Brain on Fire Part IV- Repairing the Damage Caused by Inflammation

January 13, 2014

visiting By Dr. Erin Wiley, ND

If you missed the earlier installments of  the “Brain on Fire” series by Dr. Wiley, check them out on the BLOG!

We live in an environment that promotes inflammation. Even after we do our best to decrease our exposures to the causes of inflammation, tissue damage may occur and repair needs to be done for our brain to function at its best. Fortunately, the body has many self-healing mechanisms. Natural substances in our environment can be used to help the body with the task of recovery and repair. We will explore two categories or support: “antioxidants” and  “Nrf 2 Activators”.

Antioxidants by name and by nature repair oxidative damage to tissues in the body. Two of the top anti-oxidants used in my practice to support depression include Alpha Lipoic Acid and N- Acetyl- Cysteine. Alpha Lipoic Acid is a powerful antioxidant that prevents and repairs damage. Its mechanism of action improves insulin sensitivity, increases tryptophan in the brain and promotes serotonin synthesis [21]. Studies show that this nutrient specifically protects neurons and brain tissue [22]. Alpha Lipoic Acid also participates in the induction of glutathione synthesis (glutathione is considered to be the most powerful antioxidant in the body). Alpha Lipoic Acid can be given by mouth or by IV administration.

N-Acetyl Cysteine is also another powerful antioxidant that repairs damaged brain tissue and promotes the body’s primary anti-oxidant, Glutathione. N-acetyl cysteine has been demonstrated to be neuroprotective in a variety of neurodegenerative disease models [23]. Both Alpha Lipoic Acid and N-Acetyl- Cysteine should be used under the supervision of your Naturopathic Doctor, as the dose is dependant on the client and client’s need to be monitored for side effects and interactions.

Another route of support for tissue repair is to become your own genetic architect through Nrf2 Activation and gene expression. The body has the ability to produce its own antioxidant and detoxification enzymes internally. Nrf2 is a genetic pathway that regulates the production of antioxidants such as glutathione and superoxide dismutase (SOD). This genetic pathway also regulates the production of detoxification enzymes and down regulates signaling factors that promote inflammation. You can influence your own genetic ability to repair tissue, support detoxification and calm inflammation just by consuming foods and supplements that promote this pathway!

One primary activator of this pathway is Sulforaphane, and primary component of cruciferous vegetables like broccoli, cabbage, and Brussels sprouts. Sulforaphane is most concentrated in broccoli seed extract. While changes in your diet to include more cruciferous vegetables are highly recommended, sulforaphane can also be taken as a supplement that protects brain tissue and decreases inflammation [24-26].

Curcumin is another nutrient that has been promoted for its anti-inflammatory activity. Curcumin has been studied for its effect on many neurodegenerative diseases, including a neuroprotective effect on major depression. While its action is not fully explained, it is believed to be effective due to its powerful anti-inflammatory and anti-oxidative properties [27]. While Curcumin is found in Tumeric and is considered part of an anti-inflammatory diet, it can be limited by the body’s ability to absorb the nutrient from the digestive system. Science has helped us improve its absorptive capacity by creating supplements made from a supra-critical extract, containing 95% curcuminoids, or by adding black pepper to enhance absorption.

Through simple nutrient supplementation with anti-oxidants and Nrf2 activators that promote the production of detoxification enzymes and down regulate inflammation, we have the opportunity to repair the neural damage that leads to, and is caused by, inflammation. On a long term basis, supplements such as fish oil and probiotics support an anti-inflammatory effect on the entire body and promote optimal mood and anti depressant effects that are extremely safe.  On an individual level we can play our part by promoting stress reduction, increasing exercise, and eating a diet that is low in carbohydrates and rich in healthy fats. These steps help support a healthy lifestyle that can decrease the rates of depression in our population. An integrative approach offers choice to individuals suffering with depression and the synergistic effects of these combined treatment options cannot be ignored. You can choose the interventions that are best suited to your level of readiness for lifestyle change and your Naturopathic Doctor can help you choose the integrative therapeutic options that work in conjunction with standard medical treatments for depression.


21. Salazar MR. Alpha lipoic acid: a novel treatment for depression. Med Hypotheses. 2000 Dec;55(6):510-2.

22. Packer L, Tritschler HJ, Wessel K. ?Neuroprotection by the metabolic antioxidant alpha-lipoic acid.Free Radic Biol Med. 1997;22(1-2):359-78.

23.Berk M, Malhi GS, Gray LJ, Dean OM. The promise of N-acetylcysteine in neuropsychiatry. Trends Pharmacol Sci. 2013 Jan 28.

24. Chen H, Wu J, Zhang J, Fujita Y, Ishima T, Iyo M, Hashimoto K.

Protective effects of the antioxidant sulforaphane on behavioral changes and neurotoxicity in mice after the administration of methamphetamine.

Psychopharmacology (Berl). 2012 Jul;222(1):37-45.

25. Chen G, Fang Q, Zhang J, Zhou D, Wang Z. Role of the Nrf2-ARE pathway in early brain injury after experimental subarachnoid hemorrhage. J Neurosci Res. 2011 Apr;89(4):515-23. d

26. Brandenburg LO, Kipp M, Lucius R, Pufe T, Wruck CJ. Sulforaphane suppresses LPS-induced inflammation in primary rat microglia. Inflamm Res. 2010 Jun;59(6):443-50. doi: 10.1007/s00011-009-0116-5.

27. Kulkarni SK, Dhir A. . Overview of Curcumin in Neurological Disorders.

Indian J Pharm Sci. 2010 Mar-Apr; 72(2): 149 15412.


Dr. Erin Wiley is a naturopathic doctor with a strong focus on preventative and integrative medicine. She is the Co-founder and Clinic Director of the Integrative Health Institute, an integrative medical clinic located in downtown Toronto. Erin has a strong clinical emphasis on stress related illness, anxiety, depression and hormone balance. As a naturopathic doctor, Erin is passionate about working with people to help them better understand their health and achieve their health goals.

About Integrative Health Institute:

The Integrative Health Institute (IHI) is a modern and dynamic clinic, founded in naturopathic philosophy and embodying team-driven healthcare. IHI reflects a vision to create an urban health centre that is driven by a team of practitioners passionate about health promotion and illness prevention. Since its inception, IHI has grown to become a full service integrative health clinic, with more than 13 practitioners including naturopathic doctors, osteopathic & chiropractic doctors, massage therapists, and nutritional/lifestyle coaches.

Contact Information:

Dr. Erin Wiley can be reached at or please visit her website at

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