Something New to Consider: Traumatic Brain Injury (TBI), Progesterone, Vitamin K & Vitamin D Deficiency (*Inadequacy)
Vitamin D
Vitamin D Inadequacy is common in patients after TBI and is associated with impaired cognitive function and severe depressive symptoms. It is estimated that up to 70% of the US population are inadequate in vitamin D and 40% in vitamin K. Vitamin D inadequacies are associated with significant impairment in cognitive performance after a concussion.
Vitamin D deficiency is endemic in the adolescent, adult, and elderly populations in the United States and has been associated with inflammatory, autoimmune, cardiovascular, neuromuscular, and neurodegenerative diseases as well as cancer. Population based studies have suggested that vitamin D deficiency in the elderly is indeed associated with an increased prevalence of brain injury, Parkinson’s disease, dementia, Alzheimer’s disease and stroke. You probably know that vitamin D is important in maintaining your bones, but its role in brain injury has only recently been appreciated. We are finding out that vitamin D receptors exist all throughout the brain, spinal cord, amygdala, hypothalamus, cerebellum and just about everywhere else. These technical names aren’t important just realize that vitamin D affects just about every part of your nervous system.
Systemic disease and the elderly
If you suffer a brain injury and have systemic issues such as cardiovascular disease, atherosclerosis, hypertension, diabetes, kidney disease, or cancer, the damage will be worse than if you didn’t have those diseases. And if you have a vitamin D deficiency on top of that, then this is even worse yet.
Vitamin D3 and K2
Vitamin K is another fat-soluble vitamin that works to regulate calcium and make sure it goes in the right places. Vitamin K should be taken along with vitamin D as these 2 vitamins really work together.
Both vitamin D3 and K2 have been shown to help with brain injury. Vitamin D and K should really be thought of as one vitamin since they work together. Vitamin D, without adequate amounts of vitamin K, can cause abnormal calcium metabolism and even calcifications which is why I recommend a vitamin D / K2 blend. Ideally, your levels of both vitamins would be optimized before the concussion. The reason vitamin K is so important in brain injury is that an inadequacy of vitamin K is thought to decrease intracellular glutathione. Glutathione is an antioxidant and important in decreasing the acute stress after a concussion.
It should always be remembered that most of the vitamin D we get actually comes from sun exposure. So what’s the difference between getting the right amount of sunlight and taking a vitamin D tablet? In most cases with about 15-30 minutes of mid-day sun exposure (without sunscreen), you can get significant amounts of vitamin D. You’re not still getting the vitamin K2, but you’re getting the vitamin D. Vitamin K comes from greens and fermented soybeans like natto and miso. Small amount of vitamin K2 can be found in liver and egg yolks. Check with your doctor, but consider taking increased doses of vitamin D and K2 during the time of a brain injury.
Vitamin D and Progesterone
A big surprise to may be that the female hormone, progesterone has shown to be very effective in treating the effects of traumatic brain injury (in both men and women), especially when given along with adequate amounts of vitamin D. Most people do not think about taking progesterone after they’ve had a concussion.
Progesterone is exciting in that it is one of the few agents to demonstrate significant reductions in mortality following TBI in human patients in preliminary trials. There are huge studies going on right now testing the effects of progesterone and TBI in the battlefield.
Numerous studies have been done using progesterone and vitamin D for TBI treatment. However, most of them were conducted in animals but human studies are ongoing. A recent study showed that giving progesterone and vitamin D around the time of a severe concussion were found to improve the recovery rate. Progesterone and vitamin D need to be taken together, and I would argue that vitamin K needs to included here as well.
Vitamin D is a steroid and has functional attributes similar to progesterone. Both are cheap, easy to administer and readily available. The combination of progesterone and Vitamin D could lead to improved neuronal and cellular repair and recovery after injury.
It is important to note that progesterone can be taken orally in a micronized form that enhances solubility in aqueous solutions and absorption in the gastrointestinal tract. But in some studies it appears that its positive effects in TBI are achieved only via intravenous administration and at therapeutic doses
Studies have shown that progesterone decreases the acute inflammatory response after a brain injury. It also decreases the levels of inflammatory markers such as IL – 6, TNF – alpha, and others. Progesterone also reduces cell death, improves brain blood barrier integrity, reduces cerebral edema and improves functional activity. These are all good in decreasing that acute inflammation after a brain injury.
It can be argued that progesterone works as a neuroprotective agent because, many of the processes involved in brain repair are similar to growth and organizational processes occurring in early life. Certainly debatable, but the research seems to supporting this idea.
Recent research has suggested that vitamin D supplementation and the prevention of vitamin D deficiency may serve valuable roles in the treatment of TBI and may represents an important and necessary neuroprotective treatment for TBI. And taking progesterone along with vitamin D is even more effective.
And it does not matter if you are male or female, taking progesterone may be a good thing to do if you have a brain injury. I would recommend however to use progesterone under the guidance of a doctor who can prescribe sensible doses and monitor the effects.
*note the word Inadequacy is used in the context that the amount of vitamin D is low in the body, but not enough to cause disease or pathology. An actual deficiency is a state where a vitamin is so low that overt disease is apparent, such as rickets or in the case of vitamin C, scurvy.