Have you ever been sitting on the sofa, riveted by a movie, and find when you get up to get popcorn that your foot is asleep?

It feels prickly, even partly numb, or it can even be a bit painful as you limp around trying to restore circulation.

That is a tiny bit like neuropathy.

What is Neuropathy?

When you examine the root words for “neuropathy,” you will find that it means “nerve disease” or “nerve suffering.”

Our nerves communicate signals in our body, such as take a step or reach out your hand. They also carry communication back from our touches regarding perception—the doorknob is cold, the knife is sharp.

When nerves are inflamed, damaged, and/or blocked, uncomfortable signals can be generated and cause a lot of distress.

Symptoms of Nerve Damage

Nerve pain runs the gamut from irritating to excruciating. If the nerve damage is severe, it may cause a total lack of sensation.

Losing sensation sounds better than pain, but it is dangerous. If you cannot feel the cut on your foot, you may let it go until it is infected or even life threatening. Lack of sensation disrupts your balance and can cause serious falls.

Types of Neuropathy

There are four types of neuropathies, each named for the area they affect.

The best known is peripheral neuropathy, which affects millions of people in the US.

We see peripheral neuropathy in areas of the body that have challenging circulation, farthest from the heart, like the lower leg and foot, though sometimes hands and fingers can be affected.

Causes of Neuropathy

Neuropathies can develop from:

• drug toxicity (chemotherapy)
• nutritional deficiencies
• autoimmune conditions
• circulatory disorders
• traumatic injuries
• infections
• metabolic conditions
• diabetes

Unfortunately, nerves are one of the slowest tissues in the body to repair. Peripheral nerves regrow at a rate of only one inch or less per month. The process of nerve regrowth is impaired even further by chronic and inflammatory conditions, like diabetes.

Diabetes

The most common cause of peripheral neuropathy is diabetes. In fact, it is estimated that over 40% of people with diabetes will develop diabetic peripheral neuropathy, which is the most common complication associated with diabetes.

The abnormally high level of sugar in the blood stream is irritating to the nerves and can cause inflammation. High blood sugar also inflames blood vessels, especially the tiny capillaries, and impedes circulation to the nerve tissue, cutting it off from oxygenation and nourishment.

The best thing you can do for diabetic peripheral neuropathy is to keep your blood sugars as close to normal as possible at all times.

Nutrients to Fight Neuropathy

There are nutrients that have been shown to play an important role in prevention and treatment of neuropathies, and that can improve nerve health, repair, and function.

• Alpha Lipoic Acid (ALA)

  Alpha lipoic acid is a potent antioxidant that has been clinically studied for its positive impact on diabetic neuropathy. ALA is unique because it can neutralize free radicals that are water and fat soluble, offering ideal protection for the nerves from oxidative damage.

  In a 2018 study, patients were given 600 mg per day of alpha lipoic acid for 40 days. Patients were scored on their neuropathy symptoms, pain, quality of life, and disability levels. There were significant improvements in all parameters measured.

  There was:

  • a 58% reduction in people experiencing burning
  • a 41% reduction in people experiencing painful coldness
  • a 60% reduction in people feeling electric shock
  • a 46% reduction in people experiencing tingling
  • a 58% reduction in people feeling pins and needles
  • a 50% reduction in people experiencing numbness

  Plus, half of the patients felt their health condition was “very much better” or “much better” at the end of the study.

  Another study on alpha lipoic acid demonstrated that 600 mg twice per day increased peripheral insulin sensitivity in people with type 2 diabetes, which is important with diabetic neuropathy.

• B Vitamins

  Research demonstrates that deficiencies in B vitamins, especially B1, B6, and B12, can lead to neuropathy. The use of these vitamins to treat neuropathy can be found worldwide.

  Studies

  A combination of these B vitamins was studied for its effects on symptoms of peripheral neuropathy. Improvements were noted after just 14 days of use.

  Patients were given 100 milligrams (mg) of vitamin B1, 100 mg of vitamin B6, and 5000 mcg of B12 once per day for 12 weeks.

  At the end of the study, the participants noticed a 55.9% average reduction in numbness, 64.7% average reduction in stabbing pain, over 80% reduction in burning pain, and a 62.9% reduction in total symptom score. Subjective feelings of pain also reduced by over 69%.

  • Thiamin

    There is a fat-soluble form of thiamin (vitamin B1) that is better absorbed and that stays active in the blood stream much longer called benfotiamine.

    A study on this interesting vitamin form found that 200 mg (50 mg dosed four times per day) significantly reduced neuropathy scores in three weeks.

    Participants also experienced a significant reduction in their pain.

  • Folate

    It has also been found that folate deficiency increases the risk of peripheral neuropathy, especially in people less than 40 years old.

    Folate deficient people (folate levels less than 6.8 nmol/L) under 40 are 83% more likely to have peripheral neuropathy than those of a similar age who are folate sufficient (folate levels >13.6 nmol/L).

    The methylfolate form of folate is a better supplement than folic acid, as it does not have to be converted in the liver.

    Many people are not good at converting folic acid to folate, especially older adults and those with metabolic disorders such as diabetes.

  Medications and B Deficiency

  Another cause of neuropathy is from medications, like statins that are used to lower cholesterol.

  Please remember that I am not encouraging or discouraging the use of medications. That is a discussion for you to have with your healthcare practitioner. I am saying that you need to think about nutrient supplementation if you are currently on these kinds of drugs.

  • Statins

    One study found that there is up to a 14-fold increased risk in developing neuropathy for people taking statins versus people not taking statins.

    For those on statins, the neuropathy may or may not be reversible, depending upon when it’s diagnosed.

    When statins were combined with niacin (vitamin B3), there was more than a 3-fold reduction in development of neuropathy.

  • Metformin

    Another drug that can cause vitamin B issues is metformin. People using metformin for type 2 diabetes are more likely to be vitamin B12 deficient, and that risk increases about 13% each year a person takes metformin.

• Minerals and Herbs

  • Zinc

    Zinc deficiency has also been implicated in the development of peripheral neuropathy.

    One of the mechanisms involves oxidative damage to lipids and other molecules in the body. People with type 2 diabetes and zinc deficiency have decreased nerve conduction in motor and sensory nerves throughout the body, which is never a good thing for neuropathy.

    Chelated Zinc

    All forms of zinc are not equally absorbable. Zinc chelated to an amino acid (one form is zinc glycinate) has better absorption, and better absorption increases efficacy.

  • Boswellia

    One herb of great interest for neuropathy is boswellia.

    • 5-LOX Inflammation

      Boswellia is unique because it targets a type of inflammation called 5-lipoxegenase (5-LOX).

      This is a type of inflammation that does not respond to over-the-counter anti-inflammatory drugs like ibuprofen or aspirin, or even prescription drugs in the class of non-steroidal anti-inflammatories (NSAIDs). It is a different type of inflammation.

      Boswellia has many studies showing that it has a very high level of activity against 5-LOX inflammation.

      5-LOX is seen in:

      • inflammatory lung diseases
        • asthma
        • emphysema
      • inflammatory intestinal diseases
        • colitis
        • Crohn’s
        • irritable bowel syndromes
      • certain kinds of joint pain
      • nerve inflammation

    • Vincristine

      Scientific research has shown that boswellia can be effective for neuropathic pain from the chemotherapeutic agent vincristine through its anti-inflammatory effects.

    • Schwann Cells

      Boswellia has also been studied for its positive effects on nerve recovery by increasing the proliferation of specialized nerve cells, called Schwann cells that help guide the recovery of damaged nerves.

    Boswellia vs Frankincense

    Some people call boswellia “frankincense” but they are not exactly the same.

    Frankincense is usually the term for the essential oil extraction of boswellia resin.

    Boswellia used according to Ayurvedic practice is a different extract of boswellia resin designed to be used in an oral form.

The More, The Merrier!

While all of these nutrients have individual activity, they work quite well together to address neuropathy. It may be more effective to take them in combination.

Also, anything that reduces abnormally high blood sugars is useful, too, like:

• Hintonia latiflora
• cinnamon
• berberine
• vanadium
• chromium

Take care of your nerves, and they will take care of you.

When Daniela Djordjic brought her son in to get his shots that September day in 2000, she was understandably nervous. Just two weeks earlier, 2-month-old Jovan had been rushed to the emergency room after he turned blue during a crying fit. Doctors intubated him until he stabilized, and sent him home a few days later with a diagnosis of whooping cough.

Except Djordjic and her husband, Voya, had never noticed a cough. They kept vigil over Jovan, jumping to soothe any sign of discomfort before it could turn to tears.

At the pediatrician appointment, the crying and choking began again. Lynn Porter, MD, called code blue, and what seemed like “the whole hospital ran in,” recalled Daniela, now 49, at her home in Peabody, MA. “He almost died endless times. It was very stressful, and I was lost.”

ICU doctors at Tufts Medical Center in Boston struggled to determine the problem. Jovan, who had seemed small and quiet but normal, could no longer breathe on his own. He needed almost constant sedation with Fentanyl to keep him from ripping the intubation tubes from his mouth and nose. Each time the doctors removed him from the ventilator, Jovan could only make it a day or night on his own. So much blood was pulled for testing that he needed transfusions, but a diagnosis remained elusive.

Three months later, the 28-year-old parents, both refugees from the Bosnian War, were given two options: A tracheostomy tube could be inserted in the baby’s neck so they could stop sedating him; or they could remove him from the ventilator and do nothing. “It’s your decision,” the doctor said.

“Do we want to pull the plug?” said Daniela. “I try to block that memory. How can you say, ‘I don’t want my child to live’? We said, ‘Of course we want him to live,’ with the hope that things will change. We still didn’t even know what the condition was.”

Muscle samples taken from Jovan’s hand during the trach surgery revealed missing cells in his myelin, the protective sheath around nerves that allows the brain to communicate to muscles. Doctors predicted Jovan would remain ventilator dependent and start losing his ability to move. The Djordjics sought a second opinion. That doctor ran more tests, verified that Jovan would become paralyzed from the neck down due to polyneuropathy, the malfunction of many peripheral nerves. He ran a vocal cord test that, because one of the cords was paralyzed, meant there was a 50 to 70 percent chance a future child would have the same genetic mutation. He estimated Jovan would live a year.

The prognosis confused Daniela. Why would Jovan die so soon if he was already on life support? The doctor explained that many infants with complex medical conditions develop pneumonia and respiratory problems they can’t survive, even on a ventilator.

Trach surgery was in early December. On New Year’s Day, 2001, Jovan was sent to Franciscan Children’s Hospital in Brighton, MA, a long-term pediatric rehabilitation facility, where his parents began learning how to care for him. A few months later, surgeons inserted a gastrostomy tube into the 9-month-old’s stomach so he could be fed nutritional formula that way. In October 2001, more than a year after his first hospitalization, Jovan finally came home.

Home Is Where the Heart Is

By then, the Djordjics were living in a tiny two-bedroom apartment in Somerville, MA. “Their apartment looked like an ICU,” said Kathleen “Kathy” Ryan, a former case manager with Home First, a program funded by the Massachusetts Department of Developmental Services to help families whose children qualified for living in pediatric nursing homes.

“At the time, there were only three pediatric nursing homes in the state,” Ryan said. “The department had finally gotten the message that people should not grow up in nursing homes. Voya and Daniela were working really hard at keeping Jovan alive and out of the hospital.”

Ryan understood the challenges of navigating medical services because of her own experience caring for a profoundly disabled son. She became a trusted resource for the overwhelmed couple, helping them obtain items they needed for Jovan's care, such as a wheelchair van. The couple had no idea they could be reimbursed for certain expenses, which added up quickly.

As predicted, Jovan began losing his ability to move. In a slow progression, he lost movement in his legs, then his fingers, then his arms, becoming a quadriplegic by age 8. In terms of what Jovan has lost, nothing has changed since then. However, what he’s gained is something of a miracle, thanks to his medical team, modern technology, the devotion of his family and caregivers, and maybe, just maybe, his mother’s homemade soup.

Getting a Diagnosis

Despite the prediction that Jovan would likely die before age 2, he turned 21 in 2021, the same year he finally received a more precise diagnosis than the earlier one of polyneuropathy. The medical mystery was solved during an appointment with a neurologist new to the family. He asked many questions about Jovan’s early life and family history. When he asked Daniela and Voya to remove their shoes, he knew he had the answer. Voya’s high arches—which run in his family—are a classic symptom of Charcot-Marie-Tooth disease, CMT, for short.

Caused by genetic mutation, Charcot-Marie-Tooth, pronounced (shar-KO mä-ré tooth), is a progressive nerve disease named for the three physicians who first described it in 1886. CMT damages the peripheral nerves that extend to the feet and hands, and interferes with the brain’s ability to communicate with muscles. Many people with CMT experience muscle pain, hand tremors, cold hands and feet, chronic fatigue, and develop trouble walking. Most have a normal lifespan, only very rarely do they have breathing problems. Jovan seems to be among the most extreme cases.

At an appointment in 2021, one of Jovan’s doctors asked Daniela, “How is he still alive?” After listening to her daily routine, which includes feeding him homemade food through his G-tube, he remarked, “I think it’s the nutritious food you’re giving him every day,” recalled Aleksandra “Aleks” Samardzic, Daniela’s older sister.

When members of his CAPE (Critical Care, Anesthesia, Perioperative, Extension and Home Ventilation Program) team from Boston Children’s Hospital attend conferences and discuss their “against all odds” cases with peers, they always talk about Jovan.

“He is the only one who eats food,” Daniela said. “He, knock on wood, has never had any bed sores. His skin is so good. And he’s been healthy.”

Beyond Canned Nutrition

When Jovan got home in 2001, Daniela fed him Peptamen Junior, the same canned nutrition the hospitals used. These formulas typically contain whey protein, fiber, medium chain triglycerides (MCT), and are fortified with vitamins and minerals.

“He did not tolerate the canned liquid food very well,” Samardzic said. “He had constant diarrhea. First, she tried to adjust the feeding times and quantities, but that didn’t help.” One day in 2002, when Jovan was 2, Aleksandra and Daniela’s mother, Javorka Vujnovic, who was living in the United States at the time, wondered aloud, “Why don’t we just give him some chicken soup?”

“I looked at her and said, ‘That’s not a bad idea,’” Daniela said. The memory still makes the sisters laugh.

This strategy of figuring things out as they went along, even without a true diagnosis, resonates with Ryan. “In the beginning, you really, really, really want to know. Then you realize your child is going to tell you who they are, and you’re just going to have to respond to their needs as they go along in life, and I think that’s what they’ve figured out. I mean, this family is so darn clever.”

Jovan’s doctor was not opposed to his eating food, only concerned it would not be nutritionally sufficient. Daniela began feeding Jovan some homemade food and a can of Peptamen Junior per day. Not only did his bowel movements stabilize, but his skin grew healthier, and he looked happier.

She began experimenting more and more with the food until she was able to wean Jovan from the Peptamen Junior.

“Mothers feeding children is extremely important,” Ryan said. “That’s why people are so resistant to G-tubes when they’re told their children have to get them. We’re wired to feed our children. Daniela’s a good cook, and she wants him to have good, healthy food. He can’t taste a thing, but it doesn’t matter to her.”

Over the years, Daniela perfected a food plan that met Jovan’s nutritional needs and caused no digestive discomfort. Many ventilator-dependent children struggle with digestion. Because of this, when Jovan’s G-tube was installed, the surgeon cut a muscle on the side of his stomach to move food into his small intestine faster. Unfortunately, Jovan developed a dumping syndrome, also called rapid gastric emptying, which means the food moves too quickly into the small intestine. The accelerated digestion can cause nausea, abdominal cramping, and a rapid rise of blood sugar levels that causes sweating and discomfort. To prevent these issues, Jovan is fed just a bit of food through his G-tube at regular intervals throughout the day.

The Daily Menu

Breakfast starts at 9 a.m. Earth’s Best Organic Whole Grain Oatmeal Cereal, unsweetened almond milk, and fruit (blueberries, apple, or banana) are blended to the point of near liquefaction in a heavy-duty Oster blender. The meal is put in a syringe and a small amount is placed into Jovan’s G-tube every 30 minutes.

Jovan’s diet is mostly vegan because he has issues digesting protein. For lunch, Daniela or one of Jovan’s caregivers consults the notebook kept in a kitchen drawer to see which vegetables he’s been fed recently. They chop up and simmer several new varieties, using organic produce whenever possible. Once soft, the vegetables are allowed to cool, and then put into the blender along with two tablespoons of Californian extra-virgin olive oil, some fresh garlic, and a bit of salt. One slice of whole-wheat bread (baked daily by Daniela) is torn into chunks and added to the blender along with two hard-boiled eggs and, sometimes, cooked rice. Once the blender is 75 percent full, water is added to thin the mixture, and then blended into Jovan’s “soup of the day.” About a half-cup of soup goes into the G-tube via syringe starting at 3 p.m., a process that’s repeated every half-hour until 9 p.m. Overnight, he receives Pedialyte via a feeding pump to keep him hydrated.

Even though there was concern early on that real food wouldn’t be nutritionally sufficient, it is proving to meet Jovan’s needs quite well. His blood is tested regularly, and Daniela tweaks his diet as needed. “Last time when they were doing his bloodwork when we were in the hospital, his vitamin K was a little low,” she said. “We added a few leaves of baby spinach to his diet. We make these little adjustments, but everything else seems to be fine.”

"In the more than 10 years that I've been seeing him at the house, I've marveled at the family's ability to support Jovan in his physical needs, especially with natural, well-balanced table foods," said David Casavant, MD, senior associate in Critical Care Medicine, Department of Anesthesiology, Critical Care, and Pain Management at Boston's Children Hospital and assistant professor of anesthesia at Harvard Medical School. "He's the example I think of when I explain to other patients that formula is good, but often some wholesome food can be better than something made in a factory."

Daniela doesn’t think of the cooking she does every day as anything special. When she came to this country in 1998, she was surprised at how much packaged food people ate, and confused they didn’t know how to make something as simple as yogurt. “We grew up on a mini-farm” that provided the family with eggs, milk, and meat, said Samardzic. “I don’t think our mother or grandmother ever bought any canned ingredients or ready-to-eat meals. For Daniela, switching to homemade food was just a matter of time.”

The family keeps a garden, and Daniela eats a vegan diet, always mindful of her health because so much of her son’s daily care rests upon her shoulders. She is a one-person command central who schedules the around-the-clock skilled nursing care (always challenging, and even more so during COVID), provides physical care for her son, deals with all the medical bureaucracy, and makes sure the home is stocked with medical supplies.

“She doesn’t crush,” said Samardzic. “Sometimes she’s like, ‘I don’t know if I can take this anymore physically.’ But mentally, never, never. She’s extremely, extremely strong.”

After so many years of caring for her son, Daniela knows when Jovan is in pain or something is off. “For me, after 21 years, I think it’s simple,” she said. “What you need is people. You need support in the house, of course. But you also need to know who to call and how to navigate the system. I started doing that a long time ago with the 12 doctors he has. There’s always one person I know the direct line to.”

The family prefers dealing with routine medical issues as they arise at home, resorting to hospital visits only for emergencies. Sometimes trips to the hospital can exacerbate challenges—or introduce new ones—especially if the visit occurs on a weekend when Jovan’s regular doctors are not there.

“He is alive because of medicine, obviously, and all the medical equipment,” said Samardzic. “But we are also spiritual beings, and we have energy, and we know ourselves the best. Sometimes we have to listen to our intuition, and that’s what she’s doing when it comes to him, too.”

"I think the truly magic ingredient, and the thing that makes it uniquely successful is love, and that is what abounds in this family," Dr. Casavant said.

A Good Life

In 2022, Jovan will graduate from the Kevin O'Grady School, which educates students with significant disabilities. Stephanie Couillard, M.Ed., an assistant program director there, said he is the only homeschool student she knew of who'd graduated from the 12th grade, the highest level offered.

Jovan exudes happiness around those he loves and has a good sense of humor. He gets a kick out of watching the movie "Bridge to Terabithia" with his nurses and PCAs, for example, because he knows the scene of Jess and Jack in the forest always makes them cry.

Voya, who, with Daniela, owns Sigma Pros, a general contractor and millwork supplier based in Wakefield, MA, installed a floor-to-ceiling pipe by Jovan's bed that has several articulating arms that can swivel in, left and right, and up and down, depending on what Jovan wants to do, which is typically a lot. One shelf holds his Tobii, an eye-tracking computer that speaks for him. Out of necessity and personality, Jovan is a direct communicator and often asks Daniela to connect him with people, including his grandparents in Bosnia, via video calls.

Another shelf holds a TV screen that he uses to watch movies, golf, and college football. He enjoys following the news, especially 60 Minutes, and his current crush, WCVB Channel 5 meteorologist Cindy Fitzgibbon, sent him a Happy Birthday video for his 21st birthday.

Bath time, often reduced to sponge baths for people with severe disabilities, is a joy for Jovan. Years ago, Voya designed a special tub for him with a reclining insert that can support his body.

At bath time, which occurs several times a week, the lightweight, fiberglass tub gets placed on a waist-high folding table similar to a massage table. A long extension hose attached to the bathroom showerhead fills the tub, and then a lift device moves Jovan from his bed into the tub via netting.

During a recent bath, a nurse scrubbed Jovan’s feet while Daniela washed his hair using a shower attachment. His head was wrapped in a towel warmed in the microwave while Safa Rizvancevic, a personal care attendant from Bosnia who has been with the family so long she is considered family, ran to the basement for more warm towels straight from the dryer. The machine lifted him from the tub, and he was rinsed, dried, and moved back to bed, where his skin was moisturized and he was given a foot massage. The final touch was Daniela, long hair pulled back into a no-nonsense ponytail, touching her nose to his, joy spreading over both of their faces.

His family remains determined that Jovan enjoy as full a life as possible. Each summer, they travel to a special place, often Long Island, via a caravan of vehicles that transports family members, nurses, PCAs, and all the equipment Jovan needs, including his tub, which is used as a bed for the ride. “Everything moves,” said Samardzic. “It is a mission.”

Once at the hotel, they remove all the furniture from one room so it can be outfitted into a replica of Jovan’s room at home. With such complex medical needs, it’s important that the care routine run like clockwork.

The hotel is located on a 2-mile-long boardwalk that parallels the ocean shoreline. Syringes filled with food and water are stashed in Jovan's small backpack so he can stay on his feeding schedule. The length of the boardwalk allows everyone to walk together for an hour and 40 minutes before they need to return indoors to attend to Jovan’s medical needs. Look at any photo of Jovan at the ocean and you will see his face lit with happiness.

“I meet a lot of families who have children with serious problems,” reflected Kathy Ryan. “There are moments of worry and depression and loneliness and fear. The thing about this family that I’ve always admired is that they always were up for celebrating something. They are very loving people, and they were that way to begin with. I don’t think that was new because of Jovan. They understand that there are things in life that should be celebrated and marked, and they do that, and I love that about them.”

Future Strategy

Pre-COVID, the Djordjics bought a neglected, but beautiful property in Topsfield, MA, not far from their home. They are renovating it with the hope it someday serves as a place for children with disabilities to spend time together, having fun and learning. Daniela hopes to teach younger families what she's learned, not just about physical care and feedings, but also about how to navigate medical systems, minimize hospital visits, and advocate for a loved one if a hospital stay becomes necessary. She wants parents to know they can trust themselves.

"Listen to your instincts. That, I learn over and over again. Most of the time, we know, but we don't listen to our gut because someone went to school," she said.

Call it mother's intuition, call it old-fashioned commonsense, call it what you like. But for Jovan "Jovi" Djordjic, the most important prescription, the one that has kept him not just alive but smiling, has always, always been love.

You Only Get One Brain

The scarecrow in the Wizard of Oz heroically traveled great distances, at great risk (Good Lord, flying monkeys!) to acquire a brain. But most of us take our brain for granted. We feel our heart thump, and our muscles pump, and we see the results of our kidney and intestinal function when we visit the bathroom. But do we feel our brain think?

Our brains are the seat of our consciousness, the home of all our memories and experiences. Everything we have ever learned is stored in the brain. Our emotion, our pain, our pleasure, all result from the function of our brains. It certainly makes sense to take extra care of this delicate system, because, unlike the scarecrow, we cannot travel to the Wizard to ask for a new one.

How The Brain Changes as We Age

It is a little unsettling to learn that our brain shrinks as we age. Most researchers agree that this is a normal process, as it happens in both healthy and unhealthy people. After the age of 40, we lose about 5% of our brain volume each decade.

While changes happen throughout the brain, the areas most consistently affected are the reductions in grey matter and the prefrontal cortex.

Our grey matter is involved in tasks like controlling our muscles, receiving information from our senses, speech and language, and decision making. Our prefrontal cortex deals primarily with higher-level brain processes like behavior, personality, navigating our social interactions, and also decision making.

The good news is that even though we should minimize this process whenever possible, losing a small amount of brain volume does not result in dramatic changes.

With Age Comes Wisdom

While there are challenges, there is good news, too. As we age, our brain function improves in certain areas. Older brains are better able to anticipate problems and results. We have better empathy as we age, which is important for social functioning, but also important for a number of other endeavors as we learn with time to put ourselves in another’s shoes.

Our thinking changes. We are better at synthesis—the ability to see connections between unrelated ideas and events. A great Albert Einstein quote is that we can't solve problems through the same kind of thinking as when we created them.

Keeping Your Brain Healthy

Neurotransmitters and Nutrients

Another change that occurs is a decrease in the amount of key neurotransmitters – our brain’s chemical messengers. Dopamine levels start to decrease in early adulthood and proceed at a rate of about 10% decline per decade.

Nutrients that play a very important role in keeping our neurotransmitters where they should be are choline (eggs and peanuts are especially rich in choline) and the B vitamin family. However, not all forms of B vitamins behave the same way in our bodies. The inactive forms need to be transformed in the liver to the active form before we can derive any benefit at all.

Upwards of 30% of the population is inefficient at transforming one or more of the B vitamin family. Therefore, the better way to supplement is to look for active (or bioactive) B vitamins. These have already been transformed, sometimes called “methylated,” and provide more powerful and consistent benefits.

Some examples of active B vitamins are methylcobalamin (B12), pyridoxal-5-phosphate (B6), and folate instead of folic acid.

Nourishment for Neurons

A very important protein, called brain-derived neurotrophic factor (BDNF) also drops as we age. BDNF helps facilitate a process called neurogenesis, which is the production of new neurons.

Reductions in BDNF are often seen in neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and Huntington’s disease. Fortunately, there are compounds within the turmeric plant that can help attenuate the losses of BDNF. Turmeric contains about 2-5% of a key compound called curcumin, which has been shown in human clinical studies to increase levels of BDNF.

Another compound found within turmeric essential oil, called ar-turmerone, has been shown in scientific research to increase the amount of neural stem cells, which can generate new neurons. Look for a curcumin enhanced with turmeric essential oil to receive the benefits of both of these scientifically validated compounds.

Supplements for Circulation

Blood vessels that feed our brain also experience changes beginning as early as our twenties. Cerebral blood flow (CBF) may be partly influenced by our blood vessel’s ability to dilate becoming compromised with age.

Grape seed extract is known to be a vasodilator. It helps the blood vessels relax, which improves blood flow. Compounds from grape seed extract called oligomeric proanthocyanidins (OPCs) have also been shown to help lower brain oxidative stress, which helps keep the brain cells younger and healthier.

Grape extract contains a wide size spectrum of OPCs, including tannins. It’s best to select a grape seed extract that features small OPCs, tannin free, so they are absorbed and utilized in the body.

Enzymes for Energy

Coenzyme Q­10 ­(CoQ10) is another crucial nutrient for the brain. Unfortunately, it also decreases throughout the human lifespan. Though it is commonly thought of as a heart protective compound, CoQ10 is also critical for the neurological system.

CoQ10 is a key cofactor in mitochondrial function, which helps ensure proper energy production throughout our body, including the brain. Mitochondrial dysfunction has been indicated in several neurological diseases including amyotrophic lateral sclerosis (ALS). CoQ10 acts as an antioxidant and can help protect the brain from toxin-induced lesions.

The Brain: Use It or Lose It

While these nutrients and others can improve brain function throughout our lives, it is also important to remember that supplements alone are not enough. What we eat and how we move our bodies profoundly affects brain health. Sugar and refined carbohydrates accelerate brain aging and can damage neurons over time.

Also, the overused maxim: “use it or lose it” remains true. Our brains crave novelty to grow and flourish. Trying new hobbies, learning languages, travel, conversation, games, and reading also help to keep also improve brain function—naturally.