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From Knock To Neuroinflammation: A Naturopathic Roadmap For Concussion Care with Louise Cork · Wellness by Designs - Practitioner Podcast

0:12
SPEAKER_00: Welcome back to Wellness by Designs.
0:14
SPEAKER_00: I'm your host, Andrew Whitfield Cook, and joining us today is Louise Cork, a clinical naturopath who specializes in the care of those suffering from concussion.
0:24
SPEAKER_00: Welcome to Wellness by Designs, Louise.
0:25
SPEAKER_00: How are you going?
0:26
SPEAKER_02: Yeah, good.
0:27
SPEAKER_02: Thanks for having me, Andrew.
0:28
SPEAKER_02: It's so good to be here.
0:29
SPEAKER_00: It is our pleasure.
0:31
SPEAKER_00: Um, this is such a critical topic to cover.
0:36
SPEAKER_00: Some work has been done, but not enough.
0:38
SPEAKER_00: We know this.
0:39
SPEAKER_00: So let's talk a little bit first about your practice.
0:43
SPEAKER_00: Um, how you became an expert in this area?
0:46
SPEAKER_00: What was it that drove you into this?
0:48
SPEAKER_02: Yeah, I think the pun.
0:51
SPEAKER_02: Drove me into it.
0:52
SPEAKER_02: Um, I think for me personally, um, I I grew up with brothers who played football and suffered concussions.
1:01
SPEAKER_02: Um, I've had my own neurological issues in the past, and my husband has also had issues with concussion.
1:07
SPEAKER_02: But I'm also a mother of two little boys and a little girl who love football as well.
1:14
SPEAKER_02: And you know, they lay into each other on the trampoline too, so that's alright.
1:17
SPEAKER_02: But um it's really um there's a big gap in concussion treatment at the moment, and like you said, we know this.
1:26
SPEAKER_02: And one day I was doing some advanced ADHD training, and we were talking about chronic low-grade neuroinformation, and all these pennies started dropping.
1:36
SPEAKER_02: I'm like, oh my god, chronic low-grade neuroinformation is what we see in CTE and concussion-related illnesses, and um, so that led me down a rabbit hole and uh um graduate certificate in neuroscience, and you know, I was like, the more I researched, the more I became acutely aware that there's a huge chunk of treatment missing, and naturopathic care has a lot of answers for that.
2:06
SPEAKER_02: Um, really, really, really exciting area of treatment.
2:12
SPEAKER_00: Whoa, hang on, you just said uh certificate in neuroscience.
2:16
SPEAKER_02: Oh yeah, what?
2:18
SPEAKER_02: Um yes, I am um completing my graduate certificate in neuroscience because um why not?
2:24
SPEAKER_02: Just a little bit of extra study.
2:29
SPEAKER_02: University of Southern Cross.
2:33
SPEAKER_00: Wow.
2:34
SPEAKER_00: This is incredible.
2:35
SPEAKER_00: I'm sorry, I didn't even know it was available to non-doctors.
2:39
SPEAKER_02: Yeah, yeah.
2:41
SPEAKER_02: So yeah, fantastic area of study.
2:45
SPEAKER_00: Yeah, yeah, yeah.
2:46
SPEAKER_00: Can I ask who's leading that at uh Southern Cross?
2:49
SPEAKER_02: Oh, I don't know who's leading it.
2:52
SPEAKER_02: I just attend the lectures.
2:54
SPEAKER_00: Right.
2:55
SPEAKER_02: I should probably find that out.
2:57
SPEAKER_00: Who's your lecturer?
2:58
SPEAKER_00: Who can I ask?
2:59
SPEAKER_02: Uh it's different for each subject.
3:01
SPEAKER_02: Gotcha.
3:02
SPEAKER_02: Yeah, yeah, because that because yeah, neuroscience is actually quite a diverse field.
3:07
SPEAKER_02: So it depends if you're um going down like a neurodivergence path or a clinical path, imaging, yeah.
3:14
SPEAKER_02: And I'm kind of I'm cherry picking the bits that make sense to my area of interest in concussion.
3:22
SPEAKER_02: So I I've got a variety of different people that I'm in contact with.
3:26
SPEAKER_02: Yeah.
3:26
SPEAKER_00: Wow.
3:27
SPEAKER_00: Um, okay, so um tell us a little bit about post-concussion syndrome.
3:32
SPEAKER_00: Other, you know, other what other people would call it traumatic brain injury.
3:35
SPEAKER_00: Um, there are diff varying names, but I'll let you explain that because I might get something wrong.
3:41
SPEAKER_00: Can you take us through firstly the definition or definitions?
3:44
SPEAKER_02: Yes.
3:45
SPEAKER_00: And secondly, how you assess yeah.
3:47
SPEAKER_02: So I think clinically, a um post-concussion syndrome is defined as concussion symptoms that exceed four weeks.
3:57
SPEAKER_02: Um but I think some key points to note here in defining post-concussion is that firstly, concussions are massively underreported.
4:08
SPEAKER_02: Um that's a huge problem in all, I definitely in contact sports, um, but in in general, you know, people falling off horses and accidents and things.
4:19
SPEAKER_02: And it can be actually three to six months before symptoms develop.
4:24
SPEAKER_02: And there is some statistics that suggest 72% of people have worsening symptoms at the five-year mark.
4:32
SPEAKER_02: So this is long beyond what we look at an initial injury for in conventional medical care.
4:41
SPEAKER_02: So there's lots of moving parts to this and um lots of missing parts as well.
4:47
SPEAKER_02: As you can kind of, I could tell why your face like, oh, yeah, it's big.
4:53
SPEAKER_00: It's big, like, but so forgive me, but you've just twigged to something that I had no idea about, and in that is that my previous understanding was that one must have a obviously occurred a knock or some concussive effect, whether that be an explosion or whatever, right?
5:11
SPEAKER_00: Um, some um so some some trauma to the brain, if you like, let's generalize it.
5:19
SPEAKER_00: And that you immediately had or within 24 or 48 hours had symptoms of concussion.
5:27
SPEAKER_02: Yeah.
5:27
SPEAKER_00: And then we went on.
5:28
SPEAKER_00: But you what you're saying is it you can have this thing and possibly not even present.
5:34
SPEAKER_02: Yeah, so a good example, there was actually um, there was a hit, a big hit in AFL a couple of weeks ago.
5:41
SPEAKER_02: Um, Collingwood and maybe the Lions, and one player was knocked out and the other wasn't.
5:49
SPEAKER_00: Right.
5:49
SPEAKER_02: Right?
5:50
SPEAKER_02: So, player who's knocked out, he he's gone, he's off the field, immediate care scans, all of those things.
5:56
SPEAKER_02: Concussion protocols are in play.
6:00
SPEAKER_02: The other guy passed his test and went back onto the field.
6:04
SPEAKER_02: Now, both of those people sustained the same impact.
6:08
SPEAKER_02: They both had a knock to the head.
6:11
SPEAKER_02: Um, so you're probably better off if you get knocked out cold because you got you go down the protocol path.
6:19
SPEAKER_02: The other person, all of those, the systemic cascade of um biochemical changes are still happening in that person, but they're continuing to play.
6:29
SPEAKER_02: So that's a whole nother kettle of fish.
6:32
SPEAKER_02: Um, but it brings me to what's actually happening in in concussion and post-concussion, and it is not just a knock to the head, it's a full systemic injury.
6:44
SPEAKER_02: Um, there's so much happening.
6:47
SPEAKER_02: So, in an initial concuss concussion, um, we have obviously we've got lots of stuff happening in the brain, um, inflammatory processes to try and protect the brain, but the blood-brain barrier, which is very selective, becomes less selective.
7:05
SPEAKER_02: So that's a problem.
7:06
SPEAKER_02: So things can travel into the brain that wouldn't normally go that way.
7:10
SPEAKER_02: The other thing that happens is that we have increased intestinal permeability.
7:15
SPEAKER_02: So that means whatever's already going on in the gut now becomes a bigger problem.
7:22
SPEAKER_02: And this is how um we get that persistent neuroinflammation and persistent systemic inflammation, and all the gut stuff, when unaddressed, becomes a chronic issue, just simmering away in the background until something triggers it.
7:41
SPEAKER_02: And maybe that's what's happening years down the track a virus, something that you ate, um, the balance of bacteria tipping again.
7:49
SPEAKER_02: You know, there's so there's so many variables, but you know, the research exists that all these things are happening.
7:57
SPEAKER_00: But this is concerning that, as you said, one person got up and and passed, quote unquote, the test.
8:04
SPEAKER_00: So obviously the tests are only uh for an acute sort of critical first aid sort of response, they're not looking at um systemic issues um or central, let's uh let's say central issues, um, which may present later.
8:19
SPEAKER_00: So, okay, let's think about this second player who played on.
8:23
SPEAKER_00: They go home and they may present, let's you know, say three to six months, what with tiredness, headaches?
8:30
SPEAKER_00: What are we talking about?
8:31
SPEAKER_02: Yeah, it could it could be any sort of mosaic of symptoms.
8:34
SPEAKER_02: Um, definitely could be tiredness, lethargy, headaches, maybe new onset of migraines.
8:40
SPEAKER_02: But I think in a sport context, the other thing that is really, really key here is that any other injury that player obtains um becomes problematic for that knock to the head again.
8:56
SPEAKER_02: Yeah, so there's the the concept of glial priming.
8:59
SPEAKER_02: So once you hit your head and those glial cells are primed to protect the brain, um, so if I hit my head and then you come along um later and I haven't dealt with that inflammatory cascade and I haven't supported my body to come back into balance and into health, and you punch me in the arm really hard, um, you could activate those, all that inflammation in my brain again.
9:24
SPEAKER_02: So yeah, there's lots of things that could go on.
9:27
SPEAKER_02: And I think something that we see often, particularly um, you know, if if you want to talk about a sporting context, is we see lots of um onset of mental health problems, depression, anxiety, substance addiction, um, and all of those kind of things.
9:43
SPEAKER_02: And you can kind of wind it back to what's going on in the gut, what's going on with neurotransmitters, because you know, 90 to 95% of your serotonin's made in your gut, right?
9:53
SPEAKER_02: And your gut's full of serotonin receptors.
9:55
SPEAKER_02: So if your gut's not right, your psychology can't be right either.
9:59
SPEAKER_02: Um, and like I said, prolonged injury um recovery, all kinds of things um can present.
10:07
SPEAKER_02: So you have you really have to look and you really have to timeline what's been going on for that person.
10:13
SPEAKER_03: Yeah.
10:13
SPEAKER_02: Yeah.
10:14
SPEAKER_02: And really knowing what their existing health was like before the injury is really helpful as well.
10:21
SPEAKER_00: Okay.
10:22
SPEAKER_00: Just a little uh segue.
10:24
SPEAKER_00: I want to come back to that existing health or pre-existing issues, but um I'm thinking, you know, we're we're talking about sport.
10:32
SPEAKER_00: I'm also thinking about those people that serve our country in the armed services, um, and indeed all emergency services, getting knocks, getting tackles, getting abuse, ambos, nurses, blah, doctors.
10:44
SPEAKER_00: Um uh plus, you know, kids in playgrounds.
10:47
SPEAKER_00: Um you know, da-da-da.
10:49
SPEAKER_00: So it becomes a very litigious issue with this in school now that a lot of kids are actually prevented from play being prevented from playing out of school hours, even if there's a parent there, because it it's it's a an opportunity for a litigious event.
11:06
SPEAKER_00: And this explains why.
11:08
SPEAKER_02: Yeah.
11:09
SPEAKER_02: You know, it's it is a it's a scary thing when you think about it like that.
11:13
SPEAKER_02: And I think you mentioned lots of groups who people might not normally consider um when thinking about a head injury like this.
11:20
SPEAKER_02: Another key group is um domestic violence survivors, yes.
11:26
SPEAKER_02: Um that that's a really key part of this puzzle as well.
11:30
SPEAKER_02: Um, and then because you bring in a lot of trauma into that as well, car accidents, that kind of thing as well.
11:35
SPEAKER_00: Yes, yes.
11:36
SPEAKER_02: Yes, yep.
11:37
SPEAKER_02: Yeah, um, so it's a whole can of worms.
11:40
SPEAKER_02: Yeah.
11:41
SPEAKER_00: Okay, so so how do we look for this if it's not if it might not be overtly presenting as new onset migraines or some new anxiety or stuff like that, which is real, I mean, that's a whole can of worms there.
11:55
SPEAKER_00: Um I had an interesting podcast earlier today that was just beautiful in that uh the the paradigm, if you like, the method uh methodology that this naturopath used was the t to bring back the tenase of naturopath, naturopathic medicine.
12:17
SPEAKER_00: I'm really not speaking right now, well right now am I?
12:20
SPEAKER_00: So um, and and it was to treating the gut for something distal.
12:24
SPEAKER_00: And it was this whole going back into the reasons why we do this.
12:30
SPEAKER_00: This again is going back into these naturopathic tenase, even though we have a knock to the head looking at the naturopathic tenase of gut health.
12:38
SPEAKER_02: Yeah.
12:38
SPEAKER_00: But we've got to go into this presentation.
12:41
SPEAKER_00: How do we pick that it's not something else?
12:43
SPEAKER_00: How do we pick that it's from this concussive episode?
12:47
SPEAKER_02: I I think um, like clinically, you're asking lots of questions and developing a bit of a timeline about you know how things have progressed, and you're you're piecing the puzzle together.
13:00
SPEAKER_02: And I think that's probably what naturopaths do differently to what other allied health or medical professionals do, is that we do look at the whole person and we go right back into their history, and you start to see this map of you know all the contributing factors.
13:17
SPEAKER_02: Um, and you will often see a big shift in a person's health from that point when they've had when they've had a knock to the head.
13:27
SPEAKER_02: And then, of course, someone who's uh exposed to that regularly.
13:32
SPEAKER_02: Um there was a really interesting study done by Monash University where they they monitored AFL players and um they measured hundreds and hundreds of knocks to the head, significant, but only two were diagnosed concussions.
13:47
SPEAKER_02: So you can see how how this is actually quite a bigger problem than what people realize.
13:54
SPEAKER_02: And probably the most important thing about talking about this is that people don't know.
13:59
SPEAKER_02: People don't know that I I feel terrible right now, and it's because of an injury I had a week ago, a month ago, a year ago, 10 years ago.
14:09
SPEAKER_02: And we we're honestly, we're we're seeing people die, Andrew, and that's that's my biggest concern.
14:16
SPEAKER_02: People are dying, and it's under the guise of mental health and other illnesses, um, dementia and other neurocognitive disorders, MND, you know, CTE, we're finding out about it posthumously.
14:31
SPEAKER_02: There's some evidence now that there are NRL players living with CTE.
14:36
SPEAKER_02: Um, we know it exists, we know it's happening, we know what groups of people it's happening in.
14:43
SPEAKER_02: And as a naturopath, we we have tons of things in our toolkit to do something about this, to improve outcomes, to you know, build quality of life and things like that.
14:55
SPEAKER_02: So um it's it's a critical conversation.
14:59
SPEAKER_00: D do you know what I think one of the biggest lessons I'm just opening up to is this should be a question in your first intake, and it should be a definite question, not just age and what did your mom and dad, any health issues.
15:11
SPEAKER_00: It should be have you had a knock?
15:12
SPEAKER_00: Have you had some sort of concussive injury, including MVA, sport, da-da-da.
15:18
SPEAKER_02: Yeah, have you participated in sport?
15:21
SPEAKER_00: Yeah.
15:21
SPEAKER_02: And often people go when you say, you know, you might ask about, you know, their energy levels and how they're sleeping, their moods, you know, you go through all this stuff, you talk about their gut, and you're like, oh, yeah, there's something going on there.
15:35
SPEAKER_02: And then you go, have you ever had any accidents or injuries?
15:38
SPEAKER_02: And they go, Oh, no, not really.
15:41
SPEAKER_02: Oh, I had a concussion once.
15:42
SPEAKER_02: And you go, right.
15:43
SPEAKER_02: Right.
15:44
SPEAKER_02: Tell me when it was, and and then you can really start to piece things together.
15:49
SPEAKER_02: It it does become quite obvious in clinical questioning that that it's a turning point.
15:56
SPEAKER_00: Okay, so we you mentioned some of the long-term effects of post-concussive syndrome.
16:01
SPEAKER_00: Um do we want to delve any more into the inflammatory processes at play in the body, or have we covered that?
16:09
SPEAKER_02: Um, I I think we I think we probably covered it.
16:12
SPEAKER_02: If we start talking too much about like inflammatory markers and mitochondrial dysfunction, like we'll be we're going into a biochemistry class.
16:22
SPEAKER_00: Well, we need to though, cover at least a little bit.
16:24
SPEAKER_00: So can you take us through just a little bit of the biochemical dysfunction that's going on?
16:33
SPEAKER_02: Well, I think one interesting um one interesting part of the biochemistry that's disrupted is that through that HBA axis, um, and so that impacts your thyroid, your stress, and your sex hormones.
16:47
SPEAKER_02: Um, and this is where we might get people interested because testosterone can be greatly affected in males who've had concussions or repeated concussion injuries.
16:58
SPEAKER_02: So um, and you know, a whole cascade of things can happen when testosterone is not um balanced from blood pressure to you know, all the things.
17:10
SPEAKER_02: So um it's not just even inflammatory markers, it's all those communicators are disrupted as well, you know, um, and right into the mitochondria, just not functioning properly.
17:24
SPEAKER_02: Calcium channels, there's so many things happening that you really need to peel back the layers bit by bit.
17:32
SPEAKER_02: And um I think that persistent neuroinflammation is of great concern because that's that's burning away in the background, um, and those out-of-control interleukins and TNFA and things like that as well.
17:47
SPEAKER_00: Okay, so let's go through, you know, on I I know this is going to be a a uh piece of string question, if you like, but um if if we could talk about you know the AT the um archetypical type, um what sort of things um forgive me, let me rephrase that.
18:07
SPEAKER_00: Can you take us through like a presentation from how they pre a typical patient presents to what sparks your interest in this, and then what's their therapeutic journey?
18:19
SPEAKER_00: What sort of things do you do?
18:20
SPEAKER_00: What sort of investigations, how do you come to the conclusion?
18:23
SPEAKER_00: And and even if you've got some case histories in mind that you go, ah, this happened in this patient, that'd be lovely.
18:30
SPEAKER_02: Yeah, um, you make me think of a motocross uh competitor that I have as a patient.
18:36
SPEAKER_02: Um so in motocross, it's very common to come off your bike.
18:43
SPEAKER_02: Um, it's also very common that at a competitive level, unfortunately, um a lot of these incidents are not reported because it stops competition.
18:53
SPEAKER_02: Um, and so we carry on.
18:56
SPEAKER_02: And uh a particular person I'm thinking of, I'm seeing three years down the track, and we've got lots of hormonal disruption, very, very tired, lethargic, very quick to lose energy, can't actually compete.
19:13
SPEAKER_02: Um, all kinds of uh bizarre, complex symptoms that you might not necessarily connect together immediately.
19:23
SPEAKER_02: Um, and this person was like, Oh yeah, you know, oh I've only had three really bad concussions, the others were just, you know, they're okay.
19:33
SPEAKER_02: And I'm like, okay, maybe not.
19:38
SPEAKER_02: And you can see each time they've progressively gotten worse.
19:42
SPEAKER_00: Right.
19:43
SPEAKER_02: The recovery time has gotten longer and the impact has been more significant.
19:48
SPEAKER_02: Now, down the track, this person's gone, oh, you know, all of these things I'm experiencing now, they must be something else.
19:57
SPEAKER_02: Um, lots of gut issues.
19:59
SPEAKER_02: Um, uh the list is long.
20:02
SPEAKER_02: So I think once you establish that there's concussion in the history and you've clinically asked all of the questions about every body system, understanding what's going on, then you're looking at, okay, what information do I need to proceed and make this treatment as efficient as possible?
20:20
SPEAKER_02: So I would always be going to the gut first, pretty much, and find out who's living inside that gut.
20:26
SPEAKER_02: Do we have gram-negative bacteria that are producing lipopolysaccharides traveling through the intestinal lumen?
20:35
SPEAKER_02: And then we've got toxic overload in the body, those endotoxins.
20:39
SPEAKER_02: Um, that would be probably point one.
20:41
SPEAKER_02: Um, get the gut right first, and then everything else becomes a little bit easier.
20:48
SPEAKER_02: Is yeah, yeah.
20:50
SPEAKER_02: That that's that's my um, you know, first point of call, really, because then everything else and and every person's gonna be different.
21:01
SPEAKER_02: Every treatment journey is gonna be different, but the one central thing is probably gonna be getting that gut right.
21:08
SPEAKER_00: Isn't it interesting that science is catching up with nature?
21:11
SPEAKER_02: Isn't it?
21:12
SPEAKER_02: I you know, all the things that naturopaths have been going on about for centuries, um, now the evidence is coming through, which is great because it, you know, it gives a little bit of um backing to what we're saying as well.
21:26
SPEAKER_02: Yeah.
21:26
SPEAKER_02: And then you see the results when you when you get the gut right, then you start to see progression in that person, um, and things really turn around for them, which is amazing to see because it otherwise they just think they have to live like that forever.
21:40
SPEAKER_00: Yeah.
21:40
SPEAKER_00: Yeah.
21:41
SPEAKER_00: That's right.
21:42
SPEAKER_00: You know, Mike Ash said this years ago, and it was one of these, like you went, these pennies dropping everywhere.
21:48
SPEAKER_00: It was like a light bulb or a actually a piece of four by two to the head, um, seeing as we're seeing as we're talking about concussion.
21:55
SPEAKER_00: And it was Mike Ash spoke about and he said, terrain is everything.
21:58
SPEAKER_00: And and it was one of those wake-up moments where we where I had previously um fallen into that, you know, there's the problem, treat the problem, there's do the little leaf waving doctor sort of thing.
22:11
SPEAKER_00: And that's yes, yeah, there's the problem, attack the problem, kill the bad bugs, you know, and it's like, yeah, but they keep coming back, and you know, all of this sort of thing.
22:20
SPEAKER_00: And it was like, if we fix the terrain that they're living in, what it can't be probably won't be as quick, but you get this, no, no, the body's gone, it's all right, we can do most of it.
22:28
SPEAKER_00: We might need your help a little bit, but we can do most of it, just back off.
22:32
SPEAKER_00: It's really interesting, isn't it?
22:34
SPEAKER_02: You're spot on.
22:35
SPEAKER_02: Um, the terrain is is everything, it really is.
22:39
SPEAKER_02: And you you made me think when you were speaking, then, um, if you're thinking about it, could be any context, it could be an accident, you know, you're off to hospital, lots of you might might be antibiotics, drugs, things like that.
22:52
SPEAKER_02: Or an athlete, what does an athlete do when they finish a game?
22:57
SPEAKER_02: They drink, you know, isolated whey proteins, big those big aggravating proteins or um isotonic drinks.
23:04
SPEAKER_02: And if the terrain is compromised and if you've got increased intestinal permeability, you're adding fuel to the fire.
23:11
SPEAKER_02: But if you think about the recreational footballer or the regional footballer, um they might not be drinking the protein shake, they might be going to the bar.
23:23
SPEAKER_03: Right.
23:24
SPEAKER_02: So you see, like we can very easily add fuel to this fire in doing the things that you know, oh, everyone's doing that, and that's what we do after a game.
23:36
SPEAKER_02: Um, so that's a you know, that's a whole nother discussion.
23:40
SPEAKER_02: But something to be really, really aware of.
23:43
SPEAKER_01: I love the way you say I feel and then the regional, as if the regional are any more drunk than well, I I'm a country girl, so um, I don't know what goes on.
23:54
SPEAKER_02: I don't think I don't think professional athletes are drinking after a game.
24:00
SPEAKER_02: They might, I don't know.
24:01
SPEAKER_00: No, no, they're soldiers.
24:03
SPEAKER_00: They are they are they're like military, that they're yeah, they're machines.
24:07
SPEAKER_00: That's just amazing what they put themselves through.
24:11
SPEAKER_00: And um can I make one point?
24:13
SPEAKER_00: And we're seeing this open up, thank you, uh thankfully, but um, this is not just males, this is females, you know.
24:20
SPEAKER_00: AFL, AFL, and RFL females.
24:24
SPEAKER_00: Holy crap, do they put 110% in?
24:27
SPEAKER_03: Yes.
24:27
SPEAKER_00: Um, I've seen them there that talk about machines.
24:30
SPEAKER_00: Man, I'm out.
24:33
SPEAKER_00: I mean, they're elite athletes, they're just incredible.
24:36
SPEAKER_02: I I don't think concussion and these uh repeated brain hits, they they don't discriminate based on gender.
24:43
SPEAKER_02: Um, and they really are everywhere.
24:46
SPEAKER_02: And we we need to enlighten people that this might be a real part of their health history um that's impacting their health today.
24:55
SPEAKER_00: Yeah.
24:56
SPEAKER_00: So let's go into therapy.
24:57
SPEAKER_00: You know, we talk about treating the gut.
24:59
SPEAKER_00: What sort of things do you use?
25:00
SPEAKER_00: Are we talking about um changing a whole diet to a you know, a low-reactive diet, or you know, maybe taking the load off, or are we talking about using certain supplements that are well known for their entry anti-inflammatory action?
25:13
SPEAKER_02: Probably a little bit of both.
25:15
SPEAKER_02: Um, absolutely, diet in and intake can be a huge part of healing.
25:22
SPEAKER_02: And you know, we've got to feed the the microbes that we want to proliferate, um, all of those nice butyrate producers and things like that, um, the ones that are going to give us benefit.
25:33
SPEAKER_02: So, yes, dietary intake does become a big part of the puzzle, but we need to get people feeling better quicker.
25:41
SPEAKER_02: Um, so there's, you know, there's supplements that might come to mind immediately, uh, like we spoke about before, those um ones that are being researched for migraines at the moment, your co-cuten and whatnot.
25:54
SPEAKER_02: But there's a whole host of things in the toolkit.
25:58
SPEAKER_02: So saffron is a really interesting one, um, with a lot of research behind it now, and it's really downregulating those interleukins and inflammatory markers, and it does cross the blood-brain barrier.
26:16
SPEAKER_02: So that's a key part of this puzzle here, and it interrupts that chronic inflammatory signaling in the NFKB pathway, so it downregulates that.
26:29
SPEAKER_02: Um, and overall, it can enhance your cellular resilience and in the longevity pathways.
26:37
SPEAKER_02: So that's really helpful.
26:40
SPEAKER_02: Um, it has been researched in like a mouse animal model, um, and it's significantly improved behavior and cognitive deficits.
26:50
SPEAKER_02: So it is something, you know, in naturopathically, we might use often in neurodivergence, and this is like that link, that chronic low-grade neuroinflammation that we can see in neurodivergence, um, that we see in post-concussive people as well.
27:06
SPEAKER_02: Um, we use it in mood disorders.
27:09
SPEAKER_02: So, you know, if you if you look at the mechanism of action of things, whilst they might because the research only shows us what's been researched.
27:16
SPEAKER_01: Yeah.
27:17
SPEAKER_02: And the research only shows us what it's been researched against.
27:21
SPEAKER_02: So we have to put our detective cap on.
27:25
SPEAKER_02: We need to understand the mechanism of action and what's going on in the concussion, what's happening in the individual in front of you, and then piece together that puzzle.
27:34
SPEAKER_02: So it is highly nuanced and um definitely a bit of detective work.
27:39
SPEAKER_02: And I think saffron in post-concussion, um, it can help with that microglial deactivation, so bringing those down, the brain fog, all that kind of stuff that you feel, um, you know, that they they often um say they feel like zonked, you know, kind of like a bit of a zombie, like I've slept but I haven't slept.
28:05
SPEAKER_02: Saffron, that's where that can be really, really helpful.
28:10
SPEAKER_00: What about things like curcumin, fish oils, um uh PEA?
28:16
SPEAKER_02: Yeah, PEA is a nice one.
28:19
SPEAKER_02: Um we we know that its primary mechanism is for anti-inflammatory effects and that it works on the endocannabinoid system.
28:27
SPEAKER_02: So that's really, really supportive in this way.
28:31
SPEAKER_02: Um there's some emerging research on um GPR 55 modulation, so that's emerging neuroprotective pathway research.
28:41
SPEAKER_02: So we'll watch this space on that.
28:44
SPEAKER_02: Um, but we also use P for mast cell stabilization, um, again, that deactivation of the microglial and the astrocytes, um, and pain.
28:56
SPEAKER_02: You know, you there's there's um a lot of pain in a initial acute concussive injury.
29:03
SPEAKER_02: Um so we use that clinically in other applications for neuropathic pain, chronic pain syndromes, um, sleep disorders, all that kind of stuff.
29:14
SPEAKER_00: What what sort of doses have you used with in um with PEA in this condition?
29:20
SPEAKER_00: And in can I ask in indeed other conditions?
29:23
SPEAKER_00: Because I've I found I had to use used to have to chug it in a bit.
29:26
SPEAKER_02: Yeah, I I think because it takes, I I feel like it takes a little while to build up in the body.
29:32
SPEAKER_02: Um so in a clinical setting, um, you might go pretty high to begin with until someone stabilizes and then you can kind of titrate it down to a maintenance dose.
29:44
SPEAKER_02: But it might be something that you use for a little while.
29:47
SPEAKER_02: Um, but again, very, very case by case.
29:51
SPEAKER_02: And um, you know, it's probably not every case.
29:55
SPEAKER_02: It's more, you know, if there's persistent pain and things like that as well.
30:00
SPEAKER_02: You know, if it was just if you're just managing, you know, inflammation, you might look at your fish oils for that long-term, you know, you've got to play the long game as well.
30:13
SPEAKER_02: This is a quick fix because there's lots going on.
30:16
SPEAKER_02: Specialized pro-resolving mediators, things like that.
30:19
SPEAKER_00: Yeah.
30:20
SPEAKER_00: And with um omega-3s, do you really, you know, pump it into them, like the higher dose?
30:25
SPEAKER_00: We've got to change the omega-6 to omega-3s for certainly, but um, Western diet.
30:29
SPEAKER_00: But um, you know, do we we look at this anti-inflammatory dose like in rheumatoid arthritis, for instance, we're really hammering the omega-3s.
30:38
SPEAKER_00: Um, and you you need these really high dose concentrates.
30:42
SPEAKER_02: Um, not necessarily.
30:45
SPEAKER_02: I I would prefer to go consistently.
30:49
SPEAKER_00: Right.
30:49
SPEAKER_00: Okay.
30:50
SPEAKER_02: Yeah.
30:50
SPEAKER_02: Because because it's not the only thing that you're gonna be doing.
30:54
SPEAKER_02: You know, you're gonna be doing other things as well.
30:57
SPEAKER_02: So I I would go, you know, a moderate, consistent dose over time.
31:03
SPEAKER_02: And you know, we all need a bit of fish oil in our life, right?
31:07
SPEAKER_03: Yeah.
31:07
SPEAKER_02: Yeah.
31:08
SPEAKER_02: So it's definitely it's definitely one you can take in the long term.
31:13
SPEAKER_00: And red emperor fish, just saying.
31:15
SPEAKER_00: Um and of course, poster child of inflammation, curcumin.
31:19
SPEAKER_00: Um, so so here's something.
31:21
SPEAKER_00: How high do you go with this?
31:22
SPEAKER_02: Oh, that now you have to be you have to go right back into someone's history for that because you want to know what their liver's doing.
31:28
SPEAKER_00: Um, right, okay.
31:30
SPEAKER_00: Cool.
31:31
SPEAKER_02: You you can go too high with curcumin.
31:34
SPEAKER_00: I've done it.
31:35
SPEAKER_02: We don't we don't want to turn people yellow.
31:38
SPEAKER_02: Um, yeah, I'd I'd want to know what was going on in someone's liver before um, you know, high dose curcumin.
31:47
SPEAKER_02: Again, like the fish oil, moderate and over time.
31:52
SPEAKER_02: You know, maybe if it's an acute someone's just had a knock yesterday, different story.
31:58
SPEAKER_02: But in the post-concussive, um, we're playing the long game, so moderate dose and probably having breaks from that just to ensure that there is no impact on the liver.
32:10
SPEAKER_02: But it is beautiful because you know, it's that Coxlox inhibitor.
32:14
SPEAKER_02: Um, again, it crosses the blood-brain barrier.
32:18
SPEAKER_02: So that's very, very helpful for that microglial down regulation.
32:22
SPEAKER_02: Um, and double whammy.
32:25
SPEAKER_02: It's good for the brain, it's good for the gut, and it's good for systemic inflammation.
32:29
SPEAKER_02: So it's it is doing a lot of things, it ticks a lot of boxes.
32:33
SPEAKER_00: Yeah.
32:34
SPEAKER_00: Yeah, yeah.
32:35
SPEAKER_00: Um, what else was I thinking?
32:37
SPEAKER_00: Um, other things that we can use.
32:42
SPEAKER_00: Oh, something that when it's isn't really available in Australia unless medically, but um, a lot of people buy it overseas.
32:48
SPEAKER_00: Um, certainly is overseas with great effect.
32:50
SPEAKER_00: Melatonin.
32:52
SPEAKER_02: Um, I I don't clinically recommend it because that's out of my scope of practice.
32:57
SPEAKER_02: But from my point of view, I'm I'm going back down the chain and making sure the foundations are right.
33:06
SPEAKER_02: Um I I I would go back, you know, back to the gut, what's the brain doing?
33:14
SPEAKER_02: Um, you know, what's happening with glutamine in the brain, the glutaminergic activity.
33:19
SPEAKER_00: Well, yeah, so you mentioned that then.
33:21
SPEAKER_00: So glutamine.
33:22
SPEAKER_00: So if we're talking about gut looking at the the you know, one of the pillars of health, if we're talking about gut healing in the terrain, um, you know, things like glutamine, um, the pectins, your slippery elms, the the um um uh uh uh bovine serum, immunoglobulins, things like that.
33:42
SPEAKER_00: All of these things that can help to soothe that gut lining to just relay it.
33:47
SPEAKER_00: Are these the things you employ?
33:48
SPEAKER_00: Is that where you go?
33:49
SPEAKER_02: So I would say um I would caution glutamine.
33:55
SPEAKER_00: Okay.
33:56
SPEAKER_02: I would caution glutamine um if there it's particularly in an acute injury, because adding glutamine, it does cross the blood-brain barrier, right?
34:06
SPEAKER_02: So we could actually add fuel, a little bit of fuel to the fire and incl increase that excitatory load.
34:14
SPEAKER_02: So so I would caution that.
34:16
SPEAKER_02: Um, and this is why that you know, that clinical questioning and case taking is really, really important to try and understand if that's an appropriate pathway.
34:25
SPEAKER_02: But serumbovine immunoglobulins that you mentioned and the terrain.
34:30
SPEAKER_02: Uh this.
34:31
SPEAKER_02: This is um I love it.
34:33
SPEAKER_02: I love it too.
34:34
SPEAKER_02: It's really, really exciting.
34:36
SPEAKER_02: Um, it's it's endotoxin binding, so that we love that.
34:42
SPEAKER_02: Um, those lipopolysaccharide microbes, see you later.
34:46
SPEAKER_02: Um, and it's really supporting the terrain, that intestinal barrier support and also immune modulating.
34:54
SPEAKER_02: So um lots of clinical applications, but it's so great in an acute and a chronic concussive picture.
35:01
SPEAKER_00: Yeah, yeah.
35:02
SPEAKER_00: Just along those lines, what about things like you know, probiotics, saccharomycobularity?
35:07
SPEAKER_00: I mean, you know, if we're talking about toxin binding, could be because because you know, that this serum bovine immunoglobulin.
35:15
SPEAKER_00: I'll stumble over these words, immunoglobulin.
35:18
SPEAKER_02: Like library polysaccharide.
35:19
SPEAKER_00: Like look, it it it you know, it's it's not an inexpensive um supplement.
35:25
SPEAKER_00: Bloody good.
35:26
SPEAKER_00: But it like it's just it's always in my cabinet, just whenever I have a dodgy oyster or something like that.
35:32
SPEAKER_00: It's like, oh no.
35:35
SPEAKER_00: It is, yeah.
35:36
SPEAKER_02: Um, and it's daring breed.
35:39
SPEAKER_02: That's so that's really key here.
35:40
SPEAKER_00: That's the thing.
35:41
SPEAKER_00: That's the thing, but but it's got so many facets of action.
35:48
SPEAKER_00: Um, but some people might balk at it.
35:50
SPEAKER_00: I get that.
35:52
SPEAKER_00: Nothing will take the place of me having SB.
35:55
SPEAKER_00: I will always have SB.
35:57
SPEAKER_03: Yeah.
35:58
SPEAKER_00: Like just I uh and I've got to say, I recommend Saccharomyces ballardi probably ten times more than any other probiotic from what it does.
36:11
SPEAKER_02: It it it is a really exciting um well, it's not technically a probiotic, is it?
36:17
SPEAKER_02: It's a use.
36:18
SPEAKER_02: But um it is a really exciting thing to use, and it really comes back to again selecting the right things for the person in front of you.
36:26
SPEAKER_02: Um, I think that's really, really important.
36:29
SPEAKER_02: Um what was I?
36:32
SPEAKER_02: You just made me think of something and it's left me.
36:34
SPEAKER_02: But anyway, go ahead.
36:36
SPEAKER_00: Oh, I know, I know something.
36:37
SPEAKER_00: So we were talking about certain other things that we can use, you know, there's high dose B1, B2, blah, blah, blah.
36:43
SPEAKER_00: What about, because we're seeing this issue with the TGA at the moment with high dose B6.
36:49
SPEAKER_00: No naturopath worth their salt would use high dose B6 without supplementing uh in a very short time with a complex, right?
36:57
SPEAKER_00: Yeah.
36:57
SPEAKER_00: What about using just the yeah?
37:00
SPEAKER_00: What about using just the complex?
37:02
SPEAKER_00: Is that enough to help these this post-concussive syndrome?
37:05
SPEAKER_00: You know, the activated bees?
37:07
SPEAKER_02: Yeah.
37:08
SPEAKER_02: It could be, it could have a role, absolutely.
37:11
SPEAKER_02: Um it's I know what you made me think of.
37:16
SPEAKER_02: Prevention.
37:17
SPEAKER_02: Oh.
37:18
SPEAKER_00: Knowing an ounce of prevention.
37:20
SPEAKER_00: An ounce of preventing how to cure.
37:22
SPEAKER_02: Um it's knowing we we do have a lot of opportunity, maybe not so much when it comes to accidents and things like that.
37:29
SPEAKER_02: But when it comes to people who are in an environment where they know they are at risk of head injuries or repeated minor knocks to the head because they're just as bad as a concussion, um, is prevention.
37:43
SPEAKER_02: And that is understanding what's going on in that person's health and understanding their microbiome so that you can optimize it to mitigate risks if and when they do have a concussion injury.
37:58
SPEAKER_02: So you're kind of setting the scene for things to go a little smoother.
38:03
SPEAKER_03: Yeah.
38:04
SPEAKER_02: That's something really interesting that is a complete departure from the way we usually think about these types of injuries.
38:13
SPEAKER_00: So prevention, if you can, and certainly early intervention and earlier on in the therapeutic picture rather than I got knocked out.
38:22
SPEAKER_02: Yes.
38:23
SPEAKER_00: Yeah.
38:23
SPEAKER_00: Yes.
38:24
SPEAKER_02: Yeah.
38:25
SPEAKER_02: Yeah, I think there's a lot of optimization you could be doing.
38:28
SPEAKER_02: And because each each um per se, you know, rugby, football, whatever, all of those individuals have their own unique health factors.
38:37
SPEAKER_02: Um, some of them may have had childhood illnesses.
38:41
SPEAKER_02: Have they had Epstein Barr virus, for example?
38:43
SPEAKER_02: We know that's a bit of a stealth um pain when it when it's activated.
38:50
SPEAKER_02: Um, neurodivergence.
38:51
SPEAKER_03: Yeah.
38:52
SPEAKER_02: You know, that's a whole nother consideration because we already know that those neurotransmitters work a bit differently.
38:59
SPEAKER_02: So we need to consider that person's concussion journey a little bit differently as well and make sure that they get the support that they need.
39:07
SPEAKER_00: Any other physical things that we can do?
39:09
SPEAKER_00: You know, we've spoken a lot about sport, and you know, we've got the use of strapping of helmets when there's a previous concussion, so there's some protection there, not necessarily the best, but it's something.
39:20
SPEAKER_00: I get it.
39:21
SPEAKER_00: You know, motorbike riders by law have to wear a helmet.
39:25
SPEAKER_00: Drivers have to wear a seatbelt by law.
39:28
SPEAKER_00: La la la.
39:29
SPEAKER_00: But kids in the playground.
39:31
SPEAKER_00: Um, you spoke about abuse.
39:32
SPEAKER_00: Now there's a hole, it's not a podcast.
39:35
SPEAKER_00: Yeah, that's a that's a that's a semester.
39:38
SPEAKER_00: Um that's tragic.
39:41
SPEAKER_00: But you know, are there any practical hints and tips that we can take home about prevention?
39:47
SPEAKER_00: Like you I guess where am I going here?
39:50
SPEAKER_00: Things like FIFO workers, military, maybe?
39:55
SPEAKER_00: Um, is there anything that we can maybe look for earlier that we can go, look, you know, you've you've uh you've done a tour, you've come back, um, you've you've been in um on active duty, like in the firing line for X amount of weeks.
40:11
SPEAKER_00: How about we look at what?
40:15
SPEAKER_02: Yeah.
40:16
SPEAKER_02: I I think you could do a good naturopathic workup on all those people.
40:20
SPEAKER_02: Um, sleep would be a key piece.
40:23
SPEAKER_02: Um and that question might simply be, how do you feel when you wake up in the morning?
40:29
SPEAKER_01: Right.
40:30
SPEAKER_02: Uh yes, you're gonna ask all your other sleep questions, you know, sleep on certainly waking in the night, all that kind of stuff.
40:37
SPEAKER_02: But how do you feel when you wake up in the morning?
40:40
SPEAKER_02: And if the answer is, I just I struggle to get up, I'm tired, I feel like I haven't slept, all of that kind of stuff, then you go, all right, what is one key thing that is happening when you are sleeping and that only happens when you're asleep?
40:55
SPEAKER_02: And I think of the gymphatic system.
40:57
SPEAKER_02: Have you heard of the gymphatic system before?
40:59
SPEAKER_02: Yeah, fun fact, only found in 2012.
41:02
SPEAKER_02: Love that.
41:03
SPEAKER_02: But, you know, it's our waste clearance in the brain.
41:07
SPEAKER_02: And if you're waking up feeling a bit foggy and sluggish, I'm wondering, are we clearing waste properly while you're sleeping?
41:16
SPEAKER_02: So, what's happening?
41:17
SPEAKER_02: Are we sleeping deep enough?
41:19
SPEAKER_02: And, you know, research around the gymphatic system is still quite emerging.
41:25
SPEAKER_02: Um, but we know, you know, good amounts of exercise and deep sleep are really, really important, that deep restorative, restful sleep.
41:34
SPEAKER_02: So that might be one thing that you could do as a preventative to stop things escalating.
41:43
SPEAKER_00: Well, but you know, there's lots along that lines then, and I know we're sort of getting into the therapeutics again, but but things like you know, good old magnesium, um theanine.
41:54
SPEAKER_02: Umine's great.
41:59
SPEAKER_02: Well, it's great for sleep, we know that.
42:01
SPEAKER_02: Um, and it's also really it's calming, so calming those excitatory factors.
42:08
SPEAKER_02: So it does tick a few boxes there.
42:10
SPEAKER_02: Um, and we you know we can supplement that easy.
42:13
SPEAKER_00: Tastes good.
42:14
SPEAKER_02: We yeah, tastes good.
42:16
SPEAKER_00: Even kids will take it, tastes good.
42:18
SPEAKER_02: Yeah, sometimes you can get it in, or you could encapsulate it if if you needed to.
42:23
SPEAKER_02: There's all those different things too.
42:25
SPEAKER_02: Um, but it's gonna help with the enhancing GABA and you know, your melatonin pathways and things like that.
42:33
SPEAKER_02: So that's what I mean.
42:35
SPEAKER_02: You go further down the chain of events before jumping straight to melatonin.
42:42
SPEAKER_02: I I think it's always a helpful way to do it.
42:45
SPEAKER_02: Um, yeah.
42:48
SPEAKER_02: And uh, you know, that alpha wave production that L-theanine is beautiful for, that's gonna help lymphatic clearance, restorative sleep.
42:57
SPEAKER_02: Um, there's so many weaves and turns you could take, but if I had to say one thing, yeah, that would that would be helpful.
43:06
SPEAKER_00: Cool.
43:06
SPEAKER_00: I mean, there's there's so much to learn of this, and it's sort of it's pinging questions left, right, and center.
43:11
SPEAKER_00: But I love the way that you keep coming back.
43:13
SPEAKER_00: It's like Leno, Andrew, come on, come back, come back to this naturopathic tene, the foundation.
43:19
SPEAKER_00: And I love that because it's it's it seems like a broken record, but we need to do this because we keep being drawn.
43:26
SPEAKER_00: And it's like, no, no, no, no, no, no, no, come back, you know.
43:29
SPEAKER_00: Yeah, um, it's really good work.
43:31
SPEAKER_02: Foundations first, I think.
43:32
SPEAKER_02: Yeah, like I said before, you get the gut right, and then everything else becomes a bit easier.
43:38
SPEAKER_02: And really, that naturopathic principle of the person in front of you, become the expert in the person in front of you and what their unique puzzle is and how the pieces fit together for them.
43:51
SPEAKER_02: Um, so there is no, you know, we could talk about there's so many supplements and things we can talk about, but there's not a one size fits all.
44:00
SPEAKER_02: So what's going to be right for you is going to be different for the next person and the next person.
44:06
SPEAKER_02: Um, but such an exciting um thing to talk about.
44:09
SPEAKER_02: And I hope that we can, you know, really start a conversation with people and start shifting a paradigm and highlight that there's so much more that we could do for these people who are suffering, and people that don't even know that they're suffering because of a concussion.
44:29
SPEAKER_02: That's that's the big thing.
44:31
SPEAKER_02: Because you then you circle back to all the underreported concussions.
44:35
SPEAKER_00: Louise Cork, I love your work.
44:37
SPEAKER_00: This is fantastic stuff, and it as you say, it's a critical conversation we need to have.
44:42
SPEAKER_00: So well done to you.
44:44
SPEAKER_00: I should say well done to your brothers.
44:46
SPEAKER_00: No, thanks.
44:49
SPEAKER_00: Well, no, well done for you, to you for for awakening um to this uh you know critical area of need in the it's not the community, it's really the sort of it's in the world.
45:00
SPEAKER_00: It's in the world, yeah.
45:01
SPEAKER_00: It's in the world, yeah.
45:03
SPEAKER_00: It's good stuff you're doing.
45:04
SPEAKER_00: I love it.
45:04
SPEAKER_00: It's brilliant.
45:05
SPEAKER_00: Thank you so much for joining us on Well of Spiders.
45:07
SPEAKER_02: Thank you so much for having me.
45:09
SPEAKER_00: And thank you, everyone, for joining us today.
45:11
SPEAKER_00: I'm Andrew with Phil Cook.
45:13
SPEAKER_00: You can catch up on all the other podcasts on the Designs for Health website.
45:16
SPEAKER_00: We're going to be putting up a heck of a lot of show notes for this because there's really interesting areas in this.
45:24
SPEAKER_00: But I would love, Louise, if we can put up any information to also help guide people, you know, once they go down that brain, brain, brain thing to come back to the gut.
45:34
SPEAKER_00: That'd be great.
45:35
SPEAKER_00: That'd be awesome.
45:35
SPEAKER_02: Yeah, whatever you need.
45:37
SPEAKER_02: Happy to help.
45:38
SPEAKER_00: Thanks so much for joining us.
45:39
SPEAKER_00: Thanks, everyone.