Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 08-01-2016, 07:40 PM #1
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Default Ketogenic Diet

I was surprised to see these medical studies suggesting that Ketogenic diet could be useful for recovery (They usually highlight post-incident but what do we know about the timing..).

http://uknowledge.uky.edu/cgi/viewco...radschool_diss

Ketogenic Diet - Nutrition and Traumatic Brain Injury - NCBI Bookshelf

The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury. - PubMed - NCBI

I am surprised this had not been discussed more. Concussion reduces appetite, that we know, perhaps as a neuro-protective mechanism?

I also came across this reddit thread (praising keto for TBI):
https://www.reddit.com/r/keto/commen...ssion_on_keto/

any experiences?
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Old 08-01-2016, 11:55 PM #3
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There are a few issues that need to be understood regarding the ketogenic diet.

1. The research into the ketogenic diet and TBI was done on rats and mice.
2. The rats were fed a ketogenic diet before an impact injury in one study.
3. The rats were fed a ketogenic diet immediately after an impact injury in another.
4. No comparable research has been done on humans. Human research has been focused on epilepsy.

The NCBI articles comprehensively compiled the research done so it is the most indicative source of information.

The take away is that the ketogenic diet is helpful during the acute injury phase. The research does not show a benefit for delayed use of the ketogenic diet past the acute injury phase.

A way to benefit from this information would be to promote fasting during the first 24 hours post injury. This would create a ketogenic condition and promote the neuroprotective benefits. The study did not show a benefit from fasting during the second 24 hours after injury.

It is important to understand that just consuming coconut oil or other MCT oils, even BulletProof, a concentrated MCT oil is of little benefit. The ketogenic diet requires that the body be put into a carb famine mode before the ketones are released.

Some of the anecdotal claims for MCT oils are missing some important information. If one enters carb famine mode, they will have reduce brain function. Consuming MCT oils during this famine mode will increase energy to the brain causing an increase in brain function. But, what is not considered is whether consuming carbs would also increase brain energy.

These same anecdotal claims mention a quick increase in function once the MCT oil is consumed. MCT's do not cross the blood brain barrier. Only the ketones do. The brain does not metabolize MCT oils. The liver does. So, consider these amazing claims with an understanding of brain physiology.

Some brains do not process glucose well so ketones may be more of a solution. But, these brains are likely also prone to seizures. I have not followed this condition specifically.

A possible value to the ketogenic diet may be migraines. It appears to help moderate glutamate toxicity. Glutamate can be a migraine trigger in some people. This issue was not well discussed but further investigation would be worthwhile. In the short term, fasting at the first onset of a migraine may be worthwhile.

I've been following ketogenic issues on a few different web sites. If I find anything worthwhile, I'll post it, too.

I've never notice concussion as an appetite suppressant unless nausea follows the concussion. I've only experienced this (nausea) twice in 14 concussions.
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Old 08-02-2016, 04:36 PM #4
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Mark,

Thanks so much for the response! You are right, there are no clinical studies on humans studying Keto's effect on TBI. Also most of the well published studies are on Epilepsy, as you said.

Nevertheless, some of the studies on the Keto diet are positively intriguing if I may say. Just knowing that there is a diet that has neuro-protective effects is something of interest to me as a TBI sufferer. While as you said, the theory (in humans) and evidence (in rats) suggest benefits in the short interval around TBI, the impact outside this interval is not known. But I wonder whether the neuroprotective effects found in other studies are not tempting enough to try (and trial) the diet.

This paper:
Neuroprotective and disease-modifying effects of the ketogenic diet
cites several studies uncontrolled studies in humans on the impact of keto on Parkinson and Alzheimer. To quote the "the ketogenic diet can provide symptomatic and disease-modifying activity in a broad range of neurodegenerative disorders including Alzheimer’s disease and Parkinson’s disease" The studies in humans are cited in the paper.

Then you hear a lot of theory from respectable folks on how keto can help the brain heal, protect, and reduce depression:
Your Brain on Ketones | Psychology Today
The fat-fueled brain: unnatural or advantageous? - Scientific American Blog Network

No hard evidence of any sort. But good to keep an eye on this. I might experiment with this. Have you seen anyone here with TBI trying Keto?
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Old 08-02-2016, 06:12 PM #5
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Actually, the interval where the ketogenic diet helps is known. It is the first 24 hours. They did not find a difference after 24 hours. This suggests that the cascade of events from a concussion injury that happen during the first 24 hours can be effected by a ketogenic diet.

What other studies were you referring to ? "But I wonder whether the neuroprotective effects found in other studies "

These reports and studies are using the all the published studies to draw their conclusions. It is very common to see a published article that reviews all of the studies in a particular subject.

You need to be careful to not take little bits of information out of context. Many sellers of coconut oil and other MCT products use valid bits of information to promote their product but fail to tell the whole story because it limits to true value of the MCT product. Bruce Fife kick-started the current coconut oil industry by telling half-truths. Others jumped onto his bandwagon to grab a piece of the coconut oil market.

bachissimo, If you want to research other dietary supplements that can possibly help TBI, check out Mars' new refined chocolate.
The neuroprotective effects of cocoa flavanol and its influence on cognitive performance
Mars product (CocoaVia) is still in product development so it is not widely available.
Vegetarian Capsules, 9 Count Bottle | CocoaVia
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Old 08-02-2016, 06:50 PM #6
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I am currently dealing with a really bad setback since few days now. This is the first time I have a setback that I cannot trace to a specific shock (be it medication, physical, emotional..). So I am quite confused to start with.

I do not know anything about MCT nor was I planning to use coconut oil. I have a problem with coconut and cocoa unfortunately anyway (bad reaction).

I admit again that I am going by very broad generalizations. I find people and papers discussing beneficial effect of keto on epilepsy, Alz., Park., TBI (within short window in rats right?), depression, and I find theoretical papers explaining why Keto can have these positive effects on these brain related conditions....

from this I am coming to the generalization that: Keto is good for the brain, and therefore I should try Keto.... quite a leap I admit. But I think a similar generalization led my Neurologist to tell me to take Magnesium, Omega 3,... But the difference is, these are easy mostly non-harmful supplements. The question is therefore: what can go wrong with a Keto diet? (I do not know, and would like to know).

Clearly it is a generalization. I am a scientist myself and I my field published papers have to have a good experimental design and a p<0.01

Unfortunately, the day when they will actually have a control trial on Keto with TBI is very far ...

I fully agree that there are a lot of snake oil sellers that want to jump on every little correlation to sell their oil. I was thinking about just eating high fat foods and reducing my carbs to <50g a day. But will have to read about this more...
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Old 08-02-2016, 07:32 PM #7
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There are a few risks associated with a keto diet. Those who need it for epilepsy have a valid reason to tolerate the risks plus, they tend to be children with strict supervision. When adults use the same keto diet, the results are varied.

I've read so many 'self proclaimed experts' who all seem to miss a few important facts. There is a lot of hopeful thinking and writing and conjecture.

I don't see anything that suggests value to a keto diet at your stage of PCS.

Why aren't you using the whole vitamin regimen for a few months to see if it helps ? There are no single quick fixes. It takes diligence and discipline.
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Old 08-03-2016, 12:45 PM #8
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I have been taking B (complex, B12 seperately,..), multi V, Vit D3, Onega 3 and Magnesium.
I am not sure if there are any studies backing this... but I do...


what is mind-boggling in my case (and according to Neuros to), something I mentioned earlier, is that flying is pretty much equivalent to getting another concussion. I still have not seen a case like mine.

Concussion: early July 2014
recovery: 2 weeks later. August was asymptomatic. I ran, I sprinted, I worked hard, ...
Flight: coming back from Europe on Sept 1, 2014, is when the worst symptoms started. I never had a migraine before that.... Dizziness was terrible... depression...

Recovery: Not full, but acceptable recovery by mid-MAY 2015.

Flight: Sept 1, 2015. Re-lived the exact same nightmare I lived a year before, except this time the symptoms are worse, my noise sensitivity is much much worse (I used to play piano and guitar) ....My recovery is slower and more bumpy... taking topomax last month made things much worse
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Old 08-03-2016, 02:13 PM #9
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Is the B complex a B-50 complex? There is a big difference between a B-50 Complex and a B Complex.

Flying is hours of over-stimulation (visual, audio and tactile) and a reduced oxygen level in the cells from altitude in the plane. It is not unexpected for it to cause PCS symptoms. But, they should resolve with some rest and proper nutrition.

Any neuro who says flying is as traumatic as a concussion is not basing that on medical science. A concussed brain is just more sensitive to the strains of flying.

Please do not use bold type. It is very difficult for me to read a post with bold type. It is like trying to see down the road when somebody is driving at you with high beams on. My brain wants to focus on the bold.
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Old 08-03-2016, 08:56 PM #10
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I apologize for the fonts and will keep that in mind. And also apologize if I keep hammering the flight thing. One last clarification:

No doctor told me flight=another injury but sure it had the same impact. Long story short, I was healed (zero symptoms) two weeks after concussion and was with zero symptoms for a month before the flight.

Coming back I had symptoms worse than I ever had and they lasted for about 4 months.

Same happened the following year after my second flight. I also developed new symptoms (excessive noise sensitivity) that are still with me today.

Doctors are clueless and think flight is OK (just like i was told here when I asked about the safety of the flight):

mild concussion maybe, some questions

I clearly fall in a category of my own, which is mind boggling. At the same time don't have the typical Symptoms of MdDs.
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