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Authors: Majid Fotuhi

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BOOK: Boost Your Brain
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We can’t tell, without a detailed study, just how much effect those brain drainers have had. So, if you’ve had past behaviors that are currently under control or are not evident but might have taken a toll on your brain, give yourself a “warning card.” Consider this a reminder that your brain may be in need of all the brain-building efforts you can muster.

High priority factors that warrant a warning card include a history of the following conditions:

•    Diabetes
•    High blood pressure
•    Sleep apnea
•    Heart disease
•    Stroke
•    Smoking
•    Insomnia
•    Excess weight or obesity
•    Sedentary lifestyle
•    Extremely poor diet
•    Head trauma

Digging Deeper into the Brain–Body Connection

When patients talk to me about their memory or brain health concerns, it’s often clear that they think of their own brains as mysterious black boxes, perched upon their shoulders and orchestrating their thoughts and actions in isolation from the rest of their bodies.

The brain is certainly complex, and awe-inspiring, but while it stands alone in one sense as the body’s command center, it is also an integral part of a network of organs, all of which affect—and are affected by—each other. Often my patients have no idea just how interrelated the health of their various organs is and have never really considered how far-reaching certain health problems can be.

This interconnectedness is especially important given that the human brain is in a constant state of flux, changing from hour to hour and day to day.
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Health conditions that fog the brain, limit blood flow, or change hormone levels, even for mere hours, can leave their mark on brain structure, size, and performance.

In chapter 8 you’ll get started on implementing a twelve-week plan to grow your brain. But before you move ahead, it’s important to consider—and begin to treat—medical conditions that may impede your efforts.

Key Health Conditions That Affect the Brain

To build a bigger, stronger brain you need a strong, healthy body. Here are some common health problems that impair brain function, or even reduce brain size:

Hearing Loss
Hearing, of course, provides you with auditory input, giving the brain a rich source of information to respond to and remember. Eliminate or reduce the input and you have a problem that goes far beyond just the inconvenience of constantly asking others to repeat themselves. Hearing loss, a common problem associated with aging, can actually hasten cognitive decline. As hearing fails, the elderly can find themselves increasingly isolated and less likely to use their cognitive skills. As a result, they experience “disuse atrophy”—shrinkage in the parts of the brain they’ve stopped using. But it’s important to note that hearing problems aren’t only for the elderly. There’s recent evidence that mild hearing loss in the young is on the rise.
3
Experts don’t know for sure why this is, but some suggest it may be linked to listening to loud music or to the use of earbuds, a type of headphone that sits snugly in the entrance to the ear canal.

Vision Loss
Just as the ears provide input you need for stimulating your brain and cognitive function, so too do the eyes. With aging, the risk of developing glaucoma and cataracts rises, although vision problems can occur at any time in life. Excessive computer use, or prolonged staring at any electronic device, can also cause eyestrain or blurred vision.
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Not only can such symptoms be unpleasant, but they can also reduce your cognitive function by making it hard to absorb information. Fortunately, vision problems can often be corrected with glasses, contact lenses, or surgery. Symptoms from computer use usually resolve once you stop using your computer, but they can also be avoided by limiting glare, adjusting your distance from your computer screen, and correcting minor vision problems.

Insomnia
Insomnia is a critical sleep disorder that can reduce brain function, as you’ll read in
chapter 9
. Often people ignore their insomnia, considering it just one more fact of life to be dealt with. They don’t realize that insufficient sleep could be shrinking their brains and crimping their cognitive performance. What’s more, they fail to realize that insomnia can be treated. In addition to many herbal supplements or various medications, meditation and neurofeedback have been shown to reduce sleep problems, either directly or by reducing anxiety.

Snoring
Snoring can be benign, but it can also be a sign of obstructive sleep apnea (OSA), a sleep disorder that starves the brain of oxygen, seriously shrinking the cortex and hippocampus. Unfortunately, it’s often a problem that goes ignored or is even laughed about. (Patients sometimes gleefully report they get the master bedroom to themselves because their log sawing has driven their spouses to the guest room.) But treatment for OSA, as you’ll read in chapter 9, can be highly effective, reversing the damage done in the brain.

Medications
There are a host of medications, especially in high doses, that can temporarily affect cognitive function. These include anxiety medications, such as Valium; sleeping medications, such as Ambien; narcotic pain medications, such as Percocet; and older antidepressant medications, such as amitriptyline. I often favor minimizing my patients’ medications as much as possible. Medications that dull your senses and prevent you from absorbing information can lead to disuse atrophy—shrinkage of the brain—in the long run.

Smoking
In addition to boosting your cancer and other health risks, smoking raises your risk for brain shrinkage and cognitive decline.

Lung Problems
Uncontrolled asthma, chronic obstructive pulmonary disease (COPD), or emphysema make it harder to exercise strenuously, limiting oxygen flow to the brain and putting the brakes on brain growth.

Gum Disease
Studies have linked gum disease to an increased risk of inflammation in the body and to memory impairment and dementia.
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That may be because such conditions are often interlinked with other health problems—diabetes raises the risk of dental problems, for example—or brain-shrinking lifestyle habits.

Thyroid Conditions
Hypothyroidism, a condition in which the thyroid gland doesn’t produce enough of the hormone that controls metabolism, is very common among women in particular. But men can suffer from it too, and both can suffer from hyperthyroidism, in which the thyroid gland produces too much hormone. Hypothyroidism can contribute to a variety of problems, including obesity, which, as you’ll soon read, is a brain shrinker. Hyperthyroidism, meanwhile, can cause nervousness, fatigue, or even heart failure, which also shrinks the brain.
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Cardiovascular Problems
High blood pressure, high cholesterol, and diabetes can all lead to cardiovascular problems, which increase the risk of heart attack and stroke. In addition, poor blood flow to the brain dramatically shrinks the brain.
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Although heredity plays a part in these risk factors, all are greatly reducible through lifestyle changes, and treating these conditions has been shown to reduce the risk of cognitive decline.

Liver Damage
Alcohol abuse and certain other conditions can cause liver damage, which results in increased ammonia in the blood and indirectly damages the brain. In addition, alcohol abuse by itself, even without liver failure, directly causes brain atrophy or shrinkage, especially in the pathways linked to memory and attention.

Obesity
Excess weight and obesity—particularly in the form of belly fat—are known brain shrinkers, reducing cognitive function in the short term and raising the risk of dementia in the long term. Responsible weight loss or healthy weight maintenance almost always involves dietary changes and exercise, both of which can grow the brain.

Menopause
Menopause, the end of a woman’s fertility, typically occurs between the ages of forty-five and fifty-five and can cause sleep problems and brain fog—memory lapses, slow thinking, or mild confusion—in some women. It’s important to note that menopause has not been shown to directly shrink the brain and that its associated problems disappear when menopause does.

Sexual Dysfunction
Patients often shy away from talking about this, but when I ask—and I always ask, because of its importance to overall health—I often uncover a problem. Sexual dysfunction can be a sign of another treatable health problem, such as heart disease, diabetes, or depression, or a side effect of medications. If left untreated, sexual dysfunction can affect your sense of well-being and joy. Although some people have intimacy without sexual interaction and are perfectly happy about it, many find sexual dysfunction—and the decrease in self-confidence it often brings—leaves them feeling frustrated and anxious, driving them away from the ideal alpha zone.

Urinary Frequency
Kidney, prostate, or bladder issues can cause a host of problems, including urinary frequency, which might contribute to fragmented, poor sleep. (If you wake up multiple times each night to use the bathroom, you may have a bladder problem.) Long-term poor sleep can ultimately result in a loss of synapses on a microscopic level.

Allergies
Food allergies such as gluten sensitivity may cause a host of symptoms that may impact the brain, from headaches to brain fog. Seasonal allergies can also cause headaches, congestion, interrupted sleep, and brain fog.

Back Pain
Back pain can have many causes, and it can be exacerbated by stress or depression. Often people suffer through back pain and fail to seek treatment. However, chronic pain has been shown to damage brain pathways and shrink the brain.
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Pain can also keep you from exercising, thus robbing you of a real brain builder. Fortunately, back pain is often treatable, and eliminating the pain can reverse the brain-related problems it causes.

Ankle Edema
Edema, often showing up as swollen ankles, may be a sign of kidney or even heart problems, including heart failure, which has been shown to shrink the brain. Edema is treated by treating the underlying condition.

Vitamin D Deficiency
People often forget that the skin is an organ, and one that’s integral to our health. When it comes to brain health, the biggest concern related to skin is low vitamin D, a condition that can be caused by inadequate exposure to sunshine. Since overexposure to the sun isn’t healthy either, I recommend knowing your vitamin D level and taking a vitamin D supplement (with calcium).

Numbness
Reduced sensation or tingling in the toes can be one of the first symptoms of diabetes, which as you’ll read in
chapter 11
, is a known brain shrinker.

Mental Health Conditions

A healthy body is critical for a bigger brain, but so too is a brain that’s free of disease. There are a host of medical conditions related to the brain itself, but I’ll limit this discussion to those most common and most important to improving cognitive function and building brain reserve.

Depression
Depression is a bona fide brain shrinker that has been shown to reduce the size of the hippocampus and lead to a reduction in cognitive performance. Depressed patients often report memory problems, difficulty focusing and sustaining attention, and low motivation, among other symptoms. Fortunately, treatment of depression has been shown to reverse hippocampal shrinkage in just six months.
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Anxiety
Anxiety is known to increase the risk of insomnia, stroke, and heart attack. It can increase levels of cortisol, which shrinks the hippocampus in particular. Meditation, stress reduction, cognitive behavioral therapy, and neurofeedback can all be helpful in reducing anxiety, as can medications.

Attention Deficit Disorder
ADD is actually called attention deficit hyperactivity disorder-inattentive (ADHD-I), though it’s still often unofficially referred to as ADD, especially in adults, who tend to lack the H of hyperactivity. ADD is characterized by inattention, distractibility, disorganization, and forgetfulness. Like those with depression and anxiety, people with ADD typically exhibit brain wave activity that’s far from the norm—in this case showing too much slow theta activity in the frontal lobes, the area of the brain associated with paying attention and decision making. While it may seem minor, an inability to focus can wreak havoc on a person’s cognitive performance, as many ADD sufferers can attest. Fortunately, treatment for ADD can be highly effective. Neurofeedback is one option that increasingly shows great promise for long-lasting treatment of the condition.

Body Scan

Complete the following body scan, checking off the items that apply to you and the conditions that you consider a priority. (Hint: These should be the conditions that are most severe for you and most likely to take a toll on your brain’s health.)

BOOK: Boost Your Brain
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