Neuroinflammation, Brain Function, & Mental Health

Kalea Wattles, ND:
As one of the most critical and complex organs in the body, the brain is responsible for regulating autonomic function and keeping physiological and mental-emotional processes in balance. For psychiatric conditions like depression, anxiety, and schizophrenia, symptoms may have somatic root causes in the brain. Neuroinflammation is a mediating factor that may be present in these conditions as well as cognitive decline and dementia. While mood disorders and cognitive impairment may seem like intangible symptoms, the decline of autonomic and motor function is also associated with the decline in physical brain matter. How can we optimize brain health and preserve neurological function throughout the lifespan?

On this episode of Pathways to Well-Being, Dr. Jaquel Patterson explores the systemic impacts of neuroinflammation on physiological and psychiatric conditions and outlines functional medicine approaches to optimizing brain health. Welcome to the show, Dr. Jaquel!

Jaquel Patterson, ND, MBA, IFMCP
Thank you. Thank you so much for having me. Really excited to be here to present on this or to speak on this really, really important topic.

Kalea Wattles:
Well, I think brain health is something that is relevant to all of us. It's something that we all want to think about over the lifespan, and I think it's really, functional medicine is really well-suited to address brain health because typically we think about neurology as its own separate or distinct discipline. But now we have all this research showing us that the health and the function of the brain has significant impact on disease in other areas of the body. And I think this feels so well-aligned with the systems biology approach that we use in functional medicine. So I wanted to start our episode today talking a little bit about symptoms because I think a lot of us, it's intuitive, maybe memory loss or some kind of cognitive decline, okay, we can understand how that's related to the brain, but there might be some other symptoms or clusters of symptoms that are indicative of brain dysfunction. Will you walk us through some of those things that you're looking for? Maybe some red flags you're looking for?

Jaquel Patterson:
Yeah, so one of the pieces is that we tend to, especially as we get older, we're in a very busy, fast-paced lifestyle. We tend to sometimes write these things off as due to stress, or due to overwhelm, or a busy mom, for example. And so the symptoms can include things like not just general cognitive decline that people are aware of, brain fog, memory. So a lot of people will have it start beginning with, like, short-term memory issues, inability to focus attention. Also, there's a huge interrelation too as well with brain health and also the gut microbiome. So a lot of individuals might be having digestive issues as well, which can also impact their brain health. So I think inattentiveness and focus is something that we tend to just write off again as stress or overwhelm. But things that, those small little baby things that we kind of disregard might actually be the beginnings of things like neuroinflammation. Sleep issues, insomnia, chronic stress will cause brain inflammation. So it really affects all different systems of our body, just like many things in our approach in functional medicine. And what I love about this topic is neuroinflammation and the causes of it and how that can affect brain health because oftentimes we're just looking at things like our neurotransmitters, but how does inflammation actually also impact our brain health negatively where there's this interrelationship between that as well as our neurotransmitter function?

Kalea Wattles:
Well, I'm already picking out so many body systems from what you're talking about. We've got the inflammation, we've got the immune component, we've got the gut health. So looking at the functional medicine matrix, which is essentially a map of all of our body systems, are there some matrix nodes that you prioritize when you're either assessing or treating a patient who seems to have something going on with dysfunction in the brain?

Jaquel Patterson:
Yeah, so defense and repair is definitely one of the matrix nodes, and then also energy. So why energy? Because when we look at defense and repair and inflammation, there's just a lot more oxidative stress on our system and we tend to need, we start, our mitochondria becomes depleted. We need higher levels of antioxidants. So there's definitely a relationship between those two. Defense and repair is one of my primary ones, and oftentimes support by way of the energy matrix definitely needs to be done as well.

Kalea Wattles:
I think we'll explore the matrix in more detail, matrix nodes, as we go through, and defense and repair is the perfect place to start because this really represents chronic inflammation, and you've mentioned now this term neuroinflammation a few different times. I think that that might even require a little bit of background. Will you just give us the scoop, what even is neuroinflammation?

Jaquel Patterson:
What is neuroinflammation? So we have our brain, we have what's called the blood-brain barrier. And the blood-brain barrier just protects our brain from basically any cellular traffic in and out, including, you know, white blood cells, damage, et cetera. And so most of that is actually eliminated. Our body does a great job of removing it; however, about two to three percent, there could be some solute leakage into the brain, which causes inflammation. And we have our central nervous system, which is composed of things like astrocytes, and one of the most, the major hallmarks of neuroinflammation or brain pathology is continued activation of what's called the microglia. So the microglia are, I always say it's like, they help with the macrophages’ removing of basically things that shouldn't be there. It's almost like they're coming in sweeping up the brain in terms of any, basically these inflammatory mediators or white blood cells, this leukocyte traffic and signaling that's interrupted. And so you have this activation of microglia, and when it does its job, it's clearing up everything. But the issue is when there's constant and chronic activation of the microglia, which can come from many different sources, but you'll see individuals with chronic disease conditions like type two diabetes, hypertension, autoimmune conditions, there's just a much, much higher level of this continued activation of the microglia, which in the end results in increased neuroinflammation.

Kalea Wattles:
Okay, that makes great sense. And you covered this a little bit, but hearing about neuroinflammation, I think any of us listening are like, okay, we have to figure out where this is coming from so that we can do some prevention. And you mentioned that there are some comorbid conditions, maybe inflammatory sources from other places in the body that are contributing to neuroinflammation. Will you just take a quick moment and review some of those, how maybe other organ systems can have some crosstalk? There seems to be crosstalk between the brain and these other organ systems that contribute to neuroinflammation. And you mentioned some chronic diseases that we see in clinical practice every single day, and maybe now we want to have the brain connection on our radar.

Jaquel Patterson:
Exactly. So there's tons of triggers of neuroinflammation, and when we look at chronic disease conditions like diabetes, we have this just chronic inflammatory process. And so the inflammatory markers, when you look at things like IL-6, CRP, those are at a higher level when you're looking at these chronic disease conditions like type two diabetes. And there are tons of studies that show manyfold increase with individuals with autoimmune conditions, particularly lupus as well as MS. And you have these autoantigens that cross the blood-brain barrier and also have been connected to increased risk of mental health conditions like schizophrenia. In fact, some studies have shown before a first psychotic event, there is a decrease in protective cytokines like interleukin-10, interleukin-4, and an increase in inflammatory mediators like IL-6. 

And so things like autoimmune conditions increase that risk of greater neuroinflammation and as well as chronic disease conditions like diabetes. But there are many other triggers. So people that have like TBIs, that's a trigger. There's tons of studies on infectious diseases, including COVID-19. We saw the increases up of mental health disorders as a result of it, hepatitis, HIV, so infectious triggers, bacterial infections have been connected, including things like Lyme disease, bartonella. But you also have those basic things like TBIs, chronic stress. Chronic stress affects the HPA access and causes inflammation. Environmental factors, mold has been connected, other, poor water or air pollution, people in, living in urban areas are at greater risk for neuroinflammation due to higher levels of things like arsenic, lead, cadmium. Aging, obviously, we know inflammaging. So aging is definitely one of the factors as well. And then, and then also when you look at things like pesticides, environmental exposures, and then the metabolic disorders like type two diabetes that I mentioned.

Kalea Wattles:
Yeah, I'm even thinking about a huge percentage of my patient population has hyperinsulinemia, so not even, not yet to a type two diabetes diagnosis, but really a lot of insulin. And I think about how that in and of itself can generate so much oxidative stress. So it makes me want to be really intentional about supporting metabolic health because ultimately there's an impact in the brain, and hearing you talk about all these potential triggers, the exposures, the inflammaging, the stress, I can see how just getting older, we just have longer exposure, more exposures to these factors, these predisposing factors. So once our brain is fully wired in young adulthood, what strategies can we use to protect the brain knowing that we have to engage in the world, and these types of exposures either to stress or to something environmental are somewhat inevitable?

Jaquel Patterson:
Yeah, so if you look at some basic things like exercise, exercise helps with cognitive decline, and they've had tons of studies of like just something as simple as walking 10,000 steps a day. I think we're trying to train to do these, thinking it has to be like a HIIT workout or these intense workouts, but actually things like exercise, anything that's going to increase circulation, anything where you are going to be challenging the brain by way of crossing like tai chi or kickboxing, or where things where you're crossing planes to help with cognitive function. 

Also, when you look at dietary pieces, going to the nodes of energy, typically antioxidants are going to be really supportive. There's tons of studies that have shown flavonoids, which are typically going to be in our fruits and vegetables, especially certain fruits, and colorful fruits have also a neuroprotective effect to our brain. So having a really good balanced diet by way of much more plant-based fruits and vegetables, those antioxidants will help with neuroinflammation. 

That, exercise, there have been studies for sauna. So sauna has been studied, we've done studies with thousands of individuals and have tracked them for decades and have shown sauna helping with decreasing CRP levels. And high CRP levels have been connected with things like anxiety and depression and cognitive issues. And so in those studies with things like saunas, they have shown decreased rates of schizophrenia over the long term because there's definitely a relationship between that and chronic or early-on inflammation. 

So there's also studies on forest bathing, grounding. Forest bathing has been shown in studies to decrease even CRP levels 30 days after actually doing things like forest bathing. So those are some things. And then protecting like the brain, like being mindful, especially children, teenagers that are in competitive sports, how do we prevent chronic injuries to the brain? There's a lot more support on that now in the last like five to seven years in being mindful of those activities and how you support the brain, so there's less damage. 

Also, obviously, major things like alcohol, smoking cigarettes, anything that's going to cause more, also environmental exposures as a relation of those things but are going to tax the system that increase inflammation overall as well. So generally, avoiding of those major things like alcohol, smoking, looking at environmental exposures, if you are living in an environment or working in environment with more pollution, what do you do to decrease it by way of filters, HEPA filters, et cetera? Good, clean water, continued exercise, sauna, forest bathing, and also community. There's been studies that have shown connections to people and community also help with our cognitive support, and it's something that even longevity, living longer by a connection to community and allowing you to get more external stimuli versus social isolation is actually a risk factor for mental health issues as well. So tons of things you can do supportive by way of lifestyle changes.

Kalea Wattles:
I think you just gave us a tour of the functional medicine matrix and all the modifiable lifestyle factors, which is so approachable, and I'm thinking, I mean is it safe to say that any of the interventions that we'll use to lower chronic systemic inflammation are ultimately going to be protective for the brain?

Jaquel Patterson:
100%, yeah. So definitely will be protective to the brain, and especially when you're talking about young brains and brains as we age, there are tons of studies that have even shown high CRP levels at a younger age, especially kids that have autoimmune conditions have significantly higher risk for things like schizophrenia and depression. And if you look at chronic metabolic disorders like type two diabetes, there's a much higher risk for depression as well. So as much as you can do even early on are really important for factors 20 years down the line that I think we wouldn't think would be connected, but inflammation, like you said, managing that can have these long-term benefits 20, 30, 40 years down the line for a young adult.

Kalea Wattles:
Right. When I find an elevated CRP, then we go inflammation hunting, and oftentimes I find that the gut is the source of that inflammation. We talked about, well I guess I want to focus on barrier function in the gut and the blood-brain barrier. So first let's start in the gut. If you're working up a patient who has a history of depression, anxiety, or some other dysfunction that you think is happening at the level of the brain, do you find that when you support their intestinal barrier function that their cognitive symptoms improve?

Jaquel Patterson:
Yes. And one of the, there are connections with serotonin, particularly in the gut. There are connections with our like altered glutamate, GABA, as well as dopamine in the gut. So there are also many studies that have shown deficiencies in things like Lactobacillus rhamnosus. So Lactobacillus rhamnosus is one that's been implicated as well as plantarum with mental health issues, and also, those help to support GABA levels, and GABA is an inhibitory neurotransmitter that helps us to be relaxed and calm. So when you look at individuals with more mental health disorders, they definitely tend to, if you look at the gut microbiome, have a deficiency in lactobacillus, especially strains like that Lactobacillus rhamnosus. 

And if you look at schizophrenia, there's been studies that've shown there's more facultative anaerobes and higher rates of things like Streptococcus vestibularis. And so supporting the gut health is really important, and if the permeability of the gut is weakened, they're just going to have to have higher levels of food allergies. There's going to be more exposures to things that they shouldn't have. There's going to be increases in histamine levels, and histamine also crosses the blood-brain barrier and will increase, is also considered, people don't think of but like an excitatory neurotransmitter. So see individuals with greater anxiety as well that have a lot of food allergies or environmental allergies because of histamine. So strengthening up the gut barrier, you can definitely see adjustments in mental health and also just decreasing downregulating inflammation overall and also better support of their neurotransmitters.

Kalea Wattles:
This is such a cool connection to think about, this, I guess we're now speaking about the structural integrity node of the functional medicine matrix, and I think many of us are comfortable with things that we can do to support that intestinal barrier function. But maybe I'm projecting, but I think many of us are less comfortable with interventions that can strengthen that blood-brain barrier or prevent its permeability. Will you walk us through some of your favorite interventions to support good integrity of that specific barrier?

Jaquel Patterson:
Yeah, so one of the ones I love, so Curcuma longa, and the reason I love it is because it also has been studied to help with digestive health. So a couple that have been helpful, a couple herbs that are helpful for both digestive health and brain health are actually ginger, which people only consider or think of for gut health. But it actually also helps with serotonin, it helps with balancing of serotonin levels and neurotransmitters. So we often just think of it for peristalsis, digestion, but it is one of the great ones to help not only with digestion but inflammation and also your neurotransmitter function. 

Now Curcuma longa, curcumin, turmeric has been like, there's been thousands of studies, actually even more studies for mental health, particularly depression, than actually even other studies. But it also is great for the liver and digestive health, and that has been shown to not only help with COX-1 and COX-2 but also downregulate IL-6, and IL-6 has been one of the ones, is really the most common pro-inflammatory mediator connected with neuroinflammation and brain health. And so that's another one I love. 

There's tons of other ones like Scutellaria baicalensis, which is, or I'm sorry, Scutellaria lateriflora. There's several scutellarias, but that one helps with blood-brain barrier disruption and also helps with the neurotransmitters and also other things like fish oils, omega-3, borage oil has been heavily studied to help to support brain health as well. 

Another, some other ones I love are phosphatidylserine, phosphatidylcholine. Phosphatidylserine has been shown to help also downregulate cortisol levels. So that's a great one in combination. So I'd love to see if I can get a nutrient or herb that covers more than one thing that the patient is dealing with. So something like phosphatidylserine, heavily studied for ADHD as well as Alzheimer's, but also helps to work with cortisol dysregulation. And so many individuals you may see with issues with neuroinflammation also have had chronic stress and cortisol imbalances. So phosphatidylserine can help with that and also help with sleep, which also tends to be an issue. So those are just some of the ones that have been studied, flavonoids have been studied as well for brain health and also supporting of neurotransmitter functioning.

Kalea Wattles:
It's pretty interesting, all of these interventions that you're sharing. I mean, so many of them, there's overlap with how they also support immune senescence. And so like you mentioned before, the longevity piece really seems like supporting the health of our brain. There's so many other implications for supporting our longevity and just our vitality ongoing into our life. So now we've talked about neuroinflammation and how this can potentially be a driver of brain loss. And so I wanted to talk a little bit about the brain anatomy. Will you just review like what are you looking for in terms of the anatomy of the brain, and how can those changes influence these diagnoses that we might receive later?

Jaquel Patterson:
Yes. So you want to look at, I talked a little bit earlier about blood-brain barrier, and there are particular, when you look at cells, astrocytes, microglia, that get impacted as it relates to the brain function. But there are also certain parts of the brain that get impacted for different mental health disorders. So when you look at things like anxiety, you'll see ACC, you'll see prefrontal cortex implicated, you'll see hippocampus, you'll also see amygdala. And so these have all different functions. So if you look at things like hippocampus, that's responsible for your memory function, and that's why you'll see an individual with depression and anxiety, they will have issues with short-term memory, right? Or someone with really long chronic depression, they will have significant issues with memory, where they almost can present if it's significant enough, like a person that has dementia. 

The amygdala, amygdala is our, there's a saying of like controlling your amygdala. That's that immediate like emotional response that we might have. And that is one of the parts of the brain that's more impacted with anxiety in terms of emotions, that fight or flight, that kind of like that quick reaction when someone cuts you off on the road and you have that immediate reaction, that's the amygdala. And so those will have greater activity, different parts for different condition types. And so when you look at things, those brains, the brain function, the great thing is with some of these herbs, they help to support these different parts of the brain when we talked about like Curcuma longa, when we talked about Scutellaria lateriflora, that affects the ACC, prefrontal cortex. So there are a lot of herbs and nutrients that will support these different parts of the brain that are implicated for different mental health disorders.

Kalea Wattles:
So are you, is this just from the research setting, or are you actually sending patients to get imaging?

Jaquel Patterson:
For imaging, well sometimes I do, it is actually important. That's a good point. So if someone is having a lot of, especially any kind of like significant cognitive decline or coordination issues, et cetera, you definitely want to do more of a workup like an MRI or CAT scan to rule out that there's no other, that there's not a neurological disease like MS or Parkinson's or Alzheimer's because those will all, those can actually change. You can see, for example, somebody with MS may have plaques in their brain that are evident and that can increase over time as well. So scans are also helpful.

There are also different specialty tests that can check for some of the neuroinflammatory markers, so like MMP-9. So MMP-9 is also implicated when you look at autoimmune conditions. But also that one for chronic neuroinflammation you'll see that is elevated. There are also different panels that will test for like dopaminergic antibodies in terms of changes of those getting elevated. And so those can also help to see if there's like kind of any autoantibody cross reaction and crossing of the blood-brain barrier. So those are good. But also, obviously, like imaging, just basic imaging if there are things that seem pretty overt that there's a neurological disease, but you can also do different panels that will test for things like some of those inflammatory biomarkers that I mentioned.

Kalea Wattles:
Oh, so this part's so juicy because it's like what do we actually do? And you mentioned in the beginning of the episode that sometimes we have these kind of micro-cognitive symptoms, and we think oh, it's just stress, it's I'm not sleeping well, maybe I'm a new mom. How do you decide as the clinician, this is kind of normal because of this person's life stage, and now this has actually crossed a line where I need to escalate my treatment. Is it a combination of physical exam and labs or the patient's history? What's raising your index of suspicion that something is not right?

Jaquel Patterson:
Yeah, so one of the biggest things in the history taking, you want to see also the onset, and one of the pieces that we learned as IFM practitioners are those antecedents, what were some of the antecedents before. Also looking to see if there's kind of these very significant changes like, in the last year, ever since X happened, you want to see was there trauma, was there, for example, divorce, or a lifestyle, you know, something that could actually make sense versus all of a sudden, I had these changes in symptoms, but I'm completely unaware of where and why it started. 

So in those situations, that saying like, yes, don't test, we want to do definitely some ruling out of things like autoimmune conditions, some of the chronic metabolic disorders that I mentioned, inflammatory markers, CRP, ESR, I might even do things like IL-6, I might check IL-10. I will also look if there is any exposures to infections or environmental exposures, I can test for things like mycotoxin, urine mycotoxins. I might also do, there's neurotransmitter, a urinary neurotransmitter test to look at what those are. I look to see if there's changes in medications. You know, sometimes people have had changes in medications that can significantly impact them by way of like balance and cognitive issues as well.

So that's where what's great in functional medicine, we're going to look at that whole picture and see what changes have also happened over the course of time, and was this like a gradual buildup or an immediate buildup? If it's something more immediate, I might, you want to obviously have a maybe a quicker intervention versus gradual, let's say cognitive decline that may happen over time with age. But it is tricky. It's definitely a mix of clinical physical exam findings in terms of neurological assessment, it's really helpful, I find, when my patients also have family members, which you probably have all seen that come into the visit because they are sometimes able to put in those missing gaps of missing information that the patient may have forgotten. 

And one of the things I always say, I know when my patients are well that are having mental health or issues or cognitive issues is that that significant other or that partner or parent is no longer in the room, you know, they come by themselves. So when they come in by themselves after seeing them for three or more four months, I'm like, oh, something's changed. You must be feeling better because they actually often will feel like they need less support because they can recall what's happened over the last six weeks. So that's also an interesting finding I personally see where they need more of that like social support or connection as they're going through illness because of that starting of change of either physical symptoms and also mental symptoms.

Kalea Wattles:
Yeah, helpful to have those nuanced things that we're looking for. So if someone has structural changes to the brain that are kind of manifesting as symptoms and you do all this workup and we have all of these interventions and all the lifestyle factors, is it reversible? Will the structure change again or it's enduring and then we just have to manage the downstream effects?

Jaquel Patterson:
It depends. If it's structural, when you look at like our neurons and neuroplasticity, there's definitely ability to heal and to improve it. It just often takes, when there's been more issues with the neurons, it just takes longer to heal. They don't heal as fast as when you're looking at like muscle fibers and other parts of your body. They just take a longer period of time when there's actually structural changes like things like dementia, if you look at things like Parkinson's, or our goal is really to keep them as stable as possible. You might not necessarily have that reversing or changing in the structure of the brain. But being able to improve the quality of life and also to kind of keep things at a standstill. 

You will see definitely many more changes on things like mental health conditions. Even studies have shown that an individual, which is something you should as like a pearl look out for as a clinician, if you have a patient that has a psychiatric condition, particularly like anxiety, depression, and schizophrenia, and they continue to have basically where their medication has become less effective, like where they need to keep changing, which we see all the time, keep changing their medications or they need to go on higher amounts, there has definitely been connection with higher levels of inflammation will cause it where there's a greater need for higher dosing of medication, same as you'll see for thyroid condition. Like if a person's thyroid medication needs to keep increasing, there's connections with things like cortisol and cortisol interrupting thyroid hormone. And you'll notice the person needs to keep taking more and more and more thyroid medication. So those to me are always like red flags if I'm finding like, okay, the person was managed, and now they need to keep changing medications or they need to keep going up higher. You know, what is the reason why, what's going on physiologically in their body that can help and kind of bring them backwards? And to your point and your question of can we fix, especially if it's something like that, that some other physiological change is actually interrupting it, which is preventing like good progress, those things are much easier to be able to like fix and resolve.

Kalea Wattles:
Yep, that makes good sense. And I'm sure that as you are doing all of this workup in the immune system and with the chronic inflammation, that like we talked about in the beginning, you're addressing, it's a multi-system approach. So you're addressing the brain health but also the metabolic health, and I'm sure all of that shows up in an improvement in symptoms. And I want to dive a little bit into these modifiable lifestyle factors because you've talked, now you've mentioned, you know, sleep and community and exercise. Let's talk a little bit about nutrition because that is what some consider to be the tap root of our modifiable lifestyle factors, it's so foundational to the way that we treat patients. Are there some nutritional recommendations that you find yourself giving again and again in clinic that you'd be willing to share with us?

Jaquel Patterson:
Yeah, so some of the most basic things that we know is obviously limiting intake of, so I try to meet people, and that's what we do, I think, as functional medicine providers, is like meeting people where they're at. So if someone is eating tons of processed food, high fat intake of processed foods and those, that's like the first thing we want to work on is like how to decrease it because that is definitely connected to increasing up inflammation, inflammatory processes in the body. There are definitely several studies that have shown things like Mediterranean diet has shown to have a protective effect for things like anxiety and stress, ketogenic diet. A lot of providers, our functional medicine providers kind of have different nuances with diet, but ketogenic diet has also shown to help to support like neurotransmitter function and brain function and also hormone health. So depending on also the age of the person, that might change. 

But typically in terms of diets, the diets that have been shown to be the most helpful are rich in omega-3s, because omega-3 is anti-inflammatory, also composed of DHA, which is supportive for the brain health. Anything that has a lot of antioxidants are going to be very supportive for the brain health as well. Very good intake of amino acids. So for many of my patients too, they may not eat adequate, enough protein, and so they don't have those amino acids, which are all the building blocks for neurotransmitters. So when you look at things like dopamine, you need good amounts of l-tyrosine for dopamine, for norepinephrine, for epinephrine as well. And so there's many herbs that can help with that. Like rhodiola is one, and rhodiola also helps with inflammation, but it also helps with norepinephrine, epinephrine levels, et cetera. Mushrooms are all very supportive too when you look at things, like cordyceps I love because that's one that's also helpful for inflammation. But mushrooms are also, have shown to have what's called like BDNF factors, and those are all neurotrophics that are also supportive for the brain health. So definitely as much as a well-balanced diet as you can get, high, high, high in antioxidants, high in omega-3s, decreasing of processed foods. Mediterranean diet has been heavily studied for mental health and its benefits and also things like mushroom health because mushrooms have also shown to help increase things like GABA, which are also neuroprotective as well.

Kalea Wattles:
And I presume that this isn't just helpful for someone who has a diagnosis, that this is preventive as well. You have a Mediterranean diet and plenty of dietary protein and antioxidants, I would imagine that is going to be protective of your brain health into the future as well.

Jaquel Patterson:
Yes. So those are great things to start incorporating. If I have a young person that you know is on the college campuses where they're eating really bad food like I did when I was in college, I usually will just start working with like, okay, how do we decrease those processed foods and get some more vegetables into your diet because those are going to help them, like you mentioned, in the long run. And how do we start getting them to adopt healthier lifestyles, but they help with brain health and also overall just metabolic functioning and inflammation as well.

Kalea Wattles:
Yeah. Well as we're kind of wrapping up all the tools and the things we have in our toolbox, I can't miss this opportunity to talk to you about autonomic regulation and vagus nerve therapies because it's such a hot topic right now. Everybody is exploring these interventions, and I wanted to get your take on how you're using mind-body medicine in the clinic, and if you would just share some examples of maybe different exercises or strategies that you're using with your patients who are hoping to support their either cognitive or their mental health.

Jaquel Patterson:
Yeah, I love that question because those are things that you can have people also use to self-regulate at home on their selves. And that's ultimately what we really want to do is support an individual in all ways, not just by nutrients or supplementation. So we actually at our office, and they're starting to be what's called like vagus nerve stimulators that are FDA cleared. We at our office use Alpha-Stim, s-t-i-m. And some of these like devices, which individuals can actually have at home too, are only about 10 to 20 minutes of treatments. And what they help, the vagus nerve stimulators that they've used have helped particularly with serotonin levels. When you look at things like Alpha-Stim, they've helped with dopamine as well as GABA and serotonin. So these are great like tools and devices, we actually use them in our office, and it's great because we do it with acupuncture. So if someone is getting acupuncture, we might put these nodes on their ear, and they're getting that at the same time for 10 or 15 minutes. And it's amazing how many patients we've had that have been able to decrease the amount of supplements they're on or be able to purchase it so they can have it at their home. But they're always amazed at like, how does this little thing work so effectively for my anxiety to the point where we've been able to just have things like acupuncture or have these devices be the sole way to treat and have had like over 50% relief without any intervention by way of like supplements? So all those things are also really helpful. 

Meditation, we're actually starting to have in our office more things like yoga nidra, meditation classes that we're having for patients, sound bowl, things like that to be able to have other opportunities outside of that can help calm the system. When you look at vagus nerve support, we will sometimes just do deep breathing exercises. So deep breathing exercises have been helpful for individuals, we'll have people with like tremors or shaking, and we just will have them deep breathe where they’re holding for like five to ten seconds and breathing out. And you'll see the decreasing of things like shakes or tremors just from deep breathing and stimulating that vagus nerve response. So tons of ways to support by something as simple as deep breathing at home. But there's also now, it's what's great is devices that help with the vagus nerve as well.

Kalea Wattles:
And it's amazing, we could do a whole episode on the connection to heart rate variability and how we're making it. I'm willing to make the case that all of these things we do to support our cognitive and mental health ultimately support our longevity because by improving that nervous system functioning and improving our heart rate variability, that is one marker of mortality, right?

Jaquel Patterson:
So true.

Kalea Wattles:
It's so powerful.

Jaquel Patterson:
And many of the patients we have have POTS symptoms or these changes in their like HRV, and when they're watching, looking at that and based on the amount of hours that they slept, but then their HRV might not be effective or helping them also even regulate like the intensity of their exercise. There's a connection with things like anxiety. It's good to exercise about four times a day, but there's actually like a u-verse relationship where if it's too excessive, you're going to have cortisol dysregulation, you're going to actually have worsening of anxiety symptoms. So balancing that out is a factor in your intake too. To have that conversation is also important because I think sometimes we'll just say, are you exercising regularly? Yes. But like what does that exercise look for that person? And is that the best for what they're actually coming in to see you for?

Kalea Wattles:
Yes, this is individualized precision medicine. 

Jaquel Patterson:
Yes.

Kalea Wattles:
And on that note, as we wrap up, what's the takeaway that our functional medicine practitioners should walk away from this episode feeling and knowing?

Jaquel Patterson:
Yes, as with everything, every organ system is impacted when we look at functional medicine, we're not, we're, what is it? We're many parts of us and including in our brain health, our gut is impacted, inflammation. If you're working with patients that have like lots of infections and autoimmune conditions, those directly connect to brain health, and you'll see managing that their brain health will get better, which I see very frequently. So the biggest thing is to continue to step back, I'd say, and look at what other factors can be causing the symptom the patient's having, especially as I had mentioned if there's, when they're coming to see you, they've had lots of changes in medications or they've had these different health conditions pop up in the last one or two years. What is the common, you know, denominator, what's the common thing that you're actually seeing that could connect all the dots to?

Kalea Wattles:
Beautifully said. And Dr. Jaquel, we'll continue to admire the work you're doing in the field of brain health. We so appreciate your time today in sharing all these insights for all of us to protect the brain health of our patients and of ourselves. I think that there are so many very applicable tools we can walk away from. Thank you so much for being with us today.

Jaquel Patterson:
Thank you. And thanks so much for having me. Really enjoyed this conversation and hope that folks benefit from it and also implement some of the lifestyle changes that we talked about today.

Kalea Wattles:
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