Nootropics vs Neurotrophics: Know the difference for preservation of brain health

You have likely heard the headlines: cognitive impairment and Alzheimer’s and other forms of dementia are on the rise. Part of the increase is due to an aging population. But there are reasons that are adding to the increase beyond this. The epidemics of insulin resistance (recall that dementia is often labeled “type 3 diabetes,” meaning that the brain becomes insulin resistant), SIBO endotoxemia, the ubiquity of heavy metal toxicity, and deficiencies of important nutrients such as omega-3 fatty acids and vitamin D are likely making their own contributions.

There are a number of strategies that you can adopt, however, that hold potential for reducing your risk for developing cognitive impairment, or at least delay its onset. There are also various factors that you can supplement, some of which hold potential for improving cognition and, in some cases, slow or help prevent cognitive impairment and dementia. But this area is filled with imprecise thinking and, sadly, misleading marketing. To help you get your arms around these ideas, let me introduce you to a concept that makes gaining an understanding of what works and what doesn’t that can keep you on track and avoid pitfalls that waste time, effort, money, and have little to no benefit for brain health. It is to understand what factors provide nootropic and thereby temporary effects vs neurotrophic factors that actually generate healthy improvements in brain health and physiology. 

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Transcript

Speaker 1: 0:05

You've likely heard the headlines Cognitive impairment and Alzheimer's and other forms of dementia are on the rise. Part of the increase is due to an aging population, but there are reasons that are adding to the increase beyond this the epidemics of insulin resistance Recall that dementia is often labeled type 3 diabetes, meaning that the brain becomes insulin resistant SIBO, endotoxemia, the ubiquity of heavy metal toxicity and deficiencies of important nutrients Such as omega-3 fatty acids and vitamin D Are likely making their own contributions. There are a number of strategies that you can adopt, however, that hold potential for reducing your risk for developing cognitive impairment or at least delay its onset. There are also various factors that you can supplement, some of which hold potential for improving cognition and, in some cases, slow or help prevent cognitive impairment and dementia. But this area is filled with imprecise thinking and, sadly, misleading marketing. To help you get your arms around these ideas, let me introduce you to a concept that makes gaining an understanding of what works and what doesn't. That can keep you on track and avoid pitfalls that waste your time, effort, money and have little to do with benefit for brain health. The key is to understand what factors provide nootropic, and thereby temporary, effects versus neurotrophic factors that actually generate healthy improvements in brain health and physiology. And later in the podcast, I'd like to tell you about Defiant Health's sponsors Paleo Valley, our preferred provider for many excellent organic and grass-fed food products, and BiotiQuest, my number one choice for probiotics that are scientifically formulated, unlike most other commercial probiotic products available today. This is a very important concept. I'd like to help you understand that, when you get it, a lot of things make sense in the world of trying to preserve your cognitive health and trying to avoid the prospect in your future of Alzheimer's, dementia or other forms of dementia.

Speaker 1: 2:26

Surprisingly though, this is going to seem obvious, once you hear this distinction, once you hear this idea, you're going to find that many neurologists, certainly many primary care physicians and other people involved in dementia and cognitive preservation often don't understand this distinction. This is even true in the world of pharmaceuticals For Alzheimer's disease. You're going to find that the pharmaceuticals that are commonly prescribed, like rivastigmine or Aricept, really have almost no impact on the disease itself. They may improve memory a little bit or other aspects of cognition, but they have no material effect on the progression of the disease, and so people think that it may be beneficial. Doctors think that those drugs may be beneficial, but all they do is improve memory or attention or other aspects of cognition a little bit, with no impact on the disease. So the distinction is to be able to tell the difference between what are called nootropics and neurotropics. Now that sounds kind of complicated, but it's really not.

Speaker 1: 3:29

Nootropics, very simply, are factors that improve various measures of cognition. It could be better memory, it could be greater creativity. It could be improved data acquisition, learning new things. It could be improved data acquisition, learning new things. It could be better data synthesis, that is, putting together ideas or data to come up with new conclusions. The problem with these these are good things, right. Improved cognition can be a good thing. If you're trying to write a paper or meet a work deadline, it's a good thing to have improved cognition. But what you should not do is interpret this to mean that your brain is somehow healthier, because it's a good thing to have improved cognition. But what you should not do is interpret this to mean that your brain is somehow healthier, because it's not. More often than not, it's no healthier.

Speaker 1: 4:12

How do these nootropic agents work? Well, they work primarily by increasing neurotransmitters, that is, chemicals in the brain that transact thought and memory and attention and the other aspects of cognition. These are neurotransmitters like acetylcholine or norepinephrine or dopamine. What nootropics do not do is decrease the measures, the phenomena associated with cognitive impairment and dementia. They don't. Nootropics, for instance, do not decrease the beta amyloid plaque and the tau protein, the phosphorylated tau proteins. Those are the two factors that accumulate such a gunk in your brain that messes up your capacity for clear thought and memory. So nootropics do not decrease these factors, nor do they increase what are called trophic factors. These are hormones that work within the brain to increase the proliferation and interconnections of brain cells and increase the synaptic richness, that is, the interconnections between brain cells, and support other cells like glial cells that support brain cells. So nootropics do not increase trophic factors, and these are factors that go by names like vascular endothelial growth factor or BDNF, brain-derived neurotrophic factor or IGF-1-alpha, insulin-like growth factor-1-alpha or neuronal growth factor. Don't memorize all those Just know that these so-called trophic or growth factors in the brain support brain cells, the proliferation and health of brain cells, and encourage a richer interconnection or synapses between brain cells. Nootropics do not impact this at all and so they don't reduce the accumulated gunk in your brain, like beta amyloid plaque or tau protein. They do not increase trophic factors and nootropic agents also don't prevent atrophy.

Speaker 1: 6:07

So when you have cognitive impairment and dementia, certain parts of the brain undergo atrophy. They shrink and decay. The hippocampus is the primary area that we watch for the progression of dementia. The hippocampus is a small part way inside the brain that is the part of the brain responsible for converting short-term memory into long-term memory and that becomes atrophied and shrunken in someone with dementia. And that's why people with dementia often have intact long-term memory, for instance what happened in their childhood or teenage years or young adulthood, but have almost no memory for what happened this morning, what they had for breakfast, what they had for dinner, what they did yesterday. So short-term memory is impaired because they're incapable, because of hippocampal atrophy, and converting short-term memory into consolidated long-term memory. Other parts of the brain can also undergo atrophy, such as the cerebral cortex, white and gray matter or the frontal lobe or the temporal lobe, usually in more advanced forms of dementia, also in other forms of dementia besides Alzheimer's. But nootropic agents don't have any impact on the progression of atrophy either.

Speaker 1: 7:16

Now, these agents, these so-called nootropic agents there's many of them. Some of them work, some of them don't work so well. Some of them don't work at all, but they coat by names you likely never heard of, like citicoline or dimethylaminoethanol or huperzine. Those are three that, by the way, work by increasing the level of acetylcholine neurotransmitter in your brain transiently. There's other factors like selegiline or ergoloid mesolates that increase dopamine in the brain. And then there's factors like tyrosine, the amino acid tyrosine, that increases levels of norepinephrine. And then there are nootropics that work by uncertain mechanisms, such as paracetam, aniracetam, prameracetam and my favorite, vimpocetine.

Speaker 1: 7:59

It's my favorite because it works. It tends to increase your capacity for focus, attention, creativity, synthesis of ideas. I'll sometimes take Vin Postine, for instance, when I'm on a deadline for a book or other project, and 30 milligrams really increases your capacity for thinking more clearly and producing for a few hours. Then it's gone. Another analogy that helps you understand this idea of no tropic effects is caffeine.

Speaker 1: 8:24

So you have coffee. Especially when you first started drinking coffee when you were younger, you notice that your focus, your attention was intensified. Your capacity to think and memorize was improved for a little while. So that's called a nootropic effect, because after a few hours it wears off and you may end up being more tired than you were at the start. But that's nootropic. If you drink a cup of coffee and your memory is a little bit better, your creativity and energy and focus are a little better, do you say to yourself. My brain must therefore be healthier, I must have less beta amyloid plaque. No, of course not. So that is a nootropic effect.

Speaker 1: 9:00

And I made this important distinction because there are people who try to sell you things or try to tell you that this or that nootropic because it improves, let's say, focus or memory, temporarily or transiently. It must therefore mean that your brain is healthier and that you are protected from dementia. That is absolutely not true. Now, while it's a good thing to have improved cognition, better memory and focus, etc. It does not mean you should not interpret that to mean that your long-term potential for dementia is somehow reduced, because it is not. Yet this doesn't stop many retailers or manufacturers from telling you or selling you products where they say things like if your memory is better, your brain is healthier. That is simply complete fiction. You cannot rely on that nonsense.

Speaker 1: 9:51

Now, neurotrophics are something different. These are factors that actually improve brain health and brain physiology. Now the list of things that achieve this is shorter. There's lots and lots of nootropics. There's not that many things that have been discovered to be neurotrophic. The list is growing gradually. Again, we have to be careful. There's a lot of misinformation, false advertising, other claims and false products, misleading products that you want to avoid. But just understand that there's a big difference between nootropics and neurotrophics.

Speaker 1: 10:24

So what factors distinguish something as neurotrophic? Well, first of all, a neurotrophic can also have nootropic effects. A neurotrophic factor can also increase memory, attention, focus, data acquisition, et cetera. But it also should reduce beta amyloid plaque and the tau protein that accumulate in the brains of people with cognitive impairment. Something that is neurotrophic should be shown to increase those trophic factors like BDNF, igf-1-alpha, vegf and neuronal growth factor. Some studies have shown increase in activity in the hippocampus and related areas as identified by functional MRI. That's a little bit sketchy. It's not quite clear if increased activity means there's better brain health, but it's something that's emerging and being explored. And then, something that is neurotrophic should decrease atrophy, that is, decay, degeneration of the hippocampus, the cerebral cortex, frontal lobe, temporal lobe and other brain areas. In other words, it actually stops the decay of brain anatomy and physiology. So when we come back from our message from our sponsors, let's talk about the factors and strategies that have known or fairly well established neurotrophic effects.

Speaker 1: 11:41

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Speaker 1: 13:16

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Speaker 1: 14:29

Now let's get back to our discussion. So what factors have been shown to have neurotrophic effects? At the top of the list are omega-3 fatty acids, but specifically the DHA, not so much the EPA, because the brain is largely made of DHA, and that evidence is pretty good. It's been shown that the DHA supplemented tends to improve cognition and preserve reduced likely progression of cognitive decline, especially if introduced early or taken preventively. If you have well-established dementia and you're in assisted living or memory center and you take DHA, the benefits are small to minimal. So the key is to start supplementing earlier in life, before cognitive impairment sets in, and certainly no later than the beginning of cognitive impairment. Now the dose is important because there are other benefits to omega-3 fatty acids, such as the activation of the enzyme intestinal alkaline phosphatase in the intestinal lining that tends to deactivate partially deactivate the lipopolysaccharide toxin from fecal microbes that typically infest the small intestine in many Americans nowadays. So taking both EPA and DHA are beneficial For that reason also. There may be cardiovascular benefits, of course, and a reduction of triglycerides and postprandial or aftermeal lipoproteins such as VLDL and chylomicrons topic for another day. Except that omega-3 fatty acids have a range of benefits modest benefits. So I advise taking both the EPA and the DHA, but at higher doses, typically minimum of 3,000 milligrams per day of the combination or more. 3,600 milligrams of the combination is probably ideal and if you are concerned about cognitive impairment you can always increase the DHA even further. There's no downside to taking more, except the cost it's a little bit costly.

Speaker 1: 16:25

Another very important neurotrophic strategy is to follow a diet that reduces or minimizes insulin resistance and glycation. Let's talk about that. So insulin resistance is the situation in which your body's cells, such as brain, muscle, liver, don't respond well to insulin, typically because of repeated insults from high blood glucose, high blood insulin. Those repetitive cycles trigger insulin resistance. Also, deficiency of numerous nutrients like magnesium, vitamin D all the factors in my programs that leads to insulin resistance. Also, deficiency of numerous nutrients like magnesium, vitamin D all the factors in my programs that leads to insulin resistance.

Speaker 1: 17:00

And insulin resistance is a common thread through all forms of dementia. Whether it's Alzheimer's dementia, early cognitive impairment, frontotemporal lobe dementia, parkinson's disease, lewy body disease, they all share insulin resistance. So insulin resistance is a major common factor in all forms of dementia. So you want to minimize that. So follow my programs where we eliminate wheat, grains and sugars. We never restrict fats. We restore nutrients like vitamin D, magnesium, iodine, omega-3, fatty acids. That conspire, that synergize to minimize insulin resistance and you have great improvement and protection as a neurotrophic strategy in preventing cognitive impairment and dementia.

Speaker 1: 17:46

Another thing about diet is you want to minimize glycation. Remember this Glucose modification of proteins. So the proteins in the brain are subject to glycation. When brain proteins become glycated, they become useless, essentially become junk, and just gum up your brain. So you don't want to glycate. How do you do that? Don't eat foods that raise blood glucose Wheat, grains and sugar. Address nutrients that are lacking in modern life, that allow higher blood glucoses once again vitamin d, magnesium, iodine, omega-3 fatty acids. So follow my program as written and you end up minimizing insulin resistance and glycation. And when you do that, you also minimize inflammation, because inflammation is another driving force in cognitive impairment. So diet can be viewed as something that has very potent neurotrophic effects.

Speaker 1: 18:41

Now know that there have been studies in such things as the Mediterranean diet and other similar diets. They do not. They have not been shown to affect improvements in brain health. They are not neurotrophic. They are at best, are not neurotrophic. They are at best and unevenly nootropic. So don't fall for this idea that if a Mediterranean diet or similar is better than a standard American diet, which is terrible, it does not necessarily mean that the Mediterranean diet is ideal. It's not. So we're going to go towards a diet that we think is ideal and thereby exerts better neurotrophic effects by minimizing insulin resistance, by minimizing glycation, by reducing inflammation.

Speaker 1: 19:22

Physical exercise, but especially resistance training, is likely a neurotrophic strategy. So exercise, typically 150 minutes per week of some aerobic exercise, or 75 minutes per week of at least moderate to strenuous exercise, has been shown to achieve neurotrophic effects such as preservation or increase in hippocampal size and an increase in those trophic growth factors. It's important to know that the most important kind of exercise is resistance training, not to say that resistance training alone is sufficient, but resistance training in combination with other aerobic activities like riding your bike, walking a treadmill, even better. Walking outdoors, gardening, digging in your garden, raking the leaves, cutting the grass All those things really add up to preserve brain health and have been shown to minimize or even reverse hippocampal shrinkage and other forms of atrophy in the brain and increase trophic factors in the brain. Be aware of something called exergaming. This is a new kind of idea where you combine cognitive exercise. Cognitive exercises like playing sudoku or chess or crossword puzzles or learning a new language or learning another new skill like a new musical instrument probably does not have neurotrophic effects. They do have cognitive benefits, that is, nootropic effects. But if you combine the cognitive benefits of cognitive exercises like those things I mentioned with some form of exercise. It could be a stationary bike while you play a video game and you get the best of both aerobic exercise and cognitive exercise. Of course, there's no strength training there. It's hard to do strength training while you're playing a game. But be aware it's an easy and really fun way to acquire the benefits of cognitive improvement and maybe a bit of neurotrophic benefit.

Speaker 1: 21:16

A very important neurotrophic strategy is to reduce or minimize endotoxemia. If you've been following my conversations, you know that about half of the American public has something called SIBO, that about half of the American public has something called SIBO small intestinal bacterial overgrowth a situation in which we've lost numerous beneficial microbes. That has therefore allowed the ascent of fecal microbes like E coli and salmonella into the 24 feet of small intestine, where they don't belong, where those trillions of fecal microbes infesting the small intestine live and die rapidly. When they die, they release their toxins, such as endotoxin, that is able to penetrate across the intestinal wall, the small intestinal wall, and into the bloodstream. That is a process called endotoxemia and, in my estimation, half the US population has this and it is a major driver of insulin resistance inflammation and damage to the US. Population has this and it is a major driver of insulin resistance inflammation and damage to the brain. It actually causes atrophy of the brain.

Speaker 1: 22:16

So getting control over SIBO and endotoxemia is critical. I see many people saying, oh, this is too difficult, it's too hard to understand. Some of the strategies to control are too complicated. Please don't do that. If you bury your head in the sand, not only are you increased risk for cognitive impairment and dementia, but also multiple sclerosis, parkinson's disease, migraine headaches, rosacea, psoriasis, eczema, fibromyalgia, restless leg syndrome, weight gain, obesity, type 2 diabetes, breast cancer. In other words, uncorrected SIBO and endotoxemia has major implications for your long-term health beyond even just cognitive impairment. So addressing so, if you don't know what I'm talking about, please see prior episodes of this Defiant Health podcast or my many thousands of posts in my drdavisinfinitehealthcom blog, as well as my books, especially the Super Gut book.

Speaker 1: 23:12

Now, an added bonus is when we engage in restoring the microbe lost by nearly everybody, lactobacillus roteri that we know is able to colonize the GI tract and send a signal to your brain to release the hormone oxytocin. Oxytocin is very powerful and among its effects relevant to brain health is that it reduces cortisol dramatically. Cortisol is damaging to your brain, so prolonged stress, for instance, can damage your brain from sustained elevated levels of cortisol. Well, the oxytocin boost you get from lactobacillus roteri blunts that rise dramatically. L-roteri is also unique in that, you may recall, it colonized the small intestine and that's where SIBO occurs, that's where endotoxemia originates. So when L-roteri takes up residence in the small intestine it produces bacteriocins. These are natural antibiotics effective against fecal microbes and Elroderi. Thereby, in addition to producing oxytocin, also reduces endotoxemia that drives cognitive impairment.

Speaker 1: 24:20

Oxytocin can also increase testosterone, which helps males, because an increase in testosterone, especially if it's low, can reduce abdominal visceral fat. That's a driver of inflammation. It causes a return of muscle and muscle is a major advantage in anybody. The restoration of L-reuterin oxytocin also increases a sense of optimism and generosity and sociability that likely also contribute to beneficial brain effects.

Speaker 1: 24:48

So I hope you now understand the distinction between nootropics factors that make you a little bit smarter, a little bit more clever, a little bit more creative, a little more attentive, but don't necessarily improve brain health by addressing all those factors that cause cognitive impairment.

Speaker 1: 25:04

But neurotrophic factors really do have potential for preserving brain health, even increasing hippocampal size and preventing brain atrophy, increasing those trophic factors and also, in addition, having cognitive benefits, nootropic effects. Understand this distinction and you're protected from all the silly claims often made for products. You know that most of the things that are neurotrophic, by the way, are not being advertised, and that's one of the problems we have in healthcare that if something doesn't make a lot of money, like a dementia drug, you won't hear much about it. Now, if you find this a little bit too overwhelming, I invite you to join my programs, such as my drdavisinfinitehealthcom inner circle, where we have lots and lots of learning materials, including videos, and our two-way Zoom meetings where we discuss all these issues and help you succeed. Now, if you learned something from this episode of the Defiant Health Podcast, I invite you to subscribe to your favorite podcast directory. Post a review, post a comment. Do your part to grow this movement of self-empowerment in health and minimizing our reliance on a flawed healthcare system. Thanks for listening.