137- Strategies to Reduce Inflammation After a Brain Injury with Dr. Kabran Chapek

Bryan Carroll: [00:00:15] Any trauma to the head should be taken seriously. And there are steps to take, to reduce inflammation and impact to the brain that are often overlooked. In most cases, actually last weekend, there was a soccer game in England or two opposing players, collided headfirst.

One team sent their players to the hospital out of precaution while the other team wrapped up their players bleeding head and told him to get back to playing. And then later in that same game, another player took a ball to the head and was knocked out and their team doctor woke him up and had him continue to play.

And you would think after all the concussion issues, the NFL went through years ago that other sports would be cautious, but that isn't the case, but concussions don't just happen from the sports. There can be lots of other causes as well. What's up everyone. I'm Bryan Carroll and I'm here to help people move more, eat well and be adventurous.

And today I have Dr. Kabran Chopek on the show to talk about steps, to take directly after a TBI, to protect your brain. We've talked through a lot of different strategies and ways to hack our inflammatory systems. So this is an episode you don't want to miss. And before we get started, our yearly giveaway and podcast survey are now alive.

This year. We will be giving away a Vitamix to one lucky winner, and there is an additional $100 gift card by filling out a podcast survey within the giveaway. I always let the gift card winner choose a store they want to support. So last year's one or chose trader Joe's to enter the giveaway, go to summit for wellness.com/giveaway.

Now let's dive into my conversation with Dr. Kabran. Dr. Kabran Chopek has been a staff physician at amen clinics since 2013 as a graduate of best year university in the Seattle area. He is an expert in the use of functional and integrative treatments and collaborates extensively with many of the amen clinics physicians.

He has a special interest in the assessment and treatment of Alzheimer's and dementia, traumatic brain injuries, PTSD and anxiety disorders. And Dr. Chopek is a founding president of the citrate psychiatric association of naturopathic physicians and affiliate group of the American association of naturopathic physicians.

Thank you for coming onto the show, Dr. Kabran. 

Dr. Kabran Chapek: [00:02:39] Hey, Bryan. Good to be here with you. 

Bryan Carroll: [00:02:41] Yeah, I'm super excited to chat with you because, traumatic brain injuries are just so important to learn about. And there's always so many different things going on with concussions, but before we get started with that, let's learn more about you, who you are, what got you into naturopathic medicine.

And then why are you so interested in the brain? 

Dr. Kabran Chapek: [00:03:01] Well, I'm a Naturopath, as you said, and I'm a naturopathic physician. My primary experience has been in mental health care because when I was a kid, what always got me excited was. How I can feel better and how my family can feel better. They were really into nutrition, herbs.

Like I always remember as a kid putting Vicks vapor up on my chest with the mental, Latum just opening my sinuses. I could breathe again. It was like I was coming out of a coma. It was like, felt so good and said, Oh, this is fascinating. You can do things to feel better. Mine by, and it there's just felt like myself again.

So I've always been fascinated with that. Interested in reading about herbs, nutrition, exercise. And so then when I was a senior in high school, I met, one of my parents' friends who was a teacher at Bastyr university that a naturopathic medical school in Seattle. And he told me all about naturopathic medicine, opened my eyes to it.

And I, I knew I had to go there. And that's why I went to school. 

Bryan Carroll: [00:04:03] And since you mentioned VIX, do you still use VIX or do you have like a more natural way to open up those sinuses? 

Dr. Kabran Chapek: [00:04:09] So it got fixed out there in the, in the cupboard for the kids. I don't know if it's just because it's what worked for me, but, we also do regular eucalyptus steams.

It's really helpful. If you have a cold, you boil a big tub of water pouring on the eucalyptus with a towel over your head and steam and opens up the sinuses. It's amazing. 

Bryan Carroll: [00:04:27] Ooh, that's really good. Especially as we start going into winter and people are more likely to get sick, that could be really helpful.

so one of the areas that you like to do a lot of work with is brain injuries. And, I just wanted to learn a little bit more about it. Like can brain injuries happen without us even recognizing that it's a brain injury? 

Dr. Kabran Chapek: [00:04:48] Yeah. So most people think that. You have to lose consciousness to have had a brain injury.

You have to go to the emergency room to have had a concussion or brain injury, or be assessed by a doctor, even, and many, I would say the majority of concussions are not diagnosed and go untreated and even unrecognized because we don't see the brain. We don't see the injury. That's part of the problem.

And so say you're on the soccer field. You go up for a header, you collide heads with the other player, you see stars for a second, and then you come down and you shake it off. And the coach says, go back in and continue playing. This is what happens with my kids or could happen with, you know, I pull my kids out, you know, we're not gonna keep them on the field if they're suspected of having concussion.

In fact, there's rules about this now. So it just seems stars is enough to have a. I had to enter the brain because of brain. Bryan is very soft. It's as soft as butter. The skull is hard as a rock. And so imagine, and there's many sharp bony ridges. So hitting the head, even whiplash injury as it's enough to damage the neck muscles and strain them, it's enough to shake and Jostle the, the brain inside the skull and cause injury.

So the brain can be damaged very easily, even without knowing it. 

Bryan Carroll: [00:06:13] Interesting. So you mentioned your kids and I know for a long time, if there was an injury on the field or anything, then people would say, you know, throw some dirt on it, get back out there and you being the parent. That's like, yeah, no, my kids they're done.

what kind of backlash what'd you get for that? Or do you get any backlash now? 

Dr. Kabran Chapek: [00:06:31] Now? So I live in Edmonds and everyone's very sensitive to this. and I remember at one of my kids' games, there was that he's, plays basketball and we heard everyone. I had turned around and we heard this loud crash and everyone's quiet.

And one of his teammates that fallen somehow inspect his head on the wooden floor and it was days and sitting out and, and the, the mom looked kind of frantic, like, what am I supposed to do here? And so I went over and said, you know what? And it doesn't look like he needs to go to the emergency room.

Sometimes you do. Like, I don't want to say don't be assessed fully, really. And he, he did see his doctor the next day to be assessed. That's the proper protocol, but she needed more help with like actually how to facilitate healing of the brain after a concussion. And so I gave her this list of things to do, which she was so grateful for.

and that's, what's not being done. That's what's being missed. It's the standard protocol to return to play gradually returned to exercise returned, to work after car accident, you have head injury, there's return to work protocol. All of that ignores what is going on beneath the surface, the healing that needs to happen.

The inflammation that is. Persisting the swelling that may be happening at a very microscopic level that is slowly damaging. The brain symptoms may not show up until two weeks later, I had this, pastor who I knew and, and, he had a car accident thought he was fine. The police, the emergency, everyone told him he was okay.

but then two weeks later, he goes to write a sermon. He can't focus. He can't write, his memory is not working like why symptoms can be delayed because of that swelling, that inflammation will build up into a tipping point. And then he started having symptoms. Interesting. 

Bryan Carroll: [00:08:23] So when there is swelling in the brain, what's actually being impacted, is that the brain cells, is that the neurons?

Is there something else actually being impacted in there? 

Dr. Kabran Chapek: [00:08:32] This is a whole problem with the brain and the design of the human being. We have this soft, you know, fluid filled space with nowhere, for the fluid to go if there's swelling, because the skull will, it'll just increase pressure and that increased pressure.

We'll compress the brain and start to damage the cells, the neurons, and they will begin to die, or at least be less functional. And so we have to decrease that swelling. We have to decrease the inflammation is really the key. and, and we didn't know what happened, what, how this worked until maybe like six, seven, eight years ago.

They're doing there's this new law, new round of research being done. like for example, at Stanford, they were able to look. Under a microscope, it realtime brain injury in mice and see the inflammation and the swelling of microglia sort of macrophages these immune cells, gobbling ups tissue. And the cool thing about this particular study is that after damaging these poor mice and like giving them little brain injuries, it's just so sad, but it's how we learn.

they applied glutathione to the mouse, skull topically. Glutathione is an intracellular antioxidants, very potent and a mouse school is very thin, so is able to permeate easily. And if applied immediately, there's 67% less cell death. If applied within three hours, there's 50% less cell death window of time in which to act.

So why do we sit on the sideline? Or if you're dazed, you've had a head injury. Why do we wait? To see if something happens to see if you can't write a sermon two weeks later to see if you have problems at work problems, focusing anger, problems, mood problems, why don't we do something immediately like we know to do for a sprained ankle and we apply ice and elevation.

And why don't we? Our brain is so much more important than our ankle. Even though we can't see the swelling, my, my whole goal in helping people understand their brain health and what to do about it is to be able to act immediately to have like a first aid kit for your brain that you have with you at all times, whether you're out in the mountains, backpacking.

Or in your car, it's like part of, part of your first aid kit so that you, you know, on the sidelines with the, the coaches, you know, and, and medics they have, okay, let's start this as well as applying ice, you know, help the brain to heal. 

Bryan Carroll: [00:11:09] And so I would assume that the human skull is probably too thick for a topical glutathione to be able to permeate through.

But can you put the topical glutathione somewhere on your neck or spinal cord so that it's shuttled into the brain? 

Dr. Kabran Chapek: [00:11:25] Yeah, I, I, that's a reasonable strategy. There's also. another strategy that's been used by the U S military, in the field of battle. So there's a study done. and what they had here was a hun, 81, active military.

And what they did was they gave them inositol cystine. this was in 2013, the journal plus one double blind placebo controlled trial, NAC or inositol. Cystine. The body turns into glutathione, and you can take this as a pill, as a capsule, very safe it's over the counter. And they took within 24 hours of their injury, 2000 or 4,000 milligrams of NAC and then twice daily, 2000 milligrams for several days.

And then. A thousand milligrams or 1500 milligrams twice daily for the rest of the week. So they did this for a week. And the patients who were given NAC versus those who weren't, recovered, they checked their concussion symptoms before and after. And 86% of those who took NAC recovered that no symptoms after a week versus 42% of those who didn't.

So 42% recovered, which is about normal to statistically. But half of people will have long-term symptoms from a concussion that's serious versus not, but 86% is I would want to be in the NAC group for sure. Sure. 

Bryan Carroll: [00:13:00] Interesting. So I'm, I'm trying to think through some different things here. So, When you do start getting the inflammation, then that your blood-brain barrier is probably impacted at that point.

Can you and nebulize and NAC and get that into the brain faster because of that blood brain barrier being, 

Dr. Kabran Chapek: [00:13:18] just thinking. Yes. So, so nebulous, nebulization of even glutathione, you can breathe in glutathione. Like I have, I think that actually actually. Very effective strategy. There's Ivy glutathione. If you were to have access to that, like I, for my wife for COVID, she was having some breathing problems.

I think glutathione is, is an underutilized treatment for lung problems and viral infections. I'll just say that because this is yeah. A little sticky. but, yeah, this is helpful for her for breathing and, Many patients that just it's an antioxidant and your body makes it as very fragile. It breaks down and li light with, exposure and heat exposure.

So he kept keeping the fridge and stuff, but also do lyposomal under the tongue glutathione. So my daughter, she, you know, actually they're biking right now in front of me. And, she fell off her bike. A few weeks ago. And we did the protocol even before she was having symptoms. And she, I think she had a concussion.

She had, you know, ringing in the ears and headache. And so we gave her some life Zoma to fire. Plus the NAC it's a cyclist. Let's just give it all, you know, sort of shotgun approach because. With the brain refining. It's not one thing that heals, there's not the pill that cures concussions or the pill that cures even dementia, or Alzheimer's like 200 trials have failed to find the pill to cure Alzheimer's disease.

The brain is so complicated. We need a multifaceted approach. We want. You know, anti-inflammatory plus nutritive, make sure all the nutrients are there. The blood flow is there. the brain is getting nutrition, there's antioxidants and quenching of inflammation. And you want different mechanisms at the same time.

That's what really helps with healing. make sure that there's structural integrity. Sometimes there can be impingement on the upper cervical spine. So at misalignment, there's can be hormonal deficiencies because of damage to the pituitary gland, the master hormone gland in the brain. So it really helps with healing is more of a program of putting all of those pieces together.

In order to help with healing. Right. 

Bryan Carroll: [00:15:36] And a lot of the stuff that you just mentioned is specific to the brain, but I'm also thinking about, you know, the dietary approaches and lifestyle approaches that a lot of people have, might not be the best for and inflammation in the first place. So, with that in mind, what can people do right after a head injury to minimize, just inflammatory responses from environment and food 

Dr. Kabran Chapek: [00:15:58] as well?

So there's a few studies on this showing that a high sugar diet or a lot of carbs slows healing after a concussion, mostly in animal studies again. And, there's the a ketogenic diet. I know it's kind of a fad right now, but it is a neurologically healing, helpful diet. And that if I had a serious head injury, that's something I would initiate if it's possible.

You certainly don't want carbs or sugar. So there's this site, you know, with recovery, we tend to drink these, you know, drinks, Gatorade, and carb load and things like that. You don't want to do that after a head injury, the brain, the glucose transporters in the brain, and some of the utilization of glucose in the brain has not working as well after injury.

And so here's the starving brain. Our brain uses 20 to 30% of calories in our diet in the first place, our small little brain, that's 2% of our body weight, but using a quarter of what's on our plate, straight up to the brain. And now it's now it's starving because it can't cause the glucose transporters are damaged.

So what else can we do? Well, For example, a ketogenetic diet bypasses that you're using ketones for fuel fats for fuel versus glucose. And. As a fuel source. So that's, that really helps the brain. but even just a higher fat, lower carb diet is an excellent strategy for most people and much easier to employ.

Bryan Carroll: [00:17:35] So would a food quality also make an impact? Cause you could do, you know, a ketogenic diet where you just eat hot dogs all day long in technically it'd be Quito. Food quality. Is that important? 

Dr. Kabran Chapek: [00:17:47] Yeah, it is important. So this source of the fats and the proteins is really key. You want, fish and fish oil, like wild salmon.

You want avocados versus like hydrogenated oils, which are going to be more pro-inflammatory definitely do organic, definitely do wild caught and grass fed and all of that. I think that it does make a difference. And so it's avoiding the bad and doing the good as much as you can avoiding sugar fried, you know, using brailled.

So like an ideal meal would be maybe some broiled salmon, and, half an avocado, maybe some green beans or broccoli. And, if you're doing carbs and sweet potato or something like that, there was some butter grass fed butter. That'd be a pretty good post-concussion meal. 

Bryan Carroll: [00:18:34] So when there is inflammation in the brain is a brain then more likely to become insulin resistant.

If it's not taken care of 

Dr. Kabran Chapek: [00:18:45] the brain is more likely to have difficulty long-term using fuel sources. Like normally. Yeah, that is, with dementia. Certainly there's like they call it type three diabetes, insulin resistance in the brain, essentially. And there's many similarities between dementia and traumatic brain injury.

There's a correlation there. So some of the same glucose transporters, it's, it's a different type of now function. There's not as much insulin resistance per se, but I guess that's one way to think about it. It's like, they're not, usually it's not using utilizing glucose really. 

Bryan Carroll: [00:19:23] Hmm. Perfect. so, one of the questions that I always like to ask too is, you know, you're talking about the neck, you're talking about the head and direct trauma to those areas.

Is there other ways to get a concussion that requires a whole body where you might not get hit in the neck or the head? 

Dr. Kabran Chapek: [00:19:42] What comes to mind is military. So a blast injury where it can, can damage the vital organs. That is a different kind of concussive force that penetrates more deeply to the brain. And, you know, you'll feel it.

Throughout the whole body and can actually damage multiple areas of the body. and, and for example, we were talking about hormones. That's more light, you're more likely at pituitary damage from a blast injury than a hit to the head, although it can happen with. 

Bryan Carroll: [00:20:14] Hmm. Yeah. what about like, like whiplash type events where your body, like, if you're a football player and you're running and someone hits you just right in the gut and your whole body stops, but the head keeps moving.

Dr. Kabran Chapek: [00:20:26] Yeah. Yeah. You can have injuries from that, essentially. Any, we call it an acceleration. Deceleration force could cause that, so fall from a height, you know, so working with a guy who fell off of the ladder and, it was remodeling his garage. And just straight onto concrete. So he broke his shoulder and they didn't think about his brain, but then he started having all of these, you know, anger problems and depression, and just couldn't think clearly and say, Oh, you, Oh, I guess he injured your brain as well.

And, so, fall acceleration, deceleration. It's less likely if you fall and you don't. Hit your head. It's less likely to cause injury to your, to your brain. That's going to be more subtle. Although I'll say that brain injuries are cumulative, they build up. So if you've had them before, you're more likely to have them further and you're more sensitive.

So, you know, I have patients who are so sensitive that they've had injury, they're in recovery, and then they have another car accident and my little fender bender. Most of us wouldn't have any symptoms, but then they're having all of their post-concussion syndrome symptoms back again. So it kind of depends on the susceptibility of the person and then what forced they were, what they were forced, they were experiencing by the football players, man, serious injuries.

Bryan Carroll: [00:21:54] Yeah, it reminds me of a Travis Pastrana. Who's had a ton of head injuries in his history and now it doesn't take much, it takes like a flick of a finger and he's out. So that's, that's that compound effect that you're 

Dr. Kabran Chapek: [00:22:07] talking about, right? Yes. We've only got one brain and some of these players are stopping.

They're not playing because they've had a number of concussions. They see their predecessors. At 60 65, who said, I wish I had never played my life is horrible. I'm depressed, I'm angry. I've lost my family. It's not worth it to them. So like, Hmm. That's, that's an, a sign of intelligent life. They're thinking ahead, they're getting feedback and deciding to make a different choice because their brain, you can do other things, you know, It's hard to, 

Bryan Carroll: [00:22:43] so if you, if you don't take care of the brain right away, how long can these issues last, like the inflammation in the brain?

Does the inflammation eventually, start to subside or does it just stay there and create this Everlast 

Dr. Kabran Chapek: [00:22:59] some patients it does stop, you know, so several months, you know, within a month, hopefully most of it's gone. But then there's people who it persist for months and years, and they just have this low grade inflammation.

They have damage it's like these cells have been dazed. And they're not dead, but they're not working well. So at amen clinics, we do a type of imaging called SPECT single photon emission, computed tomography. It's a mouthful, but it's essentially looking at blood flow of the brain. And this is much more sensitive than an MRI at assessing damage and injury.

In fact, it's, it will pick up, 94% of the time, mild traumatic brain injury, which is missed on MRI. And so. One of the things I've learned since working at amen clinics is that it's a major cause of, of mental illness that we didn't even know about. And, you know, four out of 10 patients come into our clinic without having had a brain injury, finding out that they actually had one on imaging and that it was contributing to their symptoms of depression or worsening ATD or worsening their memory problem.

And so when, when we treat that can common to Lee, they get better. When, when in fact they had been to like four or five, other doctors tried like 10 different medications, nothing is working. I had this patient who has a 24 years old when he came to see me, he's a jazz drummer and had been suicidally depressed since he was like 14, 15 years old.

Every single day. And he had been to some great therapist. He had tried lots of different medications. And the only thing that helped him was pot smoking cannabis. Pretty much every day, drinking alcohol had tried going to college and failed out after the first semester, just tons of anxiety and depression.

And so he was referred by a really good therapist that he'd been working with. When we looked at his brain, there was clear injury to the left side, his left frontal lobe for focus, motivation, concentration, and his left temporal lobe for memory and mood, really keeping his mood stable. And I said, We'll call him Jacob.

I said, Jacob, when did you have a brain injury? It's clear. You've had one here. He said, Oh, I don't think I've ever hit my head. Never had a brain injury. And so we asked patients 10 times because most people don't think about the brain injury that they've had. In the past, like we were just been talking about it.

They didn't lose consciousness ever. So I said, did you ever fall out of a tree? Did you ever have a car accident? Do you ever fall off a motorcycle dive into a shallow pool, fall off a fence off a horse? No, no, no. His mom was with him. I said, did you play contact sports? Oh, I did start playing football around 14 years old and he was a scrawny little kid and just get totally pounded and.

Dizzy and stuff, but like you said, you know, brush the dirt off, get back out there. You're you're fine. But he was dizzy. And so he had, had repeated mild concussions for like a year of playing football and that's when his depression started. So we changed his meds, put them on a program to heal his brain.

And then his suicidal thoughts lifted. He said he got to stop smoking pot. He did. and then he's about to graduate. I think he teach us, did graduate from the Berkeley school of music. This is now several years later doing great. So it's important to heal and assess the underlying injuries as well as treat the current symptoms.

Bryan Carroll: [00:26:36] Interesting. So with the SPECT, you're able to see where blood flow is going and not going. Is that 

Dr. Kabran Chapek: [00:26:42] correct? In the brand clean what's too active. What's attractive. 

Bryan Carroll: [00:26:46] So knowing that information, how do you then get the blood flow to start going to the right places? Is that utilizing that part of the brain for different thought processes to try to simulate that, that way?

Or do you have other methods to get that to work? 

Dr. Kabran Chapek: [00:27:00] Yeah, that's that's the challenge is trying to get the brain to work again. And it's, it's like a muscle it's responsive if given the right environment, that brain will heal. and so it's, it's decreasing inflammation. It's. Stabilizing certain areas. So the temporal lobes need different treatments than the frontal lobes and that's, what's helpful.

And once we have assessed them, okay, you need more frontal lobe support. You need more dopamine. You need more stimulation. Think about, add, think about. Problems focusing. A lot of folks will have, acquired add essentially after hitting their head. All of a sudden they're having problems, focusing impulse control, you know, they'll start using drugs or making poor decisions and, we want to stimulate the brain.

So then when you stimulating. Herbs, Jen Singh, Rhodiola, ashwagandha, stimulating medications. If, if it's really severe and is needed, sometimes medications are helpful. But for healing medic medicines, aren't really healing. It's more the nutrients and supplements that help with healing. So fish oil, multiple vitamin.

temporal lobes need different kinds of support essentially. And we can get into that too, but, it's more, so we look at the biological piece and then, one of one really useful tool for this is meditation. And actually meditation helps to calm the overactive centers because oftentimes there's overactive.

emotional centers as well. And this is true for brain injury. This is true for depression, men, many other issues as well. but meditation is very useful to calm that overactive sort of like let the feelings and thoughts wash over you that are negative, and then aspects that, meditation stimulates or works out to frontal lobe and strengthens.

There's a step above that, which is neurofeedback. Essentially, it's hooking up a cap to your head or electrodes to measure brainwave activity, figuring out which areas are low or high, and then training those sort of like you'd work with a coach to train and strengthen some muscles. You can actually work in strengthen areas of the brain that aren't working well.

and then one other treatment that I like to recommend is hyperbaric oxygen. This is like going into a tank with pressure breathing oxygen. Pushing oxygen to the deeper structures to help with healing. It's like you hear about divers going into a oxygen tank. It's like that, but much lower pressure over longer period of time.

Bryan Carroll: [00:29:29] Yeah. Now that we have better access to hyperbaric chambers. It's amazing. yeah. Do you guys have that at your place? Do you have a, one of the soft shell hyperbaric? 

Dr. Kabran Chapek: [00:29:39] Do we have a soft shell chamber? Doesn't get a ton of use because most of our patients come from many miles away and they're coming for assessment and they go back.

So we see patients from Alaska, Oregon, Idaho, Montana, and, you can rent these chambers. So I do recommend that quite frequently. Or if they have one close to them, like you said, they're more, they're popping up on every street corner. It seems like, go do some hyperbaric and you gotta do a bunch of sessions, like typically 40 to 80 sessions.

So in that case, renting them. Just logistically becomes a little bit easier. 

Bryan Carroll: [00:30:14] Yup. Yup. Well, when it comes to brain injuries, what does that do for like your nervous system, your sympathetic parasympathetic system? 

Dr. Kabran Chapek: [00:30:23] Honestly, it does a number on, on them, Bryan. the. It's, it's a, it's a strong link as well, between PTSD for many patients.

So there's PTSD and TBI and there's some overlap. And part of it is because all of a sudden the circuits are upregulated. There's more sympathetic drive. It's harder to sleep. It's harder to relax. So oftentimes at night the brain is. Overactive it's more in, it's it's, it's not that it's overactive necessarily assisted it can't turn off.

So it's almost like a lack of parasympathetic tone is another way to look at it. So, it's almost like you need some brain energy to get into a relaxed state. And so it's like you imagine the lights, fluorescent lights that are kind of flickering. They're not quite on, they're not quite off. That's what the brain is like after an injury.

It's not on, it's not off. It's just so in the daytime persons sleepy and tired and that they can't do much. And then at night they can't sleep their brains on just a little bit, not enough to do anything but not, it can't turn off either. So they're sort of in this limbo state, it's not very fun. 

Bryan Carroll: [00:31:34] Right. one of the other questions I want to ask you is about helmets.

and I know there's a lot of technology going into helmets. Are helmets actually protecting the brain from concussions, or is it more just protecting you from a physical injury to this goal? 

Dr. Kabran Chapek: [00:31:53] It, helmet's not going to keep you from having a concussion. If you're playing football. For example, having the nicest helmet, you know, doesn't mean you, you're not going to have repeated, sub-concussive hits to the brain and that's cumulating towards problems.

although the nicer helmets, I'm glad to see it. They do lessen the impact. And so there again, it's going to be less severe and, definitely should be still done, but it's not, it's not the answer to like football, for example, or. You couldn't like start boxing. And just because you're wearing a helmet or something like this, it's like that part of this, the acceleration deceleration force part of it's just the impact is still there because you got this soft brain inside the skull it's just gets, it hits up against the school is a problem.

This, you sort of need something on the inside to protect the brain, not just on the outside. 

Bryan Carroll: [00:32:47] Yeah, I believe, rugby players have like the least amount of injuries or concussions out of all the different sports. And it's because they don't really have helmets. so they learn to protect their head.

Cause if they don't protect their head, it's not good for them. So that's why all of them have those like super thick necks. They're just really strong and burly, but they're protecting their head at all times. 

Dr. Kabran Chapek: [00:33:08] Brilliant. Love that. 

Bryan Carroll: [00:33:10] Yeah. And super interesting. w was there any other things that you want to make sure that we touch on when it comes to TBIs and concussions?

Dr. Kabran Chapek: [00:33:18] It's never too late to try and heal the brain from injury. So we've worked with retired NFL and that the important work about that is that even if you've had a concussion. 20 years ago from a car accident, say, it's not too late to try and heal the brain and it's not to say. You know, we can heal the brain as fast or as well as we could immediately after injury, or even when you were younger, but we can, I, and I've seen this repeatedly.

We can improve function. We can improve how the brain is working. We can scan the brain before and after and see improvement. So these football players, we essentially took. 30 of them. We tested them for mood problems, angry, depressed focusing issues and, scanned them. Gave them treatment supplements, diet, exercise, really not sleep apnea.

Some of them got hyperbaric oxygen. And then six months later, you know, 70, 80% improvement, not only in scans, but in their, how they're feeling, focus improvement in mood and, for this very eyeopening for me that, you can heal and improve the brain even many years later. It's like those cells that are days.

But not fully dead or reawakened. And that's what we're trying to do. Rejuvenate, the brain and improve function. It's never too late. 

Bryan Carroll: [00:34:46] Perfect. And then, my final question is what is your vision of what healthy looks like and what are three things you do daily to reach that vision?

Dr. Kabran Chapek: [00:34:54] It's a great question.

I think about this enforce fears. If you think about biology, Psychology, social spiritual. If you've got all those four in alignment, you're doing pretty good and spiritual can be sense of purpose in life. I spend a lot of time working with people on biology, and you know, it's so social is your relationships.

Psychology is how you're thinking about things, your positive attitude. biology is really. Getting your nutrition, your fuel intake, your rest, and, activating exercising. three things I do each day, especially lately. I need some alone time. I sort of like work school kids school, and. I just need a minute alone sometimes to reset my batteries.

And sometimes that's with meditation. Sometimes that's just going out in the garden. I go for a run each morning, most mornings I'll say, and then protein at each meal, like keeping stable blood sugar equals stable focus and stable mood for me. So those are, those are some things that I do, I think are important.

I recommend to patients do. 

Bryan Carroll: [00:36:07] So now I'm curious how much protein do you shoot for each 

Dr. Kabran Chapek: [00:36:10] day? I'm about 20, 25 grams per meal, kind of a deal. And, you know, I think I'm about. 75 kilograms. So it's like one, one gram per kilogram, body weight, something like that. some days, a little more, some days, a little less.

I find that if I'm stressed and working hard, I need more protein. If I'm on vacation, I could almost be like vegetarian. when I did keto, I did lots of meat, lots of fat. That's one thing I don't think we get enough of that. I learned from ketosis to fat, how helpful fat is for. The brain and stabilizing blood sugar is something being raised in the eighties and nineties.

I took for granted like it was the low fat generation and fat is bad, but reprogram myself, I think fat is good and healthy and very useful for associates. Your brain is mostly made of fat too. Right. 

Bryan Carroll: [00:37:03] Which that also brings up another question that popped in my head. what about exogenous ketones right after it?

Dr. Kabran Chapek: [00:37:09] Yeah, I think that's an excellent strategy. And I talk about that in the, in the book concussion rescue. I think that, they're useful after a concussion. They're useful in addition to a low carb diet, I think on their own, they can't really, they don't do a lot other than. Just, you know, they're just not helpful unless you're also between a low carbon diet because your body's using them differently.

I was to say that 

Bryan Carroll: [00:37:39] you can't hack a bad diet with just, erogenous ketones. No. Well, people can find more about [email protected] and you are located in Bellevue Washington for the amen clinic. You also have your concussion rescue book that you mentioned, and you also have a course. 

Dr. Kabran Chapek: [00:37:57] Can you talk about the course versus based on the book it's for people, some people after concussion, can't read.

well, and so they need to watch something, just kind of simplifies it and, yeah. Makes it easy for people. there's also an audible version of the book. If you have difficulty reading. 

Bryan Carroll: [00:38:13] Perfect. Well, thank you so much for coming on to the show. this is such important information and, I know that there's a lot of people out there that are just kind of pushing through and, live in life with these different brain issues.

So I'm glad that people like you are out there helping that out. So 

Dr. Kabran Chapek: [00:38:30] thank you. Delight to talk with you, Bryan. 

Bryan Carroll: [00:38:32] I had a fantastic time brainstorming with Dr. Kabran and working through different ideas on how to better manage brain injuries. And there was a lot that we covered. So you can always go to the show [email protected] slash one three seven, to see the timestamps resources and transcripts of the episode.

Also don't forget that our giveaway for a free Vitamix and a $100 gift card is now open. Go to summit for wellness.com/giveaway to learn more. Next week, I have Dr. David Raymond on the show. Let's go learn who he is and what we will be talking about. I am here with Dr. David Rabin. Hey, Dr. Dave, what is one unique thing about you that most people don't know?

Dr. David Rabin: [00:39:16] Most people don't know that. I happen to have an, somewhat of an expertise in esoteric sports. in high school and college, I played competitive table tennis. in, medical school, I played competitive Dodge ball. And before all of that, I played competitive Foursquare and I also played mainstream sports too, but I think that's the, one of the funny things that a lot of people don't know about me.

And I also produced, I also for fun in my spare time, I love to listen to and produce music of, of several different kinds. So, yeah, that's, That's my, my esoteric fact, 

Bryan Carroll: [00:39:55] You seem like a tall and lengthy kind of dude. So I feel like table tennis and stuff. That's a little unfair that you have such a big reach.

Dr. David Rabin: [00:40:02] I'm definitely not tall. I'm very average sized, five nine, and 145. 

Bryan Carroll: [00:40:08] That's three inches taller than me. So, well, what will we be learning about in our interview together? 

Dr. David Rabin: [00:40:16] So I think we're going to, we're going to talk about, Mental health, the past present and future of mental health. we're going to talk about, where we're at with psychedelic medicines and the future of, mental health as it relates to, psychedelic assisted psychotherapy and the state-of-the-art approaches to healing that brings to the table.

and we'll also learn about. A wearable approaches, herbal plant medicine approaches and, Apollo neuroscience, which is a company that's, commercialized the technology that I developed at university of Pittsburgh to help, help us cope with chronic stress and improve performance and recovery under stress, that can help reduce some of the burden of maternity that we've been facing lately in particular.

Bryan Carroll: [00:40:58] And what are your favorite foods or nutrients that you think everyone should get more than that? 

Dr. David Rabin: [00:41:04] Hmm, I like that question. favorite foods, I would say, both. I think the foods and nutrients actually go hand in hand because I really like mushrooms and I think mushrooms are something that a lot of people don't eat enough.

everything from Shataki mushrooms to oyster mushrooms and, You know, some of the ones that more, you more typically eat King King trumpet mushrooms. These know the more common ones by talkies are very healthy. and they carry a lot of, of nutrients for us. And then also going into the supplement category, things that come with, like the standard seven or Paul Stamets, who's like one of the leading mushroom experts and I'm a huge fan of his work.

and he. Has developed some really amazing supplement formulations that combine like 14, seven to 14 different kinds of therapeutic mushrooms in small doses, you can take in a powder or capsule. so as far as my favorite supplements and foods, I would say those are. At the top. And then next to that, I would say, you know, non-psychoactive cannabis products are our second, second they're things like cannabidiol is, and particularly raw cannabidiol that's, obtained in a pure, natural, organic way without contaminants.

Most cannabidiol out there is contaminated. Unfortunately. So raw cannabidiol or cannabidiol that is either CBDA or CBD that's non contaminated is really incredible powerful stuff. great for anxiety, great for mood balancing for a lot of people. Great for pain. Great for appetite suppression, for those of us who want to lose weight, and great for metabolism.

And then also the other cannabinoids that are kind of on the, on the forefront are like CBG, CBC, CBN and there. And there's lots of more on the non-psychoactive, side of the, of the cannabinoid front. That is very exciting and on, on the way into our, into our culture. 

Bryan Carroll: [00:42:56] And what are your top three health tips for anyone who wants to improve their overall wellness?

Dr. David Rabin: [00:43:01] Top three health tips are a number one. I would try to do your best to practice the four pillars every day that you can, or every moment that you can every day. And the four pillars are similar to the four virtues of ancient Buddhism and Hinduism, but they come from South American tribal medicine and they are self gratitude.

Self compassion or sorry, self forgiveness. Self-compassion and self-love and the practices of these every day basically reinforces and builds up the foundation of trust in ourselves that allows us to heal most effectively and allows us to reach our fullest potential most effectively. So, As far as things that we can do that are really tangible within our grasp.

I would say number one, just thinking about those things every day to start just keeping them fresh in our minds and ways that we can show ourselves not we're really good at showing others these things usually, but ways that we can show ourselves gratitude, forgiveness, compassion, and self-love are really game changing for us on our growth and healing process.

the number two would be. Move always keep moving. Always keep trying to get exercise. I also struggle with this. It's something that all busy people I think struggle with, but it could not be more important now than ever to try to do everything we can to get, you know, 30 minutes of moderate physical activity a day or every day or most days it doesn't have to be intense.

It just has to be a moderate level of physical activity for 30 minutes a day can be really, really important for our health and the long-term. And I think the. The last thing. I mean, there's a lot of things here that are important to talk about, but I think the last thing is, really looking at challenge, like an opportunity for growth.

So really divorcing ourselves from this idea that. Challenge is something we should be afraid of or that we should be worried about or run from, because we're always faced with it every day. And it's never going to go away. Challenge will always come at us as long as we're on this earth. It's just part of life.

and Nietzsche said it the best, which I think was echoed by OB one, which is that, that, which does not kill us will make us strong. Right? So it's this idea that when we overcome challenge that we face, we actually become better at life, which has inherently. And more likely to overcome the next challenge that we face, which is ultimately what resilience really is.

So the sooner that we can change our mindset to like to jump, to accept that failure is inevitable. And just jump on challenge as a learning opportunity and a growth opportunity. Then the sooner that we will be on that path to reaching our greatest fullest version of ourselves. 

Bryan Carroll: [00:45:52] Dr. Rabin was so much fun to chat with.

And there were lots of questions I wanted to cover in a short amount of time. And that may be one of the top contenders for episode of the year, next year. So until next week, keep climbing to the peak of your health.