This article is copyrighted by GreenMedInfo LLC, 2019
Move over apples! Research shows an avocado a day significantly boosts lutein concentrations in your brain, with corresponding improvements in cognitive function. Lutein has beneficial antioxidant and anti-inflammatory effects, and avocados are an excellent source
Avocados are a treasure trove of nutrition, in part because they’re a bioavailable source of lutein, a carotenoid that’s excellent for your brain. Lutein crosses your blood-brain barrier and also accumulates in the macular region of your eye’s retina. The macula lutea, which is Latin for “yellow spot” and also known as macular pigment (MP), is a yellow area near the center of your retina.
Macular pigment is largely comprised of lutein and another carotenoid, zeaxanthin, and plays an important role in filtering blue light, while also offering antioxidant and anti-inflammatory properties.
However, the density of macular pigment in your retina (macular pigment density, or MPD) is also linked to cognitive function, as the amount of lutein in your retina is significantly associated with the lutein concentrations in your brain. As such, MPD can be used as a biomarker for lutein in your brain, which in turn is associated with better brain function.
A Daily Avocado Increases Lutein, Boosts Your Brain
Considering that one avocado contains about 0.5 milligrams (mg) of lutein, researchers were interested to know if eating this healthy fruit could benefit cognition. For six months, 48 adults consumed either one avocado, one potato or one cup of chickpeas daily — the latter two options serving as control options, since they contain no lutein.
At the end of the study, lutein levels in the avocado group increased by 25%, compared to 15% in the control group (which may have been due to unreported dietary changes that took place during the study). However, the avocado group also had an increase in MPD after six months, while the control group did not.
Along with improvements in memory, those eating an avocado a day had improved sustained attention, working memory and efficiency in approaching a problem, leading researchers to concluded, “Dietary recommendations including avocados may be an effective strategy for cognitive health.”
The avocados proved to be an excellent way to boost lutein levels, even though they contain relatively little. The researchers speculated this may benefit brain health via:
Modulating functional properties of synaptic membranes in the brain
Changes in the physiochemical and structural features of synaptic membranes in the brain
Avocado also has at least 28 known actions by which it exerts benefits on your body. In addition to helping your brain, avocado is a known ally for your heart. In fact, that one avocado a day may not only give you a cognitive boost but has been shown, in separate research, to improve cholesterol and lower your cardio-metabolic risk factors.
It’s just one example of why eating whole superfoods like avocado makes sense; check out GreenMedinfo’s research database for more of the latest avocado research.
The GMI Research Group (GMIRG) is dedicated to investigating the most important health and environmental issues of the day. Special emphasis will be placed on environmental health. Our focused and deep research will explore the many ways in which the present condition of the human body directly reflects the true state of the ambient environment.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.
Pyrroloquinoline quinone (PQQ) is particularly important for the health and protection of your mitochondria. It also helps regenerate new mitochondria
PQQ has been shown to improve the function of beta amyloid-damaged brain cells — a hallmark of Alzheimer’s disease — and prevent the formation of alpha-synclein proteins associated with Parkinson’s disease. It can even help prevent neuronal cell death in cases of traumatic brain injury
Studies show PQQ improves mental processing and memory. It also works synergistically with CoQ10, producing better results than either of these nutrients alone
PQQ lowers C-reactive protein and interleukin-6, which are inflammatory biomarkers, and upregulates Nrf2 expression — a biological hormetic that upregulates beneficial intercellular antioxidants
PQQ has also been shown to boost the activity of primary life span extension transcriptional factors, which led the researchers to surmise that PQQ may play a role in longevity
While your diet is one of the most important tools you can use to take control of your health, certain supplements can be helpful, especially when it comes to improving your mitochondrial function. One particularly powerful supplement in this regard is pyrroloquinoline quinone (PQQ),1 which has been shown to promote the growth of new mitochondria (mitochondrial biogenesis).
Your mitochondria also require PQQ to catalyze energy producing reactions, and it’s critical in protecting your mitochondria from damage. Your mitochondria are the tiny energy producers inside your cells, which is why mitochondrial dysfunction is at the heart of just about all chronic diseases, old age and death.
In order for your body to function properly, it needs sufficient energy and, for that, you need well-nourished, well-functioning mitochondria. PQQ is an important player in this regard.2 As noted by Dave Asprey, founder of Bulletproof and author of books on energy, life span and brain power:3
“Anti-aging starts at the cellular level and PQQ is an easy way to protect your cells, all while helping to improve the most mitochondrial-dense parts of your body like your brain and heart.”
PQQ Enhances Mitochondrial Density and Function
PQQ is relatively unique in its ability to enhance mitochondrial biogenesis, i.e., the creation of new, healthy mitochondria in aging cells, which is the basis of so many of its health benefits. As reported by Better Nutrition magazine:4
“In addition to improving energy production, this characteristic of PQQ shifts some of the aging process into reverse gear. In a study5 at the University of California, Davis, researchers gave a small group of men and women PQQ supplements and tested the effects 76 hours later.
Using blood and urine tests, researchers found that PQQ improved mitochondrial performance and reduced chronic inflammation. The effective dose was 0.3 mg of PQQ per kilogram of body weight — 20 mg of PQQ for a 150-pound person, as an example.”
One mechanism by which PQQ lowers inflammation, improves mitochondrial function and stimulates mitochondrial biogenesis is by upregulating Nrf2 expression — a biological hormetic that upregulates intercellular antioxidants such as superoxide dismutase and catalase.
PQQ has also been shown to boost the activity of primary life span extension transcriptional factors, which led the researchers to surmise that PQQ may play a “novel role” in longevity.6 Indeed, it modulates a variety of signaling pathways, including mTOR, which plays a role in aging and cancer,7 and helps repair DNA,8 all of which suggests it may help you live longer.
PQQ also enhances NADH,9 which is converted to NAD+ as food is broken down into energy.10 When DNA damage is repaired, NAD+ is used up, and if you run out you can’t repair the damage, which is likely the central cause for most of the diseases we are seeing in the modern world now.
How PQQ Protects and Benefits Your Brain
PQQ’s ability to shield your brain cells and their DNA from harm also suggests it can be a powerful preventive aid against neurodegenerative diseases. Mitochondrial DNA is quite prone to damage from free radicals and pro-oxidants. Most of the free radicals in the body are produced within the mitochondria themselves, which is why they’re so susceptible.
Free radicals are an unavoidable artifact of converting food into cellular fuel, and your food is ultimately metabolized in your mitochondria. PQQ has been shown to protect against this kind of damage. It also activates your mitochondria’s built-in repair and replication mechanisms.
In your brain, the practical end result is an overall improvement of neurologic function,11 including improved cognition, learning and memory,12 and a reduced risk of neurodegenerative diseases. Research13 has shown PQQ protects and improves the survival of neurons by stimulating the synthesis of nerve growth factor (NGF) in certain glial cells found in your central nervous system.
It’s also been shown to improve the function of beta amyloid-damaged brain cells14 — a hallmark of Alzheimer’s disease — and prevent the formation of alpha-synclein proteins associated with Parkinson’s disease.15
According to a 2012 study,16 PQQ can even help prevent neuronal cell death in cases of traumatic brain injury. According to the authors of this study, “PQQ may play an important role in recovery post-TBI.”
Adding CoQ10 Provides Synergistic Benefits
Both animal and human studies using doses between 10 and 20 milligrams (mg) of PQQ have demonstrated improvement in mental processing and memory on its own, but combining it with Coenzyme Q10 could potentially be even more beneficial.
One study found PQQ in combination with CoQ10 produced better results than either of these nutrients alone, so there appears to be some synergistic effects. I recommend using the reduced form of CoQ10, called ubiquinol, as it is more readily available for your body.
Both CoQ10 and PQQ are fat-soluble, so they’re best taken with a small amount of fat in your meal rather on an empty stomach. In addition to being a powerful antioxidant in its own right, CoQ10/ubiquinol also facilitates the recycling (catalytic conversion) of other antioxidants, so when taken in combination with PQQ, you’re really turbocharging your body’s antioxidant capacity.
PQQ Is a Powerful Antioxidant and Immune Booster
Another reason why PQQ is so beneficial has to do with its powerful antioxidant activity. It’s capable of undergoing upward of 20,000 catalytic conversions. A catalytic conversion is when an antioxidant neutralizes a free radical. In other words, PQQ is a remarkably efficient antioxidant. For comparison, vitamin C can only go through four catalytic conversions before it’s used up.17,18
Research has shown PQQ lowers the inflammatory biomarkers C-reactive protein and interleukin-6 in humans at doses between 0.2 mg and 0.3 mg per kg.19
PQQ also supports your immune function and PQQ deficiency has been linked to immune dysfunction.20 In one study,21 PQQ supplementation increased the responsiveness of B- and T-cells (white blood cells that play central roles in your immune response) to mitogens (proteins that induces cell division or mitosis).
PQQ Activates Metabolic Master Switch
The list of potential applications for PQQ is extremely long, as its metabolic effects go well beyond improving mitochondrial function. For example, it helps activate adenosine monophosphate-activated protein kinase (AMPK), which is an important molecular target for metabolic health.
AMPK is an enzyme inside your body’s cells. It’s sometimes called a “metabolic master switch” because it plays an important role in regulating metabolism. As noted in the Natural Medicine Journal:22
“AMPK induces a cascade of events within cells that are all involved in maintaining energy homeostasis … AMPK regulates an array of biological activities that normalize lipid, glucose, and energy imbalances.
Metabolic syndrome (MetS) occurs when these AMPK-regulated pathways are turned off, triggering a syndrome that includes hyperglycemia, diabetes, lipid abnormalities, and energy imbalances …
AMPK helps coordinate the response to these stressors, shifting energy toward cellular repair, maintenance, or a return to homeostasis and improved likelihood of survival.
The hormones leptin and adiponectin activate AMPK. In other words, activating AMPK can produce the same benefits as exercise, dieting, and weight loss — the lifestyle modifications considered beneficial for a range of maladies.”
With age, your AMPK level drops naturally, but poor diet can reduce AMPK activity at any age. This enzyme plays a major role in body fat composition, inflammation and blood lipids, so boosting its activity can go a long way toward improving blood sugar control, reducing visceral fat and lowering LDL cholesterol.
AMPK also stimulates mitochondrial autophagy (mitophagy) and mitochondrial biogenesis, as well as five other critically important pathways: insulin, leptin, mTOR, insulin-like growth factor 1 (IGF-1) and proliferator-activated receptor gamma co-activator 1-alpha (PGC-1α).
It is important to note that PQQ will not likely work well, if at all, if you are eating around the clock, as elevated insulin levels will activate mTOR and inhibit AMPK, thus limiting PQQ’s ability to increase it.
Other Benefits of PQQ
PQQ has also been linked to several other health benefits, including:
Improved reproductive outcomes in animals23 (PQQ deficiency has been linked to abnormal reproductive performance24)
Reduced risk of nonalcoholic fatty liver disease in offspring when given to obese mouse mothers during pregnancy and lactation25
Improved sleep (by modulating the cortisol awakening response)26
As you can see, the list of PQQ’s health benefits is quite long. And, while PQQ is found in foods such as natto, parsley, green pepper, spinach, papaya, kiwi and green tea,27 the amounts you get from your diet are likely to be insufficient if you want to reap all of its beneficial health effects.
When taking a PQQ supplement, you’ll know within a few weeks whether the brand and dosage is working for you. Overall, you should feel better, with greater energy and clearer thinking.
Hyperbaric oxygen therapy (HBOT) involves breathing air or oxygen in a pressurized chamber. The pressure allows your body to absorb a higher percentage of oxygen
There’s a wide range of conditions for which HBOT can be beneficial, including autoimmune conditions, neurological conditions, musculoskeletal injuries, mitochondrial dysfunction-driven conditions, ailments involving damaged microcirculation, chronic infections, subacute infections and cancer co-management
Hyperbaric oxygen improves mitochondrial function, helps with detoxification, inhibits and controls inflammation and optimizes your body’s energy production and healing capacity
HBOT also activates stem cell production, and can help optimize results when doing stem cell therapy
While HBOT can speed healing of any inflammatory condition, in the U.S., there are only 14 conditions for which insurance will pay, one of which is diabetic neuropathy, and typically only after other conventional treatments have failed. There are over 100 internationally recognized indications for hyperbaric use
In this interview, Dr. Jason Sonners discusses hyperbaric oxygen therapy (HBOT), which is a tremendously beneficial and widely underutilized therapy. Sonners, a chiropractor, also has a degree in applied kinesiology,1 and has worked with HBOT for over 12 years.
Even if you’re not trying to treat a specific condition and are generally healthy, HBOT can have significant benefits for longevity.
“On its most basic premise, hyperbaric oxygen [therapy] is literally the breathing of either air or oxygen under pressure. You’re inside some type of pressurized device or hyperbaric chamber. Due to the pressure, you’re exposing the body to a higher percentage of oxygen.
You could also increase that oxygen by piping oxygen into the chambers. As a result of that environment, you’re increasing the body’s capacity to absorb more oxygen than what you and I can get here at 1 atmosphere (atm),” Sonners explains.
Hyperbaric Oxygen Therapy Basics
Most healthy individuals have somewhere between 96% and 98% oxygen in their hemoglobin, which means your capacity to increase your oxygen level is between 2% and 4%, were you to breathe medical-grade oxygen, for example. That’s it; there’s no way to raise your oxygen level beyond that. The exception is if your body is under pressure.
“Two main laws govern how that works,” Sonners says. “Boyle’s Law and Henry’s Law. Basically, as you take a gas and exert pressure on it, you make the size of that gas take up less space. As a result of that pressure, you can then dissolve that gas into a liquid.
An easy example is a can of seltzer. They’re using carbon dioxide and water. But basically, you can pressurize that can, so you can put carbon dioxide into that can. As a result of that pressurization, you can dissolve molecules of carbon dioxide into the water.
In the hyperbaric version of that, we’re using oxygen, and the can is the chamber. But as a result of dumping excess oxygen inside that chamber, you can dissolve that into the liquid of your body … directly into the tissue and the plasma of your blood.
Normally your blood does not carry oxygen. We rely wholly on red blood cell oxygen-carrying capacity. But inside the chamber, you could literally bypass the red blood cell oxygen-carrying capacity altogether, and you can absorb oxygen directly into the plasma and tissue of the body.”
Your Body Needs All the Oxygen It Can Get
Sonners, who has a lot of experience with functional medicine and nutrition, views oxygen primarily as a nutrient.
“We need about 100% of the oxygen that we’re capable of carrying every minute of every day just to perform normal functions,” he says, “so there’s very little room for creating an excess of oxygen for the sake of healing or helping some of the conditions that we’ll talk about later on …
In nutrition, there’s deficiency, which has consequences. There’s optimum range, which is allowing us to do what we need to do every day. And then there are periods where we need a surplus of that nutrient to help us deal with some issue that we’re having in our health or in our life.
I look at oxygen the same way. If you’re not getting enough oxygen, whether that’s globally because of a lung or heart issue or if that’s locally because of a trauma … or some type of injury or inflammation, you could have an area of your body that has oxygen deficiency. We call that hypoxia.
There’s an optimum range of oxygen, which for us is virtually almost 100% of our oxygen-carrying capacity, every minute of every day. And then periodically, we might choose that we want to create a surplus of oxygen because oxygen … helps us detoxify, it controls inflammation, it runs our energy production and helps us to heal …
Once you expose the body to increased levels of oxygen … the whole oxidative phosphorylation [process], the whole ATP and energy production system of our body increases its capacity to produce ATP and to produce energy …
Sometimes, we might need more than the optimum range to help us get over some sort of health issue, or … from a quality of life, longevity, regenerative medicine-type standpoint …”
Conditions That Can Benefit From HBOT
Considering the importance of oxygen, there’s a long list of conditions for which HBOT is recommended. Insurance will pay for some, but not anywhere near all of them.
While HBOT can be used to help speed healing of any inflammatory condition, in the U.S., there are only 14 conditions for which insurance will pay, whereas there are up to 100 approved indications for HBOT internationally.
“In the States, we reserve it for pretty tough cases: really bad infections like gangrene, osteomyelitis, radiation burns … diabetic neuropathy … chronic wounds that are not healing with traditional attempts at antibiotics and things like that,” Sonners says.
From my perspective, it’s medically reprehensible and inexcusable for a doctor to not treat patients with diabetic neuropathy, infections in the distal extremities or peripheral vascular disease with HBOT, as it will in most cases prevent the need for amputation.
That the U.S. limits the use of HBOT to a last resort for only a few hard-to-treat conditions is truly unfortunate, as there’s a wide range of other conditions for which HBOT can be beneficial. This includes:
Any condition involving damaged microcirculation or that can benefit from capillary growth
Chronic infections such as Lyme disease, and subacute infections that cause damage over time — As noted by Sonners, “When you go into these pressurized hyperbaric chambers and you’re breathing and absorbing these higher levels of oxygen, they literally act as a natural antibiotic.”
The hyperbaric oxygen kills anaerobic bacteria and helps break down the biofilm that many anaerobic bacteria produce to protect themselves. At the same time, it’s boosting your immune system through increased neutrophil-macrophage stimulation and by feeding healthy bacteria.
Hyperbaric oxygen also combats viral and fungal infections, in part by stimulating neutrophil and macrophage activation. “You literally stimulate an increased production of white blood cells,” Sonners says, “and that’s what your body uses to fight infections”
Cancer co-management — As noted by Sonners, researchers are looking at HBOT in cancer treatments in a number of different ways. For example, doing it may allow you to use less radiation or chemo and still get the same outcome. Or, it may allow the patient to tolerate higher amounts of radiation by speeding the healing between sessions. A third avenue of investigation is the use of HBOT in isolation.
“Some of them are using it as a method to help with or augment the cancer treatment itself. Some are using it as a way to heal,” Sonners says. “There are consequences of chemotherapy. There are consequences of radiation.
The idea with most cancer treatments is we’re trying to kill cells. Hopefully, the person survives that process. If you’re augmenting with hyperbaric oxygen simultaneously, the idea is that you’re also helping to heal the tissue so that the healthy tissue can still survive or even thrive …”
HBOT Improves Mitochondrial Function
“If the idea is that we need to control inflammation, if we need to improve the rate of healing, if we need to improve mitochondrial function — all of these are going to be very solid indications of people who would respond very positively to hyperbaric treatment,” Sonners says.
One of the reasons I’m fascinated by HBOT is because of its ability to improve mitochondrial function. As noted by Sonners, longer term hyperbaric exposures will result in larger mitochondria and a greater density of mitochondria.
“Just to give you an idea, [after] 20 or 40 hours of exposure, what you’re going to end up getting [are] more efficient, bigger mitochondria, and you’re going to get a lot more of them,” he says.
“Even if you’re stuck at like 80% efficiency, if you had twice as many mitochondria, producing 80% efficiency, you’re still going to get a much better output for the patient. I think the capacity there for improving these chronic illnesses is really tremendous.”
HBOT Boosts Stem Cell Production
HBOT also activates stem cell production. Conventional stem cell therapy can cost $10,000 to $20,000 and isn’t covered by insurance. HBOT costs far less, may be covered by insurance (depending on your condition), is completely safe and has a whole host of other beneficial effects as well.
Even if you decide to get stem cell therapy, using HBOT before and after can significantly improve your end results, as the hyperbaric oxygen will help optimize your internal environment to make it more conducive to the newly injected stem cells.
Sonners suggests 10 to 20 hours of HBOT before your stem cell treatment, as that’s when your body will start upregulating its own stem cells. If you’re extracting the stem cells from your own body, you will now also have much higher amounts. After the stem cell injection, Sonners suggests doing 20 to 40 hours of HBOT to make sure the new stem cells will thrive.
Difference Between HBOT and EWOT
On a side note, there’s a similar therapy that many people confuse with HBOT. EWOT is an acronym for “exercise with oxygen therapy,” which usually involves using an oxygen concentrator and a large oxygen-filled bag that you then breathe from while exercising.
While EWOT certainly has its benefits, it’s not interchangeable with HBOT. They’re really very distinct therapies and accomplish different things. For starters, while EWOT is an active process, hyperbaric oxygen is a passive process.
With hyperbaric oxygen, you’re typically sitting or lying down and simply breathing normally. “Especially in some patient populations, you can’t even express the level of exercise you would need to in order to gain some of those benefits. That’s one difference,” Sonners says.
The primary difference, however, is that with EWOT, you’re basically increasing demand through exercise, and then you’re increasing supply through the oxygen concentrator. However, you’re still relying on your red blood cell oxygen-carrying capacity.
“If you have an issue that is trauma-related — chronic inflammation, damage to the microcirculation — there’s nothing about that excess oxygen that you’re creating through supply and demand that’s ultimately ever going to change that. So long as you are relying on red blood cells carrying, you will not get oxygen to the damaged site.
The only way you’re going to change that environmental issue, and especially the microcirculation … [and stem cells, is through] exposures to oxygen [under] pressure. This is where oxygen will be absorbed directly into the plasma and tissues along the hypoxic tissue gain access to the oxygen.
What we’re finding is that it’s not just the level of oxygen absorption. Some of our epigenome is pressure-sensitive. Pressure alone increases the response to oxygen and stimulates some of these healing responses.
The biggest difference is that one is active and one is passive. One is still relying on red blood cell oxygen-carrying capacity; one is basically bypassing red blood cell oxygen-carrying capacity.
To some degree, they’re both increasing oxygen, but I don’t think you could really compare it. I mean hyperbaric is definitely increasing oxygen capacity to a degree that is significantly higher than anything else that exists.”
So, to recap, your red blood cells (if you are healthy) are typically already saturated with oxygen at 98% to 99%, and breathing pure oxygen at normal pressures will not significantly change that. But if you breathe oxygen under pressure, it will diffuse into your cellular fluids and provide a greater delivery of oxygen to your tissues, especially if they have compromised microcirculation.
Soft Versus Hard Shell Chambers
There are two primary types of HBOT chambers: hard shell and soft shell. Hard-shell versions are available in two types — the kind you find in hospitals and the kind you typically find in private clinics or can purchase for home use.
•Hard shell 100% oxygen hospital chambers are capable of the highest pressures, which in some cases can be important, especially in cases of nonhealing wounds. In this kind of chamber, the pressurization is done with 100% oxygen. While oxygen is not really flammable, it’s an accelerant, so you have to be very careful not to create sparks. You’re wearing cotton scrubs and you can’t bring anything inside the chamber.
•Hard chambers are the next step down. Instead of filling the whole hard chamber with oxygen, air is used to create pressure, and then oxygen is being piped in separately for you to breathe.
In this type of chamber, you can wear whatever clothing you want as you don’t have the same safety concerns. You can even bring certain electronics into the chamber. In many situations, this is an ideal choice, as the safety is higher while the effectiveness of the treatment is identical, especially for most internal issues. These types of chambers are often found in private clinics.
•Soft chambers are limited in terms of the pressure you can achieve. “In the U.S., you’re only allowed to go to 1.3 atmospheres (ATA), which is about a relative 9 feet underwater. It’s considered mild HBOT. It’s about 4 to 4.25 pounds of force per square inch (psi),” Sonners says.
Still, it will allow you to absorb quite a bit more oxygen than you could normally, so it still offers very meaningful benefits. You may need to use it more frequently, and for longer duration though.
While treatments involving hard shell chambers with 100% oxygen are quite costly, typically running around $2,000 per treatment (which may or may not be covered by insurance), hard and soft chambers found in private clinics are much more affordable, typically ranging between $90 to $180 per session. While this may still sound like a lot, it could well turn out to be one of your less expensive options in the long run.
“Clinically, we used to do our typical protocols. When people weren’t responding the way we expected them to, we would introduce hyperbaric oxygen.
At this point, it’s become literally one of the first things that we do, because if we do [HBOT] early on, so many of the other therapies that we used to have to do, we don’t need to do anymore,” Sonners says.
HBOT Treatment Suggestions
Typically, you’d want to start out getting about 10 hours of treatment at a local facility to see if and how your condition responds. If you’re trying to address trauma, an injury or a condition that has a beginning and end, then whatever benefits you get from the therapy, you will keep as you heal.
Progressive and degenerative conditions, on the other hand, and/or if you’re using it for longevity purposes, treatment will need to be ongoing for long periods of time. This is a case in which you may want to consider buying your own chamber.
“Somewhere between 10 and 20 hours, you kind of know if it’s a good fit for you. From that point, with guidance of the practitioner, you should be able to figure out a baseline of what your protocol should look like,” Sonners says. “Ultimately, if you’re going to be using this thing for years and years, then you’re better off, in most cases, just to have your own.”
Unfortunately, it can be tricky finding a local HBOT facility. Usually, online search results tend to focus on hospitals, and hospitals will not provide you with HBOT unless you have one of the 14 approved indications.
“To find a center, you’re just going to be looking up hyperbaric oxygen [centers]. You’re going to be looking in the private sector, because those are the only people outside the hospital who are going to treat these other indications,” Sonners says.
One alternative is to contact either the International Hyperbaric Association2 (IHA) or Hyperbaric Medical International3 (HMI). These are the two organizations focused on educating the public on the use of HBOT in the U.S., especially for indications that aren’t FDA-approved.
“They have a tremendous amount of resources,” Sonners says. “They also probably help direct people … to centers that might be more local … That’s probably the best. Otherwise, you’d be looking at different manufacturers that produce chambers and how to get those into your home.”
If you’re in New Jersey or Pennsylvania, you can visit one of Sonner’s clinics — New Jersey HBOT Center, or HBOT PA. You can also learn more on HBOTusa.com, which is Sonner’s primary education website. There you can find a list of treated conditions, research, the benefits of HBOT in athletics, testimonials and much more. Sonners has also written a book, “Under Pressure: How One Unexpected Tool Is Revolutionizing Health,” which you can preorder here.
If you know what depression feels like – the brain clouding, the flat moods, the tiredness – you’re not alone. Over 300 million people around the world have depression, and yet there’s a lot that we still don’t quite understand.1
Thankfully, the medical field is developing some new insights that just might help us understand depression better. In a new 2019 study, researchers decided to examine the potential mechanisms of major depressive disorder in teenage girls and found some evidence that could help us better understand exactly how gut permeability (leaky gut) can lead to inflammation, which in turn, leads to depression.
New Insight into Leaky Gut and Depression
In this 2019 study, Baylor College of Medicine researchers are directly looking at gut permeability and major depressive disorder, a study that is the first of its kind.2
With a sample of forty-one 12-17 year-old teenage girls who were medically healthy, the study measured the severity of the girls’ depressive symptoms, the activity of the autonomic nervous system, intestinal permeability, or gut leakiness, and the number of inflammatory cytokines.
To measure whether the girls were depressed, an interviewer performed the Children’s Depression Rating Scale-Revised (CDRS-R) and a clinical interview. The CDRS-R is a rating scale that requires interviews of both child and parent to understand the severity of a child’s depression. Over the past few decades, the CDRS-R has become the most widely used rating scale for assessing severity and change in depression for clinical trials involving children and adolescents.3 In order to collect data on the autonomic nervous system activity, researchers measured pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) data, which are indicators for the activity levels of the sympathetic nervous system and parasympathetic nervous system respectively. They measured the leakiness of the gut using the lactulose-mannitol ratio (LMR), which involves having the teens first fast overnight and then ingesting a premeasured amount of lactulose and mannitol. The researchers then collected the urine for four hours after ingestion. By looking at the ratio of lactulose and mannitol that passed through the gut lining, researchers could calculate the permeability of the gut lining, or how “leaky” it was. To measure inflammation, the researchers took blood samples and measured inflammatory cytokines.
They found that in unmedicated teenage girls between the ages of 14-17, depression severity was associated with increased intestinal permeability, as measured by the lactulose to mannitol ratio. The leakier the gut, they found, the more severe the depression and depressive symptoms. They saw that the higher the concentration of the cytokine IL-1β, the more severe the depression. They also found that increased intestinal permeability may be the path between sympathetic nervous system activation and depression severity. Additionally, their evidence suggested that increased intestinal permeability may activate the innate immune system and push the development of depression.
The result of this study also helps clarify the mechanisms through which activating the sympathetic nervous system can increase gut permeability and activate the innate immune system–two things that are likely contributing to depression symptoms.
The Brain, The Gut, and the Immune System
If you’re wondering why intestinal permeability is related to depression, let’s back up and walk through the whole pipeline.
We start with the immune system. Throughout the last century, psychiatry has been exploring the role of the immune system in certain presentations of depression. Importantly, the gut houses over 70% of our immune system, which makes sense given that the lining of your gut is the barrier between your insides and the outside world. The gastrointestinal epithelium usually forms a single-cell-thick barrier that prevents the free movement of toxicants, microbes, and microbial antigens from entering into the rest of your body. This lining usually does a good job absorbing things we need (like food) and interfacing with foreign things that might wreak havoc–which is probably why most of our immune cells are located in the gut.4 The relationship between the gut and the brain is both complex and important. We’ve all felt the butterflies in our stomachs when we’re nervous or anxious, but it turns out that the relationship between the brain and the gut is actually bidirectional. Not only can our brains affect how our guts feel, but our gut can relay its state of calm or alarm to the nervous system and send those immune reactions up the vagus nerve to the brain.
To understand how the gut and depression are related, we should first better comprehend the triggers for inflammation, what inflammation is, and how it happens.
Stress Drives Inflammation
So what IS inflammation in the first place? Inflammation is the body’s defensive response to stresses, like injury or the ingestion of bodily-incompatible chemicals. Upon approaching a stressor, the immune system kicks into a higher gear to heal the body.
Stress is a catch-all term, a trigger that links hormones to inflammation. Essentially, when the body thinks something is wrong, the body releases hormones that tell the body to be on the lookout and get on defense, and inflammation occurs. These triggers can come in all forms, many of which are actually staples of modern American life, from sugar to stress to pesticides and pollution to anxiety to beyond. Whether psychological or physiological, stress drives the inflammation response by telling the brain to release cortisol, the steroid hormone that acts as nature’s built-in alarm system and makes it for our bodies to use blood sugar for energy so that we can flee from whatever is causing the stress.5
Once inflammation is started, not only does inflammation cause more inflammation, but recent studies have linked low-grade inflammation to depression. When inflammation reaches the brain, cells begin to take their limited supply of tryptophan to produce more anxiety-provoking chemicals like quinolinate.6 Medical literature has found that inflammation seems to be a consistent marker of depressive symptoms, like flat mood, slowed thinking, avoidance, alterations in perception, and metabolic changes.
When the body is stressed, the junctions between cells in the stomach can be less effective than they should be.7 This allows bacteria and toxicants to enter the bloodstream that can continue to cause widespread inflammation and possibly trigger a far-reaching reaction from the immune system.8 Having leaky gut cause inflammation sets off a problematic chain of events because the gut has a direct link to the brain through the vagus nerve.9
The medical field has been slowly inching up on a fuller understanding of the link between intestinal permeability (“leaky gut”) and depression. Previous studies focusing on depression and have found the chemical hints of leaky gut. For example, one study showed that patients with a recent suicide attempt had higher concentrations of an anti-lipopolysaccharides (LPS) antibody, meaning that the immune system had either encountered more of or reacted defensively against LPS, which is a molecule that marks microbe-associated patterns in the body.10 In another study, compared to healthy controls, adults with depressive or anxiety disorders, who didn’t have any symptoms of gastrointestinal disorders, still had higher concentrations of fatty acid-binding protein-2, which is produced to signify impaired intestinal epithelium integrity.11 These studies, and the first study we discussed in this post, suggest that intestinal permeability may be impaired in depression.
So What Do We Do?
All of this sounds kind of complicated, but really, this approach to depression-seeing it as a symptom that results in unhealthy inflammatory balance-means that we might be able to do more about it. It means that depression isn’t happening because of genetics or not enough serotonin. Instead, you’re probably experiencing low-grade inflammation that’s happening because your gut is stressed and leaky. The goal is to send your system a signal of safety – from the gut, from the mind, or by lessening perceived stressors and burdens through detox.
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Dr. Brogan is boarded in Psychiatry/Psychosomatic Medicine/Reproductive Psychiatry and Integrative Holistic Medicine, and practices Functional Medicine, a root-cause approach to illness as a manifestation of multiple-interrelated systems. After studying Cognitive Neuroscience at M.I.T., and receiving her M.D. from Cornell University, she completed her residency and fellowship at Bellevue/NYU. She is one of the nation’s only physicians with perinatal psychiatric training who takes a holistic evidence-based approach in the care of patients with a focus on environmental medicine and nutrition. She is also a mom of two, and an active supporter of women’s birth experience. She is the Medical Director for Fearless Parent, and an advisory board member for GreenMedInfo.com. Visit her website.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.