Post traumatic stress disorder (PTSD) can manifest in many ways and can have a devastating effects both physically and psychologically.
In the US it is estimated that anywhere from 1-3% of the population may be living with PTSD, and that figure for military personnel is believed to be closer to 30%. Dr Brandon Brock has worked extensively with injured military veterans, PTSD and traumatic brain injuries. Work which has recently earned him a humanitarian award from the International Association of Functional Neurology and Rehabilitation.
Dr Brock joins us today to give some insight into the many opportunities that taking an integrative approach can have in helping those living with PTSD.
Covered in this episode:
[00:46] Welcoming back Dr Brandon Brock
[04:44] Award-winning work with PTSD
[07:06] Defining PTSD
[09:36] Gaining trust
[12:54] Supporting carers
[14:55] Post-war reintegration
[18:05] PTSD vs other mental health disorders
[20:57] Unravelling triggers and underlying health issues
[22:48] Dr Brock's education style
[26:55] PTSD requires an integrative approach
[30:36] PTSD and Pain
[32:03] Is there a place for medicinal cannabis?
[36:21] Supplements of value in PTSD
[41:26] Herbal Medicine consideration
[43:44] Future prospects and prognosis
[45:36] What not to do
[47:30] Podcast dedication
Joining me on the line today is Dr Brandon Brock. He’s a certified chiropractor, Family Nurse Practitioner, and a functional neurology diplomate with multiple clinical interests, and I mean this! Including; functional integrative neurology, nutrition, wellness, and general medicine.
His clinical time is spread amongst three practices in Dallas, Texas. At Cerebrum Health Practices, Innovative Health and Wellness Group and Foundation Physicians Group. He has developed thousands of multidisciplinary hours of curriculum pertaining to neurology, nutrition, physical diagnosis, pharmacology, immunology, and endocrinology.
Dr Brock is currently a lecturer at the Academy of Osteopathic Science and vice president of the International Association of Functional Neurology and Rehabilitation. He's also a board member of the American Academy of Integrative Medicine. Dr Brock received the most outstanding functional neurology teacher of the year from the ACA Council of Neurology, four years straight, and two times from IAFNR.
Recently, Dr Brock received the Humanitarian Award as a result of his research on injured military veterans, PTSD, and traumatic brain injury, which we'll be podcasting about today. And I'd like to warmly welcome triple Dr Brandon brought back to FX Medicine today to talk about his work with PTSD. Welcome back, Brandon. How are you?
Brandon: Hey, I am good. It is a super pleasure to be on here with you guys. I always love to be able to chat with you guys, talk and, you know, hopefully, educate people and just have a good time.
Andrew: And that you do. And I’ve got to say I was so impressed with my first FX Medicine podcast with you. That was before your Mindd talk...Mindd Forum talk in Australia, where I recently met you.
Now, since then, you've completed not one, not two, but three doctorates. Tell us about what you've been doing.
Brandon: Well, if you ask my family I've been treating all kinds of problems, but I, you know, I became a chiropractor some years ago. I got a doctorate in nursing from Duke University. Which is the number-one doctorate program in the country right now. It's a very, very good school. I enjoyed my time there. And then I did a post-doctorate work in, really, statistical research. I was a global clinical research scholar, where they picked just certain people from different countries and we all came together at Harvard and did one, you know, sort of giant class. Where we had to go through and do research projects, and it was just a great time because we got to meet people from all over the world. They don't put people from your country in your group, so I was in a group with, you know, a person from Italy, a person from Palestine and, you know, a person from China. And it was really interesting because we all had to get together. And we were all in different time zones but we had to get our projects done. And the projects were really, really, really interesting.
Because they would give us a study that had already been published, like the Framingham study. Which is very, very old and they would give us the data set, and then we would have to come up with a new question, that had never been published, and then go through and redo the statistical analysis to determine if that question had any relevance to the topic. We had to do that five times.
Yeah, we had to do that five times, then we had to write our own sort of thesis-type paper and, you know, a whole bunch of other stuff. But it was really a good time and, you know, just a lot of other nutrition work and fellowships and stuff like that. You know hey, just doing everything I can to learn and put stuff together so that my patients can get something out of it and I can educate and, you know, be in a podcast with you guys and have a good time.
Andrew: Well, I’ve got to say, talking about receiving stuff and learning things. What I love about you is that you give back. And you, you know, have...you've been awarded a Humanitarian Award for your research on military vets with PTSD. Tell us about that award, first. What was it for?
Brandon: Well, you know, we really ventured out into a very, very interesting world and that is the world of vets. You know, combat veterans. I've got a special place in my heart for vets because I really feel like...
Brandon: ...you know, these are the guys that go out all over the world and it doesn't matter what country you're from. It doesn't matter if you're from Australia, or if you're in Europe, or if you're in America, you know, fighting for peace. And, you know, everybody has a different opinion on war, and that's really not my big piece here. My big piece is that people were sent, regardless of what they thought, and they fought. And then when you come back, you know, some people have limbs that have been blown off and all kinds of things. And they go and they get dealt with. But the one thing that's really invisible is the post-traumatic stress that they may have, and it's...there's not a tag, there's not a mark. You can't see it, and people struggle with it internally.
And they may be walking down the street and nobody really knows that they have so much stress, and so much anxiety, and so much depression, and so much pain. That maybe they are agoraphobic and they don't want to leave their home. Or maybe they can't relate to their family anymore so their marriages disintegrate, or they can't bond with their kids because they saw a child get killed. I mean there's so many things that I saw. It really moved me.
And we wanted to do whatever we could. You know, whether it be social services, or neurological activation or, you know, we even helped people get jobs and stuff like that. So it was really a project of reintegrating people that had come back and were just really, mentally decimated and needed something in their lives that was meaningful. Because a lot of these guys come back and the only thing they know how to do is battle and, well, you know, you can't...that's not a job, really, anywhere. And so we really wanted to see them get better so that they could use their skills elsewhere.
Brandon: Well, so you're going to get a couple of answers for me. And so, you know, there's the neuropsychology world that has these really strict definitions. So when you have people that live...I kind of equate myself to living with the Wolves. I was part of the Wolfpack. I didn't have PTSD and I wasn't a vet, but I lived with all these people, that were there suffering from this condition, so I got to observe it. And so I kind of...it's not that I have my own definition but I have my own thoughts, you know.
I think people get PTS. You know, you could get PTS from, you know, a car wreck where, you know, for a few months, you just have post-traumatic stress and you're scared of cars and it goes away within a few months and it kind of heals up and it's not a big deal. Then there's really PTS that turns into a disorder, where it lasts for months and months and months and it doesn't resolve and it just kind of keeps gaining traction. And, you know, there's tests that can really kind of harsh this out.
But you've got to understand something about PTS or PTSD. It is really the mother of all mental conditions. Because it can have depression in it. It can have anxiety in it. It can take somebody who may be, sort of cycles fine, and can make them full bipolar. Some people can become, you know, borderline psychotic. So all of the underlying psychological diagnoses can really fit as part of PTS or PTSD. And what we have is sort of a superstorm of mental emotions and mental dysregulation and it's very difficult to...you know, every case is different.
So somebody may be really struggling with anxiety. Somebody may be really struggling with depression. Somebody may be really, you know, identifying with suicide or even homicide. So identifying the subcategories of that condition is very important. And so it's not that there's just one test that really says, "Absolutely. This is it. This is what they have." I mean you've got to do a clinical evaluation. You've got to listen to that person. There are some tests like a caps test that you can do that can give you some insight on how severe it may be.
But what I found is this, just getting to know them, gaining their trust, understanding what their fears are, and what they're suffering with. Has been one of the greatest things that gives me insight into that person and then I can walk away and say, "You know what? I think this person's really suffering and they need help." And I think that that was one of the things that was most difficult because by the time you get that deep with those individuals, you almost have PTSD yourself. If you care for them and if you care for what they're going through, it starts to rub off on you and you start to feel it so much that you just can't help but take some of that despair with you.
Andrew: Does any clinician or should any clinician be involving the close family, in helping reach a diagnosis?
Brandon: If you take somebody with post-traumatic stress or if they, you know, got this disorder and they come home and then their family's breaking apart, it will magnify a million times. I had a Navy SEAL one time tell me, he goes, "Man, I was in the war and it gave me, you know, a lot of post-traumatic stresses," he goes, "But my wife gives me 10 times more." You know, and I was like, "Oh my gosh." I mean...and I don't think he said that as a sexist remark. He just said that as a... You know, I came home, I was a different person. She had no idea how to relate to me and I'd no idea how to relate to her. It's almost like we had to start dating over again. But he was more calloused. He didn't have as much empathy. He had been trained to be, you know, basically,, a battlefield killer. And so it was difficult for him to sort of butter himself up, and break himself down to the point to where he could feel emotions the way maybe a woman would want him to.
So one of the things I really love to do...and you’ve got to understand something, I'm not a psychologist. We had psychologists that helped us with this. But, you know, you're always a psychologist when you're a doctor, to an extent, because everybody tells you their problem. And so I like to get couples together so that I could hear both sides of the story and I always had to get them to meet in the middle. I had to teach the vet that maybe they need to soften up a little bit and understand that a woman doesn't understand some of these things. And then I had to get the woman or the wife to understand that this is not the same person, so you're going to have to meet him in the middle a little bit and help get him through some of these tough times. And when we found out that we could do that, a lot of marriages got better. And a lot of...the big thing is a lot of addictions got better. Because there were so many people that were drinking their way through their pain, or using other drugs to get through this hole they have in them because they can't fill it because nobody understands how they feel, so numb it. They just numbed it. And it really was good to have family there, you know, and it was an amazing thing to see families restored. You know, they’ve got kids, they’ve got homes together, they've got all kinds of stuff, and these are wonderful people. So that was a great thing to be able to see happen. And it didn't always happen, but I think we made a pretty good effort to see, you know, that part of their dynamics restored. And that's an awesome thing, man.
Brandon: Yeah, you know, one of the things and that's....I'll touch on that a little bit more. And that kind of goes into; some people come back and they feel may be expendable and they feel like they don't have any skills, talents, or anything to offer society because they left it all back in the war.
And, you know, one of the things I noticed is that there was a lot of substance abuse. And there was a lot of, you know, just pity that was, and I don't say that condescendingly, but there was like, "Oh god, you know, what am I going to do?" And that turned into, really, shame. And shame, the definition meaning, you know, they don't love themselves. And when they don't love themselves, they spiral into depression and anxiety, and then that turns into inward hate, and that turns into irritability and anger. And then that anger turns into reclusiveness, and that reclusiveness turns into disconnection from society. And then that turns into disability.
So, you know, we saw this sort of pattern of spiralling down. And then the other thing that we saw is that a lot of the staff, at some of the smaller, you know, VA centres, that we're supposed to take care of these individuals, weren't really anticipating people… they knew people were going to come back with blown off limbs and stuff like that, but they weren't really expecting the sheer number of people coming back with just mental strain. And I think that that was something that was greatly underestimated and there just wasn't the… there isn’t, the personnel to take care of it. So it's really important that there's other staff all throughout the country that get trained, or understand it, or work with people in a way where it's sympathetic, understanding, give them outlets and options, and then really, is just a champion for them and cheers them on. It goes a long way.
Andrew: So I think you've answered my next question, and that was, you know, we saw how some military personnel cope with reintegration into society by having that sort of safe place if you like, to complete some tasks if you like, for which they were trained i.e. the movie “Sniper." Where after Iraq, you know, he'd take fellow vets who suffered PTSD and he'd take them out of the shooting range. In Australia, one of the great organisations we have here is Mates For Mates. And, you know, you have vets looking after vets because they know exactly what pain they're going through, or at least to some degree. They know that sort of pain. How important is it to have vets looking after vets?
Brandon: Well, I will say this about the vet community, and it doesn't matter how sick you are or how damaged you are, it's a brotherhood. And one thing they don't do is depend on government programs to give them, or take care of them, in every situation. They realise that that's probably not going to happen. And, hey, look, I don't want to come down on the VA system. I think they do their best with the resources that they have, okay? I think they're probably underfunded and understaffed…
Andrew: But they need more resources, that's right.
Brandon: Yeah. But what they've done is, they've come together and they've said, "We're going to build a community where we help each other," for the exact reason that you just said and that is, "I understand what it's like to be there." And you can sit there and help individuals like this all day long. Unless you've been there, and been shot at, or been shot, or had your friend killed, or been blown up, you really, no matter how hard you try, can't put yourself in that exact situation.
So when they're together...you know, in our clinic, we would let them all sit in the room together. And we didn't do group therapy because we realised it was super counterproductive. What we did is, we would let them sit in a room together and talk. And by the time the week was out, they had all bonded on their own, they'd all done their own group therapy, they all held each other accountable, and that's the military way of working, it worked out beautiful, and we didn't really have to do a lot of intervention there. We didn't have to bring...you know, we didn't have to have a psychologist sit down and try to drag feelings out of all of them, and that does not work. But when they do it around each other, it became super therapeutic and, you know, we did things where they got to go out and shoot, and we did things where they got to go out and hunt, and we did things that were very similar to what they did when they were, you know, in battle. And that was also an outlet of energy for them that I think was very beneficial.
So a lot of this therapy was just us guiding them in a direction. It really wasn't some magic thing that we did, it was just putting them around like-minded individuals that have been in similar situations and then giving them outlets, and then hooking them up with resources, social sources, that could say, "Hey, here's a person that's hiring, here's a person that knows your skills and talents." And a lot of people got back on track. And it was...you know, those were really, really good things aside from the neurology and other stuff that we did with them.
Brandon: You know, PTSD usually has triggers. A lot of times they'll be able to say, "It was this one moment in time that messed me up and I just can't get through it." But what we found out is people were deployed for such long times and they were away from their families and they were in a foreign place and just the accumulation of not being in a familiar, loving atmosphere with their family, started to get to people. And everybody had a different threshold.
You know, if somebody comes in with just depression and they've had it their whole life and there wasn't a trigger, you know it's depression. If somebody comes in with anxiety, maybe it's the same thing. But if somebody comes in and says, "You know what? I just went through a terrible situation and I haven't been the same since," you need to start thinking they're having stress because of the event that happened. That's post-traumatic stress. And just to kind of add to that, it really comes in all different shapes and sizes. I mean, I've had people with post-divorce, post-traumatic stress a lot. Losing a child or a loved one, post-traumatic stress. It doesn't just have to be war victims or vets. We see it in a lot of the population.
Andrew: Right. What tests confirm the diagnosis? How do you tell it apart? Do you see physiological changes or is it largely based on psychological testing?
Brandon: Well, it is largely based on psychological testing and there's really talented neuropsychologists that can do some really amazing stuff to differentiate maybe which piece belongs to their past and maybe which piece belongs to what happened. And, you know, there's a skill for that and there's people that are very, very good at that.
You know, there's standardised tests for depression, there's standardised tests for anxiety, there's standardised tests for even PTSD. But, again, they can all be mixed together so it takes some skill and talent to kind of pull it apart. What we realised also is that a lot of people carried emotional baggage into war with them, and it amplified it, and turned into something else, you know, which is devastating. You know, somebody might have had some childhood abuse, so they had a little bit of, you know, already anxiety or maybe a little bit of depression or a little bit of something else. And then when they got into the battle scene, it took those feelings that they were doing pretty good with, right? And then they got a head injury, so their brain function went down. And then they saw something devastating, so their limbic system ramped up. And then their orbital frontal system didn't do well with, you know, sort of, like, diminishing those memories and it turns into a cascade that builds and builds and builds and the person gets very sick and they develop PTSD.
Andrew: So with your expert training, how do you uncover this sort of...how do you go back in time? How do you uncover the layers of the onion to work out what areas of the brain were first affected, or can you just initiate therapy and it tends to resolve? We tend to evoke neuroplasticity? Like, what happens here?
Brandon: Well, it's really interesting because if you read some of the literature, the right orbital frontal lobe is kind of one of the areas that they're suspecting that is part of the PTSD sequelae. But, at least 80% to 90% of people with PTSD have also had a mild traumatic brain injury. Which means there may be other parts of their brain involved as well.
So you might have somebody with the classic PTSD area that might be involved but then the other side of their brain may be damaged or another part may be damaged. And then we started finding things like they have an endocrine disorder and now their testosterone is lower, their oestrogen is low, and oestrogen is very neuroprotective and testosterone is too.
And then we found that a lot of people came back with infections or environmental exposures, which made more inflammation, which further damaged the brain. And then we started finding things like, you know, bad thyroids or bad guts, which made more inflammation that further perpetuated a bad brain.
So if you take it all and you put it all together, it's a stew. And it's got so many ingredients in it. You've got to start picking them out one by one and it's very, very difficult to determine which one you need to pick out first, or which one's perpetuating the entire neurological process. And there is no one like...you can't tell somebody just to suck it up, or you can't talk somebody out of it. A lot of times, their brain simply just doesn't process that.
Andrew: I've got to say, Brandon, hearing you educate me and so many others at the Mindd Forum in Sydney, Australia, I think that was in May. I must say if anybody's going to be a student of yours, they need black pen, red pen, ruler, highlighter, 2 litre flask of coffee, because...
Brandon: And a flask of whiskey.
Andrew: ...because you really go right...you dive deep. You really do tease apart everything. And you are such an expert at this neurology. Like, I was shaking my head. I was going, "I need my Anat & Phys books, now.”
So, do your courses cover this? Do your courses go right back to reteach us what we learned so many years ago, to recap and sort of go through all of the neurophysiology?
Brandon: Well, I think, right now I wouldn't want to do something that I would consider special. And this is going to be surprising to a lot of people. But I'll go back and talk about history and I'll just say this: the person that you need to learn neurology was with Dr Ted Carrick. And he is, of course, a brilliant person and a mastermind at functional neurology. And, you know, he's the one that kind of showed me some of the beauty of it and what it could do, and I admired him for that, and still do to this day and I know he helps a lot of people.
And, you know, then, really, I learned an enormous amount of functional medicine from, you know, Datis Kharrazian, who I did functional neurology seminars with and anybody can go back and do those. They're all online at functionalneurologyseminars.com. You can just go back and re-watch those and learn neurology at your own pace. And, you know, really, his contribution to my understanding of functional medicine and understanding nutrition is something that I'll cherish forever.
You know, there's psycho-pharmacologists like Steven Stahl who I studied his stuff and learned psychopharmacology and absolutely brilliant work. And so I got to learn the pharmacology part of that. And then, you know, really I've got some nurses in my life that taught me how to boil myself down, get rid of my ego, and learn how to care for humans that can't clean themselves or take care of themselves, and taught me how to be humble. And then there's some really good medical doctors that would pull me to the side and say, "Hey, you know, what are you doing? This is bad medicine. You need to do this, this way, and this, this way." And so if it was a small surgical procedure or even the usage of substances like controlled substances, that they would step in and intervene.
You know, I'm one of those guys that's very fortunate because I have, you know, six or seven people that all really interjected themselves into my life and the only ability that I had was to absorb the information from each of them and put it together in a way where I felt like it made me. And my individuality is just trying to integrate things. I'm just a cult of all the personalities that have really been in my life. I can never take what those people contributed to me. The only thing I can do now beyond that is take that, and do my best with it, and make it something that can really start to make what I call a cross-trained practitioner, an integrated practitioner. Where they've really learned their neurology, and they've learned their nutrition, and maybe they've learned their medicine, and they've learned their diagnosis, and they've got experience, and they've sort of been through the battlefield of patients and they've seen things that they can't fix, so they got to go figure it out. And they've won some and lost some, and they just have to chalk it up to their experience. You know, if I can do that, I feel like I can sort of contribute my piece.
Andrew: Well, you've certainly contributed a lot. What has probably been the biggest revelation that you've made about how we previously cared for patients with PTSD and how we should be changing our care moving forward?
Brandon: Yeah, well, I think the answer is going to flow not just through PTSD but all of medicine and all of healthcare. You know, let me tell you, and I don't have a problem saying that's around any group. Medicine has been put in, healthcare in general, has been put in silos, individual silos. Like, I'm just a doctor with these hearts, but what they don't realise is that there's multiple other systems that can affect the heart, but they don't pay attention to it because they just do hearts. So with PTSD, you can't just say, "Okay, I'm a neuropsychologist and I can tell you what your problem is."
But then my question is, "Well, what are you going to do about it? Are you going to sit there and talk them out of it?" I mean this person has five infectious diseases, three of them are viruses, they've got a terrible gut, they can't digest, their testosterone is nothing. Their marriage is in shambles, you know, they've got, you know, four or five major musculoskeletal injuries all creating inflammation so their inflammatory markers are up.
So my thing is this, to be an effective, really effective PTSD practitioner, or traumatic brain injury practitioner. Or really, any kind of chronic illness practitioner, you have to be able to do one thing, integrate. You have to do your best to become a jack of multiple trades. And if you can't do that, you're going to leave a piece of the puzzle out and you're only going to get a certain percentage of the correction made. And there is no one specialty that does the whole job. Even if you do shoulder surgery. You may be able to put that back together but if they have an inflammatory disease or an arthropathy, you have to go back and look at the immune system so that the actual surgical correction doesn't become super degenerated and now they have chronic pain.
So it's one of those things where I would just say this: with PTSD I've learned this, it's a mixed bunch. With all of these chronic illnesses, it's mixed. This is the reason why I took time out of my life and went and got educated in so many different areas and I just found the best people. And I was, like I said, fortunate enough for them to invest some time and energy into me. You know, and so now I have a company, it's called BTB Health Systems and we're doing seminars where we're doing just that. I have several different types of practitioners. We're putting it all together and we're teaching things in a way where we're kind of taking out some of the minutiae and just putting it together in a clinical way where you look at it from different angles and then say, "This is how you go after it."
Andrew: BTB Health Systems: Brandon Tara Brock?
Brandon: Yeah, you can go on. You can find it on the internet, you can find it on Facebook. It's one of those things where, you know, a couple of us kind of got together and we started realising that, you know, this is a real...it's a real problem. We don't have enough integrative practitioners.
So btbhealthsystems.com got put together and we got some vendors where there's labs, there's nutrition companies, there's laser companies, there's other device companies. They all realised the same thing. So we all pulled together so that we can make a seminar series that's really truly integrated and as good as we can do it at this day and time.
Andrew: Yeah. There's so many places we could go with regards to the presentation of PTSD and I guess one of them is pain. Now, you mentioned lasers there. You use the Thor Laser?
Brandon: There's all kinds of low-level lasers. I like low-level lasers because I can, you know, do inter-cranial stuff. And the literature is coming out now showing that, you know, there is penetration in the skull and there is mitochondrial enhancement, and there is down-regulation of inflammation because of glial cells. You know, I think it has a part. I think nutrition has a huge part. I think neurological activation has an enormous part.
In some patients, there has to be medication. Because they're just that there...if there's enough tissue that's damaged or destroyed, it has to be there. But you mentioned pain, and let me go back to pain. Pain is pain and it's nociception, like my shoulder hurts. But what we find a lot of times in PTSD is that pain turns into suffering, and suffering turns into a true mental mental issue. And so sometimes we have both. Bad knee, bad hip, bad back, and their suffering which really perpetuates depression and anxiety and the feeling of hopelessness. And there's a very fine line between pain and suffering. And when you find that line and you can help both, you've really done something special for that person.
Andrew: So I've got to ask along that lines, a bit of a controversial therapy still, and that is the use of cannabis. And I have to sort of ask for the balancing act on this. How do you... What are your thoughts on the therapeutic use of cannabis versus the issues of substance abuse that you mentioned earlier? How do you balance that one?
Brandon: Well, you know, I'm going to try to say this in a way that is politically correct, safe, and accurate as possible. The first thing I'll say to preface this is, I am not a cannabis, or THC, or marijuana expert, and I live in a state where we don't prescribe it.
Brandon: So I'll throw that out front. But then I'll say this, there are definite medicinal components of CBDs and even THC that make a big difference in pain, that make a big difference in mental function. And I don't even think we know all the things that it really does yet. I mean we have seizure patients that do well on it. There are people that can't sleep that do well on it.
But one of the things that's happened that is concerning me is the hybridisation and then the concentrations that are being used. So there's now people that are extracting 100% pure THC and not the cannabinoids or the CBD, but the THC. And, of course, everybody makes claims about it. But what I've seen is most of the people that come into my office that use that day in and day out, they are really starting to almost act psychotic.
And, you know, I would just say this, nature made certain types of proportions of each one of those chemicals for a reason. And so now we're getting into an age and a time where everybody is sort of monkeying with it. And it'll happen, you watch, they’ll genetically modify it. They'll hybridise it, they'll change it, they'll renovate it. And I don't know if it'll keep the same medicinal properties. I really think what needs to happen is there needs to be more University research done so that we can really see which strains, which concentrations work best with which conditions. And I know there's a ton of research out there already, but there needs to be a lot more.
Right now in some of the states and some of the places in the United States, you've got kids in their grandma's basement growing this stuff and then selling it. And I just don't know if that's the right way to do it.
Andrew: No, it's a hard road to travel along this one. It's like I too have issues with the over-concentration of one entity because you're getting into a pharmacological aspect there.
Just like we saw with Rauvolfia and Reserpine decades ago now. Reserpine very unstable, Rauvolfia isn't that unstable. Same sort of issues with opium poppy versus morphine or heroin or any of those opioids that you extract from the plant. As soon as you take that balance out, you're getting a very strong effect but nothing to balance it.
Brandon: I think your example of opium is 100% accurate. I mean, I get this argument all the time that, you know, marijuana has been around for years and years and years and used and used and used and I will not dispute that. But opium has been around probably longer and does have extreme medicinal properties. But that doesn't mean that if you use it every day, or in its synthetic version, or other versions of it, now, we have an opioid or opiate epidemic. And, now, in the United States, I've read statistics that there's more people addicted to pain medications than there are cigarette smokers.
Brandon: And so, you know, everything has a limit. Everything has a therapeutic margin. Everything has an overuse threshold whether it be exercise, whether it be chocolate cake, whether it be marijuana, whether it be your heart medication. You know, there's these limits and there's these, you know, therapeutic windows that I think that everything needs to have. And I think that some drugs or some substances, they haven't clearly defined some of those yet.
Andrew: So moving on from there, do you employ supplements and do you find that there are a few, dare I say the word, ‘heroes’. And indeed do you find that there's any useless ones that we've previously used that you find, "Hey, you know what? It really doesn't work that well."
Brandon: Oh, yeah. I mean we...listen, medication has a barrier. You know, nobody has a...you know I'm not gonna pick on any medication. But there are certain medications where, you know, it's not like you have a deficiency in that medication. Those things are used to alter physiology that has gone so awry that you have to now kind of mask things or rearrange it so that it pulls it back into sort of form.
Nutrition is a little bit different because nutrition sort of does things to help amplify what you can...what you really need to fight something that could go awry. And there is some nutrition that actually does suppress symptoms. So the one of the things I like about nutrition is it can prevent stuff and there's also nutrition that can stop symptoms. Very few medications are preventative. They're usually used, and not all of them, but usually used, once all hell's broke loose, we've got to do something about these symptoms.
And I love some nutrients. I love some of the antioxidants, that keep tissue from deteriorating. I love some of the nutrition that helps augment and amplify neurotransmitters. I love some of the supplements that are out there that increase blood flow and allow a brain that is really not getting enough, to get what it needs. You know, you can make a big difference in some people with some of these things. Some of the stuff, just like simple vitamins that are antioxidants, you know, your A’s, your Cs, your Es, your seleniums, and then your B vitamin complexes that are not antioxidants, but drastically needed. Sometimes we methylate them, sometimes we hydroxylate them and so forth.
They all have a place. Sometimes you got to combine them together. You need a good source that's pure. And those things when taken in the right concentrations at times, are the answer to the problem, but not always. And so I think one of the things I've learned about nutrition right out of the gate is, when is this really going to be suffice for the patient? And then when do they need a medication because this nutrition is not going to do it? Or when do you need to use both because they work together and they may do different things?
Andrew: So what about things like the essential fatty acids and their neuroprotective effect? You know, fish oils, other essential fatty acids. Even things like phosphatidylserine, which I've...now, I've never used in PTSD but I've used it for cognition issues. And, wow. When you've used adequate dosage, I've been really impressed by that.
But I'd love to know what you've seen in a really, you know, quite a severe condition, neurological condition, PTSD.
Brandon: Yeah. Well, the cool thing is that, you know, everything you just named has an effect on the immune system. So it might quiet it down. Which is...can be huge in a neuroinflammatory situation. It can also stabilise cell membranes so you don't get fragility of a cell that's already a little bit sick. It can do things like help receptor populations and you know make them more sort of, receptive to what it is they need to be receptive to. It can do things like help control and modulate, or repair a blood-brain barrier disorder. And then there's stuff that, you know, it does with, you know, skin hair and all those kinds of things.
But what I find is somebody that's deficient in the essential fatty acids, phosphatidylserine, phosphatidylcholine, N-acetyl-cysteine, the neurological system doesn't work so great. The adrenal system, really, the HPA axis, cannot regulate. The brain itself just doesn't do well. It can damage cardiac tissue and make it to where it doesn't heal appropriately or doesn't have the appropriate effects. And there's all kinds of controversy over this, but there's a really substantial amount of literature on this. If somebody just really does EBSCO searches or PubMed searches and really does an advanced, you know, sort of detailed search where they're combining different terms, you can whittle this down and find an enormous amount of information from randomised controlled studies that are done at really pretty prestigious places. I like that.
And there's a lot of people that just say, "Oh, there's no research." And then when you ask them, "Well, what research?" "Well, you know, the research." And then you say, "Well, tell me the research." "You know, I've read the research, it's just not there." And by the time you get done with the conversation, you realise they've read nothing. And, you know, it happens all the time. But the things you've just said especially like some of the essential fatty acids or things like, you know, really bad mental illnesses, when you get up to higher dosages, I've seen some things that are pretty remarkable.
Brandon: Oh, yeah. Oh, yeah. Well, we use herbal combinations with, you know, just good old-fashioned nutrients. I'll give you a good example. I get some good sources of the kava kava and instead of, you know, giving people heavy sleep medications, I can use that in a really good form, that's concentrated, and get it from a really good place. And, you know, I see people get more peaceful, more tranquil sleep and they don't rage as much. I mean that's just one example.
I have a lot of antimicrobials that are herbal that, you know, that work really well and sometimes in adjunct with anti-microbial drugs. So, yeah, man, we use them and we learn about them. And, you know, I'm not a herbalist but I definitely know enough about them. How to use that with some homeopathic remedies, with some good old-fashioned nutrition, and then the delivery route and stuff like that I think are all pretty important. And then the dosing and the timing.
Andrew: Yeah. What about when you consider the cost of nutritional supplements, have you ever looked at the potential cost savings with your research and perhaps inclusive of supplementation or do you mainly sort of work on structural behavioural type of interventions?
Brandon: Well, we do both. I mean, you know, I love chiropractic work, musculoskeletal work, structural work, gait work, neurological work. I had a doctor tell me one time, and I don't know that I can prove this, but you know, for every $1 we spend on ourselves with nutrition and something healthy, we...there's the potential of staving off $15 worth of down-the-road medical intervention. And, you know, the guy that told me that was, you know, pretty reputable and I think he had some resources to kind of show that. But, you know, I don't think it's really...it doesn't take really, the world's greatest doctor to know that if you exercise, eat right, take some nutrition, and find out what your genetic weaknesses are and look at your family history and do things to kind of block those. That you have a greater chance of living a healthier longer life without just breaking down into pieces.
Andrew: So looking at later on in life, what are the long-term prospects and prognosis of somebody with PTSD? And, indeed, what sort of changes have you seen, I guess, looking at neuroplasticity to bring their brain back to normal, to bring their functioning back to normal? Not just their brain, forgive me.
Brandon: Number one, it's just now getting recognised as something that's valid and really a big deal. Number two, I don't think you can change your brain without changing neuroplasticity. So some of the just-the-talk therapy may be futile. So I think that functional neurology, done by people who really understand it, is going to be, probably, a critical role in the future.
And then I think that nutrition is one of those things where you've just got to look at each person individually and say, "What do they need? What do their labs show?" And then when you customise that, it makes a difference in their physiology. So the practitioner in the future that can really help PTSD is going to have to look at their social setting, their marital setting, their neurological function, their plasticity, new forms of imaging that's coming out, all the other neurological tests, their lab work, their physiology, and then you're going to have to put a customised program together that's going to address every issue or else you're gonna have a faction of PTSD left over. And who knows how bad that'll be?
Andrew: So do you see changes or...in acceptance, if you like, of an integrative approach with your research, your work on PTSD sufferers?
Brandon: Well, we have a lot of people asking us about it. And, you know, I will say this, it's not a perfected science. We have not demonstrated efficacy, but we've demonstrated a lot of improvement that makes people scratch their head and say, "You know what? We need to look at this a little bit more."
Brandon: The one thing I did...I never did, is jump right out of the gate and say, "Tell me what caused this." I let them tell me on their own time after they got to know me and trust me, and I think that that was huge. Most of them would say they're either ashamed of it or they don't want to relive it or they don't want to say it for the millionth time. You know, I ease into that and I gained their trust. And I think if you come at somebody with true PTSD too quickly and too harshly, and you jump right into the triggers, what you're going to get is a meltdown or a nightmare in your exam room.
Andrew: Right. How do you approach that first practitioner - patient relationship?
Brandon: Ask them what their symptoms are. "Hey, you know, what are you feeling? What are you experiencing? What are your symptoms?" And they'll say depressed or stressed or they're having anxiety or their head hurts or they have headaches. And then say, “Okay.” And then you do your exam and then you find out which things are really there objectively not just subjectively. And then you go through that and you say, "Man, you got headaches. Wow, you know. Were you hit on the head?" And they'll say, "Yeah, you know. I was in a blast.” And then that might turn into another conversation.
And so I start with the symptoms and let that lead into the story. I don't take the story and then try to turn it into what it should be symptom-wise. And when you do that, and they know that you're examining them, and that you care about what they're feeling, not trying to get into their brain and understand what made it. It makes to me a big difference. And there may be people with different...you know, that have differing opinions and there's psychologists that might not agree with that. But for me, that's the way that I started to deal with it. And I didn't have hostility and I didn't have a breakdowns.
Andrew: Doctor, triple doctor, Brandon Brock, I truly honour you for your work and your perseverance and, by god, your mind. You are an amazing practitioner who dedicates everything to your patients. And, you know, you really go into the onion skin, you really do get down to the nitty-gritty, and I just...I feel so honoured to have met you personally and to have been educated by you. And I look forward to being educated by you further in the future.
I'd just like to dedicate this podcast, though, to our war veterans everywhere. Not glorifying war, but glorifying those who have suffered through giving so much of themselves. So Dr. Brandon Brock, thank you so much for joining us on FX Medicine today.
Brandon: Thank you, sir. Well said and I appreciate everything that you guys are doing.
|Dr Brandon Brock|
|Cerebrum Health Centre|
|Innovative Health and Wellness Group|
|Foundations Physicians Group|
|Dr Ted Carrick|
|BTB Health Systems|
Other podcasts with Brandon include: