Concussion and Dietary Supplements: How to Feed your Recovering Brain

January 16, 2019

= Authors =

Laura Diamond, MSc Global Health Student

Gabi Kaplan, Student Occupational Therapist

Jenni Diamond, OT Reg. (Ont.)

Evan Cole Lewis, MD

 

What is a concussion?

A concussion is a mild traumatic brain injury (mTBI) that affects brain function. Symptoms include, but are not limited to:

  • Headache
  • Brain fog
  • Dizziness
  • Ringing in the ears
  • Nausea or vomiting
  • Difficulty concentrating
  • Memory issues
  • Sleep issues
  • Fatigue

The effects of concussion can last for several days, weeks, or months, taking a large toll on day-to-day living and activities (1).

NCT’s team has blogged about concussion previously. For more information on concussion see here.

 

How can my diet and nutrients affect my concussion?

For many years, scientists studied the role of pharmaceutical drugs as potential treatments for concussions. To date, these pharmaceutical agents have had minimal success in treating TBI (2).

Research has revealed that following brain injury, a wide range of changes occur in both the brain and body – these include changes in nutritional status. Scientists believe that these nutrient deficiencies may worsen concussion symptoms and prolong recovery (2).  

Treating concussions with vitamins, nutrients, and minerals has great potential as an effective treatment for concussions. While still largely understudied in humans, recent animal research has shown promising results for supplementing basic nutrition to improve brain injury recovery. These nutritionally-based therapies (or “nutraceuticals”) are FDA approved and have few interactions with other drugs, making them deal candidates for concussion therapy (2).

 

Research has revealed that following brain injury, a wide range of changes occur in both the brain and body – these include changes in nutritional status.

 

Which nutraceuticals may help me?

  • Vitamins are nutrients required for normal function of our everyday physiology (2).
    • Vitamin B2 (Riboflavin): found in eggs, lean meat, low-fat milk and green vegetables (3)
    • Vitamin B3 (Niacin): found in meat, fish, soy and mushrooms (4)
    • Vitamin C: found in citrus fruits and vegetables (5)
    • Vitamin D: found in fatty fish and generated by exposure to sunlight (6)
    • Vitamin E: found in nuts, seeds, and vegetable oils (7)

Research reveals Vitamins B2, B3, C, D, and E may have a role in the treatment of concussion symptoms, either alone or in conjunction with other supplements or pharmacological treatments (2; 4; 8; 9).

  • Flavonoids, such as resveratrol, are antioxidants found in fruits, vegetables, and teas (2). Antioxidants have anti-inflammatory properties, and animal studies have shown they can reduce brain inflammation following TBI (10).
  • Omega 3 Fatty Acids (O3FA) are found in foods such as fish and flaxseed, and some dietary supplements (ex. fish oil) (11). Animal research shows supplementing with O3FA prior to concussion helps to prevent concussion and the neurobehavioral/cognitive effects that may follow brain injury (2; 10).
  • Curcumin, a phytochemical found in the spice turmeric, may assist in improving balance and reducing neuroinflammation (or swelling in the brain) (8).
  • Melatonin, a hormone that we naturally produce and is implicated in our sleep-wake cycle, may also have a neuroprotective role in TBI (8). Specifically, melatonin may reduce swelling in the brain, as well as improve cognition and neurological function (8; 10).
  • Creatine, a supplement most commonly taken by weight-lifters to increase muscle mass, may also have neuroprotective effects that aid in TBI treatment. Currently, creatine has been studied in two human-based studies in children with moderate-severe brain injury. The results indicated that children who were given creatine supplements had a significant improvement in cognition, behavior, communication, personality, and self-care, as well as a significant decrease in fatigue, headaches, and dizziness (8).
  • Coenzyme Q10 is a naturally occurring antioxidant in the human body (12). Administration of coenzyme Q10 following TBI has had a positive effect on animal brain recovery – reducing neurodegeneration (the death of brain cells) and increasing blood supply to the brain (13).
  • Magnesium, a mineral found in the human body, as well as in high-fiber foods (i.e. green vegetables), is also suggested to play a critical role in brain health (2; 14). Specifically, studies in animals have revealed that magnesium therapy promotes functional recovery from TBI. On the other hand, low levels of dietary magnesium may lead to poorer outcomes (2).

 

… vitamins and supplements found in our everyday foods have the potential to aid in the prevention, treatment and overall recovery from concussion.

 

It’s clear that many vitamins and supplements found in our everyday foods have the potential to aid in the prevention, treatment and overall recovery from concussion.

At present, the majority of the available data is limited to animal studies. Therefore, the FDA has issued warnings against the promotion of dietary supplements in concussion treatment (10). Additionally, many of these supplements are not subject to the safety/quality standards of the FDA so the exact potency of any commercial product may not reflect what is printed on the label (8). Until more human studies are completed, the role and effects of these alternative treatment options remain unclear.

 

Many supplements are not subject to the safety/quality standards of the FDA so the exact potency of any commercial product may not reflect what is printed on the label.

 

Meanwhile, it is important to be aware that “rapid, thorough evaluation by a health care provider, followed by rest, sleep, and light exercise, are essential for full recovery from a concussion” (10). And, of course, eating balanced, nutritious meals can ensure your brain receives a wide variety of the important vitamins and nutrients listed above.

So if you or a loved one are suffering from a brain injury, don’t forget about the role nutrients and vitamins may play in your recovery. Be sure to ask your doctor which of these supplements are right for you! And of course, stay tuned for more research…

 

 

Acknowledgment

Thanks to Keren Chen, Neurology Centre of Toronto’s stellar nutritionist, for comments and review.

 

References

  1. MFMER. (2018). Concussion. Retrieved from https://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/syc-20355594
  2. Haar, C. V., Peterson, T. C., Martens, K. M., & Hoane, M. R. (2016). Vitamins and nutrients as primary treatments in experimental brain injury: Clinical implications for nutraceutical therapies. Brain research, 1640, 114-129.
  3. ODS (2018). Riboflavin. Retrieved from https://ods.od.nih.gov/factsheets/Riboflavin-Consumer/
  4. Hoane, M.R. et al. Treatment with vitamin B3 improves functional recovery and reduces GFAP expression following traumatic brain injury in rats. J Neurotrauma. 2003 Nov;20(11):1189-99.
  5. ODS (2018). Vitamin C. Retrieved from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
  6. ODS (2018). Vitamin D. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
  7. ODS (2018). Vitamin E. Retrieved from https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/
  8. Ashbaugh, A., & McGrew, C. (2016). The role of nutritional supplements in sports concussion treatment. Current sports medicine reports, 15(1), 16-19.
  9. Hoane, M. R., Wolyniak, J. G., & Akstulewicz, S. L. (2005). Administration of riboflavin improves behavioral outcome and reduces edema formation and glial fibrillary acidic protein expression after traumatic brain injury. Journal of neurotrauma, 22(10), 1112-1122.
  10. Hume, A. L. (2018). FDA warns companies against promoting dietary supplements for concussions. Pharmacy Today, 24(9), 16.
  11. ODS (2018). Omega-3 Fatty Acids. Retrieved from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
  12. NCCIH (2018). Coenzyme Q10. Retrieved from https://nccih.nih.gov/health/coq10
  13. Kalayci, M., Unal, M. M., Gul, S., Acikgoz, S., Kandemir, N., Hanci, V., … & Acikgoz, B. (2011). Effect of Coenzyme Q 10 on ischemia and neuronal damage in an experimental traumatic brain-injury model in rats. BMC neuroscience, 12(1), 75.
  14. ODS (2018). Magnesium. Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/