From Dr. Lauren Deville - Naturopathic Doctor

Image by Gerd Altmann from Pixabay

One of the significant challenges for neurodegenerative conditions is how to repair the Blood Brain Barrier, once it’s disrupted.

The big picture of naturopathic medicine remains identifying and removing the obstacle(s) to cure, supplying any building blocks for health that might be missing, and supporting the body’s vitality so that it can heal itself from there. But which building blocks might specifically be useful for restoring the Blood Brain Barrier (BBB)?

Omega-3 Fatty Acids – Especially DHAEssential fatty acids (EFAs) in the omega-3 family are important building blocks for the BBB. Fish oil consists primarily of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The former is by far the most critical EFA for the brain, important for cellular signaling and communication between neurons. Studies show that when tissue levels of DHA are low, spatial memory and neurotransmission are impaired.

The brain can synthesize DHA from its precursors, alpha linolenic acid (ALA) or EPA (see the biochemical pathways here), but it’s not a very efficient process.

Both EPA and DHA appear to cross the BBB by simple diffusion, though—so it appears that the solution is (at least to some degree) as simple as just taking DHA orally. This study shows that there is a correlation between higher DHA levels in the bloodstream and better cognition, which implies that the DHA does make it into the brain, where it counts. (Studies do show that diffusion is greatly enhanced when DHA is bound to lysophosphatidylcholine, where the phospholipid is missing one of its fatty acid chains—see below, but this isn’t commercially available as of the time of this writing.)

It’s important not just to consume enough omega 3’s (and particularly DHA), but also to watch your omega 6 intake too. Both of these compete for the same metabolic pathways for uptake, so too much omega 6 (from processed vegetable oils, for instance) will mean even the omega 3s you do consume might not get utilized efficiently.

Other Fatty Acids: Phospholipids and Cholesterol Since the brain is nearly 60% fat, other fatty acids are important for repair and function of the BBB as well. These include cholesterol (another reason why cholesterol shouldn’t be avoided), as well as phospholipids, which are phosphates bound to two fatty acids. Phospholipids include especially phosphatidylcholine and phosphatidylserine, among others.

There is a definite association of phosphatidylserine loss in the brain in neurodegenerative disease — up to 20% over the normal loss from aging in the frontal cortex in Alzheimer’s Disease.

In fact, DHA isn’t only important for its own sake, but it actually is an important factor that helps to modulate the brain’s synthesis of phosphatidylserine, though some studies suggest that both DHA and EPA equally increase the brain’s phospholipid levels.

SulforaphaneThere are also some phytochemicals that aren’t considered standard micronutrients, but that can be helpful in initiating repair of the BBB. One of them is sulforaphane, an extract of broccoli. It activates the Nrf2 genetic pathway, which reduces inflammation, and enhances antioxidant status and mitochondrial function in general. This is likely at least part of the reason why it’s been shown to protect against neurodegeneration.

Sulforaphane also directly protects the tight junction proteins involved in the BBB, and blocks production of enzymes involved in breaking down its matrix.

CurcuminCurcumin is a well known anti-inflammatory compound found in turmeric. Neurological disorders and inflammation of course go together.

What’s remarkable about curcumin, though, is that even though it isn’t particularly bioavailable, enough of it can still cross the BBB, where it can exert its anti-inflammatory and antioxidant capabilities.

This study specifically demonstrated that curcumin was protective against neurological damage secondary to lipopolysaccharides (LPS) from gut dysbiosis (because of the gut-brain axis). Once in the brain, curcumin modulates the astrocyte response (which regulate blood flow, inflammatory and antioxidant responses to the insult).

This study also shows that curcumin can bind to and sort out β-amyloid plaques and neurofibrillary tangles associated with Alzheimer’s Disease. It’s also been proposed as a treatment for other neurological conditions for its inflammation modulating effects, including Parkinson’s, Huntington’s, Multiple Sclerosis, and Amyotrophic Lateral Sclerosis, and prion disease.

However, because of its low bioavailability, curcumin is being studied bound to various carriers (mostly lipids and nanoparticles) to improve absorption.

My favorite more bioavailable formulation is bound to phospholipids:

ResveratrolAnother darling of the anti-aging world is resveratrol. It too can cross the BBB, with similar studies behind it showing anti-inflammatory and antioxidant capabilities, leading to neuroprotective effects including improved cognition, mitochondrial function, and synaptic plasticity.

This study also demonstrates that resveratrol can protect against LPS-induced neuroinflammation and BBB disruption, by modulating the microglia and astrocyte response.

Resveratrol has a similar problem to curcumin, though: poor bioavailability means a delivery mechanism would greatly enhance efficacy. This study for Parkinson’s shows that resveratrol bound to phospholipid nanoparticles may do the trick.

BerberineBerberine is another common anti-inflammatory herb that has been studied and shown to reduce BBB permeability, enhance antioxidant activity, and improve memory.

The UpshotWhile any approach to neurological symptoms or neurodegeneration should include identifying and if possible removing any obstacles to cure, and supplying systemic building blocks that might be missing for the process of healing generally, building blocks for the brain will certainly include adequate cholesterol, phospholipids, and EFAs, particularly DHA.

Certain phytochemicals including sulforaphane, resveratrol, curcumin, and berberine may also help the body to heal faster and more efficiently.

Restoring the Integrity of the Blood Brain Barrier