How supplements can support your recovery
Ah, supplements. So. Many. Supplements. It really is mind-blowing.
In the context of recovering from a brain injury, supplements exist on a spectrum of things that can support you, but they aren’t necessarily the first things on that spectrum. The first things are behavioral tools like sleep hygiene, breathing exercises, light exercise, diet, and rehabilitative exercises.
Then again, when you have a brain injury, those behavioral tools might prove extraordinarily difficult without supplementation.
For example, it’s well known that people suffering from post-concussion syndrome struggle with sleep. As it happens, there are a couple of supplements that can really help with sleep.
Supplements are not a panacea, but…
I’m as susceptible as anyone else to thinking of supplements as some kind of panacea—but I know that mindset is to be avoided.
Supplements do just what the name implies. They supplement your efforts (as well as your diet). They are not magic bullets and you shouldn’t search for supplements with that expectation.
Most athletes would tell you that supplementation is an indispensable component of their training. Well, what is neurological rehabilitative exercise if not training? But is there any athlete who just takes supplements and expects results? If you think you can just take a pill (supplement or medication) and not do anything else, you’re fooling yourself.
Supplements I avoid
In general, I avoid “brain boosting” nootropics. I know it’s tempting to think these will lift the brain fog, but that’s like thinking you can take a car with misfiring spark plugs (the brain is an electrical organ after all) and make it run better by adding a second battery—more juice! (On a related note, you don’t want to massively increase your caffeine consumption to mask brain fog.)
I also avoid supplement cocktails that combine a whole bunch of supplements in one product, in part because there are often wildcard substances in there, and because I want to control the amount of every individual supplement I’m taking. I make exceptions for combinations that might include one or two nutritional co-factors that aid absorption, such as a vitamin c included with iron (I don’t take that, it’s just an example).
Supplements I consider taking
My general approach is to stick to amino acids, minerals, and a few vitamins that are either produced by the brain and body, or are definitely needed by the brain and body from food sources. I tend to approach things outside that sphere with caution.
I typically look for the variation of a supplement that can cross the blood-brain barrier unassisted. These might be prefaced by the word acetyl or the letter L (for example, Acetyl-L-Carnitine, which I do take currently).
I often follow the principle of taking the precursors of things, rather than the things themselves. By taking the precursor, you allow your biology to create however much it wants of the downstream things it needs. For example, you might take L-Tyrosine, a precursor to dopamine and noradrenaline, and allow your biology to make however much it wants of those things (L-Tyrosine is something I take occasionally, but not every day).
Do your research
Any time I consider taking a new supplement, I refer to Examine.com, which shows you the legit studies done with that supplement. Refer to that site as you consider your own supplement plan.
This seems like as good a place as any to remind you that I am not a medical practitioner of any kind. This information is based on my experience and reading.
Speaking of reading, one book that focuses heavily on supplements that might benefit those with brain injuries is Concussion Rescue by Dr. Kabran Chapek. After reading that book’s extensive supplement overview, I tried taking just about everything he mentioned (with mixed results, your mileage may vary, caveat emptor).
The supplements you take should change depending on where you are in the recovery process
After your brain injury, the list of potentially helpful supplements should change as you move past the first couple of weeks. By around the 90 to 120 day mark, that list of supplements should stabilize and remain relatively consistent (although you might try adding one or removing one as you go from there).
Here are a few supplements that can help in those first couple of weeks. You can validate these with your own healthcare provider.
Creatine: Many studies have shown a wide range of benefits and, if you wish, you can read about them at Examine.com. Here are some brief quotes and extracts from that site.
A reduction in mental fatigue has been observed in various scenarios such as demanding mental activity, sleep deprivation, and traumatic brain injury.
Dizziness as a side-effect of traumatic brain injury is reduced with 400 mg/kg/day.
400 mg/kg/day in children and adolescents subject to traumatic brain injury reduces headache frequency from around 90% down to near 10%.
400 mg/kg/day in children and adolescents subject to traumatic brain injury reduces fatigue frequency from around 90% down to near 10%.
Depression symptoms seem to improve noticeably. This improvement is probably related to serotonin (creatine supplementation appears to enhance SSRI therapy).
Magnesium: There are many kinds of magnesium, each performing a different function. Taking magnesium bisglycinate (Thorne makes a good version) about an hour before bed is solid choice, both for sleep support and nervous system support.
L-theanine: See Examine.com for more info. About 200mg taken with magnesium an hour before bed is the sleep cocktail I use.
I was able to stop using melatonin (after more than a decade of feeling totally dependent on it for sleep) by replacing it with L-theanine in combination with magnesium bisglycinate. However, if you get migraines, L-theanine might be a migraine trigger. As with anything else here, your mileage may very, proceed with caution.
One reason I’m emphasizing morning vs. night here is to underscore the importance of re-establishing your circadian rhythm. Over time, this will allow you to relax more deeply at night and be more alert during the day (one hallmark of post-concussion syndrome is a disruption in one’s ability to do that).
Down the road, you can look at adding more supplements as you climb up from the depths.
The supplements I take currently
Instead of telling you what supplements to take, which is both a bad idea and a fool’s errand, I’m just going to tell you what I take currently. I have 100% confidence that my regimen is not perfect and will be further refined over time.
I also want to mention a concept called supplement cycling. To avoid the potential downsides that come with taking things every single day, some people take time off from their supplements. I’ve heard some recommend taking one day off per week, or one week off every six weeks. Getting frequent bloodwork done is also a good idea.
First thing in the morning (with coffee)
Branched-chain amino acids
Mid to late morning (around 10:30 or 11 AM)
Night (around 10 PM)
In addition to these daily supplements, there are a couple of supplements I take now and then on an as-needed basis. They are:
Berberine (I might take this 30 minutes before a super carb heavy social meal to blunt the impact on my blood sugar)
L-Tyrosine (I might take this once in a while if I feel like I could use a dopaminergic boost to move forward)
Supplements can support your recovery, along with behavioral tools, treatments, devices, and medications. They are not a panacea, but they may be essential. An athlete would tell you that supplements are an essential component of training, and neurological rehabilitation is a form of training.
You should probably avoid any brain boosting cocktails aimed at neuro-typical people or college students. Proceed with caution and control. Research the efficacy of supplements on Examine.com. Consider sticking to things that the brain and body already produce or are known to need, and consider taking precursors to those things, so your own biology can control the dose. Look for versions of supplements that cross the blood-brain barrier.
As you move forward on the timeline of your recovery, you could try adding or taking away different things until your regimen takes shape. Take supplements at the best time of day for each supplement, or in a considered sequence with other aspects of your recovery training.
Brainwave is an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I endeavor to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve simply had a lot of sports-related concussions and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.