Your Brain on Covid-19 Long-Haul, Dr. Galland video and transcript - Aug 1, 2021

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Your Brain After Covid-19, Dr. Galland

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0:00:01.7 Scientists are increasingly concerned about the potential impact of COVID-19 on brain function and cognition. The recent meeting of the Alzheimer's Association International Conference in mid-summer 2021 received a lot of attention because of two presentations. One from the University of Texas Health Science's Center, looked at the impact of COVID-19 on people over the age of 60, and they found persistent forgetfulness, which was unrelated to severity of acute infection, but it was more likely in those who had had loss of smell. Another study from NYU medical school studied blood markers in hospitalized patients who were over the age of 60, and most of them showed changes that are associated with Alzheimer's disease. Now these were uncontrolled observational studies, but they reflect the same kinds of findings from large controlled studies done with younger people, not just the elderly, in the United Kingdom. In one study, there were 40,000 people in the UK Biobank database who had had MRIs of the brain done just before the pandemic.

01:32.2 They were randomly approached about having repeat brain MRIs six months after the beginning of the pandemic. About half of those patients had developed COVID-19 between the two scans, and the other half had not. Those who had recovered from COVID-19 showed significant changes in their brain scans, and these were not people who had been sick, only 15 out of 394 had actually been hospitalized. There was a loss of gray matter, which is a loss of brain cells in parts of the brain that regulate spatial memory and complex decision-making. These are areas that have direct connections to the nerves that carry the sense of smell and taste into the brain. In an even larger study from the UK that looked at cognitive function, not at anatomy, survivors of COVID-19, including those with mild illness, were found to have significant cognitive testing defects, when they were compared to controls who were matched for age, gender, education level, income, racial-ethnic group, and pre-existing medical disorders. The deficits affected multiple cognitive domains, but they were most pronounced on tests that assess verbal problem-solving and visual selective attention.

03:03.3 Now, those are areas that require proper function in the parts of the brain that were damaged in the MRI study, which would suggest that these are real findings. What these studies mean is that the virus that causes COVID-19, which can enter the brain directly through the nose, even with a mild infection, can damage important centers of cognitive function. Now, there are a number of warnings from the 1918 influenza pandemic that I think are relevant here. That pandemic was followed by epidemics of neurologic disease, which were illustrated in Oliver Sacks' book, Awakenings, which was adapted into a movie starring Robert De Niro and Robin Williams. The most dramatic of these was the sleeping sickness, encephalitis lethargica that De Niro suffered from in the movie. Now, there were new diagnoses of post-influenza brain disease for 10 years after the 1918 pandemic up until about 1929, and they reached their peak in 1923, four years after the pandemic's end. So maybe we haven't yet seen the full impact of COVID-19 on cognitive function in people who have been sick.

04:39.5 Now, how can mild COVID hurt the brain? Well, it seems that when COVID-19 impacts the brain, there is a very low level of inflammation, very different than what happens in the lungs and the respiratory tract or in the blood vessels. The number of viral particles is quite low, and the level of inflammation, although some inflammation is present, is very mild. The brain's response to this virus is to lose brain cells or neurons through a process called apoptosis, that is the cells just drop out rather than mounting a strong inflammatory response. So the solution to apoptosis of brain cells is to stimulate the production of a protein that is normally made in the brain, BDNF, also known as brain-derived neurotrophic factor. Now, BDNF supports the survival of neurons and strengthens their connections to other neurons. Loss of BDNF causes cognitive dysfunction, and people who have severe COVID-19 show a decline in blood levels of BDNF, but the real place where BDNF is important is in the brain. So what you see in the blood is only a remote indicator of what's happening in the brain, and maybe for recovery, you actually need a high level.

06:12.3 There are a number of lifestyle influences on BDNF. Among the most interesting are the effects of diet and the gut microbiome, which is the collection of microbes, bacteria in particular, that live in the gastrointestinal tract. Gut bacteria produce a substance called butyrate. This is a short-chain fatty acid that is made in the large intestine, it diffuses into the body, it travels throughout the body and it reaches the brain. And in the brain, it stimulates an increase in the production of BDNF. Mice that are germ-free, that is they have no bacteria in their bodies, have reduced levels of BDNF. And giving them butyrate alone without replacing the bacteria, activates the gene for creating BDNF, increasing the brain levels.

07:09.4 Now, BDNF enhances a process called neuroplasticity, which is the brain's ability to generate new connections and heal itself after injury. Studies in mice have shown that a Western diet, which is high in refined foods and in sugar and in unhealthy fats, impairs neuroplasticity. Among the dietary components, aside from the general pattern of diet that have been most studied in enhancing BDNF is a substance called curcumin, in particular, in its relationship to memory, and a part of the brain called the hippocampus.

07:55.2 Now, curcumin is a group of bioflavonoids that are found in the spice turmeric. And the hippocampus is the chief center for memory in the brain. Well, laboratory studies have shown that curcumin raises brain BDNF and increases neuronal responsiveness and survival. Stress induces the formation of steroids like cortisone or in animals corticosterone, and their impact is to reduce BDNF and decrease neuroplasticity. Well, curcumin protects hippocampal neurons from steroid-induced toxicity. There are a number of clinical trials in humans demonstrating a positive effect on supplementing with curcumin and levels of BDNF measured in blood, either in the serum or in the plasma of blood. At a dose of 500 to 750 milligrams a day, curcumin elevates the levels of BDNF in the serum of diabetics. Without curcumin, the serum BDNF is depressed in diabetics. In women who have premenstrual syndrome during the late luteal phase, the premenstrual phase, taking curcumin increases serum levels of BDNF and relieves the symptoms of PMS. And in people with depression who also have low baseline levels of BDNF, taking 1000 milligrams a day of curcumin increases plasma BDNF and improves the clinical response to antidepressant drugs.

09:40.0 Now, there are other substances and other activities that have been shown to enhance BDNF in the laboratory and in real life. Exercise enhances brain BDNF in laboratory animals, aerobic exercise does it the best, and swimming is probably the best way to achieve that. And niacin, vitamin B3 has also been shown to increase brain BDNF. A study in humans found that whole coffee fruit concentrate at a dose of 100 milligrams, this is low in caffeine, it is rich in the polyphenols that are found in the coffee bean, that dose increased plasma BDNF by 143% in a random group of human subjects. Omega-3 fats have an effect on BDNF and on neuroplasticity and a process called neurogenesis, which is the creation of new neurons. In a pre-clinical review, omega-3 fatty acids were found to enhance neurogenesis in the hippocampus of adults. Now, there are only two areas in the brain where neurogenesis can occur, the hippocampus is one. It also promotes neuroplasticity and supports the growth of neurons and their connections with each other.

11:08.9 The benefits have been attributed to two fatty acids that are found in fish oil, EPA or eicosapentaenoic acid and DHA or docosahexaenoic acid. But alpha-linolenic acid, sometimes called ALA, which is found in vegetable sources of Omega-3s like chia seeds and flax seeds and hemp seeds, and also in leafy-green vegetables, alpha-linolenic acid also protects the brain. And this was demonstrated in rodent models of stroke where it increased brain BDNF. Now, in the clinical trials of EPA-DHA, which have looked at the cognitive effects, the dose is really important. At 1200 milligrams a day of EPA plus DHA, there was no impact in patients with cognitive decline. At 2200 milligrams a day, there was an enhancement of memory in healthy older adults. And these are controlled clinical trials. At 3000 milligrams a day, when combined with the antioxidant alpha-lipoic acid, EPA and DHA slowed cognitive decline over a 12-month period for patients with Alzheimer's disease.

12:32.3 Now there are other substances that have been shown to enhance neuroplasticity and cognitive function, natural products that are found in food, although they haven't been demonstrated to have a direct effect on BDNF. One of the most important of these is fisetin, a bioflavonoid that is most concentrated in strawberries. A review from the SOC Institute looking at pre-clinical models, that is these are animals and lab models, found that fisetin prevents development and progression of multiple neurologic disorders and reduces age-associated changes in the brain. Fisetin in food, and it's very well-absorbed orally, promotes hippocampal neuroplasticity. In a randomized control trial of people who had just had a stroke, a dose of 100 milligrams a day of fisetin for seven days improved the clinical form of treatment and reduced the serum markers of inflammation, including CRP or C-reactive protein, and two other markers MMP-2 and MMP-9. Now, one cup of strawberries has about 25 milligrams of fisetin. So this was the equivalent of eating a quart of strawberries a day for seven days.

13:52.8 Another bioflavonoid with important demonstrated neuroprotective effects is luteolin, which is found in a number of vegetables, probably most concentrated in celery. A review from the University of Missouri looked at diverse mechanisms of neuroprotection for luteolin, most of them were based on decreasing inflammation. In a laboratory study of stroke, luteolin reversed learning and memory deficits and preserved neuro-hippocampal neuroplasticity. In a clinical trial with humans at doses of 45 and 90 milligrams a day, luteolin enhanced brain performance, muscle oxygen extraction and oxygen delivery to the brain. In this clinical trial, it was combined with another polyphenol, mangiferin.

14:48.2 Resveratrol is a polyphenol that's been extensively studied in the laboratory and in humans. And there are 15 randomized control trials registered with the National Library of Medicine that have shown cognition enhancement in humans by resveratrol supplementation. In post-menopausal women, a low dose, 75 milligrams a day was found to enhance blood flow to the brain, that cerebrovascular function and cognitive function. In older adults, 200 milligrams a day improve memory and measures of functional connectivity in the hippocampus. That's exactly the area that we wanna target.

15:35.1 In another study of healthy older adults, it took 1000 milligrams a day, 300 didn't work, to increase psychomotor speed, which is the rapidity of responses and movement. And in veterans suffering from Gulf War Syndrome, 200 and 600 milligrams a day, improve symptoms. That this is all likely to be due to an improvement in neuroplasticity is based on studies in rats where rats who had suffered from strokes or diabetes, resveratrol administration improved neuroplasticity in those animal models. So there are a number of approaches that you can take right now to enhance brain function if you've suffered from COVID-19 by enhancing the synthesis of BDNF. First, diet. A whole foods, low sugar diet, high in vegetables and Omega-3 fats. You can supplement this diet with prebiotics, a variety of probiotics, and even with butyrate itself. Butyrate is very well-absorbed when taken orally.

16:52.3 Regular exercise enhances BDNF. If you have chronic fatigue as part of your long COVID syndrome, you're gonna have to be very careful about how you exercise. And swimming seems to have the greatest effect, but any form of aerobic exercise that you can do every day without crashing, is likely to be helpful. There are a number of supplements that you can take. Bioflavonoids include curcumin, 1000 milligrams a day, fisetin at doses of 100 milligrams a day or more, and luteolin at a dose of maybe 150 milligrams a day or more. That is not very well absorbed from food, so a liposomal form will be more active. And resveratrol, which has a wide dose range, 75 to 1000 milligrams a day, also taken with food. Omega-3 fats may help enhance brain recovery. The dose that is likely to be needed is 3000 milligrams a day of EPA plus DHA. In addition, the antioxidant alpha-lipoic acid at a dose of 600 milligrams per day. Niacin and its derivatives may be helpful, in particular nicotinamide mononucleotide, NMN, at doses of 250 to 500 milligrams per day. And whole coffee fruit extract at a dose of 100 milligrams a day.

18:29.8 More information is available in two videos that I created on healing and understanding long COVID. Healing Long COVID is a YouTube video intended for all audiences. Understanding Long COVID is on Vimeo and it's a comprehensive presentation of PowerPoint for health professionals. The easiest way to access these is going to my website, drgallon.com, selecting the coronavirus guidebook and clicking the links to these presentations. Next to the coronavirus guidebook is another document called The Gut Microbiome and COVID-19. And there I have a lot of information on how to restore a normal healthy microbiome after COVID-19, and in particular, to naturally enhance the production of butyrate to help recovery, not only of the gut, but of brain function.

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Many of the nutrients mentioned increase activation of the Vitamin D Receptor

Vitamin D Receptor activation can be increased by any of: Resveratrol,  Omega-3,  Magnesium,  Zinc,   Quercetin,   non-daily Vit D,  Curcumin, intense exercise,   Ginger,   Essential oils, etc  Note: The founder of VitaminDWiki uses 10 of the 13 known VDR activators

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VitaminDWiki pages containing LONG-HAUL in title

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COVID-19 in VitaminDWiki

COVID-19 treated by Vitamin D - studies, reports, videos

• As of March 31, 2024, the VitaminDWiki COVID page had:  trial results,   meta-analyses and reviews,   Mortality studies   see related:   Governments,   HealthProblems,   Hospitals,  Dark Skins,   All 26 COVID risk factors are associated with low Vit D,   Fight COVID-19 with 50K Vit D weekly   Vaccines   Take lots of Vitamin D at first signs of COVID   166 COVID Clinical Trials using Vitamin D (Aug 2023)   Prevent a COVID death: 9 dollars of Vitamin D or 900,000 dollars of vaccine - Aug 2023

5 most-recently changed Virus entries

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VitaminDWiki pages in both Virus and Vitamin D Receptor categories:

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VitaminDWiki pages in both Virus and Resveratrol categories:

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BDNF occurs in 132 pages in VitaminDWiki as of Aug 2021

Search for BNDF Examples

• Nerve growth and survival depends on BDNF (Brain-Derived Neurotrophic Factor), which is associated with Vitamin D
• Beneficial action of resveratrol: How and why (BNDF, etc.)– Feb 2016