How well do you understand the inner workings of the brain?
We're well aware of the effects that poor nutrition, lack of sleep, excessive or chronic stress and toxins can play on brain and cognitive health. But what are the actual mechanisms of damage to the brain? How does the brain clean away damaged cellular debris and what happens when our normal healing mechanisms don't work? Furthermore, how can we repair a brain damaged by chronic inflammation?
Ahead of his travels down under for the 7th BioCeuticals Research Symposium, we welcome back Dr Brandon Brock, who has dedicated his career to caring for the brains of children, adults and indeed, military personnel.
In today's podcast, we'll discuss how chronic, unremitting inflammation damages the minds of so many patients. He shares how to best assess what the real issue is with their neurology, and what we can do to either mitigate, or repair the inflamed brain.
Covered in this episode
[01:56] Welcoming back Dr Brandon Brock
[03:38] How does inflammation affect the brain?
[09:06] What are the brain's cleaning mechanisms?
[10:58] Understanding cerebrospinal fluid
[12:40] Can stress alone cause brain trauma?
[14:22] Neuro-immune excitotoxicity
[17:32] The cornerstone of most neuro-degenerative diseases
[19:07] Infections: an underestimated element in brain inflammation
[23:04] Putting on the detective hat
[26:37] Genetic impacts of sustained brain injury
[29:15] Paediatric vs. Adult vs. Elderly brains
[31:51] "Raising a generation of broken brains"
[34:54] Quality brain nutrition
[39:21] Regulating immunity
[45:01] How to incorporate longer consults into practice
[47:56] What to expect from Dr Brock at the 7th BioCeuticals Research Symposium
Andrew: This is FX Medicine, I'm Andrew Whitfield-Cook. Joining us on the line from Texas, U.S.A. is Dr. Brandon Brock. He's a practitioner in Dallas who holds a doctorate in family nursing practice from Duke University and a doctorate in chiropractic. He's also working on another doctorate. He has a diploma in functional neurology, nutrition, conventional medicine, and integrated medicine as well. He holds fellowship status in childhood disorders, neurology, electrodiagnostic medicine, and neurochemistry, and is a global clinical research scholar from Harvard Medical School. Dr. Brock has been named Neurology Instructor of the Year five times by various organizations, received the living legacy award from Stanford University, and was Duke University's Spotlight Student of the Month.
He serves as a clinician at Foundation Physicians Group and chief clinician at Innovative Health and Wellness in Dallas, Texas. He's a clinical educator for the BTB Health Systems and also works to educate practitioners through his website, drbrocklectures.com. And lastly, Dr. Brock sits also on the Mind Foundation Australia, providing ex-Australian practitioners with high level education to help children with neurobiological disorders. Welcome to FX Medicine, Brandon, how are you?
Brandon: I am fantastic. Thank you for having me on.
Andrew: First of all, and I always ask this, Brandon, have you got a life outside of research? Like, where do you find the time?
Brandon: The days are longer in Texas, do you know that?
Andrew: Now, you'll be speaking at the BioCeuticals Research Symposium in 2019 but I want to delve into brain. You and I have spoken about PTSD and all of the sort of traumatic brain injury issues, but I want to sort of talk about more of the biochemical issues that go on and how that manifests. So, how does inflammation affect the brain?
Brandon: Interestingly enough, a lot of the major pharmaceutical companies are kind of getting out of that question because they can't crack it.
Brandon: You know, and the reason why is you got to look at how many things cause inflammation? And this is a big question to ask before we really get to the main point, you know, inflammation does affect the brain. But I'll rewind just a second and just say, you know, look, there's infection. It causes inflammation. There are genetic things that cause inflammation. There's gut things that cause inflammation, there's environmental exposure, there's emotional stress. So, you can see that the world that we live in and the things that we're exposed to create that inflammation. Those markers, those inflammatory cytokines that have a way of either destroying the blood-brain barrier or infiltrating the blood-brain barrier, or if there's actually trauma to the brain itself, there’s inflammation created inside the brain.
And so, these nasty little things, they go in there and they trick these immune cells called glial cells, mainly the microglial cell system, into creating more inflammatory cytokines that really go and attack neurons. And the things they do to neurons is just really interesting. They raise their threshold for excitation so they overfire and then they fail metabolically, so they don't have the energy to keep up with their pace. And then there's receptors also that when activated they just start to count down clocks for apoptosis where the cell just destroyed…
Brandon: …or just, you know, blows up kind of so to speak.
The biggest thing is this inflammation creates what we call really a loss of cerebral volume, or cell volume. You lose cells, and over time you lose function and it stops connectivity from recurring, so all that beautiful circuitry that makes everything connect with, you know, one thing with another, it's not appropriate. So you start losing function over time, or things don't heal, like traumatic brain injuries. So, we found that a lot of times that if you don't control inflammation, you can't allow the brain to heal or the brain becomes pathological.
Andrew: But, of course, you know, we're constantly under fire from inflammation.
Andrew: Our body has elegant mechanisms normally in place to regulate inflammation or even to use inflammation in an acute situation and recover. I guess, how does the brain normally regulate inflammation and what goes wrong?
Brandon: That's another great question. You're right. I mean, we are primed to inflame as part of the healing process. And, you know, we have things like pathogens and those are called PAMPs, and then we have destruction or damage, and those are called DAMPs. So, we have PAMPs and DAMPs and these things create, you know, inflammation and they create destruction. But in order to deal with these things, you have to have inflammation to clean up the mess or destroy the pathogen. And, of course, inflammation can be phagocytic cells, they come and eat a pathogen, or if you have a bunch of debris fields because there's necrotic tissue, you have cells that come and sort of clean up the mess. Both very important. Without that, we can't get rid of things that makes us sick and we can't get rid of tissue that's been destroyed, because if tissues that's been destroyed is not cleared out, your immune system has the possibility of tagging it as a foreign tissue and you can get immunity to it. It's called autoimmune disease.
Andrew: Right. Yep.
Brandon: So, the brain, those same microglial cells I was talking about, I kind of left it very one-sided because I was hoping we would go in this direction and that is, the same cells that trigger inflammation that destroy the brain, they usually do this through an unusual mechanism. When there's initial, some sort of insult or damage or something that's going on with the brain, it will either get rid of the inflammatory process or clean things out really quickly and then it'll stay on for a period of time, and, depending on what you read, it may stay on for a couple of weeks to a month, and it may clean out debris depending on how much damage there is. But if there's enough inflammation or enough damage, then these glial cells, these microglial cells, they'll start to ramify, their own genome will start to change.
So, let's say you have a head injury and you clean it up, and you mitigate that head injury and everything is okay. If you get hit in the head again during that process, those microglial cells say, "Wait a minute, we don't like this." So they genetically ramify and they stay on longer. So now, maybe, instead of four weeks they stay on for 16 weeks. If you get another head injury during that time period, now they just stay on forever, they don't turn off, they kind of get stuck in the “on" position. And this is one of the mechanisms behind that, you know, chronic, traumatic, encephalopathic mechanism that you see a lot of footballers getting into.
Andrew: Yeah, yeah.
Brandon: So, you got to have the brain turn on and turn off. When inflammation is sustained for too long, it doesn't turn off very well.
Andrew: Right. We know how hard some diseases like, for instance, meningococcal disease are hard to treat because it's hard to get drugs across the blood-brain barrier. Conversely, when the brain has debris from damaged cells internally, how does it clear them?
Brandon: The flow of cerebral spinal fluid.
Brandon: Because as all of these cells dump out their garbage through, you know, for instance fasting, it does a great job of going through mechanisms that create, you know, the cellular dumping mechanism. And this weight is carried through the CSF, and that cerebral spinal fluid is very important that it circulates, and this is one of the reasons why a lot of chiropractors have been very successful, you know, some of your upper cervical guys, you know, they do a lot, not necessarily to decompress the brain stem, I think that that's probably an inaccurate mechanism. But some of those upper cervical receptors are very good for initiating that CSF pumping mechanism so that the debris can circulate around.
Brandon: And I think that that is one of the things that's missing in a lot of treatment is, you know, good biomechanics, good upper cervical biomechanics, and good cerebral blood flow.
And they've done actual MRI studies now in different types of sequencing, that you can actually utilise to see if somebody has good CSF blood flow.
Brandon: And that whole process of getting rid of that stuff out of the cells is called autophagy, and autophagy is the ability for the cell to get rid of that debris and then that debris to be removed is through those pumping mechanisms. One of the greatest ways to create autophagy is just a two to three day fast.
Andrew: So, like I've wondered, you know, we've always conceived the blood-brain barrier as being relatively impermeable. Hence, the issues of treating encephalitis and such things with antibiotics, rather large molecules compared to our biomechanical molecules of waste. But I've always been interested in where does the CSF dump to? Is it the third ventricle?
Brandon: Well, you got a fourth ventricle, down to the third ventricle, down to the Sylvian system, down to the aqueducts, all the way down and it goes all the way around. And, of course, you have interchange through the blood-brain barrier at various areas that are a little bit more prominent than some of the other areas.
Brandon: And there's an exchange mechanism for some of these molecules where it just gets into the blood and it just get dumped, some of this debris just gets dumped just like other wastes, and it gets bio-transformed, broken down into elemental parts and so forth. But it doesn't happen if it becomes stagnant and just sits in a ventricular system or circulating around the brain itself. And so, this is why those pumping mechanisms are so vitally important is because the pumping mechanism, just like the lymphatic system is a pumping mechanism.
You know, when there's inflammation, certain things happen. CSF stops flowing, lymphatic fluid stops flowing, and the barrier systems break down…
Brandon: …and there's four barrier systems that can break down. I mean, you know, you got your blood-brain barrier, you got your gut barrier, your lung barrier. And interestingly enough, you have an olfactory barrier. So, all of these barrier systems break down, the gut becomes inflamed, the brain becomes inflamed, the CSF system doesn't pump, there's inflammation everywhere, your lymphatics becomes stagnant, and the next thing you know you're just collecting junk.
Andrew: We've spoken about brain trauma from football injuries. I was thinking about boxers. You and I have spoken previously about military personnel, you know, and the issues that they've been exposed to in their working life. But what about the everyday Joe, talking about brain trauma, can stress, just prolonged stress cause these same effects?
Brandon: Yes, it's really interesting. Well, we do know that stress really creates, especially high cortisol levels, creates a high probability that you're going to break down the gap juncts in your gut, you know, those little slots between the cells that can breakdown, the zonula occludens, they can break down and that can create inflammatory response that eventually can work its way to the brain. We know that stress also has the ability to break down the blood-brain barrier, and then catecholamines…
Brandon: …like your epinephrine, norepinephrine, they're just a little bit different by their half-life, but they go into certain parts of the brain and just destroy it. So once they get in, which they're created in the brain anyway but they're also created by the adrenal system.
But once you get too many catecholamines or you have too much stress, it starts to eat away the foundation of the hippocampus, which is one of the biggest components of your short-term memory system. So, I mean, stress is one of those things that really makes this really bad circumstantial situation where stress can occur much easier if you've already got it, or inflammation can occur much easier. And then it also starts to break down the very tissue that is prone to inflammation if it gets in. So, I would say that if you're inflamed and under stress then you have a double whammy going on.
Brandon: Yeah. And that's really, so, you know, we really call this neuroimmunoexcitotoxicity. And, you know, you kind of leave a little bit of part of the story out, whenever I say inflammation just destroys cells. And I told you that it makes them closer to thresholds of a fire easier. And the interesting thing is that on the coating of a lot of these cells, you have these things called NMDA receptors, N-Methyl-D-aspartate. And the really cool thing is that when you activate your body, your muscles and the periphery, it activates these little bitty receptors that surround an NMDA receptor. So, these receptors in your body activate what's called an AMPA receptor, and then that carries the action potential to the next neuron, so that you can go all the way to the cortex or in different areas.
Each time you activate an AMPA receptor, it activates something called an NMDA receptor. And that NMDA receptor is really sort of covered like a well, okay? With magnesium. And so, when you activate that AMPA receptor, it knocks off the magnesium and the extracellular calcium is allowed to float in, and it activates the genetic response or activation of the cell. And it actives the energy producing part which is the mitochondria. So, it's a vital part, so when you move and you exercise, you kick that magnesium off, calcium comes in, it activates your gene response and you get protein replication and everything stays really good. Because you have to have protein to make new receptors, you've got to have protein to make synaptic connectivity, and you've got to have protein that actually keeps the mitochondria that makes ATP going.
The only problem is, when you get sustained inflammation, it goes over there and it knocks that magnesium plug off or activates that receptor to the point to where there's more calcium influxing not just through that receptor but through other receptors as well, so the cell gets flooded with calcium. So now, instead of having that beautiful genetic response that you're supposed to have from activation and from exercise and all those things…
Brandon: …you start to overstimulate that cell with calcium and it does everything in reverse. It creates free radical damage, it creates superoxide anions, it activates this inducible nitric oxides which turn into this stuff called peroxynitrate which makes the cell sort of kind of blow up. And so, through this mechanism of inflammation, you get neuroexcitotoxicity, so that's why we call it neuroimmunoexcitotoxicity.
The inflammation eventually makes the cell kind of go crazy. And it makes it to where exercise is counterproductive and people feel bad after they do things that are, you know, requiring physical activity, or if they over stimulate their brain they have seizures, because a seizing brain is a cell that just fire spontaneously that's unregulated. So, the cornerstone, and there's some really good papers on this, the cornerstone that most neurodegenerative diseases is disregulation of that calcium regulating mechanism.
Brandon: And this is one of the reasons why a lot of our patients that have neurodegeration, we give them a certain type of magnesium, like the magnesium threonate line is really good to get in there and plug that. And we may lower their calcium because it may not trigger osteoporosis, like they think it's going to. But the only thing it may do, in the presence of inflammation, is destroy their vasculature and destroy their brain. So we may change some of those ratios therapeutically, and I think that's a good clinical nugget for some people to know because they're always taught, keep magnesium and calcium at a certain ratio.
Andrew: Do you ever, ever find that?
Brandon: Well, I mean, I think some people try to formulate their products like that but there's a lot of people getting away from it because they realise sometimes you need it for constipation, sometimes you need it for coronary artery occlusion.
Andrew: I'd like to find a food with two-to-one calcium-magnesium ratio.
Brandon: I think you're right. I think it's engineered, I think it's, you know, I think it's something...and we all know that physiology is never the same and it never requires ratios. It's like fatty acid ratios,
Brandon: You know, and we've found that fatty, you know, your essential fatty acids, your omega 3s, one of the interesting things is that in the western guides over here in the states, there's a 20 to 1 ratio really of the good to bad, and it should be a 2 to 1 ratio.
Brandon: And so there's a lot of people dying from heart disease and inflammation because of a bad fatty acid profile.
Brandon: Well, some of the things we've been seeing lately, and I think one of the really massively overlooked, and I think this is because of, you know, I really think modern medicine has done this to us, and that's infection. And they, you know, a lot of people look at immunoglobulins and they look at IgM, meaning, "Okay, you're actively infected," and then IgG just means you have a tracer or a memory to it. And everybody just kind of, you know, ignores, you know, immunoglobulin A and of course if you got immunoglobulin E, you just got allergies. But, what people don't realise is that all of these create inflammation. So, if your IgG is four times higher than the upper limit, it doesn't necessarily indicate that everything is okay, there’s still an inflammatory response that's keeping something in control, albeit, it may not be out of control, like an IgM response.
So, we've looked at things like herpes type 6 virus, or herpes type 1, or herpes type 2, or cytomegalovirus, or toxoplasmosis. You know, there's a host of viruses and bacteria that we look at. And, of course, a few things get out of control and you get full-fledged, you know, clinical encephalitis or, you know, meningitis, and those are terrible things. But there's also people that have just this low level inflammation from trying to control an infectious disease, it is not really making the host or the human super-duper sick but they're having to stay inflamed in order to keep that thing in check.
So, one of the big things I think that's important in learning how to treat brain is look at the entire immune system, look at the immunoglobulins and then look at the thing that connects the white blood cells to those immunoglobulins, which is your complement system, and then be able to break down the percentages or understand the different types of white blood cells that you have, and if those populations are appropriate. And then be able to look at the antibody profiles to know which tissues are being attacked. And this is one of the things that we've been able to do and say, "Okay, look. You've got an immune system that's ramped up and you've got antibodies to your cerebellum, and you've got cerebellar symptoms and that's cross-reacting with your thyroid, and that thyroid is cross-reacting with Epstein Barr, and it's all cross-reacting with, you know, spinach, soy, gluten, and, you know, tomatoes."
Brandon: Which is not a very unusual combination, believe it or not. And when you trace it back to its origin, and this is why I thought this, you know, part was really, you know, vital to talk about.
You maybe able to find out, okay, there's brain autoimmunity, we got to do something. Let's stop inflammation. But if you stop that inflammation inappropriately, now you don't stop the infection,
Brandon: And now the infection creates other problems. So you have to be able to control the infection if it's there, and identify it, and then allow the immune system to do its job without completely neutralising it, and then give nutrients and activation to repair the parts of the brain that have been damaged, so it becomes sort of a tiptoe through the tulips type of method where you have to control multiple things at once in a way that you orchestrate it to build, destroy, but maintain and not completely stop the immunological system.
Andrew: Yeah. Look, I remember the age of cortisol as an exogenous cortisol being the panacea for everything. And I never, never really embraced it, and I think it was Andrew Heyman who woke me up with basically a sledgehammer to the head, you know. And it was the obvious thing, like you're eluding to now. If you dampen inflammation and turn it off without addressing why it was on in the first place, then you can have a runaway infection, and you don't even know.
Brandon: Yeah, and then your adrenals will really quit.
Andrew: Yeah. So, here's one. What about these commonalities? Like how do you try, and I know this is a big detective work question, but how do you try and tease apart the true culprit that you should be addressing? We think about parasites and we think gut, and then we think about moulds, and what about common things? What about people with allergies, with rhinosinusitis, polyps, you know, causing, not an abscess, but a collection of pus and gunk in the nose, how do you get down to the true culprit?
Brandon: That's a great question. Well, so, I'll kind of give you a short version of a very, very, very long version. You know, one of the things that I look at is just the basic CBC.
Brandon: And you look at that and what happens commonly in medicine is, you look at that CBC in absolutes. You absolutely have anaemia, or you absolutely don't. Or you absolutely have bacterial infection, or you absolutely don't. But we've started looking at this in really in looking, tightening up the ranges and looking at some of the ratios between all of these cellular types. So, here's a good scenario for you. So, the person eats a histamine-rich food and they react. Their IgE levels are up. You do an environmental panel on them and, you know, they're allergic to ragweed and, you know, four or five other things.
And then you look at their eosinophil count and it's really high. And then you say, "Wow, man, what's perpetuating this?" Well, the other thing that perpetuates eosinophils is parasites, and then you ask them if they have a gut problem and they're like, "Yeah, I've got a gut problem and, you know, an itchy rectal region for 10 years."
Brandon: And then you run the parasitology panel on them and you find that they have a parasite that's been driving up IgE that has made them prone for allergies, their histamine levels are up, every time they eat histamine-rich foods they go crazy, and they're inflamed with high levels of eosinophils and neutrophils, and this whole thing is creating an inflammatory cascade, and if anything else goes wrong anywhere else like the brain, they're already primed and ready to make it worse.
Andrew: Yep. Yeah.
Brandon: So, that's kind of one way, I mean, and we could do the same thing with a virus, we could do the same thing with a bacteria, we could do the same thing with a mould, we could do the same thing with Lyme, we could do the same thing with, you know, any of those. But I always assume that if any part of that CBC is skewed..you know, it's really interesting, we can look at white blood cells, they're normal but neutrophils are up a little bit or maybe there's a little bit of sustained inflammation and not a pure infection. Where is it coming from?
Brandon: Well, then you ask them about their guts and they're like, "Yeah. My gut has been hurting me for so long but it's just normal." Well, why is it normal? Because it's been there for 10 years. So, you have to know the right questions…
Brandon: …and then what those questions mean, and then you really have to start drawing out a story, and if you can put the story together, you can, most of the time, string out the beginning and the end of what somebody is really suffering from. The problem is you got a lot of people that are good at treating parts of that story.
Brandon: A functional neurologist is really good at treating the end, a medical neurologist is good at treating the very, very end. You've got somebody who is a gut practitioner, they're good at just treating the gut part but they don't get rid of the neurological stuff sometimes. So, this is why we're really trying to integrate practitioners because there really is nobody that's absolutely right. We're all missing part of the story, it is just a matter of how much of it you're missing.
Brandon: Yeah. Well, I mean, it can be anything from a head injury that doesn't resolve and, you know, we did some really great research, or I would say research, we looked at some data, and we found that there was a really high correlation between post-concussive syndrome and people that had unresolved autoimmune diseases, inflammation, infectious diseases, or endocrine pathologies. In other words, the vast majority of people that didn't, from mild traumatic brain injury, that didn't just heal in that normal two to three-month time period, and they went into a post-concussive phase which is more than three months. Upwards of 80% to 85% of those people had another condition, and I would almost bet that the 15% that we didn't find something on, it was just something we weren't looking for.
Brandon: Most people heal, most people heal, you know? So, these conditions are like traumatic brain injury that doesn't heal, or if it keeps going long enough and your brain atrophies. And remember that NMDA receptor story I told you a minute ago, if that's going on and you lose energy, you will start to replicate broken genes. This is your epigenetic response. So you start to trigger deleted or duplicated components of your genome, so now you switch on a genetic disease. And this could be anything from Huntington's disease, to being prone to Alzheimer’s disease, the damaging in the parts of the brain that make dopamine, so now you have the neurological but not the gut part, but the neurological part of Parkinson disease. Or maybe you start doing things like you trigger certain genes that make you get vascular hyperplasia, or you end up getting atheromas, and so you get vascular dementia. I mean, there's so many things that can happen with sustained inflammation. What it really boils down to is, what is in your genome?
Andrew: Yeah, right.
Brandon: You know, and so that’s, all of this stuff that we're talking about is the one common element that leads to neurological disease and that goes back to the very first point that I actually said when we started talking and that is, a lot of the pharmaceutical companies are pulling out of this whole deal. Because, if you look at what I just told you and what we've been talking about, how difficult is it to make a single pill that could reverse all of that story, that is individualised in every single person where the end result is one thing: You’ve lost brain matter.
Brandon: It’s like solving 10 Rubik's cubes in one hand.
Andrew: Yeah. Brandon, just before you alluded to a thing that is pertinent for elderly people, the vascular dementia. Obviously, adults are going to have a cumulative dose, if you like, of stressors during their life that's greater than paediatrics. Do you see great differences in the paediatric population, the patients that you see, versus the adult or even elderly population? And is this in part due to the permeability of the blood-brain barrier?
Brandon: Well, that's a great question. So, it's you're growing up versus you're growing down, is kind of the way I see it. You know, when you're growing down or you're older, and you start to get brain insult, you just lose cells, they die,
Brandon: And that's obviously a big problem. As you're growing up, you may have the cells and it may not destroy them but it stops them from connecting appropriately, so now you have disconnected or a lack of coherence. And then you really see this big time on autistic kids, they have the lack of coherence. So all their Brodmann areas may be separated from each other, so the whole brain doesn't come online at once, just one area really well. And let's say that you have one area that is amazingly efficient but not connected to the other areas, this could lead to savant type of behaviour.
Or you may have, you know, a parent that says, "We see super intelligence in this child, but they are autistic and we just can't get through to him." Well, what you're seeing is that one part of the brain really, really work but it doesn't disperse and connect to the other areas. So, in the grow up phase, we see a lack of developmental connectivity and symmetry. And then on the grow down phase where you're an adult, we see actual brain death and then, of course, a lack of pathway connectivity as well. And this is one of the reasons why you see, you know, adults that are in the grow down or the death phase, they become child-like. You know, both are a loss of the regulating centres of the higher cortical centres which regulate pure, good old-fashioned limbic activity, that's very difficult to kill.
And the reason why limbic activity is difficult to kill is because we were all meant to have a limbic system that would save us in the event of something going wrong.
Andrew: In an emergency, yeah.
Brandon: So, you know, and that's the thing, man. Children are limbic, adults can become limbic, this is why you see adults, they're in nursing homes. They can become a little bit belligerent.
Brandon: And, you know, it's a sad thing to see, one, they don't develop, one, they de-develop.
Andrew: So, with that, from a development perspective, my wife is a teacher, right? And she works well with kids with behavioural disorders. And I shouldn't say disorders, issues, anyway, one of the things that Lee gets across is this sort of safety, this safe zone. Is one of the important things that we're just missing in our education system is that these kids have a threat response that's amplified, so we need to take away the threat response?
Brandon: Yeah. Well, you know, I'll say a couple of things here real quick and, you know, I heard you say something about disorder a second ago, and I don't think that that's really inappropriate. Because, it is the lack of organisation within the brain, it is disorder.
Brandon: And I don't think that...I think when used in the appropriate context, it's not meant to be condescending or hateful.
Brandon: I think it's very descriptive of exactly what's going on, it is disorganisation. And I think that, you know, my wife and, you know, we got a lot of similarities, you and I. My wife was an English teacher for 20 years and she had one of the most, you know, I would say that literature and math are the two most, that's where you really see children either make it or break it.
Brandon: They either can read and write or they can't, or they can either do mathematical equations or they can't. It's not like some of the other classes where there's just a little bit of memorisation and stuff like that. Understanding poetry is something that's deeper than just being able to read and not have, you know, comprehension is what you would say.
Andrew: Yep, comprehension, yeah.
Brandon: So, you know, one of the things that she would tell me is, you know, we have so many standardised tests for kids now, and teachers teach under stress. And then teaching under that stress knowing that they have to have a certain percentage of their kids pass these tests creates a situation of alarm within that teacher and you can only imagine how much the students sense that.
Brandon: And then the students know that they can't move onward in their life unless they pass these tests, so that creates an alarm response. And then they walk out of their classroom and they go into the hallway and there's fashion, and there's being cool, and there's, you know, who do you know, and what sport do you play? So, I mean, I think that children, more than ever, are in an environment that is just as stressful as many adults that have to deal with jobs and, you know, difficult people at their workplace.
And I think that if you have the right child, meaning, one that's inflamed, and one that has brain autoimmunity, and doesn't get nutrition at home because maybe they're in poverty, and maybe they have a broken home, so they're already under stress because they know their family is not a nuclear family. And you put that together, you know, we're raising a generation of broken brain.
Andrew: Yeah, absolutely.
Brandon: And it's amazing to me why people are surprised about some of these things, you know? I mean, how do we expect children to cope with this? And then people will say, "Well, why hasn't it always been like this?" And the answer is, because it hasn't always been like this! The world is changing
Brandon: And I think a lot of the pressure still on kids are just enormous.
Andrew: You mention and poor-eating habits, poor choices, poor availability of foods, of healthy, nutritious foods before. Julia Rucklidge in Massey University in New Zealand and Felice Jacka down in Melbourne, Australia have done incredible work showing the definite advantages of a good, healthy diet. Julia Rucklidge has used a supplement to help supplement dietary changes and shown benefits in these people. Why are we not using these simple measures to get them good food, to get them a supplement if need be?
Brandon: You know, here's the thing. People, and this is not conspiracy theory, this is just pretty much the way it runs in the world. And I think that there's a lot of people that...well, there's not many people anymore that disagree with this kind of stuff and let's just face it, when you got the major food manufacturers creating the most food and feeding the most people, in order to do that, you have to have foods that are preserved.
Brandon: Which means they don't go bad, they can stay on shelves forever, you know? These guys make an enormous amount of money, but they have to put a lot of stuff in their food to keep it that way because living food that has real nutrients and it was not meant to live forever if it's pulled out of the ground or if it's killed and slaughtered and butchered. You know, those things go bad.
So, in order to keep them from going bad, they either become artificial, or there is something in it that really nature didn't intend to be there. Now, the people that do this are the ones that hire the most lobbyists, they're the ones that have the most money to throw around. You don't have the, you know, Broccoli Grower Association throwing out millions of dollars of lobbying money. I mean it's, and I don't even know if there is, you know, such a thing. But, the bottom line is, there's a lot more pressure in the governmental systems to support food that is highly preserved. And there's a lot more pressure in the system because there's so much of that food, it's easier to bring the price down, so they think that they're getting a better deal because they get a greater volume and they can feed more people and they can last a lot longer, so the world is a lot safer. But what they don't realise is, in the process of making the world safer, they're making the world sicker.
And I can tell you right now, I worked in paediatrics for two years, and during that two-year period I would say that 50% of the time I had nothing but foster children.
Brandon: And dealing with foster children, I had to deal with children that were on government subsidised food. And so I started breaking down government subsidised food and started looking at what was in it. And the kind of food that they were being given, thank God they were being given food, I’m not against, you know, feeding the homeless or the sick or the needy. But I started looking at it and it was a recipe for autoimmune disease, deterioration, inflammation, and bad brains. And then we had to kind of step back and look and say, "Why are some of these kids actually acting the way they are?"
Well, they're acting this way because of poverty and their parents. Okay, maybe, maybe that's part of the equation but maybe the other part of the equation is, they haven't had a solid macronutrient in two or three years.
Brandon: And I think that when we look at the whole system, I'm not going to say it's rigged, I'm going to say it's designed to support nutrition that is sustainable and preserved, and keeps bugs off of it, it keeps the shelf-life greater. So that we don't have to raffle through this quickly or transport it as fast, or worrying about storing it somewhere where there's not good hygiene. And so, you know, scientists have, in their own, you know, in their minds they are doing good diligence, we're making food that's sustainable so that people don't die of starvation and that, in part, is true. But we have to look at the other side of it and say, what are we creating over decades? We're creating sicker children that breed with sicker children and that is actually genetically passed down.
Brandon: And, you know, it is what it is. This is not conspiracy stuff, this is just good old-fashioned science and nutrition.
Brandon: And it's a difficult thing because on one hand you're feeding people but on the other hand, like I said, you're slowly making the population sick.
Brandon: That's a good question, man. I got to tell you, this is where a lot of the research is right now. I mean, you look at, I'll give you a good example. Let me work through this through a hypothetical case study, and this isn't so hypothetical, this comes in the office, it was just, it's been in my office already this week. You know, we got somebody that comes in and every time they eat a certain type of food, maybe starchy or sugary food, they bloat and they feel almost like they're pregnant, you know, they're very just uncomfortable. You know, you got to undo the top button of your pants, you know, and then you start asking them about some other things and they're like, "Yeah, I remember this happens, I get brain fog, and I get anxiety." And this is a very common cluster of symptoms that I get in my office quite a bit.
So, let me break that down for you a little bit. So, they have a low stomach acidity because they're on a proton pump inhibitor like, you know, one of these medications that stops, you know, just consider an antacid, right?
Brandon: So, they lower their acidity, they don't break down the normal bacteria that's consumed on a daily basis, and they really start to colonise this bacteria and they get overgrowth. And now, they have SIBO or SIFO. And, you know, these are small intestinal bacteria or fungal overgrowths, and because their brain is so bad, they don't have good gastro clearance time and they get a little gastroparesis so things hang out a little longer than they should so they colonise.
And so now every time they eat certain foods, you know, maybe let's just say a starch or sugar, not all of them, but some of them, for example. Bacteria that they eat, they gobble them up and they make methane and then make hydrogen. And so that makes the gut distend and hydrogen may create diarrhoea, methane may produce constipation, and then it goes down and it pushes the ileocecal valve open and then all the bad guys come really rushing through the gate and more bacteria comes into the small intestines. So people get gassy and they get bloated. The other thing that happens is, they produce these lethocholates, these chemicals that go to the gap junctions that I talked about earlier. So, picture the fortress around a fort, it starts to pick some of the planks out of the fence and people can basically slide through it, that's what these lethocholates make.
So now you're bloated, and you're distended, and you got gas, and your gut barrier is breaking down. And all these undigested proteins, where it should be amino acids but they're polypeptides, and they're going through the holes, and they're going into a system that really is not geared to see this polypeptides. You got to understand, your immune system sees these polypeptides as things like viruses. They understand what an amino acid is, they're pre-programmed for that.
Brandon: So they see these peptides come through and they're like, "What the heck is this? Let's eat it and then tag it, so if it ever comes through again we can react to it quickly." So now you start creating a sustained inflammatory response and that goes up to the brain, gets into the brain and damages the output from the entire cortex to the hypothalamus, down to your vagal system or your vagus nerve, okay? Now, your vagus nerve comes back down to your gut and it makes you make stomach acid. Remember, I told you if you don't make stomach acid you get SIBO?
Brandon: And then it goes down and it makes your gut have peristalsis, so that you can clear your faeces out. Remember, I told you if you don't do that you get more SIBO?
Brandon: And it goes to your spleen and it controls you turning white blood cells into the kind that are going to go attack and make an alarm response. The differentiation between different types of T4 cells and, you know, T4 and CD8 cells.
Brandon: It allows the spleen to regulate and then it goes to the liver and it makes your P450 system, your phase one of detoxification regulate all of this inflammatory stuff. So, think about it, your guts break down, you get inflamed, it goes to your brain, shuts the vagal system down. And now that vagal system comes back down and just perpetuates the gut to be worse, and it is a massive cycle. So, that's just me starting at the gut.
Now, we can start at the brain if you wanted to. But think if you have a parasite, that story can happen. If you have a bacterial overgrowth, just say strep, or let's say that you have, you know, some sort of other exotic, you know, infectious disease, like some sort of parasite, you've been to another country or something. Anything that's in there that shouldn't be in there aren't the good guys overgrow and can't be controlled and eliminated. It's going to create an ecosystem that is not conducive for that human, it will break them down. And I see patients like that, you know, all the time and some people ask me all the time, "Well, how do you know which is causing which?"
So, I ask patients, "Well, what happened, what are you suffering from?" And they'll say, "Anxiety." So I'm like, "No, tell me what happened 10 years ago. Did you have emotional trauma?" "No, I never had any emotional trauma, but I had diarrhoea." "Well, how long have you had diarrhoea ?" "Ten years." "Well, why didn't you tell me you had that?"
Andrew: Yeah. Yeah, yeah.
Brandon: ”Well, it's normal, I have it all the time. I've just learn to live with it." And then you find out they've had that gut response, it messed up their brain, and now they have a raw limbic system that's firing like crazy and they have anxiety because of their gut. And now they're stuck on a medication because the only thing that anybody ever listened to was the end story, nobody went back 10 years ago.
Andrew: Yeah. We're in an unfortunate situation in Australia where our GPs are only having time for an average, you know, eight minutes per consultation. How can anybody take a full personal, let alone a family history?
Brandon: Yeah. You know, and this is what I told, and I think this is a good tidbit for a lot of people that are listening to this. They are thinking the same thing. They're like, "How do I do this?" Well, here's how you do it. Let's say that you have a certain type of practice. You leave it that way and then you just take Thursday afternoons. And you say, "Okay, on Thursday afternoons I'm going to let in my harder patients and I'm going to spend an hour talking to ‘em. I may not know how to put all this together but I'm going to spend an hour talking to ‘em. And then two hours after work I'm going to sit down, I'm going to spend some time working on these cases and figuring how to put the nuts and bolts together. And you do that for three or four months and then you say, "I got this. I can do it in an hour now."
And then you do it in 30 minutes, and then you say, "You know what? I'm going to do this two afternoons a week." And you do it two afternoons a week and you get it to where you can do it in 30 minutes very efficiently and your followups can be done in 15 minutes, and some of those are a little bit longer, some are a little bit shorter, but you're getting to where you can put the story together better. And you've done that for a year and now you're doing it three afternoons a week, and then a lot of people get to the point where this is all they do.
Brandon: And they get complicated cases and they break them down and they learn how to do it very quickly and efficiently. And they learn how to knit each of these stories together and then you can figure out, do I intervene at the gut? Do I intervene at the brain? Do I intervene at the immune system? Is there an infectious disease, or are they just purely an endocrine disorder?
And that, again, I'm defining the integrated practitioner. We've got to go back to that because medicine has made it cool to become ultraspecialised.
Brandon: There’s not a lot of people who are really, and I hate to say this and this doesn't, I don't want this to come across narcissistically, but a Jack of all Trades.
Andrew: I love what you said then about the practical way in which people can become slowly expert, because it takes away that feeling of overwhelm when somebody says, "I'm going to do what Brandon Brock says." And then they go and change their whole practice in one fell swoop and end up needing, you know, 80 hours per week to be able to accomplish that, an impossible task. Whereas, if you just made it little bit by little bit, became more proficient. I love it, Brandon, it's brilliant.
Brandon: It's important for me to be able to say that. I had to think back about how I learned it, and I learned it by sitting down and refusing to quit learning it. But I also know that I had to serve people to the best of my ability with my other time. So, I just, I was thinking to myself, how do I teach this stuff and how do I get this message across to people to where they'll actually do it because it's not easy? And then I thought, "Well, how did I do it?" Well, this is how I did it.
Brandon: I would just allocate time, get better, allocate time, get better. And now, I don't know how to think any different.
Andrew: Yeah. Brandon, you'll be speaking at the 2019 BioCeuticals Symposium in Sydney. Tell us a little bit about. You've given us a tidbit here and I think it's one of the most important ones about how to allocate time to become proficient. But what else will practitioners be able to take away, to be able to integrate into their practice afterwards?
Brandon: Well…and, of course, the more I lecture, the more I start thinking myself, "What are people going to really get from this other than me just looking cool up here?" You know, trying to talk and be smooth or whatever. I really want people to get… I guess you could say sort of a basic outline of where to start. Like, let's say I wanted you to do that. I wanted you to start your practice that way where one afternoon you were doing it. Okay, that's fine. What's the template to even start thinking?
Brandon: So, what I want to do is show some cases and some clinical, some real clinical stuff where people can really emotionally attach to that person and say, "Okay, we got to do something. What happened?" And then, really, I'm going to teach backwards.
I'm going to show the case and show the problems and then say, "Let me show you how we worked backwards. And as I do this, I need you to write down notes. Not what's already on your notes, I need you to write down what's going to make sense to you, in your practice.”
Brandon: You're going to build a matrix and that matrix is going to involve, okay, look, we had to understand antibodies. How do I look at that and how do I know? We had to look at immune deficiency or immune dysregulation, how do I look at that and how do I know? We had to look and understand some neurological functions, so how do I learn a little bit about the nervous system? And in each one of these, I'm going to give, "Here's the markers. Here's where you find them. Here's how you study them."
So, I'm going to give the matrix as I go backwards, and then I'm going to show how I combined that matrix to where, let's say there's 20 different things that could go wrong and you find out that, of the 20 points of the matrix, there's five of them that fit with that patient. And then how do you narrow it down even further? So, we've got that 20 point matrix, you've narrowed it down to five. I started at the case, I backed through it, showed you which one of those components that were actually in, and then you narrowed it down to five. And you're like, "I got it down to five." Well, then I'm going to teach you how to snap those five things together to make the story that encompasses the patient. But, again, like I was really, I really want to practice this next part, and this is the most important part.
If you've got those things all laid out, which one do you treat first so that you don't mess up the others? So, putting it into a priority. So, I started with a patient, narrowed it down to the components, snapped the components together, then ordered them in priority, one, two, three, four, five, for instance. And then you start to eliminate one, then you eliminate the other, and eventually, when you do that and you learn that art, and you learn that matrix. See, the matrix is this: detoxification is one section, endocrinology is one section. So, you can say to yourself, "Man, I understand all these different notches that I've got to learn. I'm going to spend a month learning about endocrinology and that's going to make me better. I'm going to spend a month on immunology, that's going to make me better."
And every time you learn a little bit more about each one of those components to that matrix, you can learn to connect them together. And then once you get experience, you can learn how to put it in order. And then once you've put it in order, you can learn how to systematically treat that person to where they have a higher probability of getting whole again. And I think that that is what I want people to take away. I want them to take away the process, because it's very easy to learn about detox and be good at it, but never know how to snap it into that matrix.
Brandon: It’s very easy to learn functional neurology and not know how to snap it into that matrix. But when you learn how to pull it all together and become multi-faceted, and this is why people give me such a hard time now, why do you keep going back to school? Because my matrix is not full yet. That's it, that's my answer.
Andrew: That's dedication.
Brandon: My mom thinks I'm crazy, my wife thinks I'm crazy, everybody thinks I'm crazy. You know, why are you doing this? Because the matrix in my mind is not full, and so I had to keep going until probably the day I die.
Andrew: Dr. Brandon Brock, we're all so much looking forward to when you come to Australia for the BioCeuticals Symposium in May 2019. I hope everybody can join us there. You've awakened us to not just the research aspects, but it's the dedication and care that you give to patients that I truly admire you for, and so, thank you so much for joining us and for giving us a glimpse into what you'll be taking us through at the symposium.
Brandon: Thank you.
Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.
Other podcasts with Brandon include:
- Blending Functional Medicine and Neurology with Dr Brandon Brock
- Post Traumatic Stress Disorder with Dr Brandon Brock