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Today I discuss how research shows that rest may be an outdated approach to the treatment of concussion.
A Concussion is a common occurrence in daily life in Canada. There is a strong association between concussions and Canadians favourite sports especially ice hockey, Canadian football, rugby and soccer. The majority of people who suffer a concussion do not experience any lasting health consequences. However, for some people, the effects can be debilitating and longlasting known as post concussion syndrome. In this article, we will discuss the pathophysiology, symptoms and signs, and treatment options for a concussion and post concussion syndrome.
What is a Concussion?
A concussion is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces. In laymen’s terms, this means that an impact to the skull causes chemical changes that affect how the mind works.
Head injuries cause a disruption in the movement of ions in and out of nerve endings. This disruption is known as an Ionic Shift. When an ionic shift occurs, the brain uses a large amount of energy in the form of glucose to correct this shift. If change continues over a long period the demand for energy outweighs the supply leading to an Energy Crisis.
At the same time as the ionic shift, a reduction in the blood flow to the brain occurs further reducing the supply of energy/glucose.
A brain injury affects the visual and vestibular systems and cognitive or thinking processes.
How Do Concussions Affect the Visual System?
The brain dedicates about 70% of its energy to processing signals from the eyes. This strong connection between the brain and eyes mean that a concussion will significantly affect the visual system.
Common ways in which a concussion affects the visual system include difficulties tracking and focusing on objects. According to research, up to 90% of concussions can cause at least one visual disturbance.
How Does a Concussion Affect the Vestibular system?
Along with cognitive and other sensory processes the vestibular system uses the remaining 30% of the brains sensory processing. The vestibular system is also densely connected with the visual system. As such the vestibular system is highly susceptible to injury following a traumatic brain injury. For example, for people with concussion dizziness is the second most common symptom.
How Does a Concussion Affect Cognition?
According to research an energy crisis during the acute stages of concussion can lead to cognitive difficulties such as:
- Reaction time
- Information processing
- Working memory
What are the symptoms of Concussion?
The common symptoms of concussion include:
- Light and sound sensitivity
- Nausea and vomiting
- Balance problems
- Fatigue /Sleepiness
- Sleep issues
- Difficulty concentrating
- Memory issues
- Anxiety and Depression
It is important to realise that symptoms may be immediate, but are often delayed. Loss of consciousness occurs in less than 10% of cases and is not a marker of severity. Similarly, the degree of force of impact is always consistent with symptom severity.
How to Treat Concussion
When treating a concussion, it is essential to recognise and address the injury as early as possible. If a person experiences a head injury, even if they do not appear to have symptoms, it is essential to seek out an objective clinical evaluation. Diagnosis of concussion should not be made on symptoms alone.
How Most Medical Doctors Treat Concussion
Most medical doctors traditionally prescribe rest for a concussion. This rest includes avoidance of time watching TV, playing video games, reading, and texting. All these restrictions are related to the eyes or visual system and do not address the vestibular and cognitive processes.
Complete rest of the visual system is critical within the first 24 to 48 hours following the injury because the eyes are a significant drain on energy. After that time it is vital to address the other systems.
Clinical recovery vs physiological recovery
The majority of well-managed concussion cases will exhibit clinical recovery in a relatively quick timeframe. Clinical improvement is defined as a remission of symptoms. For adults, clinical recovery is usually within two weeks while children and adolescents are generally within 30 days.
There is some evidence however that complete physiological from concussion recovery may take longer than clinical improvement. Physiological recovery is defined as the normalisation of objective medical testing.
A concussion renders the brain more susceptible to cellular injury. If additional trauma is sustained before physiological recovery more severe brain damage may result in an increase in symptoms, a more prolonged recovery timeframe, and Second Impact Syndrome.
Second Impact Syndrome
Second Impact Syndrome (SIS) happens when a second trauma occurs when the brain is still in a state of energy crisis.
SIS results in severe neurological impairment and brain swelling which may lead to coma and death.
SIS is a rare but devastating consequence of a premature return to sport.
Post Concussion Syndrome
Post concussion syndrome occurs when symptoms exceed expected the anticipated timeframe for recovery. According to research, 15 to 20 % of individuals with a concussion continue to experience persistent and potentially debilitating problems months after injury.
Unfortunately, the current Canadian healthcare system is not currently for this patient population.
What Causes Post Concussion Syndrome?
The causes of Post Concussion Syndrome are not well understood, and they are thought to be a combination of neuropathological and psychological factors. Researchers have identified some risk factors for persistent symptoms from concussion including:
- A high initial symptom load
- History of a migraine
- History of vestibular or visual symptoms
- History of anxiety or depression
- History of insomnia
- Teenage females tend to at a higher risk for a protracted recovery
Symptoms of PCS
Symptoms of PCS may include:
- Visual and balance problems
- Neck pain
- Anxiety and depression
- Headaches and migraines
The symptoms of PCS are not specific to a concussion and share clinical features of other conditions such as PTSD, depression, chronic pain and insomnia. As such, PCS requires an interdisciplinary approach to treatment.
Concussion results in an energy crisis that is typically resolvable, but should be appropriately managed.
During the acute stage of concussion, the brain is highly susceptible to further injury so underscoring the importance of a delayed return to sport.
It is critical to managing the injury early and effectively, particularly in those at higher risk of symptoms.
The treatment of Post Concussion Syndrome relies upon the identification of triggers and managing them accordingly.
Many of my clients report headaches that correlate with their menstrual cycle. These clients assume that their headaches are an indication of an underlying hormonal problem. This conclusion is logical and possible, but another common underlying cause is histamine intolerance.
I recently had a client say to me. “I have been getting headaches.” “Do the headaches correlate to any foods you are eating”, I replied. ” No,” she said. “But they do appear to relate to my menstrual cycle.” “In particular, they occur on day 13 of my cycle and occasionally a few days before my period begins.
Interestingly, the timing of the headaches coincides with two peaks of estrogen in the menstrual cycle.
The first peak is the highest and occurs towards the end of ovulation. The second peak occurs a few days before the start of menstruation.
Estrogen decreases the levels of Diamine Oxidase (DAO) the body. DAO is one of the main enzymes in the body that breaks down histamine.
Histamine is a compound that the body produces in the presence of allergens and gut and systemic infections such as Lyme disease.
Chronic or longstanding infections will lead to a buildup of histamine in the body. An excessive accumulation of histamine will lead to symptoms such as headaches.
Therefore if you have an underlying infection with a related high level of histamine, a peak in estrogen and an associated drop in DAO will lead to a spike in histamine.
If you think that you suffer from histamine related menstrual headaches, the following strategies may help.
Strategies to help lower histamine related menstrual headaches
For tackling histamine related menstrual headaches, there are two categories of treatment: symptom-reducing and root cause resolution.
1. Take a Diamine Oxidase (DAO) supplement
If you get histamine related menstrual headaches, try taking a DAO supplement a day or two before you expect your symptoms. I recommend Seeking Health Histamine Block.
2. Avoid high histamine foods
High histamine foods include fermented vegetables and dairy, processed meats and food additives. Avoiding high histamine foods a few days before and during the days you expect your headaches to occur may help reduce symptoms.
3. Take Vitamin C and Quercetin
Quercetin and Vitamin C both help to lower histamine in the body. Taking both nutrients a few days before and during days that you expect your symptoms may improve. I suggest taking Design for Health Stellar C, which contains both Quercetin and Vitamin C.
Root cause resolution
As we discussed above, the body produces histamine in the presence of allergens and infections such as gut infections and Lyme disease. Chronic or longstanding infections will lead to a buildup of histamine. Functional medicine practitioners can help identify and treat underlying infections. Gut infections that can cause excess histamine include Small Intestinal Bacterial Overgrowth (SIBO) and parasites.
This article is not intended to provide medical advice, diagnosis or treatment.
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In this article, I am going to discuss ways of preventing and treating food allergies and sensitivities.
Some people have the perception that food allergies and sensitivities are more prominent than in the past.
For example, when I was a child in the 1970’s, we were never told about the dangers of bringing peanuts to school. Today, I hear from the parents of my child clients that this is commonplace.
However, despite hearing this observation, is the issue increasing or we are merely more aware of it.
Scientific research shows us that the incidence of celiac disease is much higher than when I was a child. Researchers can show this increase by analysing old blood samples and applying the modern day diagnostic criteria. What they found is that celiac disease is over four times higher today than it was a half-century ago.
So why is the incidence of food allergies and sensitivities increasing?
To answer this question we must first look at why some people develop allergies and intolerances, and some people do not.
Eggs and Liver
Over the past fifty years, we have seen a change away from particular foods including a reduction in the consumption of eggs and liver.
When we remove foods from our diets, this will have a detrimental effect on our nutritional status.
Our immune system requires certain nutrients to work efficiently, and without them, it can become over-reactive, and we can develop allergies and intolerances.
Two essential nutrients for a healthy immune system are retinoic acid and prostaglandin E2.
Retinoic acid is a molecule that we make from retinol. Prostaglandin E2 Is made from arachidonic acid an omega-6 fatty acid that we also find in animal foods.
Retinol is found mainly in liver and cod liver oil with smaller amounts in egg yolks and dairy fat. Arachidonic acid is found primarily in liver and egg yolks. Therefore a reduction in the consumption of liver and egg yolks has probably played a role in the increase in food allergies and food intolerances.
Nonsteroidal Anti-Inflammatory Drugs
Another important consideration is the increased use the over-the-counter nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, acetaminophen, and aspirin. These drugs block the enzyme COX in the body. The enzyme COX converts arachidonic acid into the prostaglandin E2 which we require to ward off allergies and intolerances.
If we are in pain, out of all the NSAIDs from a research point of view, the safest one is aspirin.
How Can We Use This Information?
Regarding food intolerances, I think it is more accessible to prevent them than to fix them. To avoid the development of food intolerances of, we need to introduce both liver and eggs into the diets of our children from an early age. For example, beginning with eating liver once or twice a week and eating egg yolks every day or every other day.
Secondly, avoid the unnecessary use of the NSAIDs. There are many natural and safer alternatives to NSAIDs. I suggest seeking out a local Naturopathic Doctor or Homeopath for advice.
As I mentioned above, there is no easy way to fix food intolerances. The first thing to do is identify which foods you cannot tolerate and cut them out of your diet. My preferred method of determining food intolerances is to carry out a food elimination diet. I also find muscle testing a useful tool.
If you suspect that gluten is an issue, it is essential that you rule out celiac disease. Celiac is a serious medical condition which means you must be very strict with the avoidance.
Similarly, if you are anaphylactic to a food such as peanuts, complete avoidance is imperative. Unlike Celiac disease, it may be possible to treat food allergies even if they cause anaphylaxis. I recommend you look at Natural Allergy Treatment which I have found very effective.
If food intolerances do not induce a medical condition or very uncomfortable effects, it may be possible to reintroduce them over time. I suggest trying to reintroduce foods after say 3-4 months. If there are several foods then introduce them one at a time over a week.
You may also try consuming the foods in a predigested form. For example, if you have a problem with nuts, try soaking them and sprouting them. If you are dealing with grains, try using sourdough grains, long-fermented grains, and so on.
This article is not intended to provide medical advice, diagnosis or treatment.
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