Underlying Cause of Chronic Illness

• Increased Inflammation

What is Inflammation?

• Ancient Greeks– Internal Fire

• Ancient Romans– Heat– Pain– Swelling– Redness

What is Inflammation?

• Complex orchestration of pro-inflammatory and anti-inflammatory events

• Usually associated with pain• Mediated by eicosanoids• Treated by drugs that alter eicosanoids

– Aspirin– NSAID’s– COX-2 inhibitors– Steroids

Events That Turn On Inflammatory Responses

• Microbial invasion

• Injuries

• Diet

Two Types of Inflammation

• Screaming Pain– Organ or joint damage

• Silent Pain– Cellular inflammation

Measuring Cellular Inflammation

• High sensitivity C-reactive protein– Non-specific– Highly variable due to infection

• AA/EPA Ratio– Most precise marker of eicosanoid

precursors at cellular level– Highly reliable

Typical AA/EPA Ratios

1.5Japanese

15Americans

20Depression

25ADHD

40Brain Trauma

Diseases Associated With Cellular Inflammation• Obesity• Type 2 Diabetes• Heart Disease• Cancer• Alzheimer’s• ADHD• Asthma• Allergies• Inflammatory conditions (“itis”)

Typical Chronic Conditions In Retired NFL Players

• Obesity• Diabetes• Heart Disease• Arthritic Pain• Depression• ADHD• Dementia

My Early Days With The NFL

• Marv Marinovitch

• Garrett Giemont

• Jon Kolb

Improvement of Performance Of NFL Players

• LA Rams– Doug Smith– Lucious Smith

• Pittsburgh Steelers– Steve Courson

Current NFL Teams We Work With

• Green Bay Packers• New York Jets• San Diego Chargers• Oakland Raiders

My Early Days with Dr. Dan Amen

Cerebral Blood Flow Can Be Altered By Zone Diet and High Dose Fish Oil

Before

After

Effect of High-Dose Fish Oil on ADHD• Improvement

is rapid• Must be

continued to maintain benefits

AA/EPA Ratio

0

5

10

15

20

25

30

35

aaepa_1 aaepa2 aaepa3

101

102

103

104

106

107

108

109

110

Clinical Global Impression

0

1

2

3

4

5

6

psoi mglob_im fglob

101

102

103

104

106

107

108

109

110

Sorgi et al Nutrition J 6:16 (2007)

Linear Regression with95.00% Mean Prediction Interval

- 80.00 - 60.00 - 40.00 - 20.00

AA/ EPA ratio % change pre- final

- 40.00

- 20.00

0.00

20.00

SEVEREITY OF ILLNESS % CHANGE PRE-FINAL

WW

W

W

W

W

W

W

SEVEREITY OF ILLNESS % CHANGE PRE- FINAL = 4.38 + 0.45 * aa.e.pfR-Square = 0.73

ADHD Improvement Is Correlated with AA/EPA

p =.007

Sorgi et al Nutrition J 6:16 (2007)

SPECT Scan 12-09

Traumatic Brain Injury

• Leading cause of death and lifelong disability among children and young adults in the United States

• 1.5 million Americans survive a traumatic brain injury, among whom approximately 230,000 are hospitalized

• 50,000 Americans die each year following traumatic brain injury

Protocol

• EPA/DHA concentrate (2:1)

• 15 grams of EPA and DHA per day

• Measure AA/EPA ratio in the isolated plasma phospholipids weekly to ensure AA/EPA ratio >1.5

Medical Miracle or High-Dose Fish Oil?

Results to Date

26 M WV Coal miner CO Coma Recovered

40 M TX Firefighter CO Coma Recovered

12 M NY Baseball player Commotio cordis

ComaCardiac arrest

Recovered

40 M KY Firefighter CO Coma Recovered

29 M WV Logger CHI Coma Recovered

43 F NY Childbirth Anoxia Coma Recovered

55 F FL Stroke Ischemia Coma Recovered

Is There a Blood Test for Predicting Future Dementia?

Group Relative IncreaseIn The AA/EPA Ratio

Normal (n = 19) 1.0Alzheimer’s (n = 19) 1.9Other dementias (n = 10) 1.8Cognitively impaired (n = 36) 1.7

Conquer et al. Lipids 35: 1305 (2000)

AA/EPA Ratio Can Change Rapidly In Brain Trauma Patients

• Pre-Treatment (11-23-10)– AA/EPA ratio = 41

• Post-Treatment (1-20-11)– AA/EPA ratio =3

Other Neurological Conditions Treated By

High-Dose Fish Oil

Bipolar Depression Can Be Treated with High-Dose Fish Oil

• 9.6 grams of n-3 per day

• 500% greater remission in 3 months

Stoll et al Arch Gen Psychiatry 56: 407 (1999)

AA/EPA

Disability Status

6

2.2

1.5

1.6*

Start 2 Year

Multiple Sclerosis Disability Can Be Reversed

* p < 0.005

Nordvik et al Acta Neurol Scand 102:143 (2000)

My Most Well Known Parkinson’s Patient

Animal Studies

• Weight drop onto steel helmet affixed to skull

• Produces reliable and reproducible injury

• High yield of traumatically injured axons in white matter tracts

Impact Acceleration Injury

Omega-3 Blood Levels

-10%

10%

30%

no supplement

10mg/kg/day

40mg/kg/day

% Change in omega 3 levels from baseline

Miles et al. J Neurosurgery 114: 77 (2011)

AA/EPA Ratio

0%

50%

100% no supplement

10mg/kg/day

40mg/kg/day

% Change in AA/EPA ratio from baseline

Miles et al. J Neurosurgery 114: 77 (2011)

Amyloid Precursor Protein

Accumulation in retraction bulbs of morphologically injured axons

Immunohistochemistry

Animals subjected to impact acceleration injury demonstrate APP positive axons with retraction bulb morphology at 30 days

Immunohistochemistry

Animals subjected to impact acceleration injury and supplemented with 40 mg/kg/day EPA:DHA demonstrate fewer APP positive axons with retraction bulb morphology at 30 days

APP positive axonsA

xon

s p

er h

igh

po

wer

fie

ld

NoSupplement

Sham10 mg/kg/d

40mg/kg/d

9.64

0.216 0.410.330

5

10

Chronic Disease – What’s Below the Surface

Autoimmune

Cancer

Heart diseaseAging

Neurological

Cellular Inflammation

Summary

• Cellular inflammation is the underlying cause of neurological disease

• It can be reversed by high-dose fish oil• Test, don’t guess about how much fish

oil you need• No one is going to help you rebuild

your brain except yourself