A few questions about recovery from PCS
 

1. Why does only a minority of concussion sufferers develop PCS? Most people that suffer a concussion report symptoms for only a few days - why do some people develop PCS?

2. From the portion of the concussion sufferers that develop PCS, why do some people take weeks to recover, other take months or years, while others have PCS for decades? Why is the recovery rate so different among PCS sufferers?

3. Does young age improve PCS outcome (better healing rate and extent)?

4. Can supplements help the brain physically recover, or they are like wearing glasses? I mean, can supplements aid in the recovery process, or they just temporarily mask your symptoms while you take them?

5. Some people here report having symptoms for 20+ years. That sounds like a very long time to have PCS. How come symptoms can persist for such long periods of time?

6. Is neuron loss the primary cause for PCS symptoms, or is it the loss of connections between neurons that is more problematic? Can certain supplements help rebuild connections between neurons, therefore increasing the brain's recovery capacity?

Thanks,
-ProAgonist

1. 2. and 3. Nobody knows.

4. The proper supplements can help the brain repair the myelin sheath that surrounds nerve fibers. It also help restore and maintain the blood brain barrier. They can help the brain tolerate stress. They can help the brain metabolize properly.

5. Every concussion results in permanent brain injury. That may be only evident when a subsequent concussion is suffered resulting in more severe and prolonged symptoms and recovery time. Or, it may mean symptoms manifest during times of stress. For some of us, PCS may be prolonged from a single concussion. For others, we suffer Multiple Impact Syndrome meaning we have suffered a cumulative injury that causes persistent symptoms.

In my case, I have suffered symptoms since my severe concussion at 10 years old. I did not understand these issues until I learned more about PCS years later. I did not connect my struggles with depression and struggles with friendships until decades later.

6. Yes, to all. PCS can be due to a myriad of neurological injuries and dysfunctions. The right supplements can help, but slowly over time.

Supplements are not just a healing aid. These also help with day to day function. For many, we know that supplements are a lifetime commitment to allow us to be more functional. Without my supplement regimen, I tend to be moody and volatile.

But, these answers do not change anything. Focusing on the whys and wherefores just causes anxiety. Anxiety is a brain polluter and stressor.

Mark,

Thank you for your reply.

While I have personally accepted the fact that I have a brain injury and am no longer depressed about it, there are still a few things that I'd like to understand.

You said every concussion results in permanent brain injury. Getting a concussion is a very common thing - there are more than 15 million concussions in the US every year. Do all of these people have permanent brain damage? Getting hit in the head with a force sufficient to concuss is a common thing, so is permanent brain injury a common thing as well? I see people getting hit in the head all the time - do all of them have permanent brain injury that can be detected decades later in advanced brain scans, even if they feel fine a week after the hit?

Also, does neuron loss matter that much if symptoms fade? After all, does it really matter if someone has less neurons because of a concussion, but they don't feel any different than before the concussion?

And if supplements are a daily commitment, does it mean that taking supplements daily for 1-2 years and then just stopping is useless and doesn't cause any long-term beneficial changes?

You said that anxiety is an enemy to concussion recovery, and I find that true - when I put the PCS aside and ignored it (didn't think about the future after it), I started feeling better and my recovery was accelerated. But is it a good strategy? Or should I focus on my injury, remind myself I have it, and therefore limit my activities? In my experience, ignoring PCS and just carrying on with life as I did before was beneficial for my recovery, but I fear this is a bad strategy.

I have read that 15-20 percent of people who develop PCS are those people who have had a prior brain injury or are mentally depressed and very sensitive. That may also include mental conditions such as ADHD, OCD, severe anxiety and depression, sensitive nature and are very emotional and self conscious all the time. These are the people who most likely will develop PCS if their brains are injured.

I do have ADHD and OCD, and aside from OCD I just have high levels of anxiety (actually now I have much lower levels of anxiety after attending CBT treatments for 3 months).

That could explain why I have developed PCS.

I was certainly going through a depressing time when I acquired my injury, I'd hit my head twice before in my late teens but didn't develop PCS way back then, I think mine was the straw that broke the proverbial camels back! But, I do wonder if the state of my mind contributed.

This is an discussion that is the result of unresolved anxiety. It is not productive.

<You said every concussion results in permanent brain injury. Getting a concussion is a very common thing - there are more than 15 million concussions in the US every year.>

Correction..... 1.5 million to 5 million concussions a year.

<Do all of these people have permanent brain damage? >
Remember, that damage may not be obviously symptomatic. It may just mean the next concussion is easier to get.

<Getting hit in the head with a force sufficient to concuss is a common thing, so is permanent brain injury a common thing as well? I see people getting hit in the head all the time - do all of them have permanent brain injury that can be detected decades later in advanced brain scans, even if they feel fine a week after the hit?>
Only 1 out of 100 get a concussion each year, so it is not common. Yes, there is a youth population that has been taking risks and getting concussed. Nobody has studied the population with advanced brain scans. Besides, brain scans don't matter if the person feels fine.

<Also, does neuron loss matter that much if symptoms fade? After all, does it really matter if someone has less neurons because of a concussion, but they don't feel any different than before the concussion?>
For most, it does not matter. People lose neurons from getting drunk all the time. Life then goes on.

And if supplements are a daily commitment, does it mean that taking supplements daily for 1-2 years and then just stopping is useless and doesn't cause any long-term beneficial changes? Think of it like exercise. You can get in shape for 2 years then become a couch potato and no longer benefit from that exercise.

<You said that anxiety is an enemy to concussion recovery, and I find that true - when I put the PCS aside and ignored it (didn't think about the future after it), I started feeling better and my recovery was accelerated. But is it a good strategy? >

YES, YES, YES,

<Or should I focus on my injury, remind myself I have it, and therefore limit my activities? In my experience, ignoring PCS and just carrying on with life as I did before was beneficial for my recovery, but I fear this is a bad strategy. >

Why would this be a bad strategy ? Get on with your life. If you need to make minor adjustments, then do it and go on. Have ear plugs handy if you need them from time to time. Reduce your risk for the future by stopping engaging in risky activities. Wear a helmet for some activities (snowboarding, etc)

Or, you can focus on your injury and be wrapped up in anxiety and never have any sense of a life.

It's a choice only YOU can make. Make a good choice.

Mark,

Thanks a lot. The choice I made is to go on with my life!

I was quite disappointed to hear, though, that supplements are like wearing glasses - they only help you when they're in your system. I thought they also speed up the recovery process, but oh well.

Supplements do both. They help your brain heal. They do not cause your brain to heal. But since the brain is damaged, it has a greater need for a higher level of nutrition. Plus, the injured brain is more sensitive to stress so taking supplements to reduce that sensitivity is worthwhile.

What do you have against taking supplements ?

How about this example? Not exact. Just to demonstrate an idea.

Your injured brain is working at a 5 out of 10.

Taking supplements helps it recover to a 9 out of 10.

Discontinuing supplements and your brain works at 8 out of 10.

A brain on supplements during stress drops to an 8 out of 10 from 9 out of 10, a 1 point drop.

A supplement free brain during stress drops to a 6 out of 10 from 8 out of 10, a 2 point drop.

So, do you want to have a brain that works at its optimum or at a level less than optimum ?

Supplements are just too big of an issue for me, because of multiple reasons.

First of all, I think I'm not being taken very seriously when I mention feeling bad due to my PCS. When I'm in a fog and I tell my parents that it's because of the concussion I've had and that I'm still recovering from it, they brush it off and tell me the recovery from concussions is very fast and I'm just exaggerating. Convincing them that I have symptoms 10.5 months after the concussion is very difficult.

Second, I live in Israel. Unlike in the US, Israel is much more limited in its medical consumer products - I doubt I can get half of your supplement list here in Israel. You live in the US so getting supplements for you is very easy - everything can be bought in the US nowadays. I'm not sure if I can get many of the supplements on your list here, probably because they're not imported. Haven't checked though.

And third, your supplement list is big, and contains 20-30 supplements. That means, 20-30 pills to be taken every morning. I feel like this is too much for me. Even if I can convince my parents that it would be helpful and even if I can get all of them in Israel, taking 20-30 pills every morning will take a lot of time and it will make me feel uncomfortable to take so many pills on a daily basis, especially if it means for the rest of my lives. It just feels too much to handle for me - if it was 3 or 4 pills, fine, but so many? Might be problematic and time consuming.

The only supplement I've taken from your list is Omega 3 in liquid form, 9-18 grams a day. I've taken it for a couple of weeks intermittently, but then I just ran out of it and haven't asked my parents for a new bottle. I asked for one and got one a few months later, took it for a few weeks at 9 grams a day dosage, and then ran out so I stopped. The last time I've taken Omega 3 was in April 2015.

If my parents knew that the Omega 3 is for the concussion, I'm not sure they would have bought me it. I've just told them it could help with ADHD and it's just generally good for brain health, but didn't mention that I want it for the treatment of my brain injury.

So as you see, yes, I want to heal as fast and efficiently as possible, but this is very problematic.

In summary, not only that I live in Israel which might be limited in the supplements you mentioned, I live with my parents and am dependent on them financially, so getting the supplements might be even more of a problem. Also, as I said, taking 20-30 pills every morning sounds too much for me. Can you understand me on this part? I just can't imagine swallowing 20-30 pills a morning for the rest of my life.

So there are multiple problems here and I wish it was simpler.

The regimen is not 20 to 30 pills. It can be less than 10. Here is the basic regimen in order of importance.

B-12
B-50 Complex
D-3
Magnesium citrate w calcium citrate
Fish oil
Vit E
Vit C
Niacin

These are all valuable for basic brain health regarding OCD, ADHD, depression etc. so you can ask for them for these reasons.

There are plenty of supplement sources in Israel. http://www.biovea.com/il/ is just one. There are many companies that import to Israel and claim to be better priced than Israel based companies.

I make up zip lock bags with my regimen so I don't have to open a bunch of bottles. You can buy week-at-a-time compartmented containers at any pharmacy. Seniors use them to keep track of their daily meds. There is an Israeli company called Sabi that makes them.

My wife uses the compartment system. I use plastic zip-lock bags. I make up 45 days at a time rather than a week or two like my wife.

If you have anxiety, OCD and ADHD, you need to decide if you are going to take control of or be controlled by your condition.

Thanks a lot for the basic list, Mark.

Does B-12 help repair the myelin sheath, which is the connecting structure between neurons? Is this way it is on the top of the list?

Thanks for the website you've linked. I'll probably ask to purchase the supplements from them when I start taking them.

There are 2 things I'm unsure about, though:

1. You mentioned Magnesium citrate. Magnesium is an NMDA receptor antagonist, which means it can potentiate different drugs by reversing tolerance to them (NMDA receptors on certain neurons can reduce the sensitivity of other receptors on the same neurons). My concern is taking Magnesium with stimulants for ADHD - I've heard many reports that Magnesium taken with stimulants greatly enhances their effects through NMDA antagonism. Also, Glutamate is an important neurotransmitter for learning and memory, and Magnesium blocks the receptors for Glutamate. Couldn't it make things worse, then?

2. Does the fish oil you have comes in tablet/pill form? You mentioned in another thread that you take 3 grams of fish oil per day - tablets containing fish oil usually contain anywhere between 300-900mg of DHA + EPA. I've not seen any supplement store that sells tablets with more than 900mg of fish oil. Do you take multiple tablets in order to get 3 grams of fish oil? Also, I can get fish oil liquid (containing DHA + EPA) at a relatively cheap price. Is there a significant difference between taking fish oil as liquid versus taking it in tablets? Or can I take all supplements as tablets and only the fish oil as liquid?

On another note, CBT helped me significantly for my social anxiety and fear of getting hit in the head, but certain parts of my OCD have become much worse. For example, I'm sometimes afraid to touch objects that fell on panels in my room, since I sprayed the panels with an insecticide 5 months ago. I'm afraid that the insecticide is still there and that it can poison me if I pick up the object and then the insecticide will get into my body by mistake. I'm also sometimes not touching kitchen towels since I'm anxious about whether or not they got dish soap on them, and if they do, I'm afraid it'll get into my system and hurt me.

I know these sound obsessive, and they only appeared a few months ago. I don't know why, but a few months ago, my OCD suddenly started becoming much, much worse. Just suddenly without a warning. My social anxiety has improved, but my OCD got really bad.

I have only sometimes tried to apply the relaxation techniques from CBT to my OCD fears of being poisoned, but I find myself many times forgetting to do it or giving up. I need to work on it more.

So is it best to combine supplements with psychological work on resolving OCD, or should I just use the relaxation techniques first?

Actually, the myelin sheath is the protective/insulation sheath that surrounds the axons. Yes, B-12 helps with its repair. Signals do not transmit well if the insulation layer is poor. OCD is often related to weaknesses in how these signals transmit.

There is evidence that suggests that magnesium deficiency contributes to ADHD. Google magnesium and ADHD. Mag is known for its calming effect. Whether there is an interaction issue with ADHD meds, I could not find any.

I don't take 3 grams of fish oil. Many recommend that much. I take one large liquid filled softgel pill. There are versions with high concentrations of the Omega 3.

I am surprised you have not used facts to over-rule some of your OCD issues. The insecticide issue should be easy to resolve. The PartsPerMillion to achieve toxicity should be available. You'd have to wipe down the panels then eat the wipe to even start to ingest a measurable level. Same goes for the dish towel except I expect the dishtowel is used on dishes after they have been rinsed with clean water.

Use your analytical mind to resolve these issues. That is what CBT is about. BTW, People are living longer that ever before. If these chemicals were dangerous, why do we live so long? You have many other issues in your life that create a risk of many magnitudes higher.

Supplements could enhance the value of your psychological help.

Pro,

My dad is 82 years old.

He flew crop dusters in the worst of chemicals made in open cockpit planes for around 12 years of his 43 years flying crop dusters.

He was born and raised on a farm so as a young child he was working with arsenic as a pesticide without safety equipment.

At 82 he still flies and teaches aerobatics And flies himself between his house in Idaho and mine in Calif. I know plenty of crop dusters in there 80's and the only ones I know who haven't made it to an old age died from crashes.

Chemicals nowadays are worlds safer but caution is still a good habit. All insecticides I am aware of for home purposes are synthetic pyrethroids, a derivative of pyrethrum which is a naturally occurring insecticide and are typically inactive within 24 to 48 hours within a home and very weakened within a couple of hours of exposure to an open environmentand are considerably weaker than their like ingredient Ag chemicals I use.

If you follow the directions and use common sense you will be safe, same with dish soap.

Bud