated to do things, energy is low. You start having… Some of those are symptoms of depression. Same for anxiety. It's when…We’re all anxious sometimes, worried about performance, speaking, public speaking, things like that. But if it's keeping you up at night and affecting your day-to-day function that's when it becomes an illness. When any of these affect the day-to-day functioning, that’s when we consider it a problem.
Host: Okay, alright. And these…Do they develop internally or are there external factors that play a part in mental illness?
Dr. Chapek: I was thinking about it this way, Wes, like four circles at Amen Clinics. We talk about the four circles, the biology, the psychology, the social aspects relationships, and spiritual, which can be your sense of purpose in life.
Dr. Chapek: And so we tend to focus a lot on the biology, like the chemistry is not correct. Some people are more susceptible to depression, anxiety. It runs in families and there's a genetic component. You can have deficiencies. A Vitamin D deficiency makes you more susceptible to depression. Iron and zinc deficiencies make you more susceptible to depression, for example. But in the psychological aspects of things that you've grown up with, the messages that you've gotten about yourself in the world that can affect “how you feel”. And there's a social aspect. You break up with a girlfriend, something happens, there's a loss in your life, move even, change in school, back in the house. And then the spiritual aspect. Do you have a sense of purpose and where you're going in life? Moving forward, what are you about in your day-to-day? So any of those can affect you. And sometimes when they pile up, there's the perfect storm. Multiple factors, break up with the girlfriend, you haven't slept well, and then eventually you can cross the line into that depressive episode.
Host: And at your clinic, at Amen Clinics, when you treat a patient do you treat all four circles that you talked about, the biology and…?
Dr. Chapek: Yes.
Dr. Chapek: Absolutely. As a naturopathic physician, that’s one reason I love working at Amen Clinics is that it already had that holistic mindset, looking at the whole person and all of these, aspects. Because this is what I think of when people heal, is when you have everything in line. And that's when you feel your best is when you have those four circles balanced.
Host: So do you work with just the biology part with your patients and refer them to life coaches or therapists or psychologists? Does it take a team of people to work with a patient?
Dr. Chapek: I do refer out all the time for specialists, especially if there's trauma. I’ll refer to a therapist that does trauma work. I always do some counseling and talk about social, talk about a sense of purpose, and Biology. I do all of it because I think we have to and I can't not do it. But I mostly focus on biology and trying to figure out that because that's what people are coming in for. They've heard about SPECT imaging maybe and they want to have their labs checked for optimal ranges and will put back together. But I do it all.
Host: Can you tell us a little bit more about SPECT imaging?
Dr. Chapek: Yes. So SPECT stands for Single-Photon Emission Computed Tomography. It's a mouthful and it's a blood flow study where. It's not new – It has been around. We didn't invent SPECT imaging. It's been around for at least 50 or more years and most hospitals around the world have SPECT imaging for looking at heart conditions, looking for cancer and Dementia, and things like this. And Dr. Amen, 30 years ago is our founder and he said, “We need to be using this in the clinical setting to understand people”. And so, over the past 30 years, we’ve collected a database now of 150,000 scans. And so we have the world's largest database. We can compare when a patient comes in, we compare their scans to the database and it shows what’s overactive, what's underactive, any injury, signs of toxicity and damage etc. And then we work to repair that, and then we can rescan them and hopefully show improvement.
Host: So those 150,000 scans, have you personally gone through all of them? Have you studied all of them or a fraction of them? (laughing)
Dr. Chapek: Oh no. We do have a research team who… It's really fun to be able to enter a question, you know, what causes low activity in the brain, for example. Or what's the difference between the male and the female brain? And what we found is, for example, what causes decreased blood flow for the general population is aging, unfortunately, not something we can modify. Number two is schizophrenia and number three was cannabis. People using pot, and thenit just decreases overall blood flow to the brain.
Host: Does that have a negative effect?
Dr. Chapek: It does.
Dr. Chapek: We want more blood flow to the brain. We don't ever want less, and cannabis and drugs, in general, would decrease blood flow. And that's what's difficult to understand for some folks who find it helpful, for example for PTSD, anxiety. It’s like, “Why can this be a bad thing? It's helping me relax and calm”. But just to keep in mind that over time, regular habitual use is the problem and that can cause decreased motivation, decrease blood to the brain. The brain doesn't work as well if it doesn't have as much blood flow.
Host: I see. Did you mention schizophrenia? So how does that affect? Does that affect blood flow?
Dr. Chapek: That’s…We think about it as much. It's really a biological disease and it is degenerative and inflammatory and, yes, people with schizophrenia do tend to die younger and…
Dr. Chapek: So that's why we think that’s the case. But it was surprising to me as well, I didn't expect that.
Host: Let's talk about your research and let's talk about how you came to the conclusion that brain injuries can cause mental illness. When did you start studying that and come to the conclusion? How did that happen?
Dr. Chapek: It really started when I started working at Amen Clinics about 7 years ago. And I hadn't thought about this before because I’d worked already 6 years in mental health and hadn't really considered that brain injuries are significant, a major cause of mental illness until we started looking at the brain. And I had a patient who really drove this point home to me, we’ll just call him Jeremy, but when he was 21 he came into see us and he had been a jazz drummer, really bright guy, really active, but he was depressed. He was suicidally depressed since he was about 14 years old and he'd seen some really good therapists. He had taken every class of medication and nothing was working, he was still suicidal. And when he came in and on his intake, there is no history of brain injury. Yet clearly when we looked at his scans, he had left-side damage to his left frontal lobe in his left temporal lobe. I said, “Jeremy, when did you have a brain injury? This is terrible”. And he said, “I have never had a brain injury. What are you talking about?”
Dr. Chapek: And I asked, “Well, okay So, did you ever?” Because people forget when they've hit their head and they think it had to be, I must've had to go to the ER or lost consciousness to have had a brain injury but you don't have to. You don't have to have a loss of consciousness to have a brain injury, that’s what I’m here to tell you.
Dr. Chapek: And so I said, “Well, okay. No falls, no motor vehicle accidents. How about contact sports?”. “Oh, yeah. I did start playing football when I was about 13, 14 years old”. And he was just a scrawny little kid, he has smashed up against the coach’s son who is 6 feet tall at the time and he would just get pounded in headaches and dizziness after practices.
Host: Oh, okay.
Dr. Chapek: So his brain injury started there. And so instead of just giving him more meds, we gave him a program to help heal his brain, and over the next several months he stopped having suicidal thoughts, his depression lifted and now it's about two years later and he's about to graduate from the Berkeley School of Music in near the Boston area. He’s doing very well.
Host: Is the brain a muscle that can be trained or repaired?
Dr. Chapek: Yes, good insight. Absolutely, it can. The brain can be healed. That’s what we didn't use to know. We thought, “Okay, you’ve damaged it. This is the best that we can do.” A year later, if you haven’t improved that's where you going to be stuck for the rest of your life.
Dr. Chapek: But we now know that you can heal many years later and we’ve been able to prove this with our research and work with professional football players. And I can send you pictures before and after scans of players who have really damaged brains and it's been 16 years later and yet they are able to heal, they’re able to improve their memory, maybe have rage and anger problems that can be improved, depression problems that can be improved and that is just remarkable and really rewarding to see that.
Host: I have to ask you how that happens but I don't know. I think we'd probably be jumping ahead of ourselves. (laughing) I think those are the questions I had for you at the end. You know what? We’ll make a note of it and talk about how the healing process of the brain works in just a moment because we’re like to create a little bit more based on our conversation. You mentioned football players. I've heard about it in the news. It's been highlighted, you know, in media. We heard it on the nightly news, you hear, you can read articles about it. There might have been active in and lawsuits…
Dr. Chapek: Yes.
Host: And in the NFL. It's quite a cause of debate. Why do you call traumatic brain injuries the silent epidemic?
Dr. Chapek: Track brain injuries go unnoticed for two reasons. One is, we hit our head and it's cumulative. It's the cumulative damages, even if you haven’t lost consciousness. The definition of a concussion is having symptoms after hitting your head like headaches, dizziness, confusion, nausea. And sometimes you don't have those symptoms immediately. Sometimes they are delayed for several weeks. I have this pastor who was in a car accident and was seemed to be fine, In the ER seemed to be fine. He went home, but two weeks later, he couldn't write a sermon because he had so much difficulty with concentration. It was out of the blue and it was because the swelling started at the car accident, it’s very gradual, very slow. It didn't show up on the CT scan and eventually got to the point where it was compressing his brain and causing problems. And so the symptoms can be delayed. We minimize them, we’re told we’re fine, you go to the emergency room. You’re fine, meaning the well-meaning doctor says you’re fine and that you survived, you’re going to live, but changes can happen. And we just don't see our brain. Like you can see a sprained ankle, the swelling, you can see a scrape but you can't see the damage to the brain. So it easily minimizes and we don't want there to be changes to our brain, so we minimize that as well. So for these reasons, we've ignored our brain and I think is to our detriment.
Host: Okay, while you're telling me about this, I'm just thinking about all the times that my kids have fallen off the bed and hit their head on the floor. (laughing) That's all I can think about and I think I should ask you like it’s pretty old now. Is it just the developing brain or the developing mind that, you know, could be impacted? Or just the developed mind, you know, in a teenager or an adult, a young adult or an adult be affected by brain injury? Or are children susceptible to that as well?
Dr. Chapek: Yeah. Unfortunately, no one can escape the effects of… No one is immune. Everyone can be affected.
Host: I see.
Dr. Chapek: We all hit our heads at times and that's, I mean, I rarely see a scan where there's not just a little bit of injury. It’s just the timeline’s importance. Was there any change in symptoms around, you know, in the months afterward and then so that's one aspect that, you know, human beings were active, your kids are active, my kids are active. I’ve hit my head a number of times, I fell out of trees, you know, and it shows up on the scan and you can improve it. And think it's keeping in mind because it does set you up for things like Dementia and Alzheimer's, depression, anxiety. It kind of weakens the foundation…
Dr. Chapek: …or it can make you more susceptible to brain problems later on. It doesn't have to be that, you know, if you fall as a kid, necessarily, were our causing behavioral problems. For example, kids with ADHD tend to have more head injuries because they tend to be more impulsive, they'll take risks, they like to jump off things in and such. And so they tend to have more head injuries and that makes their focus and ADD worse and so it's kind of a…
Host: So there is a correlation. I need to ask you this, what is the, physically, how severe does an impact have to be to actually cause damage that will show up in my activity? Is it just as simple as maybe falling off from a bicycle, hitting your head on a door latch or something, or something more severe like the pastor you mentioned with a car accident, possibly whiplash into an airbag or steering wheel? How severe does the physical impact need to be to actually cause damage?
Dr. Chapek: Great question. It differs. So it's interesting like I've had a number of patients where they were surprised at how severe their symptoms were after just a, you know, they stood up too fast and hit their head on the back of a cupboard door, was dazed, but then they really started having concussion symptoms… when previously they had had a loss of consciousness, or concussions, been knocked out and they didn't have symptoms. But then this was like the straw that broke the camel’s back.
Dr. Chapek: And so it's cumulative. So it really varies. If it's hard enough to see stars, definitely a concussion-like level. And some people will have lost consciousness concussions. Whiplash is definitely enough to cause brain injury because think about it, the brain is so soft. It's as soft as butter, like jello.
Host: Really? Really.
Dr. Chapek: Yes. Tremendously soft. It doesn't have much structure like Wes, if you set a brain like we took a fresh brain out and set it on the counter, it’ll be gooey in several hours.
Dr. Chapek: It's not rubbery and stiff at all, and it floats in cerebrospinal fluid housed in a school that has many short bony ridges. And so imagine, you have this soft egg-like thing with many short bony ridges and you justle it really fast forward and backward. That could certainly bruise and damage your brain.
Host: Remarkable. I did not envision or imagine my brain to be like that because Hollywood, you know, you see pictures and maybe a cadaver or a horror movie or something. And it doesn't look like the way you explained it. So how about activities like roller coasters or things like that which, you know, shake you a lot.
Dr. Chapek: Yes. I think any, you know, Shaken Baby Syndrome is, unfortunately, a very sad and deathly scenario. That's real. Roller coasters, not too bad. I hate roller coasters, they terrify me. (laughing)
Host: Me too.
Dr. Chapek: And so I think yes. They’re bad for you. (laughing) But, that’s just a personal fear thing. And I think they're okay though, for the most part, unless it's a real… And some people will get a little whiplash and stuff from them.
Host: You created something called First Aid For Your Brain and you recommended immediate steps of someone that sustains a head injury. What are those steps?
Dr. Chapek: Let me tell you about the science a little bit. I think I'll make it more impactful even.
Dr. Chapek: So, this researcher at Stanford, was an undergraduate student actually, and he did an experiment where he took a microscope and was able to implant it into a mouse skull. This is what they do unfortunately with research and sometimes to help us understand. And then they gave this poor little mouse a head injury and were able to witness real-time footage of the brain injury happening with this cascade of inflammatory events, oxidative damage, kind of like rust, a car rusting in the rain. There is inflammation, these immune cells were activating. There’s this whole inflammatory cascade that happens and they are able to see that. They never had seen this before. This was in 2013. And then what they did is they applied glutathione, which is an antioxidant, really powerful one, to the mouse skull. It was absorbed and if applied immediately, there’s 67% less cell death. If applied within three hours, there's 50% less cell death. So when I learned about this, I realized there's this window of time in which we need to act, that when the current protocol is sort of watch and wait, if someone has a concussion versus doing something immediately like we would for a sprained ankle. So imagine. you know, my son plays basketball and so he gets this sprained ankle. Everyone rushes for ice and rest and compression, elevation. We have this protocol. Why don't we have something for our brains? Or we do something immediately to quench inflammation and damage. So I developed a protocol based on research on things that help with immediate quenching of inflammation in the brain. They did a study on NAC with active N-acetylcysteine, which is the precursor to glutathione in active military. And so these soldiers were in the field of war. Sometimes they had a head injury due to an IED explosion, a blast, or they hit their head on the tanker or something and then they would go to the medic and say, “I've had a concussion”. They check him out, “Yes. Here's the NAC” and they did the study on those who got it and who didn't. After a week, 82% had resolution of their symptoms if they took the NAC, 42% had resolution if they didn't. So significant improvement just from NAC, for example. And so what they’ve done is taken NAC, Vitamin C, these antioxidants and you take them all at once. Vitamin D, curcumin, and quench inflammation over that next week and I think people should have this in their car or in their first aid kit because your brain is your most important organ. Why would you have Band-Aids to help the scrape but not these supplements that could help save brain cells?
Host: Did these supplements need to be prescribed by a doctor or they over-the-counter?
Dr. Chapek: These are over-the-counter. These are over-the-counter and these supplements are very safe.
Dr. Chapek: There's no real risk to taking them and, you know, the only thing I would…You know, one of the things is omega-3 fatty acids and if you take too much Omega-3 there's an increased risk of bleeding. So I've got sort of a moderate dose in there that I think is safe. So, NAC, curcumin, vitamin C, Vitamin D, Omega-3, and I also think that MCT oil, Medium Chain Triglyceride Oil, and branched-chain amino acids are also important.
Host: These sound like something that ER doctors and doctors need to be aware of and when they treat patients for concussions when they come in and saying, you know, we had an accident or something happened, they should be prescribing this, even though it's over-the-counter.
Dr. Chapek: Yes. I would love to see that.
Host: Because you mentioned that it's only been since 2013. You, yourself, have been studying this for 7 years at Amen Clinics and these studies that you studied were conducted in 2013. So, that’s not a very long time for information to get around to all the doctors in the world.
Dr. Chapek: Yes, it's true. It’s true. And so that's why I'm talking with you and I want to expand that and share that because, man, there are 3 million visits to the ER each year and it continues to increase as their population increases. And yet the standards of care, the protocols are the same. Essentially it's rest and don't go to school, don’t go to work, maybe you need rehab, physical therapy, things like that, but that's mostly just rest and hoping that your brain heals. I think we should really put the brain in a healing environment to help it to heal. And that I would like ER doctors and, you know, after the CT scans been done, “Yes, no bleed” instead of just, “Okay some Tylenol”. Let's get you some actual healing for your brain and put you on the right path to recoveries. Even if you're not having symptoms now, let's prevent them from happening. Like I said, the pastor, 2 weeks later he had symptoms. He could have potentially taken a different path and not had long-term problems in that injury.
Host: This is a perfect moment to ask you now about healing and how you heal people with brain injuries. What is the process, medication? What other things… I can’t even start to imagine so you’ll need to fill in all the blanks that I have regarding healing the brain. What do you do with patients?
Dr. Chapek: Absolutely. The best way to heal the brain first is to assess which areas are damaged and where someone's at. So, we will start with a really good assessment. Best treatment starts with a good assessment, checking cognitive functioning, scanning their brain, understanding which areas are damaged. And then the thoroughness of the program is what tends to help, you know, it's like filling in all of the gaps, looking at these different factors, because if someone is in a crappy diet and just taking supplements, it’s going to be very difficult for them to heal. You know, the brain uses 20 to 30% of calories in the diet. A quarter of what’s on your plate goes to your brain.
Host: Really? Is it in terms of energy?
Dr. Chapek: In terms of energy. It’s a very active organ, very hungry. And so if you think about if you're eating junk, your brain's getting this junk and more pro-inflammatory. And there's a number of studies showing that, that if rats fed a higher sugar diet don't heal as easily from a concussion. They have more cognitive problems after having these concussions.
Dr. Chapek: So this same is true for humans. So diet’s a key. I recommend a lower carb, higher fat diet, eliminating common food allergens like gluten, dairy, soy maybe corn. Some people…
Host: Eliminating these. Eliminating gluten, soy?
Dr. Chapek: Dairy.
Host: Dairy as well? (laughing) Okay. And the last thing you mentioned was?
Dr. Chapek: Maybe corn.
Dr. Chapek: Yes.
Dr. Chapek: Yes. It’s hard to do those. (laughing)
Host: It sounds like pretty much what I eat every day. (laughing) It’s like, what do I eat now?
Dr. Chapek: Right. (laughing) These are staples, I know.
Host: But we’ve covered many alternatives in our previous episodes of how-to, you know, eliminate these from our diets. And it is very, very possible and a very healthy way, in a very delicious way as well. But I digress, and I'd like to let you to continue. What other things apart from the diet are necessary for the brain to heal?
Dr. Chapek: The supplements are important so we want to flood the brain with nutrients. So, for example ,the football players we’re talking about earlier, it was a very simple protocol. They were given high potency multiple vitamins that had all the B vitamins that were activated and easily absorbed. High dose fish oil, 3g a day of EPA and DHA combined. They were also given a formula that had nutrients that increase blood flow to the brain and helps stabilize the brain. Ginkgo antioxidants, Alpha Lipoic acid, and the NAC I mentioned earlier. Phosphatidylserine, that’s a mouthful. Phosphatidylserine is spelled out with a P-H, phosphatidyl and that really helps with memory and cell membrane stability. Acetyl l-carnitine helps with brain energy. So it’s like we want to hit each of these elements that help the brain to balance and heal, not just lots of fish oil or not just lots of antioxidants, but we kind of want the whole. So we give them those supplements, we have them exercise and some of them needed to lose weight. Check for sleep apnea because that's essentially choking or loss of oxygen to the brain when you're sleepy not getting rest. I really think it's important to check labs to look for nutrient deficiencies and hormonal deficiencies, 25 to 50% of people with a history of brain injury have damage to the pituitary gland which can cause testosterone deficiency in men and women, estrogen, progesterone, growth hormone deficiency, thyroid changes, adrenal changes. Dr. Kevin Yuen down in Arizona is probably one of the leading experts. He’s at the Barrow Institute for pituitary problems and checking for this issue. There's a number of people around that help with this. Dr. Mark Gordon has also trained many doctors so… I did some training with him on how to assess and treat pituitary problems specifically like this unique aspect that I wasn't looking at when I first started doing this work, but added in later. So, it’s really helpful. They can cure people who are sleeping, 30 to 70% of people with a history of brain injury have sleep problems. I think it's more like 70% and so if you're not sleeping well, we have to get that going whether sleep apnea or just the brain’s kind of not firing properly that's keeping people awake.
Host: Sleeping means the quantity or the quality of sleep?
Dr. Chapek: Both. Yes, you have to have quantity and quality, 7 ½ hours quantity, quality…Yes, sleep apnea really can interfere with the deep stages of sleep. You need a deep sleep, you need REM sleep. That's when you produce hormones as in your brain will detoxify and begin to heal and that's like number one if you don't have good sleep. It's going to be very difficult to heal.
Host: How do I know if I have REM sleep?
Dr. Chapek: Well, dreaming is one way to know if you had, some people don’t remember their dreams. I always just think if you wake up feeling unrested, that’s when I asked patients, “Are you tired during the day? Do you feel like you could take a nap or you’re just feeling tired? Like you actually could fall asleep during the day”. You probably aren’t getting enough REM in deep sleep. Maybe you want to do a sleep study or at least see a sleep doctor or see if your doctor figures things out. You know, that’s important. So nutrition, supplements, exercise, or aerobic exercises is what I am talking about versus strength training.
Host: Basically anything that increases the blood flow to the brain. So I'm assuming any exercises which pump up the heart rate?
Dr. Chapek: Any aerobic exercises, swimming, biking, running, jump rope, elliptical. Whatever you like to do. I think that’s the key to exercises. Scheduling it in and doing something you don't hate, at least.
Host: When it comes to health, we really just focus on how we look and it's our bodies, you know, what do my arms look like, what does my chest look like, my thighs, you know, my glutes. Am I thin, am I pear-shaped, am I Apple-shaped, just like that? And now you're going through all the things that are required to keep your brain healthy. I did not know the 20 to 30% of the energy I require is required by the brain. And now that I know that I'm going to be thinking differently about what, you know, obviously, obviously, you know, whatever I eat goes to use in my muscles and everything but…I was aware, of course, you are aware that your brain uses, but not to this level. It's kind of eye-opening.
Dr. Chapek: Cool. I'm always, I'm still fascinated by that as well. How hungry our brains actually are and how much nutrition they need to function well. And when you have a degenerative condition whether it's Alzheimer's, Dementia, or brain injury, there are many correlations between the two. And so many of these strategies will help other conditions as well. And so dementia and brain injury, one of the key pieces here with diet is that some of the glucose transporters are damaged. So it's harder for the brain to actually get in that nutrition and it's already so hungry. And that's where things like a ketogenic diet may actually be helpful because ketone bodies from the ketogenic diet that’s fats burning those fats for fuel, can be sort of absorbed more easily by the… They kind of go around those glucose transporters and these are absorbed into the brain and all of a sudden the brain has fuel again and can function better.
Host: Very interesting. Very, very interesting. Okay. So exercises in terms of aerobics or anything to get your heart rate up. Usually, when you repair the brain or you have a patient, you work with a lot of B vitamins, fish oil nutrients, NAC. These are over-the-counter but honestly, I don't think there is a kind of self-medication that would help here. In any case, all the symptoms that you described, I think it's important that you visit your professional, your doctor to get advice. Do you, I mean, people walk into your clinic in Seattle, but how about somebody like me who's in Toronto or, you know, do you help people across the States?
Dr. Chapek: I do. I certainly see people, we do. Especially now with COVID, we can do telemedicine more freely and easily and I'll do consultations and work with local providers to prescribe things to the patients if need be, but certainly get passing information like these are labs you should do, this is what you should think about. We also have eight clinics. So we have other clinics around the country. There are clinics in New York and there are clinics in LA and all over. And we do have people that fly out all the time. We love Canadians. Canadians come down quite often and we scan their brains.
Host: Mostly from Vancouver probably, yes?
Dr. Chapek: Mostly Vancouver, yes.
Host: How do people get in touch with you?
Dr. Chapek: We're at amenclinics.com or they can call the clinic at 425-455-7500. That’s our clinic in Bellevue. Well, see that's how they do it.
Host: That's A-M-E-N clinics.com, correct?
Dr. Chapek: Yes.
Host: I’d like to speak just briefly about degenerative diseases which you mentioned a little bit before. For example, Alzheimer's, Dementia, Parkinson. It wasn't on our list of questions today, but it is intriguing. I do want to talk about it a little bit. As we get older our brains tend to function differently. How can we… What causes Alzheimer's? What causes Dementia? What causes Parkinson?
Dr. Chapek: That is a great question and we didn't really use to know and now we think we have an idea about what's happening. It's really fascinating in the past several years. The person leading the charge in this is Dr. Dale Bredesen. He’s a neurologist at UCLA in the Buck Institute and he spent his career studying Alzheimer's, specifically, trying to find the pill that would cure the disease, you know, science failed to do this. There have been over 200 studies, and they all pretty much failed to find the cause and the treatment for Alzheimer's disease and Dementia. And so, but each researcher has their own perspective like, “Oh, it's genetics. It’s the APOA4 allele” or “Oh, it's toxins in our environment” and certainly with Parkinson's, that is a key piece of the puzzle, “Oh, it's insulin resistance in the brain”. Type III diabetes, you may have heard of this as well. Well, in fact, what Bredesen did is took all of their different researchers working in their silos individually and put them together and said, “Oh, we need a programmatic approach. What if we treat all of the risk factors?” and that's what at the Amen Clinics, we look at doing anyway. So it made so much sense to us, worked with him, understood what his approach was. Dr. Amen came up with the BRIGHT MINDS risk factors and wrote the book, Memory Rescue, and so you can look at all of your individual risk factors and put those together and you treat all of those at the same time. It is like tipping the scales instead of headed towards nerve degeneration and Alzheimer's, Dementia. You can tip the scales back towards healthy brain function improvement if you can catch it early enough. And so it's not treating Dementia but it's treating all of the risk factors like high blood sugar, high blood pressure, inflammation, toxins, deficiencies in hormones and nutrients. Those are kind of the big ones.
Host: There’s a lot of things that go into tackling this problem, but includes all the four circles that you mentioned before.
Dr. Chapek: Exactly. Yes, heavy on the biology but the other pieces are really important and brain training is really helpful. Brain exercises like phone apps but also crossword or learning a language. But it’s like you have to get the chemistry right. You do have to get the brain all that it needs and take away the inflammation and sort of flood it with nutrients and antioxidants.
Host: So there is a treatment for these diseases.
Dr. Chapek: Yes. There are strategies that help slow the progression and we try and improve symptoms. We talk about the first goal, let's slow progression. Hopefully, you can live the rest of your life at this level or better. I can't guarantee anything, but yes. There are strategies that work and Dr. Bredesen is published now. First, he had 10 patients who had either early Alzheimer's or mild cognitive impairment, which is a step right before that. Six of them were not able to work and after they did this protocol, the six who were unable to work, were able to go back to work, and 9/10 improved overall. And then he published in the Journal, Alzheimer's, several years ago, I think in 2018. Now, he had a hundred patients with the majority improved. There's a FINGER trial out of Finland and showing that people with early changes were able to actually improve their processing speed and brain function later in life, which we didn't think was possible. And all they did was nutrients, multiple vitamins and fish oil, modify their blood pressure and blood sugar and diet. Some simple things, do some brain games and they improve how their brains were working in 1200 patients.
Host: What do I need to look out for, personally, regarding Alzheimer's and Parkinson's? What are the things that I should notice before I go get a consultation with the doctors and you know what I think might want to get a check for this?
Dr. Chapek: If there's changes in functioning as far as losing your keys, not remembering that the… One of the things is a word-finding difficulty. That’s a very common early sign where meaning, you're talking and you're trying to describe, say, a pencil or something but you can't quite think of the word for pencil-like, “Oh, you know that thing you write with. It’s not a pen. What is it?” That kind of thing, that's very concerning. I would want to get that checked out with your doctor. But other things can cause that, too. It’s not always Alzheimer's, Dementia. Like sleep deprivation, chronic sleep deprivation will make someone look like they have Dementia very quickly.
Dr. Chapek: So there's a number of things that can cause us and younger people as well as older people, hormonal changes, anemia, thyroid problems. A number of issues can mold toxicity.
Host: So it’s important to have general overall good health, take care of our bodies and our brains in terms of our diets, our exercise, our way of life.
Dr. Chapek: Absolutely. And if you have symptoms, get them checked out. See your doctor and look more into what you can do to improve your brain and body.
Host: Dr. Chapek, thank you so much for a very informative hour discussion on the brain, on mental illness, and various topics that we covered today. Hopefully, we can reach out to you again. You have an extremely busy schedule and we can reach out to you again possibly later on at the end of the year and do a follow-up and talk more about this and find out what's going on with you. But thank you so much for being on the Lifelong Wellness podcast today.
Dr. Chapek: It’s been my pleasure. And you know it's never too late to do something to improve the health of your brain and so I hope that your listeners got that from today.
Host: I’m sure they did. Thank you very much.
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