The major cause of the problems we see from a brain injury are caused mainly from mitochondrial injury dysfunction. And it is not by coincidence that the highest concentration of mitochondria exists in the front of the brain. These brain injured cells impair neurologic functions, which are observed in individuals with TBI. Mitochondrial injury leads to oxidative stress and subsequent apoptosis (cell death) and decreased cellular energy production. The topic of mitochondrial dysfunction after TBI is hugely complex and requires treatment that specifically addresses the secondary injury.
Optimizing mitochondrial function can be done on several fronts. The major things to consider are nutrition, supplementation, light and PEMF (pulsed electromagnetic frequencies). The nutrition part of optimizing mitochondrial health was (briefly) addressed in the posts 3 and 5. Here, we will focus on the possible supplements used to optimize mitochondrial function.
There are many supplements that optimize the function of the mitochondria. Energy production comes from the mitochondria, at least for what we know at this point in time. It is possible that the structure and energy of water may tie into how ATP drives function and movement. If you want an example of how important mitochondria are, look no further than the heart. The heart is an incredible organ. Weighing in at 10.5 ounces, it beats more than 100,000 times per day, driving blood through more than 60,000 miles of blood vessels.
It is well known that heart muscle and brain are the most mitochondrial dense tissues in our body. Mitochondria produce ATP within the cells, and ATP is essential for myocardial cellular integrity and function. However, in ischemic heart (or brain) disease, ATP levels can be reduced, with supply not meeting demand.
Optimizing the fuel for the cells is one way that you can take care of your heart and brain. There are certain nutrients the heart needs for optimal function of the mitochondria: Ribose, Coenzyme Q10, Carnitine, Creatine, and Magnesium
Carnitine (L-carnitine) is a non-essential organic acid that is synthesized in the body from lysine and methionine and is mainly found in red meats and dairy products. It is also widely available as an over-the-counter nutritional supplement which is has been shown to be beneficial in traumatic brain injury. The reason why carnitine helps TBI is not well known, but it is thought to help increase ATP production in the brain by augmenting mitochondrial function.
It is important to remember that the synthesis of carnitine is highly dependent on adequate amounts of vitamin C in the body. Carnitine also plays a role in the production of acetylcholine, an important neurotransmitter. Carnitine
comes from animal products. Carnitine also reduces red blood cell fragility, erythropoietin resistance, enhances bone marrow, and is very important in fat energy metabolism.
Elderly people may suffer from a relative carnitine deficiency (inadequacy). Serum levels of carnitine tend to increase until approximately the age of 70, after which they decline for unknown reasons. The decline is correlated with lean body mass. It has been shown that supplementation with 2 grams of carnitine per day is associated with less fatigue and a better body composition in the elderly and can increase muscle function.
During ischemic events (as in a brain injury) carnitine levels are depleted. Investigators used carnitine in a model of brain injury and found that carnitine likely provides neuroprotection by improving cerebral energy metabolism and, therefore, lessens the chance of cell death caused by metabolic failure. Carnitine ameliorated mitochondrial dysfunction after spinal cord injury. Since cerebral oxidative glucose metabolism is impaired after TBI, carnitine likely works by providing alternate fuels to the brain. Furthermore, when ketones were used along with carnitine, ATP production was further enhanced.
Formation or distribution of free oxygen radicals should be decreased to enable healing of the brain after a TBI. Coenzyme Q10 (CoQ10), a component of the mitochondrial electron transport chain, is a strong antioxidant that plays a role in membrane stabilization. It is also used for preventing neurodegeneration against mitochondrial deficiency and oxidative stress. Therefore, CoQ10 has received increasing attention as therapeutic and preventive intervention
for neurodegenerative diseases. CoQ10 occurs naturally in the body and is essential to survival. CoQ10 works as an electron carrier in the mitochondria, the powerhouse of the cells, to produce energy; it is also a powerful antioxidant. CoQ10 exists in significant quantities in our brains, heart, liver, kidneys, and muscle. CoQ10 can enhance blood flow and decrease oxidized LDL (bad cholesterol). Several pharmaceuticals can actually deplete the levels of CoQ10 in tissues such as statins.
Coenzyme CoQ10 levels are decreased in traumatic injuries. Many studies using CoQ10 for TBI’s have shown positive results in the short term, but not a lot is known about the long term benefits. CoQ10 is available without a prescription and has a remarkable safety profile. CoQ10 can be extracted from animals, synthesized by bacteria, or just completely synthesized. And it is said that grapefruit juice greatly increases the absorption of CoQ10. Natural ways to take CoQ10 include organ meats such as heart, liver and kidney (see liver article). Another less known organ meat is brain, somewhat a taboo subject, but it is consumed in many parts of the world. The reason is because brain tissue is the most mitochondrial rich organ in the body. As the Chinese saying goes, “eat the organ that ails you.”
Also fatty fish such as sardines and mackerel are great sources of CoQ10. Vegetable sources include spinach, broccoli, and cauliflower. Egg yolks contain more CoQ10 than the white, another reason to eat the yolk. Other vegetable sources include oils, peanuts, and soybeans, however all of these sources must be consumed in excess of amounts making it difficult to get a significant amount of CoQ10 from non-animal sources.
A final note about CoQ10 and statins. Statins are purported to have anti-inflammatory effects are used to treat many patients with TBI because they block the synthesis of cholesterol, but these drugs also block the synthesis of CoQ10, which further decreases levels in the body. This certainly raises the question whether or not a person should continue taking a statin after a brain injury. This is an another topic and there are pros and cons. But let it be said that a recent study (see below) closely examined the relationship between statins and trauma and found that many of the studies have a big risk of being biased and more study needs to be done before recommending statins for trauma, including concussions.
The next blog post will focus more nutrients that support mitochondrial health.