We decided to sit down and have a chat with our practice owner and MD, Dr. Philip Oubre, and functional nutritionist, Aubree Steen.
We're diving into another 4 part series focusing on brain health. We're diving into part 3 here, following with:
1. How Indoor Air and Mold Affect the Brain
2. How Butyrate Helps Power the Brain
3. How to Test Your Brain Function
4. Keto, Cycling Keto, and Fasting
Dr. Philip Oubre (00:01):
Hey guys, we're going to be talking about brain health again. This is our third video in this series, but today we're going to be talking about testing of brain health because there's a lot of, the brain is kind of an unusual organ. There's not just a-
Aubree Steen, FNTP (00:11):
How do you test it?
Dr. Philip Oubre (00:12):
Aubree Steen, FNTP (00:13):
Right. Other than-
Dr. Philip Oubre (00:13):
So, there's multiple ways and the functional medicine way.
Aubree Steen, FNTP (00:15):
Where are my keys? Just kidding.
Dr. Philip Oubre (00:19):
And so I'm Dr. Philip Oubre. This is-
Aubree Steen, FNTP (00:20):
I'm Aubree Steen.
Dr. Philip Oubre (00:21):
And that's actually a great point. That's a great place to start is a loved one may have told you that you need to worry about your brain and especially if you're a male, you're like, "No, I'm fine." So there's actually tests that can help you determine whether or not you have brain dysfunction or not.
Aubree Steen, FNTP (00:37):
So whether you want to prove someone wrong and say that you do have good brain health or if you really want to see what's going on in there.
Dr. Philip Oubre (00:42):
Right. And so everybody kind of forgets their keys every now and then, or walks into the pantry, forgot why they were there or whatnot. And ends up grabbing what they shouldn't grab while they're in the pantry.
Aubree Steen, FNTP (00:52):
Put the sock in the fridge.
Dr. Philip Oubre (00:54):
So at some point, though, it becomes abnormal. So how do you determine when that's abnormal, even though that your spouse is complaining about your memory. Is it really abnormal or did you just not care about that task that they told you about?
Aubree Steen, FNTP (01:07):
Is it happening on a consistent basis and is it happening with more things often than not? Are you driving and constantly missing your exit? Are you constantly forgetting to call someone back? Are you constantly forgetting to turn the oven off or lock the door? Not just those neurotic tendencies of like, did I do this? Actually forgetting these things over and over and over again. Or are you super anxious? Do you have depression, mental illness, OCD, neurotic tendencies that are actually interfering with your daily life?
Dr. Philip Oubre (01:33):
So the first steps towards this diagnosing brain dysfunction is just that section is called Subjective Cognitive Impairment. Which means someone told you, you have cognitive impairment. You might think you have cognitive impairment. They probably don't use that word, but they said, "Hey, you're forgetting a lot of stuff."
Aubree Steen, FNTP (01:49):
You're so cognitive impaired.
Dr. Philip Oubre (01:50):
So the doctor will say Subjective Cognitive Impairment. So what we want to help you with is finding out if it's actually clinical or not. And one of the ways we like to do it is something called a CNS vital signs. It's a software that someone has created online. And so we send a link to a patient and they take their own test at home with a keyboard and mouse-
Aubree Steen, FNTP (02:09):
Dr. Philip Oubre (02:10):
Well it's not easy. I mean, it is easy to get the test set up, but it is difficult. It is a brain challenge.
Aubree Steen, FNTP (02:17):
It is. It hurts a little bit.
Dr. Philip Oubre (02:18):
It does hurt a little bit. And it's a solid 30 minutes of testing. Now they've come out with all kinds of array of testing that you can do on it. And so the basic one for cognitive decline or cognitive impairment is simply that basic panel, the CNS vital signs.
Dr. Philip Oubre (02:33):
Now you may be thinking, well, I'm not 80 years old. I don't need to worry about dementia or whatnot, but you can see cognitive impairment in all kinds of different types. Okay? So Aubree kind of mentioned some of those types already. If you're so OCD that you're actually distracted. So this test is actually pretty thorough as far as analyzing totally different aspects of your brain. As far as visual-spatial, maybe you couldn't park the car for some reason, and you're having some visual-spatial issues, but your memory is perfectly fine or your concentration's perfectly fine.
Dr. Philip Oubre (03:01):
So this task goes through each, piece by piece, and can analyze each one. And then by the end of it, it gives you a score. And that score is based on the average. So, always like to warn people that there's two reasons to do this test: one is to see if you actually are dysfunctional. I mean, if all your results are in the red zone, then that's a concern. But say you're a highly intellectual individual, you're able to accomplish a lot. You're a CEO, owner, whatever it may be. If your numbers are at 95, they're all based on 100, 100 being normal or average. So if all of your scores are 95, yet you feel like you're a high functioning individual, then that may be diagnostic for you that you're underperforming.
Dr. Philip Oubre (03:38):
So the second reason to do this test is whatever baseline levels you get, then you can retest in three, six months, we just did a video on butyrate. So say you've been doing some fasting, you've been eating more vegetables. You've been eating more fats and trying to do ketogenic, trying to generate your own butyrate. Maybe you're taking the butyrate supplement, whatever it may be. And now you want to test again to see if that has actually done anything, because you might still be forgetting your keys. You might still have put the sock in the oven. That's dangerous.
Dr. Philip Oubre (04:07):
But anyway, so you can retest and actually put some hard data to it and the test is cheap. It's really not that expensive. I actually think it's like 50 bucks. So that's not bad in the brain health world. So if you have those issues, that's just telling you how your brain is functioning.
Aubree Steen, FNTP (04:25):
Right. It's not telling you the "Why?".
Dr. Philip Oubre (04:26):
Aubree Steen, FNTP (04:27):
We're just quantifying your brain function.
Dr. Philip Oubre (04:29):
Right. So one of the next things we wanted to tell you about is what testing you can do to find out some of the "Why?" your brain might be dysfunctional.
Aubree Steen, FNTP (04:36):
Yeah. And more so of the kind of, not oh, there's toxins on board, but similarly it's kind of like the bridge between the root cause of it all and the symptoms itself. So blood tests are one way that you can do it. One that I really like is from Cyrex Laboratories. I'm going to read a couple of markers off my phone, but one of my favorite ones is the blood-brain barrier permeability.
Dr. Philip Oubre (04:56):
Do you have the array number? Don't they list it by array number?
Aubree Steen, FNTP (05:00):
Oh I do...
Dr. Philip Oubre (05:01):
So [crosstalk 00:05:01] for panels. And so they usually call them by-
Aubree Steen, FNTP (05:04):
It's Array 20.
Dr. Philip Oubre (05:05):
Array 20. [crosstalk 00:05:06] That has the blood-brain barrier tests-
Aubree Steen, FNTP (05:07):
The IGA and IgM. And we use this on multiple patients, which is kind of nice. And you can kind of see, how is my blood-brain barrier? Cause we say that a lot, especially with intestinal permeability. But you do have different toxins in different or like particles that cross the blood-brain barrier, which immediately impedes your brain. In the nicest way possible.
Dr. Philip Oubre (05:26):
So this test looks for antibodies against the blood-brain barrier, is one of the things it looks at. And the idea there is that your BBB, your blood-brain barrier is just that. It is a barrier to keep things out of the brain that may be circulating in the bloodstream. Say, well, I was going to use alcohol, but that, that cross the blood brain barrier, but say mold toxins, you don't want it to cross the blood-brain barrier. But if you're in, if your immune system is attacking the blood-brain barrier, then it makes it leaky. It makes it porous. There's holes in it. So things that aren't supposed to cross into the brain, can. This is of the ideas behind why two people can be exposed to something, one is perfectly fine, one is not; because their environment is different. So one person has a leak, your blood-brain barrier. So you can see this. And there are things that trigger the blood-brain barrier. Auto-immunity like gluten.
Aubree Steen, FNTP (06:10):
Right. And the cool thing about it is I'll tell you like a yellow, green, or a green, yellow, or red. Kind of like, do you have a lot of antibodies? Do you have minimal? Should you be concerned? And I think we've had even very sick patients who have stayed in the green, which is kind of nice.
Aubree Steen, FNTP (06:25):
The next one is Array 7X, and that's the neurological autoimmunity. So do you have autoimmunity? Is your body attacking the brain itself? And that has quite a few things like the myelin basic protein antibodies to myelin sheath in the brain.
Dr. Philip Oubre (06:37):
Myelin is the thing that coats the nerves to protect them because the nerve is stretched over really long spaces. Every cell is microscopic and linked, but you think there's two cells that go from the brain all the way to your foot. Two cells. Okay. That nerve is stretched really, really long. There's one that goes from the brain to the spinal cord. And another one that goes from the spinal cord to the foot, that's two cells that are stretched feet. Yeah. Okay. So those nerves, they obviously can't survive. So the myelin sheath coats them, kind of like insulation or electrical wire and there's nurse cells that feed that myelin sheath in order to support that nerve. So if your immune system is destroying the insulation, the nerve can't fire. So I use the example of brain to foot, but say that's brain to brain, say that's focus, say that's vision, say that's hearing, whatever it may be. You can damage your ability to think.
Aubree Steen, FNTP (07:24):
Yeah. Next one is asialoganglioside.
Dr. Philip Oubre (07:30):
That's interesting. So the ganglion cells are the ones that protect the brain.
Aubree Steen, FNTP (07:35):
Dr. Philip Oubre (07:36):
That must just be some sort of protein made by a brain cell that's specific to a brain cell.
Aubree Steen, FNTP (07:41):
Yeah. A couple other ones, I guess. Synapse ... So there's cerebellar, which obviously cerebellum is attacking the cerebellum. Often made of tubulin and then the synapse of those nerve cells, how they communicate towards each other as well. So it has about like six to seven different markers on here that kind of tell you, where are you? Are you within range? Are you equivocal? Are you out of range? Or do you have a big issue or not?
Dr. Philip Oubre (08:02):
And this is something any doctor can order. They can call Cyrex, set up an account. Their tests aren't cheap unfortunately, but you order the test. It's a simple blood test, it doesn't require a whole lot of effort. If somebody can draw blood and they can send it in.
Aubree Steen, FNTP (08:15):
But it's kind of good if you have that patient or if you are that patient who is super nervous, if you do have autoimmunity and you are having brain fog and all these others issues and you're like, "How much is my brain being attacked?" Because there's a difference of neurological autoimmunity versus symptoms of having brain fog from mycotoxins. I mean, obviously that can eventually lead to neurological autoimmunity, but if you are very anxious and you really do just kind of want to quantify where's my health at, testing is always a really good way to go.
Dr. Philip Oubre (08:42):
There's other labs that do similar things. So we've used the Cunningham panel in the past. We use Vibrant America, they call their test the Neural Zoomer. And so it's just working with your provider as far as which lab they choose to use. I'd say Cyrex was probably one of the pioneers there, but all the labs do great work. And so just find out what wherever your price point is. But then you have to get down to the root of treating that, right? So if you have brain autoimmunity, then you actually have to reverse the autoimmune condition. And I, we believe, and we have seen that almost every autoimmune condition, autoimmune patient that has come to us, we have been able to reverse their disease, reduce their, their symptom burden. And so that's not a test that you do, and then you go, "Oh my God, that's it, I'm might as well go dig my grave now".
Dr. Philip Oubre (09:25):
Right? You're doing that market to find out that you have a problem, you're going to take your health seriously. You're going to start working with a functional medicine provider. You're going to take our courses, start changing your health on your own without having to pay the expense of a functional medicine provider. And you're going to take over your health and you can reverse this on your own by doing that.
Aubree Steen, FNTP (09:40):
Dr. Philip Oubre (09:41):
So there's all kinds of other tests you can do for brain health. Those are the ones that are pretty specific to the brain, unless there's anything else you can think of that are specific blood tests?
Aubree Steen, FNTP (09:52):
No, I mean, one of the ways I do like Cyrex, if you see those numbers and try to do their intestinal permeability tests and see, where are you, do you have intracellular or paracellular kind of testing on permeability kind of like, is it blown through the cell? Is it through the cell and endotoxemia where you can see there's toxins leaking to the gut? And usually that is related to blood-brain barrier dysfunction. So other than that, not really
Dr. Philip Oubre (10:15):
Do not rely on CT scans and MRIs to assess brain function. All that looks at is the structure, right? So if you look at a house, it could be beautiful on the outside and it could be totally rotten hoarder on the inside. Right? So just because you have an MRI of the brain and you don't see anything, don't think that, "Oh, well they'll just never find it." That's just looking at the structure. You have no idea what's going on in the biochemistry. You have no idea what's going on at the cellular level. There's all kinds of other root causes that go with brain health. Those are the specific brain tests. I guess functional MRI is another thing that's getting more popular. It's not really my favorite. I think the functional MRI uses some sort of radioactive dye and it doesn't really change a whole lot. When you can test things without radiation that's always my preference. But the functional MRI is really neat to see. I think it will get more popular over time. It's just hard to find.
Dr. Philip Oubre (11:04):
So don't forget that there are still other causes of brain health. We always go back to the five finger metaphor. So to go over that, I've done it in other videos. But gut is number one, biological toxins, which are found in the gut and sinuses from yeast and bacteria. Number three is mold, which we talked about in a previous video on brain health. Number four is environmental chemicals. And number five is heavy metals.
Dr. Philip Oubre (11:26):
We see a lot of heavy metals linked to brain dysfunction. And yes, that's one of those things that unfortunately, until you do the test, you have no idea if you're heavy metal overload or not. The majority, and I made the majority, I'd probably say 99% of our patients that come back with excessive heavy metal levels have no idea where they got them and had no idea that they were that high until we did the test. So heavy metals is one of those things that I constantly preach on. You've got to find a heavy metal provider that's competent and can do it safely to find it if you have a problem. And once you know that you don't, then you can move on to the others. But heavy metals, and especially lead and mercury love to affect the brain.
Aubree Steen, FNTP (12:04):
Moldy people, super brain. Yeah. One thing I do want to say is, please don't waste your money on these tests if you're not going to change your diet first. And I really mean that, like, take out the most inflammatory foods, take out gluten and dairy and sugar and then see if it improves and then maybe get it tested as well. But sometimes it's like, yeah, you can test it. But if you're still eating a ton of really bad food, that's known to cause brain fog and confusion and dizziness and exhaustion and things, just do yourself a favor and limit those just for a little bit and then get tested.
Dr. Philip Oubre (12:35):
There's a lot more science coming out in these tests. So these are just some of the earliest markers that are being discovered right now. I wouldn't doubt fast forward in two or three years, that that panel is now 20 markers long. We've just got a long ways to go in autoimmunity and brain.
Aubree Steen, FNTP (12:48):
Dr. Philip Oubre (12:49):
So that'll wrap up this video, be sure to like our channel subscribe. Hit the little bell to get notifications when we make another video and until then get working on that brain health. Okay. See you later.