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How to Improve Brain Health & Offset Neurodegeneration | Dr. Gary Steinberg

Episode 177 May 20, 2024 1h 55m 23 insights
In this episode, my guest is Dr. Gary Steinberg, MD, PhD, a neurosurgeon and a professor of neurosciences, neurosurgery, and neurology at Stanford University School of Medicine. We discuss brain health and brain injuries, including concussion, traumatic brain injury (TBI), stroke, aneurysm, and transient ischemic attacks (TIA). We discuss key and lesser-known risk factors for brain health and explain how certain treatments and medications can improve brain health and cognitive function. We also cover novel mechanisms to improve recovery after concussions and brain injury, including the use of stem cells, temperature (mild hypothermia), and vagus nerve stimulation. Dr. Steinberg also describes new advances in neurosurgery and minimally invasive brain augmentation. This episode ought to be of interest to anyone seeking actionable tools to improve their brain health and for those seeking to improve recovery after a brain injury such as concussion, stroke, aneurysm, or TBI. For show notes, including referenced articles and additional resources, please visit hubermanlab.com.
Actionable Insights

1. Avoid Unproven Stem Cell Therapies

Do not seek unproven stem cell therapies, especially those offered outside regulated clinical trials or in other countries, as they can be dangerous and lead to severe, irreversible harm, such as blindness or tumor development.

2. Avoid Chiropractic Neck Manipulation

Do not allow chiropractors to manipulate your neck, as this can cause a tear in the artery wall (dissection), leading to a stroke, despite being a rare but devastating occurrence.

3. Prioritize 7-9 Hours Sleep

Aim for 7 to 9 hours of sleep per night, as adequate sleep is the critical foundation for mental health, physical health, and overall performance, and the expert personally increased his sleep to this range.

4. Avoid Smoking Completely

Refrain from smoking, as it is a very high risk factor for developing blood clots that can lead to strokes, heart attacks, and peripheral vascular disease.

5. Avoid Cocaine & Methamphetamine

Do not use cocaine or methamphetamine, as these drugs severely damage blood vessels and significantly increase the risk of developing aneurysms or experiencing brain hemorrhages.

6. Avoid Excessive Alcohol Intake

Limit alcohol consumption to avoid overindulgence, as it is a contributory factor that can promote problems with blood vessels, clots, and make vessels more fragile, increasing hemorrhage risk.

7. Manage Blood Pressure

Actively manage and maintain healthy blood pressure levels, ideally 120 or lower (or individualized as advised by a physician), to reduce the risk of clots and arterial disease.

8. Manage High LDL Cholesterol

If you have high ‘bad’ cholesterol (LDL) that cannot be reduced through diet alone, consider taking a statin as recommended by a physician to prevent strokes and heart attacks.

9. Consider Statins for Vessel Health

Discuss with your doctor the potential benefit of taking statins for blood vessel integrity, as they have been shown to be beneficial even for individuals without high LDL cholesterol and may reduce cognitive decline risk.

10. Hydrate Consistently Throughout Day

Hydrate consistently throughout the day to the point that your urine is crystal clear, as this is important for blood pressure, general health, and kidney function.

11. Control Sleep Environment Temperature

Control the temperature of your sleeping environment to optimize sleep quality; your body temperature needs to drop 1-3 degrees to fall and stay deeply asleep, and increase 1-3 degrees to wake up refreshed.

12. Address Snoring & Sleep Apnea

Address snoring and potential sleep apnea to ensure clear breathing throughout the night, which is essential for feeling rested and for overall brain and body health.

13. Concussion Recovery: Gradual Stimulation

During concussion recovery, avoid total sensory deprivation but also do not overstress the brain; ensure it receives input without being overwhelmed to aid recovery.

14. Concussion Recovery: Avoid Aspirin

Do not take aspirin or other blood-thinning agents after a traumatic brain injury or concussion if there is any risk of contusion or hemorrhage, as it could worsen bleeding.

15. Thoughtfully Interpret Exploratory Scans

Interpret results from exploratory total body or brain scans very thoughtfully, consulting with a specialist to avoid undue concern or unnecessary invasive procedures for incidental, often benign, findings.

16. Promote Brain Plasticity Post-Injury

Engage in physical therapy and activity after a stroke or traumatic brain injury to stimulate endogenous stem cells, recruit new circuits, and promote the recovery of function.

17. Consider Constraint Therapy Post-Stroke

For stroke recovery, consider constraint therapy (restraining the uninjured limb to force use of the affected limb), but be mindful of optimal timing, as applying it too soon can sometimes be detrimental.

18. Avoid Tackle Football/Rugby

For non-professional athletes, consider avoiding tackle football or rugby due to the risk of concussions and potential long-term brain injury, opting for other sports with similar benefits but less risk.

19. Avoid Repeated Soccer Heading

Be aware that multiple instances of heading a soccer ball may lead to concussions and long-term injury, and consider limiting this activity.

20. Don’t Worry About Minor Head Hits

Do not worry about common, minor head injuries from everyday life if symptoms resolve within a day or two, as the skull is designed to protect the brain in most such cases.

21. Reduce Caffeine Intake

Consider reducing caffeine intake if it leads to excessively high blood pressure or other signs of overdoing it, as the expert personally cut back on caffeine after a health event.

22. Practice Moderation in Life

Adopt a philosophy of moderation in all aspects of life, as it is key to both health and happiness, and promotes longevity.

23. Oral Contraceptives & Stroke Risk

Women who have had strokes or are at risk for stroke should consider alternative forms of contraception, as oral contraceptives can increase the risk of developing clots.