Andrew: Forgive the pun.

Louise: …that drove me into it. I think, for me, personally, I grew up with brothers who played football and suffered concussions. I’ve had my own neurological issues in the past, and my husband has also had issues with concussion. But I’m also a mother of two little boys and a little girl, who love football as well. And they lay into each other on the trampoline too, so that’s a worry. But it’s really… There’s a big gap in concussion treatment at the moment. And like you said, we know this. And one day, I was doing some advanced ADHD training, and we were talking about chronic low-grade neuroinflammation, and all these pennies started dropping. I’m like, oh my god, chronic low-grade neuroinflammation is what we see in CTE and concussion-related illnesses. And so that led me down a rabbit hole and a graduate certificate in neuroscience. And 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. Really, really, really exciting area of treatment.

Andrew: Well, hang on. You just said a certificate in neuroscience.

Louise: Oh, yeah.

Andrew: What?

Louise: Yes, I am completing my graduate certificate in neuroscience, because why not? Just a little bit of extra brain study.

Andrew: Where is that through?

Louise: Hmm?

Andrew: Where?

Louise: University of Southern Cross.

Andrew: Wow. This is incredible. I’m sorry. I didn’t even know it was available to non-doctors.

Louise: Yeah. Yeah.

Andrew: Wow.

Louise: So, yeah.

Andrew: That’s fantastic.

Louise: Fantastic area of study.

Andrew: Yeah, yeah, yeah. Can I ask who’s leading that at Southern Cross? Who…there’s so many lecturers.

Louise: Oh. I don’t know who’s leading it. I just attend to attend the lectures.

Andrew: Okay. Right.

Louise: I should probably find that out.

Andrew: Who’s your lecturer? Can I ask?

Louise: It’s different for each subject.

Andrew: Gotcha. [crosstalk 00:03:03]

Louise: Yeah. Because, yeah, neuroscience is actually quite a diverse field, so it depends if you’re going down a neurodivergence path, or a clinical path, imaging. Yeah. And I’m cherry-picking the bits that make sense to my area of interest, in concussion. So, I’ve got a variety of different people that I’m in contact with. Yeah.

Andrew: Wow. Okay. So, tell us a little bit about post-concussion syndrome. Other people would call it traumatic brain injury. There are varying names, but I’ll let you explain that, because I might get something wrong. Can you take us through, firstly, the definition, or definitions?

Louise: Yeah, so…

Andrew: And secondly, how you assess?

Louise: Yeah. So, I think, clinically, a post-concussion syndrome is defined as concussion symptoms that exceed four weeks. But I think some key points to note here, in defining post-concussion, is that firstly, concussions are massively underreported. That’s a huge problem in all, definitely in contact sports. But in general, people falling off horses and accidents and things. And it can be, actually, three to six months before symptoms develop. And there is some statistics that suggest 72% of people have worsening symptoms at the five-year mark. So, this is long beyond what we look at an initial injury for in conventional medical care. So, there’s lots of moving parts to this, and lots of missing parts as well, as you can kind of, I can tell by your face, you’re like, “Oh.” Yeah. It’s big.

Andrew: It’s big. So, forgive me. You’ve just tweaked to something that I had no idea about. And 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? So, some trauma to the brain, if you like. Let’s generalize it. And that you immediately had, or within 24 or 48 hours, had symptoms of concussion.

Louise: Yeah.

Andrew: And then we went on. But what you’re saying is you can have this thing, and possibly not even present.

Louise: Yeah. So, a good example, there was actually, there was a hit, a big hit in the AFL a couple of weeks ago, Collingwood and maybe the Lions. And one player was knocked, out and the other wasn’t.

Andrew: Yeah. Yeah. Right.

Louise: Right? So, player who’s knocked out, he’s gone, he’s off the field, immediate care scans, all of those things. Concussion protocols are in play. The other guy passed his test and went back onto the field. Now, both of those people’s, the same impact. They both had a knock to the head. So, you’re probably better off if you get knocked out cold, because you go down the protocol path. The other person, all of those, the systemic cascade of biochemical changes, are still happening in that person, but they’re continuing to play.

Andrew: Right.

Louise: So, that’s a whole ‘nother kettle of fish. But it brings me to what’s actually happening in concussion and post-concussion. And it is not just a knock to the head. It’s a full systemic injury. There’s so much happening. So, in an initial concussion, we have, obviously, we’ve got lots of stuff happening in the brain, inflammatory processes to try and protect the brain. But, the blood-brain barrier, which is very selective, becomes less selective. So that’s the problem. So, things can travel into the brain that wouldn’t normally go that way. The other thing that happens is that we have increased intestinal permeability. So, that means whatever’s already going on in the gut now becomes a bigger problem. And this is how 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. And maybe that’s what’s happening years down the track, a virus, something that you ate, the balance of bacteria tipping again. There’s so many variables, but the research exists that all these things are happening.

Andrew: But this is concerning that, as you said, one person got up and “passed” the test. So, obviously, the tests are only for an acute critical first aid response. Then not looking at systemic issues, or central, let’s say central issues, which may present later. So, okay. Let’s think about this second player, who played on. They go home, and they may present, let’s say, three to six months, what, with tiredness, headaches? What are we talking about?

Louise: Yeah. It could be any sort of mosaic of symptoms. Definitely could be tiredness, lethargy, headaches, maybe new onset of migraines. But I think, in a sport context, the other thing that is really, really key here is that any other injury that player obtains becomes problematic for that knock to the head again.

Andrew: [inaudible 00:08:55]

Louise: Yeah. So, there’s the concept of glial priming. So, once you hit your head, and those glial cells are primed to protect the brain. So, if I hit my head, and then you come along 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, you could activate those, all that inflammation in my brain again. So, yeah, there’s lots of things that could go on. And I think something that we see often, particularly, you know, if you wanna talk about a sporting context, is we see lots of onset of mental health problems, depression, anxiety, substance addiction, and all of those kind of things. 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? And your gut’s full of serotonin receptors. So if your gut’s not right, your psychology can’t be right either. And like I said, prolonged injury, recovery, all kinds of things can present. So you have, you really have to look, and you really have to timeline what’s been going on for that person.

Andrew: Yeah.

Louise: Yeah. And [crosstalk 00:10:15] really, knowing what their existing health was like before the injury is really helpful as well.

Andrew: Okay. Just a little segue. I wanna come back to that existing health, or pre-existing issues, but I’m thinking, you know, we’re talking about sport. I’m also thinking about those people that serve our country in the armed services, and indeed, all emergency services, getting knocks, getting tackles, getting abuse, ambos, nurses, blood doctors, plus, you know, kids in playgrounds, you know, da da da. So, it becomes a very litigious issue with this in school now, that a lot of kids are actually being prevented from playing out of school hours, even if there’s a parent there, because it’s an opportunity for a litigious event. And this explains why.

Louise: Yeah.

Andrew: You know?

Louise: It’s a scary thing when you think about it like that. And I think, you mentioned lots of groups who people might not normally consider when thinking about a head injury like this. Another key group is domestic violence survivors.

Andrew: Yes. Yes.

Louise: And that’s a really key part of this puzzle as well. And then, because you bring in a lot of trauma into that as well, car accidents, that kind of thing as well.

Andrew: MVAs, yes. Yes.

Louise: Yeah. Yep.

Andrew: Yeah.

Louise: So, it’s a whole can of worms.

Andrew: Wow.

Louise: Yeah.

Andrew: Okay. 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. I had an interesting podcast earlier today that was just beautiful, in that the paradigm, if you like, the methodology that this naturopath used was to bring back the tenets of naturopathic medicine. I’m really not speaking right now, well right now, am I? So, and it was to treating the gut, for something distal. And it was this whole, going back into the reasons why we do this. This, again, is going back into these naturopathic tenets, even though we have a knock to the head, looking at the naturopathic tenets of gut health.

Louise: Yeah.

Andrew: But we’ve gotta go into this presentation. How do we pick that it’s not something else? How do we pick that it’s from this concussive episode?

Louise: I think, 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 piecing the puzzle together. 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. And you will often see a big shift in a person’s health from that point…

Andrew: Right.

Louise: …when they’ve had a knock to the head. And then, of course, someone who’s exposed to that regularly. There was a really interesting study done by Monash University, where they monitored AFL players, and they measured hundreds and hundreds of knocks to the head, significant, but only two were diagnosed concussions, so you can see how this is actually quite a bigger problem than what people realize. And probably the most important thing about talking about this is that people don’t know. People don’t know that, 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. And honestly, we’re seeing people die, Andrew. And that’s my biggest concern. People are dying. And it’s under the guise of mental health and other illnesses. Dementia and other neurocognitive disorders, MND. You know, CTE, we’re finding out about it posthumously. There’s some evidence now that there are NRL players living with CTE. We know it exists. We know it’s happening. We know what groups of people it’s happening in. And as a naturopath, we have tons of things in our toolkit to do something about this, to improve outcomes, to build quality of life, and things like that. So, it’s a critical conversation.

Andrew: 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 mum and dad…any health issues. It should be “have you had a knock?” Have you had some sort of concussion injury, including MVA, sport, da da da?

Louise: Yeah. Have you participated in sport?

Andrew: Yeah.

Louise: 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. And then you go, “have you ever had any accidents or injuries?” And they go, “Oh, no, not really. Oh, I had a concussion once.” And you go, “Right.”

Andrew: Right.

Louise: “Tell me when it was.” And then you can really start to piece things together. It does become quite obvious, in clinical questioning, that that is a turning point.

Andrew: Okay. So, you mentioned some of the long-term effects of post-concussive syndrome. Do we wanna delve any more into the inflammatory processes at play in the body? Or have we covered that?

Louise: I think we probably covered it. If we start talking too much about, like, inflammatory markers and mitochondrial dysfunction, like, we’ll be…we’re going into a biochemistry class.

Andrew: Well, we need to, though…

Louise: Yeah, yeah.

Andrew: …cover at least a little bit. So, can you take us through just a little bit of the biochemical dysfunction that’s going on?

Louise: Well, I think one interesting of the biochemistry that’s disrupted is that through that HPA axis. And so, that impacts your thyroid, your stress, and your sex hormones. 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. So, and, you know, a whole cascade of things can happen when testosterone is not balanced, from blood pressure to, you know, all the things. So, it’s not just even inflammatory markers, it’s all those communicators are disrupted as well, you know. And right into the mitochondria, just not functioning properly. Calcium channels. There’s so many things happening, that you really need to peel back the layers, bit by bit. And I think that persistent neuroinflammation is of great concern, because that’s burning away in the background. And those out-of-control interleukins and TFA and things like that as well.

Andrew: Okay. So, let’s go through, you know, I know this is gonna be a piece-of-string question, if you like, but if we could talk about, you know, the archetypical type, what sort of things… Forgive me. Let me rephrase that. Can you take us through, like, a presentation, from how they, a typical patient presents, to what sparks your interest in this? And then what’s their therapeutic journey? What sort of things do you do? What sort of investigations? How do you come to the conclusion? And even if you’ve got some case histories in mind, that you go, “Oh, this happened in this patient,” that’d be lovely.

Louise: Yeah. You make me think of a motocross competitor that I have as a patient. So, in motocross, it’s very common to come off your bike. It’s also very common that, at a competitive level, unfortunately, a lot of these incidents are not reported because it stops competition.

Andrew: Yeah, right.

Louise: And so we carry on. And 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. All kinds of bizarre, complex symptoms that you might not necessarily connect together immediately. 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 were okay.” And I’m like, “Okay. Maybe not.” And you can see, each time, they’ve progressively gotten worse.

Andrew: Right.

Louise: The recovery time has gotten longer, and the impact has been more significant. Now, down the track, this person’s gone, “Oh, you know, all these things I’m experiencing now, they must be something else.” Lots of gut issues. The list is long. 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? So, I would always be going to the gut first, pretty much, and find out who’s living inside that gut. Do we have gram-negative bacteria, that are producing lipopolysaccharides, traveling through the intestinal lumen, and then we’ve got toxic overload in the body, those endotoxins. That would be probably point one. Get the gut right first, and then everything else becomes a little bit easier, is… Yeah. Yeah. That’s my first point of call, really, because then everything else… And every person’s gonna be different. Every treatment journey’s gonna be different, but the one central thing is probably gonna be getting that gut right.

Andrew: Isn’t it interesting that science is catching up with nature?

Louise: Isn’t it? All the things that naturopaths have been going on about for centuries, now the evidence is coming through, which is great, because it gives a little bit of backing to what we’re saying as well. And then you see the results, when you get the gut right. Then you start to see progression in that person, and things really turn around for them, which is amazing to see because otherwise, they just think they have to live like that forever.

Andrew: Yeah. Yeah, that’s right. You know, Mike Ash said this years ago, and it was one of these, like you went, these pennies dropping everywhere. It was like a light bulb, or actually a piece of 4×2 to the head, seeing as we’re talking about concussion. And it was Mike Ash spoke about, and he said, “terrain is everything.” And it was one of those wake-up moments, where I had previously fallen into that, you know, there’s the problem. Treat the problem. Let’s do the little leaf-waving, doctor sort of thing. And that’s [crosstalk 00:22:12]

Louise: Yes, yeah.

Andrew: There’s the problem. Attack the problem, kill the bad bugs, you know? And it’s like, yeah, but they keep coming back, and all of this sort of thing. And it was like, if we fix the terrain that they’re living in, it probably won’t be as quick, but you get this, “No, no,” the body’s going, “it’s all right. We can do most of it. We might need your help a little bit, but we can do most of it. Just back off.” It’s really interesting, isn’t it?

Louise: That’s right. You’re spot-on. The terrain is everything. It really is. And you made me think, when you were speaking then, 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. Or, an athlete. What does an athlete do when they finish a game? They drink, you know, isolated whey proteins, those big, aggravating proteins, or isotonic drinks. And if the terrain is compromised, and if you’ve got increased intestinal permeability, you’re adding fuel to the fire. But if you think about the recreational footballer or the regional footballer, they might not be drinking the protein shake. They might be going to the bar.

Andrew: Right.

Louise: 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.” So, that’s, you know, that’s a whole ‘nother discussion…

Andrew: That is a whole ‘nother discussion.

Louise: …but something to be really, really aware of.

Andrew: I love the way you say AFL, and then the regional, and if the regional are any more drunk [crosstalk 00:23:48]

Louise: Well, I’m a country girl, so I know what goes on. I don’t think professional athletes are drinking pints after a game.

Andrew: That wouldn’t be [crosstalk 00:23:59] No.

Louise: They might. I don’t know.

Andrew: No, they’re soldiers. They are. They are, they’re like military. They’re machines. It’s just amazing what they put themselves through. And can I make one point, and we’re seeing this open up, thank you, thankfully, but this is not just males. This is females. You know, AFL and RFL females, holy crap, do they put 110% in.

Louise: Yes.

Andrew: I’ve seen them. Talk about machines, man. I’m out. I mean, they’re elite athletes. They’re just incredible.

Louise: I don’t think concussion and these repeated brain hits, they don’t discriminate based on gender. And they really are everywhere. And we need to enlighten people that this might be a real part of their health history, that’s impacting their health today.

Andrew: Yeah. So, let’s go into therapy. You know, we talk about treating the gut. What sort of things do you use? Are we talking about 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 anti-inflammatory action?

Louise: Probably a little bit of both. Absolutely, diet and intake can be a huge part of healing. And, you know, we’ve gotta feed the microbes that we wanna proliferate, all of those nice butyrate producers and things like that, the ones that are gonna give us benefit. So, yes, dietary intake does become a big part of the puzzle, but we need to get people feeling better quicker. So, there’s, you know, there’s supplements that might come to mind immediately, like we spoke about before, those ones that are being researched for migraines at the moment, your CoQ10 and whatnot. But there’s a whole host of things in the toolkit. So, saffron is a really interesting one, 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. So, that’s a key part of this puzzle here. And it interrupts that chronic inflammatory signaling, in the NF-κB pathway. So, downregulates that. And overall, it can enhance your cellular resilience, in the longevity pathway. So, that’s really helpful. It has been researched in, like, a mouse animal model, and it’s significantly improved behavior and cognitive deficits. So, it is something, you know, naturopathically, we might use often in neurodivergence. And this is like that link, that chronic low-grade neuroinflammation that we can see in neurodivergence, that we see in post-concussive people as well. We use it in mood disorders. So, you know, if you look at the mechanism of action of things, whilst they might…because the research only shows us what’s been researched.

Andrew: Yeah. Yeah.

Louise: And the research only shows us what it’s been researched against.

Andrew: Yes.

Louise: So, we have to put our detective cap on. 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. So, it is highly nuanced, and definitely a bit of detective work. And I think saffron in post-concussion, it can help with that microglial deactivation. So, bringing those down, the brain fog, all that kind of stuff that you feel, you know, that they often say they feel, like, zonked, you know, kind of like a bit of a zombie, like I’ve slept but I haven’t slept. Saffron, that’s where that can be really, really helpful.

Andrew: What about things like curcumin, fish oils, PEA?

Louise: Yeah, PEA is a nice one. We know that its primary mechanism is for anti-inflammatory effects, and that it works on the endocannabinoid system, so, that’s really, really supportive in this way. There’s some emerging research on GPR55 modulation. So, that’s emerging neuroprotective pathway research, so, we’ll watch this space on that. But we also use PEA for mast cell stabilization. Again, that deactivation of the microglial and the astrocytes. And pain, you know. There’s a lot of pain in an initial acute concussive injury. So we use that clinically in other applications for neuropathic pain, chronic pain syndromes, sleep disorders, all that kind of stuff.

Andrew: What sort of doses have you used with PEA in this condition? And can I ask, in indeed, other conditions? Because I found I used to have to chug it in a bit.

Louise: Yeah, I think, because it takes, I feel like it takes a little while to build up in the body. So, in a clinical setting, you might go pretty high to begin with, until someone stabilizes, and then you can kind of titrate it down to a maintenance dose. But it might be something that you use for a little while. But again, very, very case-by-case. And it’s probably not every case. It’s more, you know, if there’s persistent pain and things like that as well. If you’re just managing inflammation, you might look at your fish oils…

Andrew: Yeah.

Louise: …for that long-term, you know, you gotta play the long game as well.

Andrew: Yeah.

Louise: This isn’t a quick fix, because there’s lots going on. Specialized pro-resolving mediators, things like that.

Andrew: Yeah. And with omega-3s, do you really, you know, pump it into them, like, the higher dose? We’ve gotta change the omega-6 to omega-3s, certainly, but…Western diet. But…

Louise: Yes. Yeah.

Andrew: …you know, do we look at this anti-inflammatory dose, like, in rheumatoid arthritis, for instance, we’re really hammering the omega-3s. And you need these really high-dose concentrates?

Louise: Not necessarily. I would prefer to go consistently.

Andrew: Right. Okay.

Louise: Yeah. Because it’s not the only thing that you’re gonna be doing. You know, you’re gonna be doing other things as well.

Andrew: Right.

Louise: So, I would go, you know, a moderate, consistent dose, over time. And, you know, we all need a bit of fish oil in our life, right?

Andrew: Yeah.

Louise: Yeah. So, it’s definitely one you can take in the long term.

Andrew: And red emperor fish. Just saying. And of course, poster child of inflammation, curcumin. So, here’s something. How high do you go with this?

Louise: Oh, now, you have to really, you have to go right back into someone’s history for that, because you wanna know what their liver’s doing.

Andrew: Right. Okay. Good.

Louise: You can go too high with curcumin.

Andrew: I’ve done it.

Louise: We don’t wanna turn people yellow. Yeah, I’d wanna know what was going on in someone’s liver before, you know, high-dose curcumin. Again, like the fish oil, moderate, and over time, you know, maybe if it’s an acute, someone’s just had a knock yesterday, different story. But in the post-concussive, 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. But it is beautiful because, you know, it’s that COX-LOX inhibitor. Again, it crosses the blood-brain barrier. So, that’s very, very helpful for that microglial downregulation. And, double whammy, it’s good for the brain, it’s good for the gut, and it’s good for systemic inflammation. So, it is doing a lot of things. It ticks a lot of boxes. Yeah.

Andrew: Yeah. Yeah, yeah. What else was I thinking? Other things that we can use. Oh. Something that it isn’t really available in Australia unless medically, but a lot of people buy it overseas, certainly is overseas with great effect, melatonin.

Louise: I don’t clinically recommend it, because that’s out of my scope of practice. But, from my point of view, I’m going back down the chain, and making sure the foundations are right. So, I would go back, you know, back to the gut. What’s the brain doing? You know, what’s happening with glutamine in the brain, the glutamatergic activity?

Andrew: Yeah. So, you mentioned that then. So, glutamine. So, if we’re talking about gut, looking at one of the pillars of health, if we’re talking about gut healing and the terrain, you know, things like glutamine, the pectins, your slippery elms, the bovine serum immunoglobulins, things like that, all of these things that can help to soothe that gut lining, to just re-lay it. Are these the things you employ? Is that where you go?

Louise: So, I would say…I would caution glutamine.

Andrew: Okay.

Louise: I would caution glutamine, particularly in an acute injury, because adding glutamine, it does cross the blood-brain barrier, right? So, we could actually add a little bit of fuel to the fire, and increase that excitatory load.

Andrew: Glutamate. Yep. Yeah.

Louise: So, I would caution that. 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. But, serum bovine immunoglobulins, that you mentioned, and the terrain…

Andrew: Love this.

Louise: …this is…

Andrew: I love it.

Louise: I love it too. It’s really, really exciting. It’s endotoxin binding, so, we love that. Those lipopolysaccharide microbes, see you later. And it’s really supporting the terrain, that intestinal barrier support, and also immune-modulating. So, lots of clinical applications, but it’s so great, in an acute and a chronic concussive picture.

Andrew: Yeah, yeah. Just along those lines, what about things like, you know, probiotics? Saccharomyces boulardii? I mean, you know, if you’re talking about toxin binding.

Louise: Could be.

Andrew: Because, you know, this serum bovine immunoglobulin, I’ll stumble over these words, immunoglobulin.

Louise: Like “lipopolysaccharide.”

Andrew: Like, look, it’s not an inexpensive supplement.

Louise: Oh, it is expensive.

Andrew: It’s bloody good. But, like, it’s just, it’s always in my cabinet. Just, whenever I have a dodgy oyster or something, I’m like, “Oh, no.”

Louise: Bit of a ride-or-die supplement.

Andrew: It is. Yeah. But it’s just got such…

Louise: And it’s dairy-free. So that’s really key here.

Andrew: Yeah. That’s the thing. That’s the thing.

Louise: Yeah.

Andrew: But it’s got so many facets of action. But some people might balk at it. I get that. Nothing will take the place of me having SB. I will always have SB. Like, this… And I’ve gotta say, I recommend Saccharomyces boulardii probably 10 times more than any other probiotic, from what it does.

Louise: It is a really exciting… Well, it’s not technically a probiotic, is it? It’s a yeast.

Andrew: Yeah.

Louise: But 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. I think that’s really, really important. What was I… You just made me think of something, and it’s left me. But anyway. Go ahead.

Andrew: Oh, I know something. So, we were talking about certain other things that we can use. You know, there’s high-dose B1, B2, blah, blah, blah. What about, because we’re seeing this issue with the TGA at the moment, with high-dose B6. No naturopath worth their salt would use high-dose B6 without supplementing, in a very short time, with a complex, right?

Louise: Yeah. [crosstalk 00:36:58]

Andrew: What about using just the…yeah. What about using just the complex? Is that enough to help this post-concussive syndrome? You know, the activated Bs?

Louise: Like a B complex?

Andrew: Yeah.

Louise: It could be…it could have a role, absolutely.

Andrew: Okay.

Louise: It’s, I know what you made me think of. Prevention.

Andrew: Oh.

Louise: Knowing…

Andrew: An ounce of prevention…

Louise: An ounce of prevention.

Andrew: …is better than a pound of cure.

Louise: It’s knowing… We do have a lot of opportunity, maybe not so much when it comes to accidents and things like that. But when it comes to people who are in an environment where they know they’re at risk of head injuries, or repeated minor knocks to the head, because they’re just as bad as a concussion, is prevention, 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. So you’re kind of setting the scene for things to go a little smoother.

Andrew: Yeah.

Louise: That’s something really interesting, that is a complete departure from the way we usually think about these types of injuries.

Andrew: So, prevention if you can, and certainly early intervention, and earlier on in the therapeutic picture, rather than, “I got knocked out.”

Louise: Yes.

Andrew: Yeah.

Louise: Yes. Yep. Yeah, I think there’s a lot of optimization you could be doing. And because each [inaudible 00:38:31] rugby, football, whatever, all of those individuals have their own unique health factors. Some of them may have had childhood illnesses. Have they had Epstein-Barr virus, for example? We know that’s a bit of a stealth pain, when it’s activated. Neurodivergence. You know, that’s a whole ‘nother consideration, because we already know that those neurotransmitters work a bit differently. 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.

Andrew: Any other physical things that we can do? 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. I get it. You know, motorbike riders, by law, have to wear a helmet. Drivers have to wear a seatbelt, by law. La, la, la. But kids in the playground. You spoke about abuse. Now, there’s a whole…it’s not a podcast.

Louise: Yeah, that’s a mini-series.

Andrew: I mean, that’s a semester. That’s tragic. But, you know, are there any practical hints and tips that we can take home about prevention? Like, I guess, where am I going here? Things like FIFO workers? Military, maybe? Is there anything that we can maybe look for earlier, that we can go, look, you know, you’ve done a tour, you’ve come back, you’ve been on active duty, like, in the firing line, for X amount of weeks. How about we look at…what? [crosstalk 00:40:15]

Louise: Yeah. I think you could do a good naturopathic workup on all those people. Sleep would be a key piece.

Andrew: Yeah. Yep.

Louise: And that question might simply be, “how do you feel when you wake up in the morning?”

Andrew: Right.

Louise: Yes, you’re gonna ask all your other sleep questions, you know, sleep onset, are you waking in the night, all that kind of stuff. But how do you feel when you wake up in the morning? And if the answer is, “I just, I struggle to get up. I’m tired. I feel like I haven’t slept,” all 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 sleep? And I think of the glymphatic system. Have you heard of the glymphatic system before?

Andrew: Yep. Yeah.

Louise: Fun fact, only found in 2012. Love that. But, you know, it’s our waste clearance in the brain. And if you’re waking up feeling a bit foggy and sluggish, I’m wondering, are we clearing waste properly while you’re sleeping?

Andrew: Right. Yeah.

Louise: So, what’s happening? Are we sleeping deep enough? And, you know, research around the glymphatic system is still quite emerging. But we know, you know, good amounts of exercise, and deep sleep, are really, really important, that deep, restorative, restful sleep. So, that might be one thing that you could do as a preventative, to stop things escalating. One thing. [crosstalk 00:41:45]

Andrew: So, just along that lines then, and I know we’re sort of getting into the therapeutics again, but things like, you know, good old magnesium. Theanine? [crosstalk 00:41:56] herbs?

Louise: Yeah, L-theanine’s great. L-theanine’s great. Well, it’s great for sleep. We know that. And it’s also really, it’s calming, so, calming those excitatory factors. So, it does tick a few boxes there. And, you know, we can supplement that easily.

Andrew: Tastes good.

Louise: Well, yeah.

Andrew: Tastes good. Even kids will take it. Tastes good.

Louise: Yeah. Sometimes you can get it in…or you could encapsulate it if you needed to.

Andrew: Yeah, you don’t need to.

Louise: There’s all those kind of things too.

Andrew: Tastes good.

Louise: But it’s gonna help with the enhancing GABA, and, you know, your melatonin pathways and things like that. So, that’s what I mean, you go further down the chain of events before jumping straight to melatonin.

Andrew: Hmm. Yeah.

Louise: I think it’s always a helpful way to do it. Yeah. And, you know, that alpha wave production that L-theanine is beautiful for, that’s gonna help glymphatic clearance, restorative sleep. There’s so many weaves and turns you could take, but if I had to say one thing, yeah, that would be helpful.

Andrew: Cool. I mean, there’s so much to learn of this, and it’s sort of, it’s pinging questions left, right, and center, but I love the way you keep coming back. It’s like, “No, no. Andrew, come on. Come back. Come back to this naturopathic tenet, the foundation.” And I love that, because it seems like a broken record, but we need to do this, because we keep being drawn. And so, “No, no, no, no, no, no, no. Come back,” you know?

Louise: Yeah.

Andrew: It’s really good [crosstalk 00:43:31] I love it.

Louise: Foundations first, I think.

Andrew: Yeah.

Louise: Yeah. Like I said before, you get the gut right, and then everything else becomes a bit easier. 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. So, there is no, you know…we could talk about this, so many supplements and things we can talk about, but there’s not a one size fits all. So, what’s gonna be right for you is gonna be different for the next person and the next person. But such an exciting thing to talk about. 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. That’s the big thing, because then you circle back to all the underreported concussions.

Andrew: Hmm. Louise Cork, I love your work. This is fantastic stuff. And as you say, it’s a critical conversation we need to have. So, well done to you. I should say, well done to your brothers.

Louise: Thanks.

Andrew: No, well done to you, for awakening to this critical area of need in the…it’s not the community. It’s really the sort of…

Louise: It’s in the world.

Andrew: It’s in the world. Yeah.

Louise: It’s in the world. Yeah.

Andrew: So, yeah. It’s good stuff you’re doing. I love it. It’s brilliant. Thank you so much for joining us on “Wellness by Designs.”

Louise: Thank you so much for having me.

Andrew: And thank you, everyone, for joining us today. I’m Andrew Whitfield-Cook. You can catch up on all the other podcasts on the Designs for Health website. We’re gonna be putting up a heck of a lot of show notes for this, because there’s really interesting areas in this. 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, that’d be great. That’d be awesome.

Louise: Yep. Whatever you need. Happy to help.

Andrew: Thanks so much for joining us. Thanks, everyone.