Healthy Beginnings

Post-concussion syndrome: Why do you still have symptoms? (part 2 of 2)

Concussion symptoms can vary — as can the right treatment to fix certain cases.

Last month, we reviewed the logistics and ethics regarding poor diagnosis and treatment of post-concussion syndrome. Now, let’s talk about what happened when you were concussed, what’s causing your multitude of symptoms, and the main reasons why they may not be going away in a significant percentage of cases.

When you hit your head or experience a severe “whipping” back and forth of the head without actually “hitting” it (think whiplash), your blood-brain barrier becomes violated.

The “blood-brain barrier” is the blood vessels going to your brain. Blood circulates through them, and they should be constructed like a PVC pipe, without any holes in them. Actually, they should have microscopic pores that allow tiny nutrients like sodium and glucose in to feed brain metabolism.

All “large molecules” that are toxic to the brain should not be able to enter — thus the term “barrier.” In concussions, it has been established that the blood-brain barrier becomes permeable. Damage causes it to become as permeable as Swiss cheese.

Now, many types of proteins and molecules can get into the brain that don’t belong there. The brain and the rest the body have separate immune systems. Immune cells from the body start tracking to the brain. They don’t belong there.

The brain’s separate immune system is designed to control inflammation. We don’t want runaway inflammation in the brain causing severely damaging effects to the brain tissue. When this system breaks down, people can get meningitis and die. In meningitis, there is an enormous amount of inflammation in the brain’s meninges, and there’s nowhere for that inflammation to go.

So, inflammatory immune cells from the body start going to the brain through the broken blood barrier, and they actually turn on the brain’s immune system, which then creates more inflammation — long-lasting inflammation.

It is further understood that concussive trauma and increased inflammation can increase stress hormones by 200 percent to 300 percent. The stress hormones can then, in many cases, break down the gastrointestinal barrier system within 2 to 12 weeks and cause “gut” symptoms.

More importantly, this gut breakdown creates more inflammation and can cause the inside of your intestines to become like a sieve (leaky gut). Now undigested food particles can get into your bloodstream where they don’t belong. The immune system further attacks these particles that don’t belong in the bloodstream and creates more inflammation and food sensitivities.

These inflammatory proteins then track back to the brain to go through the blood-brain barrier and perpetuate more inflammation. This is the vicious cycle that is now the current understood model for post concussion syndrome. Guess what. None of the tests performed in neurological offices tests for any of this.

More physiology. Due to uncontrolled brain inflammation, the mitochondria in the brain cells lose their ability to make energy. So now you’re fatigued and have trouble concentrating. The memory area is damaged. The cerebellum, which is the true balance center of the brain, becomes affected and develops balance deficits. Inflammation hits the left temporal/frontal area. You can’t find your words and you develop poor memory.

In addition to all of this, the brainstem can get twisted during the concussive hit or violent flexion and extension of the head and the brainstem can become affected.

The brainstem is where numerous neurological pathways are located. Disruption of these pathways can cause dizziness as well. More profoundly, the brainstem injury can affect pituitary function. This is your master hormonal gland, and damage to it can affect virtually any of your hormones.

If you’re a guy, your testosterone can become low. You might make too much prolactin. Or your adrenal glands might be affected. Thyroid problem? Absolutely — thyroid dysfunction can be caused by this mechanism.

So if you’re experiencing any of the various symptoms that we’ve written about in this concussion discussion article series — what does it take to get better?

There are many promising tests under development, but most are not available to the public as of yet. However, if you can find doctors who understand concussion and its neurological and gastrointestinal vicious cycles, a thorough history and neurologically based examination can establish what parts of the brain are affected, and the proper rehabilitative approach for that individual can be assessed.

Testing is available to determine digestive/gut involvement and antigenic and inflammatory contributors. Most can be addressed with herbs, botanicals, nutraceuticals and diet (mainly understanding food sensitivities).

Specific, individual brain rehabilitative protocols are very effective — PCS can be complex, but improving or eliminating symptoms is very doable in the properly selected post concussion patients.

Martin Rutherford, D.C., C.M.F.P., is a Certified Functional Medicine Practitioner and clinic director of Power Health in Reno. Randall Gates, D.C., D.A.C.N.B., is also a doctor there. Visit www.PowerHealthReno.com to learn more.