Improve Your Brain Health Workbook by drtalks

Meet Dr. Ken Sharlin

I am a board certified neurologist who has been in practice since 1998. I completed my medical education at Emory University in Atlanta, GA (1992), and post-graduate training at Emory Affiliated Hospitals, The University of Virginia, and Vanderbilt University. In addition to my M.D., I have a Masters in Public Health (Emory-1991). Originally from New Jersey I live and work in Springfield, MO. I am married and have three grown children. I became interested in Functional Medicine while exploring my own health and performance as a cyclist, runner, and triathlete.

Tell us about you

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Inflammation & Chronic Disease

Why are these so important?

Chronic diseases are defined broadly as conditions that last one year or more and require ongoing medical attention or limit activities of daily living. Chronic diseases such as heart disease, cancer and diabetes are the leading causes of death and disability in the U.S. Age, family genetics and gender make it difficult for older adults to avoid becoming a chronic disease statistic. Eighty percent of adults 65 and older have at least one condition, while 68 percent have two or more. With Americans getting older and the costs of health care rising rapidly, we have an evolving crisis. According to Fidelity Investments, a 65-year-old couple retiring in 2020 can expect to spend $285,000 in health care and medical expenses throughout retirement, not including nursing home costs.

Millions of consumers are seeking better care than what the current system offers. People want an approach that eliminates symptoms by resolving root causes, rather than just managing symptoms and never addressing the reason we get sick in the first place. But those solutions are hard to find. Consequently, consumers desperate for answers, are selfdiagnosing and experimenting with advice from INTERNET sources because most doctors do not have the tools to help them.

You probably have a parent, friend or co-worker who is managing a condition right now, or perhaps you are managing one yourself. With these kinds of odds, you might wonder if there is anything you can do to prevent the onset of symptoms or make managing an existing condition easier. Yes, you can! It’s called functional medicine which addresses the root causes of disease. It looks at the pattern of dysfunction underlying chronic diseases and offers a model of care that can prevent or help reverse illness. It is based on how our genes are stimulated by and respond to our environment and the behaviors we practice. If we can change our environment and our behavior, we can change the way our genes perform.

Dr. Sharlin uses the principles of functional medicine in his Brain Tune Up program for preventing memory loss and protecting your brain. He uses a Five Pillar Approach to help give you power over your brain.

“Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.”

“People want an approach that eliminates symptoms by resolving root causes, rather than just managing symptoms, and never addressing why we get sick in the first place.”

“Functional medicine addresses the root causes of disease.”

Unique Five Pillar Approach

Your Health, Your Choices, Our Solutions

IDENTIFY

We begin by correctly naming the problem. The last thing anyone wants is the wrong diagnosis or lack of solutions when you know something is wrong.

INVESTIGATE

We will take a deep dive with you to get to the root cause of your symptoms or chronic illness.

INTEGRATE

We help you put the puzzle pieces together. We create a plan that is unique and personalized to you.

RESTORE

We help you act. Our goal is to restore balance in your life.

REGENERATE

We want you to feel like your BEST self. We facilitate the restoration of your brain and nervous system vitality by incorporating cutting-edge regenerative treatment strategies.

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It’s important to understand is that inflammation is the single most influential cause of all the brain disease. Inflammation is the body’s normal response to injury or threat from the environment. If inflammation is the orchestra, the musicians are the major players that make up the inflammatory process. Under normal circumstances, short-term inflammation is good. It protects us. But when signals from the environment cause inflammation to be long-term, the consequences can be devastating—causing chronic inflammation. From a practical standpoint, there are basically seven things that cause chronic inflammation.

Dr. Sharlin’s Seven Solutions for Chronic Inflammation.

SLEEP

Quality over quantity

Sleep is one of the most important tools we have in our healthy brain toolbox. Sleep deprivation can impact your life in a variety of ways from depression to appetite. Getting good quality sleep can help you preserve and protect your brain in the future.

EAT

You are what you eat

Your diet is one of the most influential factors in your health, happiness and longevity. An anti-inflammatory diet can help you avoid long-term or chronic disease.

MOVE

Sunshine and Exercise

Getting your heart rate up for brief periods can help you preserve and protect your brain from long-term or chronic illnesses. Walking, moving and dancing can all be great ways to start investing in your brain health.

BE AND PRACTICE STRESS RESILIENCE

Mindfulness in all things

Focus on being. Staying in the moment can have a dramatic impact on your mood, your health and overall wellness. I believe that taking 5 to 10 minutes each day to meditate and relax can improve and protect your brain throughout your life.

CONNECT & BUILD STRONG RELATIONSHIPS

Focus on your network

Making and maintaining connections with your friends, family and loved ones will help you maintain a sense of purpose and protect your brain health throughout your life.

FILL IN THE GAPS

Get the right nutrients

Getting enough of the right nutrients is essential to maintaining your vitality and giving your brain the tools it needs to protect itself. Understand which nutrients may be missing from your regular diet—adjust and supplement where necessary.

STIMULATE

Engage your brain

Learn an instrument, a hobby or a new skill. Engaging in these activities help preserve and grow your brain, creating new connections in your brain and protecting you from developing long-term chronic illness as you age.

“Making and maintaining connections with your friends, family, and loved ones will help you maintain a sense of purpose and protect your brain health throughout your life.“

Nutrition

678,000 people die each year from an unhealthy diet, and the numbers could be even be higher, as most chronic diseases can be traced back to diet. Remember, when your grandma said, “eat everything on your plate,” or we used to say “you are what you eat?”Guess what...you are what you eat. So, what should you be eating, We recommend the Mediterranean diet or an anti-inflammatory diet.

An anti-inflammatory diet consists of eating plenty of vegetables and organic, lean meats. Think about your supermarket and how the edges of the supermarket are where you will find all those delicious fruits and vegetables. Most of your plate should be vegetables that you roast, steam or sauté in healthy oils like avocado oil. Also think about nuts, seeds and small amounts of fruit like strawberries, blackberries or blueberries, which do not raise your blood sugar too much. High blood sugar triggers inflammation which affects the brain, causing diseases like Alzheimer’s, Parkinson’s, ALS, and Multiple Sclerosis.

Supplements & Pharmacology

VITAMINS AND NUTRIENTS

As outlined earlier, the importance of good nutrition cannot be overstated. But getting this key needle-mover perfect every day is virtually impossible. Unless your diet consists strictly of fish plucked straight from a pristinely clean ocean, all organic produce and purely healthy fats, you stand to benefit significantly from simple, yet strategic supplementation. It’s not only the “easy button” for this pain-relieving approach, but it also directly impacts your overall health.

BEWARE BUYER! THE SUPPLEMENT INDUSTRY IS NOTORIOUS FOR BEING POORLY REGULATED. SHORTCUTS TO SAVE ON MANUFACTURING COSTS CAN COST YOU TIME AND MONEY.

Invest in yourself by using only high-quality supplements, certified by NSF (nsf.org) and/or GMP (Good Manufacturing Practices). For treating pain due to inflammation, Turmeric/ Curcuminoids are a must. For overall wellness, Omega 3 and Vitamin D + K should be at the top of your list.

Don’t delay in getting these on board and working for you!

Neurofitness

Your body is smart. It learns how to do something as efficiently as possible in a relatively short time. If you’ve been doing the same workout for months (or years!), you probably do not get all the benefits compared to when you first started. Your body is going through the motions with minimal energy expenditure if you’re doing the same round of bicep curls and overhead presses. Your brain can quickly check out too.

To remember a new routine requires your brain to learn a new pattern. Your body has to recruit different muscles in different ways. If you’re new to resistance training, learning how to do a proper squat or compound movement like a squat to overhead press can be both a challenge to the brain and body. This new routine and a new way of resistance training may be all you need to trigger new brain cells’ growth. If you’re not new to resistance training, you have two possible action steps. The first step is to try unilateral training. That means doing your squat to overhead press one arm at a time or do a single-arm chest press. This requires your brain and body to do something you know in a new way, recruiting new muscles and creating new neural pathways. The second step is to add a cognitive skill. A simple place to start is counting your repetitions by 2 (2,4,6,8) instead of the standard 1,2,3,4. Adding brain training on top of physical exercise multiplies the effect.

That’s it. You now know the critical steps of an upgrade to both the hardware and the software, leading to a better body and a healthier, more resilient brain.

Recharge and Optimize Your Thoughts

In our minds, the term “lifestyle” is often associated with food and exercise. Beyond what we’ve shared so far, there are other factors to consider when putting the critical pieces together that will ultimately result in the YOU you’ve always wanted – vibrant, resilient, free of the restraints that come with identifying life through the lens of illness. When, in our disease-mode, we become the person whose life is defined by an anticipated downhill course of what will come next, until it controls our thoughts and actions completely. It does not have to be this way.

“The conscious mind is the director of your movie, the author of your book, or the captain of the ship. “

“With repeated and purposeful direction from the conscious mind, habits are also formed and maintained in the unconscious mind. “

Thoughts can be so satisfying. Inside your mind, you can have conversations you are unwilling to speak, explore new ideas and dreams of the future, figure out a new way to solve a pesky problem. Thoughts can either comfort yourself or put yourself in the sympathetic state of “flight, flight, or freeze.” The conscious mind is the director of your movie, the author of your book, or the captain of the ship. Whatever metaphor speaks to you. The subconscious mind – or the crew – will take direction from the conscious mind and give you what you ask for. You can see how important it is for you to choose your thoughts purposefully. If you do not take control to manage your thoughts, it is much like an unsupervised child taking over the situation. Lots of drama and tantrums, eventually exhaustion.

The primary function of the unconscious mind is to keep you alive and whole. It wants to follow instructions from your conscious mind and follow the moral code you were taught as a child. The unconscious mind stores all of your memories, and emotions run your body systems. It has detailed awareness of your body in the here and now but, more importantly, what your body would be like in perfect health. It receives all external data from the five senses and filters it before presenting that information to your conscious mind for further instructions. The unconscious regulates your energy depending on how it perceives your physical and emotional data and the direction it receives from your conscious mind.

With repeated and purposeful direction from the conscious mind, habits are also formed and maintained in the unconscious mind. However, conflicting guidance from the conscious mind decreases the efficiency of habit formation. The unconscious mind senses symbols and metaphors, so conscious thought needs to be specific in its direction. For example, if you think, “I don’t want to be fat,” your mind sees a symbol of a heavy body, and your unconscious mind will give you that picture. It is especially important to have a clear and moving image in your mind of the future you wish to achieve. The unconscious mind also works with emotions. Purposely choosing regenerative emotions like gratitude, love, hope, peacefulness, vitality, and zest will not only direct the unconscious but guide the heart to regulate with coherence. The heart operates by increasing the heart rate as you breathe in and decreasing the heart rate as you exhale. This is called heart rate variability. The greater the variability and the more regular this occurs, the healthier you will feel. You can practice heart coherence by breathing in a deep and regular pattern while experiencing a regenerative emotion. Daily practice of heart coherence will increase your stress resilience. Much like

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the way a cell phone loses battery power when too many apps are open at once. Closing the apps and plugging it in will fill the battery. When you have a full battery by controlling the thoughts and emotions you choose to think and feel, you have the strength and resilience to handle stressful situations with ease.

Letting your mind worry and chew on negative thoughts and feelings tells your body that you are not safe. The sympathetic part of the autonomic nervous system responds by pushing out 1400 hormones and neurotransmitters like cortisol to be in a state of alert! This eventually drains your body systems of energy. Using your conscious mind to direct your body with positive thoughts and emotions, purposefully will energize your battery by creating a healing hormones and neurotransmitter chemicals like DHEA. These chemicals will let your body rest and repair and allow you to achieve the healthy body you see in your clear and moving picture of the future.

There are several strategies you can use to shift your energy toward growth and revitalization. One that we especially like at Sharlin Health and Neurology is the Quick Coherence ® Technique developed by our friends at The Heartmath Institute. The Quick Coherence ® Technique helps you create a coherent state, offering access to your heart’s intelligence. It uses the power of your heart to balance thoughts and emotions, allowing you to achieve a neutral, poised state for clear thinking. It is a powerful technique that connects you with. Your energetic heart zone to help you release stress, balance your emotions, and feel better fast.

Connect (Your Brain Needs It)

Once you’ve mastered the ability to recharge and optimize your thoughts, the next critical step is to connect with others you know and trust, and who can reflect the same positive “can do” energy that you put out. It’s infectious – in a good way. Social isolation is a significant health problem for older adults. Not only is loneliness a risk factor for Alzheimer’s disease and depression, but social isolation will virtually guarantee that those affected by these conditions will deteriorate much more quickly. Family, friendships, and community are part of who we are and what we do. At the most primitive level, our hunter-gatherer ancestors were more likely to find food, water, safety, and shelter, and reproduce if they were among the company of others. There is safety in numbers. This has ensured our species success through the millennia. Not surprisingly, then, according to Dr.

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Matthew Lieberman, “the same brain regions that register the distress of physical pain are also active in situations where we experience social pain, such as rejection or exclusion. Social pain may not be pleasant at the moment, but we would be lost without it.” It’s a call to action. It’s why Lieberman titled his book, Why Our Brains are Wired to Connect (Crown, 2013).

Not only does the brain function more optimally when we connect, but we are rewarded for doing so. Oxytocin, a hormone that comes from the brain region known as the hypothalamus and pituitary glands, plays a critical role in life, bonding, positive, trusting relationships, maternal care, and sexual behavior, reducing anxiety and depression. Not surprisingly, it turns out that oxytocin has both antiinflammatory and antioxidant effects.

What can you do to connect? Here are a few ideas:

• Make it a daily practice to hug at least one person close to you 60 seconds every day. (Make sure you have permission.) The “love” reward – Oxytocin – will increase for both of you.

• Set aside specific times during the day when the phones, tablets, computers, and television are turned off, and you have a real face-to-face conversation, such as at mealtime, and ask meaningful questions or thoughtful discussions like, “tell me what was the best part of your day so far?” or “what was the most challenging for you and what solution did you discover to help you through it?”

• Join a club – crafting, wine, sports, dance, book, or gardener’s club – whatever excites you.

• Take a class that invites interaction and join a study group. Learning and socialization are a great combination!

• Attend a house of faith that calls to you and get to know your extended family there.

• Have a regular telephone date with someone you love who is far away, a dear family member or friend.

• Connect with your purpose or personal vision every morning.

Whatever you choose, fill your life with rich, meaningful, and non-judgmental interaction. It’s easy to withdraw after a diagnosis, and that is the worst thing you can do for your brains and overall health. Real friends do not judge. Don’t be afraid. Just get out and do it!

Sleep

The first tool in reversing chronic illness is sleep. One out of three American adults are not getting enough sleep which significantly impacts the brain. Older adults who aren’t getting enough sleep are at an increased risk for diseases like Alzheimer’s. In middle age, Alzheimer’s disease can start, because we know that this condition can begin up to 20 years before the onset of the illness. Lack of sleep impacts the brain in so many ways. If you are looking to increase productivity in your life, begin with getting enough sleep. If you have a lot of daytime fatigue, look at your quality and quantity of sleep.

Sleep problems can be the result of various conditions or medical problems. Many medications which are used to treat insomnia, are only effective in the short term. Ongoing use of sleeping pills may lead to dependence and interfere with developing good sleep habits that can prolong sleep difficulties. It is important to discuss your sleep problems with your doctor and find out what is right for you.

The most common cause of insomnia is a change in your daily routine like traveling or changing work hours, etc. This can lead to habits that interfere with your sleep. Therefore, paying attention to good sleep hygiene is the most important thing you can do to maintain good sleep. ‘Sleep hygiene’ is used to describe good sleep habits, and strategies for longterm solutions to sleep difficulties have been developed through considerable research on sleep.

Sleep Hygiene Suggestions:

KEEP REGULAR SLEEP HOURS

Go to bed at the same time each day and get up at the same time even on weekends and days off. This regular rhythm will make you feel better and give your body something to work from. Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime may include a warm bath or shower, aromatherapy, reading or listening to soothing music. Use a relaxation exercise just before going to sleep or try using relaxing imagery to encourage your body to rest.

THE BEDROOM IS FOR SLEEPING

Use your bed for sleep and intimate activities. This will help you associate your bed with sleep, not with other activities like paying bills or watching TV. Keep the temperature in your bedroom cool. Keep the bedroom quiet and dark enough to facilitate sleep.

REGULAR EXERCISE

Get regular exercise each day including stretching and aerobic exercise—preferably in the morning. Get regular exposure to outdoor or bright lights, especially late in the afternoon.

AVOID CAFFEINE, NICOTINE & ALCOHOL

These substances act as stimulants and interfere with falling asleep. Avoid coffee, tea, soft drinks, chocolate and some medications or cigarettes for at least four to six hours before bedtime. Many people believe that alcohol is relaxing and helps them to get to sleep, however, it can interrupt the quality of sleep.

EAT RIGHT

A healthy, balanced diet will help you sleep well. However, avoid a heavy meal before bedtime. Some people find an empty stomach at bedtime can be very distracting, so a light snack can be useful.

AVOID NAPS DURING THE DAY

If you can’t make it through the day without a nap, make sure it is for less than an hour and before 3 p.m.

KEEP EYES OFF THE CLOCK

If you haven’t been able to get to sleep after about 20 minutes or more, get up and do something calming or boring until you feel sleepy, then return to bed and try again. Sit quietly on the sofa with the lights off or read something. Avoid doing anything too stimulating or interesting.

USE A SLEEP DIARY

Keeping track of your sleep habits can be a useful way of making sure you are informed about your sleep. Also, consider writing down any worries or thoughts that are bugging you, allowing your brain to let go of them.

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SLEEP DIARY

Each morning place a check mark in the box beside the strategies you used the day before and then rate your overall sleep quality for that night.

Week #: ________________

Sleep Strategy

Comfortable sleep environment

Relaxation exercise

Light bedtime snack

Exercised late afternoon or early evening

(but at least 2 hours before bed)

Followed bedtime routine

Woke up at set time

Went to bed when sleepy

Used bed only for sleep

Got out of bed if not asleep with 20-30 mins.

Avoided caffeine, alcohol, and smoking at least 4 hours before bedtime

Avoided naps

Other strategy (specify)

Quality of Sleep: Rate from 10 to 10

0=poor sleep/restless and unsatisfying

10=no sleep problems/restful and satisfying

Comments:

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Stress

How does your body respond to stress?

The autonomic nervous system is a control system that is part of the nervous system that supplies the internal organs which includes the blood vessels and works automatically without a person’s conscious effort. There are two main divisions: Sympathetic and the parasympathetic. The sympathetic division is the primary mechanism in control of the flight-or-flight response and prepares the body to react to stressful or emergency situations. The body sends cortisol, norepinephrine, and various other hormones and neurotransmitters in response to perceived threat. The heart rate increases, and the force of the heart contractions become stronger to widen the airways to make breathing easier. The pupils dilate, palms may sweat, and your hair may stand on end. Other body processes not critical to the perceived emergency such as digestion and urination slow down.

The counterpart or the parasympathetic division which is controls the body processes during ordinary situations and primarily conserves, restores, and repairs. It is powered by the vagus nerve which is the longest cranial nerve and has communication with every organ. Acetylcholine, DHEA, and many other soothing hormones and neurotransmitters are produced to slow the system down. The heart rate slows, the blood pressure decreases to normal rate and the digestion is stimulated to process nutrition and eliminate any waste, so the energy is available to restore and build tissue.

The relaxation response occurs when the body is no longer in perceived danger, and the autonomic nervous system functioning returns to normal. The relaxation response is the opposite of your body’s stress response.

Normally the body can turn off the fight-or-flight response when the perceived threat is gone. However, for whatever reason in our current world that fight-or-flight response is triggered many times during a day. We react to a wide range of stressors most of which are more situational than an actual need for survival. With this chronic perceived stress reaction, the body is trained to be on alert constantly

“Purposefully choosing renewing thoughts and emotions is one way to create an atmosphere of safety so that the body responds, and the vagal nerve can do its work. “

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which overtaxes the nervous system and eventually wears on our health and well-being. Digestion is affected so we do not receive nutrients and therefore the body is unable to rest and to repair itself. When the body feels safe the vagus nerve alerts the brain to releases neurotransmitters when inflammatory proteins called cytokines are present for the purpose of reducing and controlling inflammation so that the body can repair and restore.

Purposefully choosing renewing thoughts and emotions is one way to create an atmosphere of safety so that the body responds, and the vagal nerve can do its work. Other ways to improve send the message of calm and safety to the body include gargling which directly stimulates the vagus nerve, breathwork using the belly, laughter to soothing neurotransmitters, fasting to give the digestion process a break, Yoga using gentle movement and breathing, and massage to stimulate the lymphatics and improve vagal tone.

Practicing compassionate self-care allows the body to be in a state of balance and calm. Consistent practice teaches the body not to constantly react to perceived threats and to be more resilient to stress so that it can react appropriately when a true emergency presents itself.

Tips for Reducing Stress:

BREATH

Our breathing changes when we are feeling anxious. We tend to take short, quick, shallow breaths, or can even hyperventilate which is called “over-breathing” This can make you feel even more anxious due to a racing heart, dizziness or headache.

Calm breathing is a tool you can use whenever you are feeling anxious. Calm breathing involves taking smooth, slow and regular breaths. Sitting upright is usually better than lying down or slouching because it can increase the capacity of your lungs to fill with air. It is best to “take the weight off” your shoulders by supporting your arms on the side-arms of a chair, or your lap.

• Sit up straight on your sits bones and rotate your clavicle out allowing your shoulders to relax and drop.

• Place your tongue on the roof of your mouth like you are sucking a piece of candy (first calming action taken by infant).

• Take a slow deep breath in through your nose and allow

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your ribcage to expand and allow the air to expand your belly like a balloon.

• Hold your breath for one or two seconds.

• Passively release the air from your nose.

• Repeat the deep breath and place your attention on your heart space. Focus on a feeling of gratefulness or peace. You may even imagine there is a golden light surrounding your heart space.

• Each time you take a breath, expand the feeling from your heart space or the golden light into your shoulders, arms, palms and fingers. Then. push the next breath into your hips, legs, feet, and toes.

• About 6-8 breathing cycles per minute is often helpful to decrease anxiety but find your own comfortable breathing rhythm.

• Make sure you are not over-breathing; it is important to pause for a few seconds after each breath.

• Try lying down on the floor with one hand on your heart, placing your other hand on your abdomen. Watch the hand on your abdomen rise as you fill your lungs with air, expanding your chest. (The hand over your heart should barely move, if at all.)

• Try calm breathing for at least five minutes twice a day. Once you are comfortable with this technique, you can start using it in situations that cause anxiety.

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PROGRESSIVE MUSCLE RELAXATION

Practicing progressive muscle relaxation may help reduce anxiety and stress from your body. Regular practice allows you to become aware of tension in areas of you body and gives you skills to experience immediate relaxation. By tensing each muscle before the point of strain and then releasing the muscle, you will allow the muscle to relax. If you have an injury or intense pain, you may want to avoid that area or be very gentle. Pay attention to the feeling of releasing the tension in each muscle.

Close your eyes and sit back in your chair or lie down in a comfortable position. Breath in air from your nose filling your chest cavity and hold for a few seconds. Passively release the air for a count of five and breath in through your nose for the count of five. Then allow the air to leave for a count of five noticing the tension leave your body as you release the air. Take in several more breaths counting to five and releasing tension on the count of five.

Now, place your attention on the area of your feet. Begin by tensing your feet by curling your toes and the arch of your foot. Hold the curl and feel the tension in the muscles noticing the feeling for the count of five. (Pause to breathe in through your nose to the count of five). As you passively breath out, release the tension in your foot and notice the foot relax as the air leaves your body.