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Seven Key Trends in Brain Health

Jun 1st 2023 | By Craig P. Tanio, MD, FACP, IFMCP

doctor holding brain in his hand

Optimizing brain health is an area that is critical to achieving the goals of the vast majority of our patients and community including those who are interested in addressing:

· Neurodegenerative diseases such as mild cognitive impairment, Alzheimer’s, Lewy Body and Parkinson’s – both prevention and active treatment

· Longevity – a number of clinical interventions that can potentially address longevity can have a direct impact on brain health and their effectiveness can be tracked in that manner.

· Mood Disorders – improving brain health and brain cellular health can have a dramatic impact on mood disorder

· Fatiguing illnesses – the root cause of most fatiguing illnesses (e.g., CIRS / Lyme / Long Covid) seem to be centered into molecular processes that involve the brain

In preparation for the Evanthea Clinical Trial on Reversing Cognitive Decline that Rezilir is participating in (, we have done a substantial review of clinical interventions that can have an impact on brain health.

Memory Loss Reversal Trial Information

This week, we would like to highlight seven trends in brain health that have emerged from the research that have a significant impact on clinical care. We will go deep into one of these trends and will explore the remainder of these trends in future newsletters. The top 7 of these are as follows.

7 Key Trends in Brain Health:

1. The Inflamed Brain: Research reveals considerable overlapping biologic mechanisms in conditions ranging from Long Covid, ME / CFS, CIRS, Lyme / Tick-borne Illnesses to mild cognitive impairment, Alzheimer’s, Lewy Body, ALS and multiple sclerosis. Insights from one area of research such as Long Covid may provide considerable utility in the care of patients with other conditions. Deeper understanding of these biologic mechanisms may help tailor personalized interventions for individuals with these conditions.

2. Tackling Inflammation: Since neuroinflammation is a common pathway in many of these conditions, there continues to be more research including randomized controlled trials that show the effectiveness of interventions that address neuroinflammation such as Hyperbaric Oxygen Therapy to improve brain health and cognitive function in a variety of conditions.

3. Boosting Circulation: New findings show that addressing vascular inflammation and improving blood flow with agents like nattokinase and CGRP antagonists can have positive effects on brain health in a number of conditions.

4. The Exposome Connection: Research highlights the growing importance of environmental factors, including exposure to toxicants such as mold, air pollution, heavy metals, and chemicals, in affecting brain health and cognitive function.

5. Enhancing Autophagy: Studies show that interventions that promote autophagy, the body’s natural process for clearing damaged cells and proteins, can play a crucial role in clearing abnormal proteins such as spike protein, amyloid, tau and synuclein, thereby maintaining a healthy brain.

6. Addressing Chronic Infections: Exciting research on drugs like Dapsone highlights the importance of treating chronic infections to prevent Alzheimer’s and support overall brain health.

7. Precision Medicine Initiatives: Programs like the Cincinnati Cohort Biomarker Program are putting together deep databases that should be extraordinarily helpful in identifying biomarkers and mechanisms in Parkinson’s and Alzheimer’s to pave the way for personalized treatment approaches. There are an increasing number of initiatives such as the Evanthea Trial to start to test precision medicine approaches in brain health.

The Inflamed Brain


Let’s start today with the Inflamed Brain. As research starts to accelerate on the mechanisms of Long Covid / Post Covid syndrome it is becoming clear that there is considerable overlap in the biologic mechanisms underlying Long Covid and other fatiguing illnesses such as ME/CFS, CIRS and Tick borne illnesses as well as other neurodegenerative conditions such as mild cognitive impairment, Alzheimer’s, Lewy Body, Parkinson’s, ALS and neuroautoimmune conditions such as multiple sclerosis. These overlapping mechanisms include the following.

· Neuroinflammation: Research shows that neuroinflammation is a key factor in the progression of many conditions, such as Alzheimer’s disease, Long COVID, and ME/CFS. In these conditions, the immune response leads to an increase in pro-inflammatory cytokines, which may contribute to ongoing neurological symptoms.

· Oxidative stress: Oxidative stress is a common thread in these conditions. The inflammatory response to infections, such as SARS-CoV-2, can result in increased production of reactive oxygen species (ROS), leading to cellular damage and fatigue. In Alzheimer’s disease, oxidative stress is thought to be an early event contributing to neuronal dysfunction and death.

· Vascular dysfunction: Vascular dysfunction has been observed in both post-COVID syndrome and Alzheimer’s disease. In post-COVID syndrome, endothelial damage and inflammation can lead to vascular complications, which may contribute to neurological symptoms. In Alzheimer’s disease, vascular dysfunction is thought to play a role in disease progression, with impaired blood flow and reduced nutrient delivery to neurons contributing to neuronal dysfunction and death.

· Mitochondrial dysfunction: Mitochondria play a crucial role in energy production, and their dysfunction has been proposed as a contributing factor in both CFS/ME and AD. In CFS/ME, impaired mitochondrial function may lead to reduced cellular energy production and increased fatigue. In AD, mitochondrial dysfunction is associated with increased oxidative stress, impaired energy metabolism, and neuronal death.

· Blood-brain barrier (BBB) dysfunction: The blood-brain barrier plays a crucial role in protecting the brain from harmful substances and maintaining homeostasis. There is evidence that SARS-CoV-2 infection can lead to BBB dysfunction, which may contribute to neurological symptoms in post-COVID syndrome. In Alzheimer’s disease, BBB dysfunction has also been observed and is thought to contribute to disease progression.

· Impaired autophagy: Autophagy is a cellular process responsible for the degradation and recycling of damaged organelles, proteins, and other cellular components. Impaired autophagy has been implicated in both ME/CFS and AD. In ME/CFS, reduced autophagy may contribute to cellular dysfunction, while in AD, impaired autophagy is thought to be involved in the accumulation of toxic proteins, such as amyloid-beta and tau.

· Cognitive impairment: Both post-COVID syndrome and Alzheimer’s disease are associated with cognitive dysfunction. In post-COVID syndrome & ME/CFS, individuals may experience difficulties with memory, attention, and information processing. In Alzheimer’s disease, cognitive decline is more severe and progressive, affecting memory, language, and executive function.

· The exposome: Many studies suggest that exposure to environmental toxins (e.g., molds, indoor & outdoor air pollution, heavy metals, pesticides) or reactivation of chronic infections (e.g., HHV6, EBV) can play a role in either triggering the initial condition or enabling ongoing inflammation that contributes to the likelihood of developing long-term symptoms.

The implications of these findings are significant:

· Most of these conditions will likely require a precision medicine-based, multi-modal set of interventions.

· Research in one area will likely have benefits in other areas; however, there aren’t as many clinicians who work in both cognitive impairment and ME/CFS.

· Staying closely in touch with the latest research will enable us to more precisely adjust the “N of 1” medicine that we do with many of our patients.

In the upcoming weeks, we will continue to explore each of these trends as well as share practical strategies for implementing interventions that can improve your brain health. As always, we welcome your feedback and questions, so please let us know how we’re doing and what you’d like to hear more about.  Please email us at In addition, please subscribe to our weekly newsletter for updates, tips and other exciting information we want to share with you. You can subscribe on our homepage at

Yours in health,

Dr. Craig Tanio & the Rezilir Team

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