Nutrition. Vitamins. You.
Written by: Dr. Claire Arcidiacono, ND For further questions or concerns email me at [email protected]† In our last blog we started talking about Alzheimer disease. We began our discussion with talking about what it is, how it affects the brain and also what are the …
Written by: Dr. Claire Arcidiacono, ND For further questions or concerns email me at [email protected]† Dementia is a complex issue that concerns many people. Dementia is a complex topic because not only is it considered by many to be a neurocognitive disorder on its own, but …
Written by: Dr. Claire Arcidiacono, ND
For further questions or concerns email me at [email protected]†
In our last blog we started our conversation regarding brain health talking about different conditions that you should rule out when experiencing memory changes. This week we will be delving into more neurologically based tests. Let’s start with recommended blood tests. When you visit your doctor, they may recommend some or all of the following tests. To start with a simple CBC or complete blood count. Included in a CBC is white blood cells, red blood cells, hemoglobin and hematocrit. The next test is a CMP or comprehensive metabolic panel. This panel includes sodium, glucose, bicarb, creatine, BUN, and liver function tests. As I mentioned in my prior blog thyroid hormones as well as certain vitamins may also be tested. † (1)
Depending on what the doctor suspects is causing the memory / brain changes they may also recommend what is called a cerebrospinal fluid exam. (Remember this? It is that fluid that is around your brain that brings nutrients and collects the brains waste!). The doctor will collect the cerebrospinal fluid by doing a lumbar puncture or spinal tap. This is possible since in addition to surrounding your brain the cerebrospinal fluid (CSF) also surrounds the spinal cord. Once the CSF has been collected a number of tests can be performed. CSF tests can be used to indicate if there is rapid injury to nerve cells in the brain. A CSF is highly recommended in all cases of rapidly progressive dementia. It is also suggested if Creutzfeldt-Jakob disease is suspected, by collecting CSF, it allows us to study brain markers from living humans. Current research has found certain CSF markers to be reliable in helping detect early Alzheimer disease. The more we study these markers the more we find markers associated with degenerative disease and thus we are able to diagnose these conditions earlier. † (2)
In addition to blood tests and CSF tests the doctor may recommend certain scans. I know that these tests can be intimidating. It is important to discuss any fears you may have. I know that some people are concerned with radiation, any dye that is used as well as suffering from claustrophobia induced anxiety. Feel free to call an Invite nutritionist to talk about your concerns. Anyhow on to the tests! The first test that the doctor may recommend for dementia is called a magnetic resonance imaging or MRI. An MRI produces images of the inside of the body using magnetic fields and radio waves rather than X-Rays. It is considered to be non-invasive. While an MRI can be done without contrast in some cases the doctor may recommend its use. For example, contrast can help with the visibility of tumors, inflammation and it can help us see the blood vessels better. An MRI can help your neurologist diagnose several different brain conditions. These include dementia, stroke, aneurysm, brain hemorrhages, infections, MS, cancers and traumatic brain injury. In summary an MRI can detect inflammation, swelling, structural issues, growths, fluid leaks, bleeding and any white matter disease. † (3)
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Another type of structural scan that the doctor may recommend is a computed tomography or CT scan. This is very similar to an MRI. However, it does involve x-rays unlike the MRI. Additionally, the image produced is not as clear as the image produced by an MRI. †
There are 3 types of functional (rather than structural) scans that your doctor may suggest. The first is a SPECT which shows how blood flows through the brain. A radioactive material is injected into a vein and then a scanner tract the material as it flows through the brain. When there is any disease in the brain there is usually less blood flow/ circulation.†
Now I know that I already spoke about the MRI but there is a special type of MRI called a functional MRI (fMRI). This is used to show any changes in circulation to the brain. It is performed in a similar way to a traditional MRI. †
Lastly your doctor may recommend a PET scan. What this scan looks for is how much energy is used by the brain. This is very similar to the SPECT scan in that it also uses a radioactive material that is “tracked” through the brain. This test can help detect such things Amyloid protein which is a sign of Alzheimer disease. † (2)
In addition to these tests, it is important for your doctor to do a complete history. This includes neuro-psychological testing. This is the most common screening tests and takes approximately 5 minutes. The abbreviated mental test score (AMTS) helps to detect possible dementia and includes 10 unique questions such as your address and date of birth. Another screening test is the mini cog which usually takes approximately 3 mins. A more sensitive screening test is known as the general practitioner assessment cognition (GPCOG). This involves an interview with both the patient and someone who knows the patient well. Lastly there is the Montreal cognitive assessment which consists of 30 questions takes approximately 10 minutes to complete. (4) In a 2021 study the MCA was found to be a better measure of cognitive function than the MMSE. † (5)
ICYMI:DAILY FOCUS & MEMORY SUPPORT JUST GOT EASIER, INVITE HEALTH PODCAST, EPISODE 648>>LISTEN NOW!
When seeking a consultation with an Invite nutritionist, it is important to bring a food log for 1 week including any liquids you consume. It is also important to include a list of any medications and supplements you are taking. †
Next week we will be starting more condition blogs and we will start off with one of the most common, which is dementia. †
REFERENCES
Subscribe Today! Please see below for a complete transcript of this episode. FEELING FRAZZLED? GET FOCUSED! INVITE HEALTH PODCAST, EPISODE 650 Hosted by Amanda Williams, MD, MPH. *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast, where our degreed health care …
Subscribe Today! Please see below for a complete transcript of this episode. DAILY FOCUS & MEMORY SUPPORT JUST GOT EASIER, INVITE HEALTH PODCAST, EPISODE 648 Hosted by Amanda Williams, MD, MPH. *Intro Music* InViteⓇ Health Podcast Intro: [00:00:04] Welcome to the InViteⓇ Health Podcast, where our …
Written by: Dr. Claire Arcidiacono, ND
For further questions or concerns email me at [email protected]†
In our last blog we completed our talk about brain anatomy. Today we will be expanding on this topic by delving into what type of blood work/ testing you should talk to your doctor about if you have any concerns regarding your brain health/ memory. Now this topic will be split into 2 parts. When it comes to brain health/memory there are a number of chronic conditions that can cause concerns with both brain health/ memory. There are also distinct illnesses that can affect the brain, for example dementia. To start with in this blog, we will be reviewing the tests that can help rule out the chronic conditions that can affect memory and brain health.
Interestingly simple dehydration can affect memory especially if it is chronic. One question I always ask people is how much water are you drinking a day? A simple equation to know how much water your body needs is to take half your body weight and drink that amount in ounces. For example, if you weigh 160lbs you would drink 80 ounces of water per day. The next question I always ask people is what prescription medications are you taking? This is important because as we know some medications can affect memory. This is especially a problem for those talking multiple prescriptions since the effect of medications on memory can be cumulative. Unfortunately, with many prescription medications they can have series side effects if they are stopped abruptly. It is always important to talk to your doctor about changing or weaning off of any medications you are having side effects from taking. † (1)
Memory/brain health can also be affected by certain psychological conditions. For example, many of the symptoms associated with depression can mimic signs of dementia. (2) Individuals with frontotemporal dementia (FTD) are often misdiagnosed as having depression since they both present with apathy and emotional withdraw. † (1)
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Chronic alcoholism also mimics dementia because of a number of different reasons. As we know chronic alcoholism can deplete certain nutrients that cause dementia like symptoms. Chronic alcoholism can also lead to dehydration which as we know can mimic dementia. Chronic alcoholism can also cause damage to the brain and can affect the brain’s ability to form new memories. Proper treatment could help the brain’s ability to from new memories if it administered early enough. † (3)
Certain infections can also affect the brain/ memory. For example, untreated syphilis can affect the brain leading to dementia like symptoms. (4) Lyme disease can also become a chronic illness if it is not treated properly. Chronic Lyme disease can affect the white matter of the brain leading to memory problems. (5) In addition to chronic Lyme more studies every day are finding a link between chronic COVID and memory changes. (6) Additionally, meningitis and encephalitis can lead to memory changes. † (1)
Certain nutritional deficiencies can affect brain health and thus cause memory problems. A deficiency of B1 or thiamine can cause something called Wernicke-Korsakoff syndrome. One of the signs of this syndrome is altered mental status as well as changes in memory. (7) A long-term deficiency of vitamin B3 or Niacin can also cause pellagra which has dementia as one of its defining symptoms. (As fun fact Pellagra symptoms are called the 3D’s – dermatitis, dementia and diarrhea). (8) Having a B12 deficiency can also cause cognitive changes. If you are anemic for a long time the symptoms can resemble dementia. Additionally, any changes in sodium, calcium and even healthy fats can affect our brain and thus our memory. † (1)
Certain chronic conditions can affect the brain and therefore affect memory. Celiac disease according to studies can affect the brain causing memory problems. (9) As I mentioned in my last series certain chronic autoimmune disorder such as SLE can cause symptoms that mimic dementia. (10) If you read my series on thyroid, you may recall that hypothyroidism can also have symptoms that can mimic dementia. (1) For more information on this please see my blog on hypothyroidism. Another topic that I have covered in prior blogs is blood sugar. Having low blood sugar can cause symptoms that can mimic dementia. However, as you may recall from my series on blood sugar having high blood sugar can also lead to problems with brain health. (1) For more information on how to talk to your doctor about SLE, hypothyroidism, and blood sugar irregularities please see my prior blogs on these topics. †
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In this blog I have covered the most important conditions that need to be ruled out when it comes to memory/ brain health. Taking to your doctor may reveal other chronic conditions that need to be ruled out. In my next blog I will be focusing on tests that are directly linked to the brain and to memory. I wanted to start with tests that rule out chronic conditions because if you have any underlying condition causing the symptoms it must be addressed first in order for your memory to improve. As I always say if you have foot pain due to a rock in your shoes you need to remove the rock before true healing can occur. The same is true for memory/brain health. In my next blog I will focus on more brain specific tests that you should talk to your doctor about. †
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