《为什么我的大脑不好使了》（第二十一章）翻译项目报告.pdf

'．妥站．＇—广■一‘粋＇—’Ｉ－１：．－—＾＾：？体感據六壽巧译专业学位硕±论文．＇《６针ＡＡ？夫雜豕ＡＡ了》４一（第？卡章＾知々巧《振４张晚巧巧巧教巧Ｓ巧天敏巧巧专业名巧：巧译巧古巧巧巧向：巧巧笔巧论文巧女时间：２０１６年４月论义巧巧时间：２０１６年５月论义编々：２０１６４０３巧、；－－－■－却‘。．．皆．１．＇＾譯＊－一．？却－ SichuanInternationalStudiesUniversityATranslationProjectReportonWhyIsn"tMyBrainWorking（Chapter21）byZhangXiaomingAthesissubmittedtotheGraduateSchoolinpartialfulfillmentoftherequirementsforthedegreeofMasterofTranslationandInterpretingunderthesupervisionofProfessorJiangTianminChongqing,P.R.ChinaMay2016 《为什么我的大脑不好使了》第二十一章翻译报告摘要本文是一篇翻译报告。翻译项目原文为《为什么我的大脑不好使了》一书中的第二十一章。该书由美国洛马林达大学医学院预防医学临床副教授、美国国立大学健康科学学院的兼职教授达特斯·克雷恩（DatisKharrazian）于2013年所著。书中主要讲述的是大脑健康与日常饮食的关系，以及如何改善大脑亚健康的方法。作者在文中强调的重点包括：大脑亚健康并不只出现在高龄人群中，其趋势正逐渐向低龄化发展。我们只需通过简单的饮食和生活习惯变化，以及普通的营养治疗即可提高大脑健康程度。本篇项目的原文本属于信息类文本，报告主要使用的是在翻译信息类文本时所需的翻译理论——文本类型理论。本篇翻译报告主要包括两大部分：一、笔者基于原文的主要内容、文章结构以及语言特色、翻译时遇到的难点及其应对方法，对文章进行重点研究后完成的翻译报告。报告首先介绍此翻译项目的背景和意义，接着对原文的特征进行分析，然后介绍翻译理论指导、翻译难点及应对方法。报告最后将整个翻译过程中所取得的经验和教训进行总结，并提出局限性。二、英文原文第二十一章及其中文翻译。关键词：翻译方法；意译；翻译难点；文本类型翻译理论ii ATranslationProjectReportonWhyIsn"tMyBrainWorking(Chapter21)AbstractThisisatranslationreport.WrittenbyDatisKharrazianin2013,thesourcetextisthechapter21ofWhyIsn"tMyBrainWorking,whichteachespeopleeasystrategiestoimprovetheirbrainfunction.Thepoorbrainhealthdoesn’tjusthappentoseniors—braindisorderanddegenerationareontheriseforyoungandoldalike.Thekeystoneofthisbooktellsushowsimpledietandlifestylechangesandnutritionaltherapycanprofoundlyimpactpeople’sbrainhealthaswellasthequalityoftheirlife.ThistranslationprojectincludesanE-CtranslationofChapter21ofthebookandatranslationreport.Drawingonthetranslation,thereportsummarizesthedifficultiesencounteredinthetranslationandcorrespondingsolutions.Specifically,basedonTextTypologyTheory,itanalyzesthetextfunctionsofmedicalmaterialsandcorrespondingtranslationmethodsusedintheproject,suchasfreetranslationandsoon.Itaimstoprovidingapracticalguidancefortranslatinganinformativetext.Keywords：translationmethods;freetranslation;translationdifficulties;texttypologytheoryiii AcknowledgementsMycordialandsincerethankswouldfirstgotoProfessorJiangwhoinspiredmemosttochoosethisprojectandprovidedmewithmuchsupportduringthetranslationprocess.Heworkeddiligentlyontranslationtheoryandthenimpartedusentirely,whichhelpedmetoaccomplishthisthesis.Secondly,thousandsofthankswillbegiventotheTranslationAcademy,forthestrictdemandandrequirementtheymade,whichencourageustocompleteahighstandardandmeaningfultranslationreportinourwholelife.Moreover,warmappreciationisrenderedtomyfriendsWuYulian,whoproofreadmythesiscarefullyandunderlinedtheerrorsbothingrammarandformat.Lastbutnotleast,amillionthankswouldalsobegiventomyparentswhoalwaysbelievingme,givingmeconfidenceinovercomingallofthedifficulties.iv Contents摘要.............................................................................................................................ⅱAbstract.......................................................................................................................ⅲAcknowledgements.....................................................................................................ⅳChapterOneIntroduction..............................................................................................11.1DescriptionoftheTranslationProject.............................................................11.2ProjectSignificance.........................................................................................21.3ProjectStructure...............................................................................................3ChapterTwoIntroductiontotheSourceText...............................................................42.1AbouttheAuthor.............................................................................................42.2AbouttheSourceText.....................................................................................42.2.1Content..................................................................................................42.2.2LinguisticFeatures................................................................................5ChapterThreeTheoreticalGuidanceandTranslationMethods....................................63.1TheoreticalGuidance.....................................................................................63.2TranslationDifficulties....................................................................................63.3MedicalandNutritionTerms...........................................................................73.4FreeTranslation...............................................................................................83.4.1Negation................................................................................................9ChapterFourConclusion.............................................................................................114.1TranslationExperience..................................................................................114.2ProblemsUnsolved.......................................................................................11References...................................................................................................................12Appendix1SourceText..............................................................................................13Appendix2ChineseVersion.......................................................................................45v ChapterOneIntroductiontotheTranslationProject1.1DescriptionofthetranslationALotofworkhasbeendonetofinishtheproject,ofwhichIchosethefollowingtoexplainhere.Thefirstisaboutmychoiceofthesourcetext.Thenumberofpeoplewhosuffersfrombrainfog,lossoffocus,lossofmemory,ordepressionisincreasingconstantly.Butsofartherehaven’tsimilarbooksinChina,nottomentionmostofourChineseevendidn’tnoticesuchaproblem.Throughthisbook,wecanhaveabasicunderstandingofourbrainsituation,noticethesignificanceoftakingintoaccountourbrainhealth,andlearnthesimplemethodstodealwithpoorbrainhealth.ThereasonthatIchoosethelastchaptertotranslateisbecausethischapterisaconclusionofthewholebook.Notknowingmuchaboutthemedicalknowledge,ItriedmybestinbackgroundreadingandlookingupforrelevantterminologywhenIstartedtotranslate.Withthehelpoftoolslikegoogle,Baidu,etc.,IfinishedthefirstdraftoftranslationonJanuary,2016,thesecondMarch,2016andthethirdApril,2016.Improvementsweremadeintherevisionsintermsofnaturalness,correctnessandfaithfulness.WhatIhopetoconveythroughthisprojectisthatourChineseneedtoraisetheirawarenessofpoorbrainhealth,followthesuggestionsthedoctorgivesandgetabetterbrainhealth.1 1.2ProjectSignificanceFatiguefromreading,drivingorworking,etc.,asmountingcasesreportedindicate,couldbesignsofpoorbrainhealthorbraindegeneration.Braindegenerationisaseriousproblemthatgoeslargelyunaddresseduntilit’sintheendstagesandtoolatetorescue.There’snosimilarbookorphysicianguidanceteachingustonoticethiskindofproblem,toattachgreatimportancetotheseverityofpoorbrainhealth,andtodealwithitseriously.Apartfromgoingtothehospital,there’snothingwecandoevenifwehaveapreliminaryawarenessofbrainhealthproblem.ThisprojectintendstocallonChinesereaderstopayenoughattentiontobrainhealthandlearnhowtogettheirbrainbackbytakingsimplemethodsprovidedinthebook.Theauthorofthebookhasspentmorethanadecadeteachingthousandsofhoursofpostgraduateeducationinnon-pharmaceuticalapplicationstochronicillnesses,autoimmunedisorders,andcomplexneurologicaldisordersallovertheworldtohealthcareproviders.Thisbookharnessescutting-edgescientificresearchforsafe,simple,andtrulyeffectivesolutionstodecliningbrainfunction.Readerscanlearnhowsimpledietandlifestylechangesandnutritionaltherapycanprofoundlyimpacttheirbrainhealthandthusthequalityoftheirlife.Thisbookbenefitsmyfamilyalot.Wakingupat2-4a.m.frequentlyinthepast,mymotherrarelysleptwellatnight,leadingtoseriousconsequenceslikeeasyfatigue,andbeingweakandemotional.Knowingthatmymothersufferedfromhypoglycemiaforalongtime,Ineverconnectherinsomniatohypoglycemia.IwassuddenlyenlightenedwhenItranslatedthesectionofStabilizingBloodSugar,whichpointsout,“Donoteatsweetsorstarchyfoodsbeforebed.Thisisoneoftheworstthingsthehypoglycemicpersoncando.Yourbloodsugarwillcrashduringthenight.Chancesareyouradrenalswillkickintoaction,creatingrestlesssleeporthat3a.m.wakeupwithanxiety”.Ifollowedtheadviceandmymothergotabigrelieffrominsomniaafterherdinnerchanged.2 1.3ProjectStructureThistranslationreportincludesfiveparts.Thefirstpartisabriefintroductionofthewholetranslationproject,consistingofitsbackground,significanceandstructure.Thesecondpartisaboutthesourcetext,includinganintroductiontotheauthorandthebook,thegeneralinformation,contentsandfeaturesofthesourcetext.Thethirdpartistoexplainthetranslationtheoryandtranslationmethodsappliedinthetranslationproject.Thefourthpartdealswiththedifficultiesandsolutionsintranslation,suchasdiction,additionandomission,conversionanddivision.Thefifthpartistheconclusion,whichsummarizeslessonsdrawnfromtheproject,andsomeproblemstobesolvedinthetranslationproject.3 ChapterTwoIntroductiontotheSourceText2.1AbouttheAuthorDr.KharrazianservesasanassociateclinicalprofessorfortheDepartmentofPreventiveMedicineatLomaLindaUniversitySchoolofMedicineandisanadjunctprofessorattheNationalUniversityofHealthSciencesandBastyrUniversity.Dr.DatisKharrazianhasspentmorethanadecadeteachingseveralthousandhoursofpostgraduateeducationinnon-pharmaceuticalapplicationsforchronicillnesses,autoimmunedisorders,andcomplexneurologicaldisordersallovertheworldtohealthcareproviders.Hehastrainedthousandsofhealthcareprofessionalsinanevidence-andphysiological-basedmodelofclinicalpractice.Hisreputationnotonlyasaneducatorbutalsoasaclinicianhasbecomerenownedworldwide.Theauthorhasalsobeenaleadingeducatorinfunctionalmedicineandnutritionandhaspersonallytrainedseveralthousandhealthcareprovidersinpost-graduateseminarsduringthelast15years.Theseseminarsareapprovedbythepost-graduatedepartmentattheUniversityofBridgeport.Healsospeaksatnumerousnationalandinternationalmedicalsymposiumseveryyear.2.2AbouttheSourceText2.2.1ContentThisbookoffersarevolutionaryunderstandingofbraindeclineandeffectivestrategiestorecoverbrainhealth.Itexplorestheunderlyingcausesofwhyyourbrainisn’tworking,whyyouhaveachronichealthproblem,orwhyyoudon’tfeelasgoodasyouoncedid.Weareexperiencingacriticallackofawarenessandcarefortheexplosionofchronicneurologicalandautoimmunecases—the“mystery”conditions—inourpopulationtoday.Itteachesushowtorecognizethedisease,andthenhowtodealwithit.Chapter21sumsupthegistofthewholebook,offeringa4 referenceguideforbrainhealth.Theseincludesimpledietandlifestylechangesandnutritionaltherapy.2.2.2LinguisticFeaturesWhyIsn’tMyBrainWorkingisaninformativetext.AlthoughasmallpartofthecontentisinclinedtooralEnglish,therestofthebookisquiteformal.Manyspecializedvocabulariesareusedinthisbook.Amongthemaresomeveryimportantnotions,suchasleakygut,Lectins,L-glutamine,CoQ10andPhosphatidylserine.Mostsentencesinthesourcetextarenotofcomplicatestructure.Simplesentencesareused,togetherwithformalexpressions,toforegroundcertaininformation,forexample,Nofoodisamorepotenttriggerofneurologicalproblemsandautoimmunitythangluten.Whenadviceisgiven,animperativesentenceisusedtomakeitdirectandconcise,forexample,Useacoffeeenemaforpoormotilityandtoimprovevagalplasticity.Still,complexandcompoundsentencesarenotrareinthesourcetext,forinstance,althoughneurotransmittersupportcanoftenpromotebrainhealth,itshouldnotbeviewedasaone-size-fits-allapproachthatwillworkforeveryoneoreverycondition.Thissentenceincludestwosubordinateclauses,anadverbialclauseofconcessionledby“although”andarelativeclauseledby“that”.5 ChapterThreeTheoreticalGuidanceandTranslationMethods3.1TheoreticalGuidanceKatharinaReisssuggests“specifictranslationmethodsaccordingtotexttype”.Accordingtohertypology,textcanbeinformative,expressive,operativeandaudio-medial.Informativetextincludesnewsreports,educationaltext,inventories,pressreleasesandcomments,commercialcorrespondence,inventoriesofmerchandise,operatinginstructions,directionsforuse,patentspecifications,treaties,officialdocuments,thenaturalsciences,andothertechnicalfields.Shedefinesinformativetextasfollows:“Plaincommunicationoffacts:information,options,etc.Thelanguagedimensionusedtotransmittheinformationislogicalreferential,thecontentor‘topic’isthemainfocusofthecommunication,andthetexttypeisinformative.”(Munday,2008,p72)Accordingly,“theTTofaninformativetextshouldtransmitthefullreferentialorconceptualconceptoftheST.Thetranslationshouldbein‘plainprose’,withoutredundancyandwiththeuseofexplicitationwhenrequired”.(Munday,2008,p73)3.2TranslationDifficultiesThebiggestdifficultyintranslatinganinformativetextistheso-calledterminology,especiallyinourunknownarea.TheSToftheprojectcontainsnumerousmedicaltermsandnutritiontermswhichIdonotknowwell.Inthiscase,thetranslatortriedeveryefforttoensuretheaccuracyandreadabilityofthetranslationmainlybylookingupallkindsofparalleltext.TobefaithfultotheST,literaltranslationisused.Thecompoundsentenceandcomplexsentencearebigchallenges,too.SyntaxdifferencesexistbetweenEnglishandChineseintermsof,amongothersthings,structure.Tobridgethedifferences,thetranslatortrieddifferentmethodsflexibly,suchasnegation,freetranslation.6 3.3MedicalandNutritionTermsAsmentionedabove,thesourcetextisaninformativetext.“TheTTofaninformativetextshouldtransmitthefullreferentialorconceptualconceptoftheST.Thetranslationshouldbein‘plainprose’,withoutredundancyandwiththeuseofexplicitationwhenrequired.”(Munday,2008,p73)Basedonthisadvice,Iemployedliteraltranslationtodealwithfrequentmedicalandnutritionterms.Tofacilitatetargetreaders,especiallycommonreaders,tobetterunderstandtheliteraltranslations,Iexplainedthemedicaltermsconsideringthattheymaynotknowthemeaningoftheseterminologies.Forexample：Example1:ST:leakygutTT:肠漏症(肠漏症是肠道因感染、过敏、发炎或失去健康的菌群相平衡时，肠粘膜受到破坏而失去完整性，此时肠道内许多未被消化的大分子、代谢所产生的废物或微生物毒素等物质，会透过渗漏的肠壁进入血液循环中，今而刺激自身免疫系统，危害肝脏胰脏等器官，从而引起各种疾病如自体免疫疾病、如腹胀、痉挛等肠胃疾病、疲劳、食物敏感度增加、关节痛以及皮疹等疾病。)Itookthefollowingsteps:Isearched“leakygut”inBaidutofinditsChineseequivalent:IputthecorrespondingChinese“肠漏症”inBaiduagaintofindmoreaboutthis7 terminology.Ichoseanreliablesourcetogettheexplanation.3.4FreeTranslationDifferenttranslationstrategiesshouldbeusedindifferentsituationtoensureaccurateinformationconveyedintheTTandunderstandabletotargetreaders.Forinstance,whennecessary,Iusedfreetranslationtomakethetranslationsmoothandconformtothenormsofthetargetlanguage.Freetranslationisatranslationprocedurewherebythetranslatorreplacesawordinthesourcetextbyagroupofwordsoranexpressioninthetargettext.Whateverthesourcetextis,informationloss,causedbyculturaldifferencesbetweensourcelanguageandtargetlanguage,isprevailingintheprocessoftranslation(夏廷德,2006,p.202).Example2:ST:Weknowthehealthofthegutprofoundlyimpactsbrainhealthandfunction.Likewise,poorbrainfunctioncanimpactgutfunctionbyimpairingactivityofthevagusnerve,whichhandlescommunicationbetweenthebrainandgut.Symptomsofpoorvagalfunctionincludepoor8 intestinalmotility(constipation),poordigestiveenzymeproduction(bloating,indigestion),floatingstoolorundigestedfoodinstool,andsymptomsofpoorliverdetoxification.Youcanimprovetheplasticityandfunctionofthevalgusnervewithsomesimpleexercises:TT:我们知道，肠道的健康对大脑的健康运转有着深刻的影响。同样，大脑在亚健康的状况下，迷走神经的系统活动会降低，对肠道健康造成影响。大脑与肠道的之间的联系就是通过交感神经完成的。迷走神经紊乱的症状包括：肠动力不足（便秘）、消化酶分泌不足（腹胀、消化不良）、腹泻或不消化以及肝脏排毒不畅。可通过一些简单的锻炼提升交感神经的适应性和功能：Inthisparagraph，theword“poor”showedupforseveraltimes,butitshouldnotbetranslatedinonemeaning.FromWikipedia,“Poorisanadjectiverelatedtoastateofpoverty,lowqualityorpity”.InChinese,itmeans“低劣的”,“次等的”,“衰弱的”,“不幸的”,etc.SincetheSTisaboutbrainfunction,“poor”means“sub-healthycondition”.Butstill,itcannotbetranslatedintoonesameword.Differentwordshouldbeusedindifferentphrase.Forexample,“Poorbrainfunction”means“大脑亚健康”,“poorvagalfunction”means“迷走神经紊乱”,“poorintestinalmotility”means“肠动力不足”,“poordigestiveenzymeproduction”means“消化酶分泌不足”and“poorliverdetoxification”means肝脏排毒不畅.Example3:ST:Useacoffeeenemaforpoormotilityandtoimprovevagalplasticity.TT:用咖啡灌肠法提高肠动力，提高迷走神经可塑性。Inthissentence,“poormotility”means“动力不足”.Itisnothardtofindliteraltranslationdoesn’tworkhereifweconsiderthemeaningofthewholesentence.“Usecoffeeenematoenhancepoorintestinalmotility”istheimplicationof“Useacoffeeenemaforpoormotility”.Example4:ST:Usegoodjudgmenttoworkwithinyourlimitsanddonotharmyourself.TT:运动时准确判断你的身体承受极限，千万不要伤害到自己。“Goodjudgment”means“好的判断力”.Iftranslatedliterally,itwillbe“运用好的判断力判断身体承受极限.”ItisinappropriateinChineseandabetterwayistorestructurethesentenceaccordingtothecontextandfindoutitsimplications.Then,thewholesentencecanbe“运动时准确判断你的身体承受极限，千万不要伤害到自己.9 3.4.1Negation(正说反译)NegationherereferstothetranslationstrategyofputtingthemeaningofSTinatotallydifferentwayintheTTtoconformtoitsnorm,especiallywhenthewayofSTisagainsttheChineseexpressionhabit.(Zhang,2009,p99)Itiscommonthatnegationisusedintranslatingnegativesentences.Forexample,“Nodepositwillberefundedunlessticketproduced.”willbetranslatedinto“凭票退还押金”and“Iwon"tkeepyouwaitinglong”willbetranslatedinto“我一会儿就回来”.Example5:ST:Nofoodisamorepotenttriggerofneurologicalproblemsandautoimmunitythangluten.TT：含谷蛋白的食物最易造成脑神经失调和自身免疫失调。Thisisanegativesentencewithamore---thanstructure.IfItranslateitliterally,itwillbe“没有食物比含谷蛋白的食物更易引起脑神经失调和自身免疫失调”,alongcomplexsentencethatreadsawkwardinChinese.Example6:ST:AlthoughDHEAisnecessary,supplementingwithDHEAisonlyrecommendedforashortperiodoftimeandwhenlabtestingshowschronicadrenalfatigue.TT:尽管脱氢表雄酮是人体内必不可少的成分，但不建议进行长期补充，或只在实验测试结果表明肾上腺长期疲劳的情况下进行少量的补充。Themainsentenceis“supplementisrecommendedforashortperiodoftime”.Iftranslatedliterally,itwillbe“对某某只建议短时间的补充”.Inasimilarvein,tomakethetranslationmorenatural,negationseemednecessary,“不建议进行长期补充”.10 ChapterFourConclusion4.1TranslationExperienceAftercompletingthisproject,Iaccumulatedmanyvaluabletranslationexperiencestoimprovemytranslationskills.Someofthemaresummarizedbelow.Firstly,itisnecessarytomakeagoodpreparationbeforetranslation.ThewholetextshouldbereadfromAtoZandthetranslatorshouldlookupeverysingletermthatrelatedtomedicalandnutritionbeforehebeginsthiswork.Secondly,itisadvisabletousesometoolsandaskforhelpfromothers.Specifically,wheneverthetranslatorisnotcertainaboutmeaningsoftheSToritsChineseequivalent,heneedstomakefulluseofrelatedinstrumentsandnetworkresourcesandgofindteachersandclassmatesforhelp.Thirdly,thetranslatorneedstoreviewthetranslationstrategiesthathehaslearntinschoolandputthemintopractice.Inourcase,translationstrategiessuchasnegation,adaptation,freetranslation,etc.havebeentaughtfullybyourtutorandotherteachersoverthepasttwoyears.Thesestrategiescanhelpusalotinourjob.4.2ProblemsUnsolvedAlthoughthetranslationtaskhasbeendoneatthemoment,therearestillseveralproblemsleft.First,severaltermswerenotfoundontheInternetaftergreatefforts.IncaseImightnotunderstandthemcorrectly,IhadtheEnglishtermstogetherwithmytranslation.Second,duetoinsufficientbackgroundknowledge,althoughItriedmybest,thereareplacesinthetranslationwherethelogicseemsabittwisted.Therefore,Ineedtoworkhardertoexpandmyknowledgeandimprovemytranslationability.11 ReferencesBecker,AltonL..(2000).BeyondTranslation:EssaystowardaModernPhilology.AnnArbor,Michigan:UniversityofMichiganPress.DanielG.AMEN,M.D..(2006).MakingAGoodBrainGreat.U.S.:RandomHouse.Nida,EugeneA.&CharlesR.Taber.(2004).TheTheoryandPracticeofTranslation.Shanghai:ShanghaiForeignLanguageEducationPress.Reiss.Katharina.(1971).TranslationCriticism:PotentialsandLimitations:CategoriesandCriteriaforTranslationQualityAssessment.EroolF.Rhodes.Manchester:St.Jerome.MarkShuttleworth,MoiraCowie.(1997).DictionaryofTranslationStudies.London:SaintJeromePublications.Munday,J.(2008).TranslationasIntervention.London:BloomsburyAcademicPeterNewmark.(1981).ApproachestoTranslation.OxfordandNewYork:Pergamon.ZinanYeandLynetteXiaojingShi.(1988).IntroductiontoChinese-EnglishTranslation:KeyConceptsandTechniques.U.S.:HippocreneBooksInc..柯细香.(2013).翻译目的论及其翻译策.武汉：武汉纺织大学学报,廖七一.(2004).当代英国翻译理论.武汉：湖北教育出版社.连淑能.(2008).英汉对比研究.北京：高等教育出版社.马祖毅.(1998).中国翻译简史.北京：中国对外翻译出版公s司.谭载喜.(1998).新编奈达论翻译.北京：中国对外翻译出版公司.谭载喜.(1991).西方翻译简史(增订版).北京:商务印书馆.夏延德.(2006).翻译补偿研究.湖北：湖北教育出版社.张培基.(2009).英汉翻译教程.上海：上海外语教育出版社.12 Appendix1.SourceTextWHYISN’TMYBRAINWORKINGCHAPTERTWENTYONETHEBRAINHEALTHREFERENCEGUIDEInthissectionIwillgooverthebare-bonebasicsofwhatyouneedtoknowtogetyourbrainbackonline.OneofthemostcommoncomplaintsIreceivedafterthethyroidbookcameoutwasthatitwastoohardtounderstandortoodifficulttoimplement.Thetruthisthismaterialiscomplexanddifficulttounderstand.Ihavedonemybesttodistillextremelyintricateimmuneandneurologicalmechanismsintoinformationpeoplecanapply,butIagreeitmaynotbeeasytograspatfirst,evenforpractitioners(whichiswhythegoodpractitionersstudythematerialregularlyinsteadofjustshowingupatseminars).Throwinpoorbrainfunctionanditcanbedownrightoverwhelming.Althoughworkingwithaqualifiedpractitionerisfrequentlynecessary,youmustrealizethebulkoftheworkfallsonyourshoulders.Hippocratessaid,“Letfoodbethymedicineandmedicinebethyfood.”Whenitcomestoaddressingyourbrainhealth,yourfirstandmostimportantstep—andprobablyyourmostdifficult—ischangingyourdiet.TakechargeofyourbrainbytakingchargeofyourdietIfyouwantyourbraintoworkyouhavetochangeyourdiet.Thiscanmakeitmoredifficulttoeatout,eatatfriends’houses,grabeasysnacks,oreatdirt-cheap.Ifyouaregoingtocomplainendlessly,thenthisprogramisprobablynotrightforyou.Yournegativeattitudewillraisestresslevelsandinflammatorycytokines.Also,ifyouareworkingwithapractitioner,heorshewillnotbeabletogiveyouthebestcareifyouderailyourprogressbyeatingfoodsthat13 triggeraninflammatoryreaction.Ifyouhaveaneatingdisorder,Irealizethatcanmakethisdifficult.Thatisatopicforadifferentbook,buteveryeffortcounts,anditmaybeworthgettingprofessionalhelporgroupsupport.That’sthebadnews.Thegoodnewsismany,manypeopleexperienceprofoundimprovementonastricterdietandlovefollowingit.Manyalsoexperiencedevastatingreboundsthroughcheatsoraccidentalexposures,whichhelpscompliance.Theothergoodnewsis,thankstotheInternet,youcanfindsupportandfriendshipfromonlinetribesofpeopleonthesamepath.GOGLUTEN-FREE(CHAPTEREIGHT)Attheveryleastyoushouldadoptastrictgluten-freediet.Nofoodisamorepotenttriggerofneurologicalproblemsandautoimmunitythangluten.Standardlabtestingforglutenisnotreliable,asmostlabsonlytestforantibodiestoalphagliadinandintestinaltransglutaminase(TG2).Amorecompletescreen,suchasCyrexLabs’Wheat/GlutenProteomeSensitivityandAutoimmunityPanelArray3,includes:•alphagliadin•omegagliadin•gammagliadin•deamidatedgliadin•wheatgermagglutinin(WGA)•gluteomorphin•prodynorphin•transglutaminase-2(TG2)•transglutaminase-3(TG3)•transglutaminase-6(TG6)Ifyourbrainisnotworking,agluten-freedietisyourfirststeptowardbetterbrainhealth.14 THELEAKYGUTDIET(CHAPTERNINE)Inmanycases,goinggluten-freealoneisnotenough.Manypeople,particularlythosewithautoimmuneandneurologicalissues,havesensitivitiestootherfoodsduetocross-reactivityandleakygut.ThisisthedietIrecommendtopeopleexperiencingbrainhealthissues.Thisdietallowstheimmunesystemtorestandtheguttorepair,whichprofoundlyimpactsbrainhealthasdiscussedinChapterNine.LengthoftimeondietYoumayonlyneedtofollowthisdietforafewdaystoaweekafteraccidentalexposureoraslip.Oryoumayneedtofollowitforamonthormoretorepairleakygut.YoucanconfirmwhetheryouhaverepairedyourleakygutbyusingtheCyrexIntestinalAntigenicPermeabilityScreen.However,manypeoplewithautoimmunereactionsorbrainhealthissuesmakethisdietorsomevariationofitawayoflifeforoptimalfunction.Howoftenyoueat—keepingbloodsugarstableiskeyAkeyaspecttothisdietiskeepingyourbloodsugarstable.Thismeansyoushouldeatoftenenoughthatyoudonotbecomehungryorfeelyourenergycrash,whichwilltriggerstressandinflammation.Asyourbloodsugarbecomesmorestableyoumayfindyoucangolongerbetweeneating.KeepingoverallcarbohydrateconsumptionlowcomparedtothestandardAmericandiet(SAD)isvitaltostabilizingbloodsugar.Theamountofcarbohydratesapersonneedsvariesentirelyupontheperson,hisorherlifestyle,andhealthissues.FoodstoavoidYouavoidthesefoodsbecausetheyhavebeenshowntotriggerinflammationandstressinmanypeople,whichwillexacerbateyourautoimmunecondition,inflammation,andpoorbrainhealth.•ALLsugarsandsweeteners,evenhoney,agave,maplesyrup,coconutsugar,datesugar,etc.Donotbedeceivedby“low-glycemic”sweeteners;theyarestillhighinsugar15 •High-glycemicfruits:watermelon,mango,pineapple,raisins,grapes,cannedfruits,dates,driedfruits,etc.•Tomatoes,potatoes,ormushrooms•Grains:wheat,oats,rice,barley,buckwheat,corn,quinoa,etc.•Dairy:milk,cream,cheese,butter,whey.GheeisOKformanypeople,butitdependsontheindividual•Eggsorfoodsthatcontaineggs(suchasmayonnaise)•Soy:soymilk,soysauce,tofu,tempeh,soyprotein,etc.•Alcohol•Lectins—amajorpromoterofleakygut—foundinnuts,beans,soy,potatoes,tomato,eggplant,peppers,peanutoil,peanutbutterandsoyoil,amongothers•Instantcoffee:Manybrandsofinstantcoffeearecontaminatedwithgluten•Processedfoods•CannedfoodsFoodstoeatYouneedtogiveyourselfmoretimetoshopandpreparesoyoualwayshavesomethingonhandtoeatorwhenyougoout.Forresourcesvisitmywebsite.•Mostvegetables(excepttomato,potatoes,andmushrooms):asparagus,spinach,lettuce,broccoli,beets,cauliflower,carrots,celery,artichokes,garlic,onions,zucchini,squash,rhubarb,cucumbers,turnipsandwatercress,amongothers.•Fermentedfoods:sauerkraut,kimchi,pickledginger,fermentedcucumbers,coconutyogurt,kombucha,etc.Youwillprobablyneedtomakeyourownorbuyoneofthefewbrandsthataregenuinelyfermentedandfreeofsugarsoradditives.•Meats:fish,chicken,beef,lamb,organmeats,etc.•Low-glycemicfruits:apricots,plums,apples,peaches,pears,cherriesandberries,tonameafew.•Coconut:coconutoil,coconutbutter,coconutmilk,coconutcream•Herbalteas•Olivesandoliveoil16 FoodsensitivitypanelYoumayalsochoosetodoafoodsensitivitypaneltoconfirmwhethercertainfoodsarecausinganimmunereaction.TheCyrexLabsGluten-AssociatedSensitivityandCrossReactiveFoodsArray4testsforthesevariousfoodreactions.SUPPLEMENTSTOSUPPORTTHELEAKYGUTDIET(CHAPTERNINE)Thisdietisverytherapeuticinitself.However,youmaywanttofurthersupportthisdietwithvariousnutritionalandbotanicalcompoundstotameinflammationandfacilitaterepairofthegutlining.Nutrientstosupportthegutlining•L-glutamine•Deglycyrrhizinatedlicorice•Aloeleafextract•Tillandsia•Marshmallowextract•MSM•Gammaoryzanol•Slipperyelmbark•Germanchamomile•MarigoldflowerextractProbioticsProbioticscanbeanimportantpartofmodulatingthegut’simmunesystemandrestoringahealthybalanceofgutflora.•Saccharomycesboulardii•Lactobacillussporogenes•DDS-1Lactobacilliacidophilus•Arabinogalactan17 Detoxingyeast,bacteria,andparasitesSometimeseradicatingyeastandbacterialovergrowthsandparasitesisanecessarypartofrestoringguthealth.However,it’salsonecessarytotreadgentlyinthisterritory.Tooaggressiveofadetoxmakessomepeopleveryillwithsymptomsofnausea,vomiting,diarrhea,orothereffects.Alwaysstartslowlyandwithsmalldoseswhentakinggutdetoxifyingcompounds.Yeastandbacterialovergrowth•Undecylenicacid•Caprylicacid•Uvaursi•Cat’sclaw•Paud’arcoParasites•Wormwoodextract•Oliveleafextract•Garlicextract•BlackwalnutextractH.pyloriandbacterialovergrowth•Berberine•Yerbamansa•OreganoextractSTIMULATETHEVAGUSNERVE(CHAPTERNINE)Weknowthehealthofthegutprofoundlyimpactsbrainhealthandfunction.Likewise,poorbrainfunctioncanimpactgutfunctionbyimpairingactivityofthevagusnerve,whichhandlescommunicationbetweenthebrainandgut.Symptomsofpoorvagalfunctionincludepoorintestinalmotility(constipation),poordigestiveenzymeproduction(bloating,indigestion),18 floatingstoolorundigestedfoodinstool,andsymptomsofpoorliverdetoxification.Youcanimprovetheplasticityandfunctionofthevagusnervewithsomesimpleexercises:•Gargling:Drinkseverallargeglassesofwaterperdayandgargleeachsipuntilyoufinishtheglassofwater.Youshouldgarglelongenoughanddeepenoughtomakeitabitchallenging.Dothisexerciseforseveralweekstohelpstrengthenthevagalpathways.•Singloudly:Singasloudasyoucanwhenit’sappropriate.Thisworksthemusclesinthebackofthethroattoactivatethevagus.•Gag:Layatonguebladeonthebackofyourtongueandpushdowntoactivateagagreflex.Gagreflexeswiththetonguedepressorsarelikedoingpush-upsforthevaguswhilegarglingandsingingloudlyarelikedoingsprints.Youneedtoperformthemforseveralweekstoproducechange,justasyouwouldwithweighttraining.UseacoffeeenemaforpoormotilityandtoimprovevagalplasticityInpatientswithbraindegenerationandregularconstipation,Iencouragethemtoperformdailycoffeeenemas.PurchaseanenemabagwithananalinserttubeandalubricantsuchasKYJelly.Makeorganiccoffeeandcoolittoroomtemperature(avoidinstantcoffeeasitmaybecontaminatedwithgluten).Filltheenemabagwithcoffeeandlubricatetheanaltipofthetube.Youwillthenneedtolieonyourrightside.Itisbesttoperformthisinthebathtubincaseyouspillanything.Insertthetubeintoyouranusandraisethebagwithyourhandsoitishigherthanyourhead.Thehigheryouraisethebagthefasterthebagwillempty.Oncethecoffeehasdrainedfromthebagintoyourintestinestrytoholdthecontentsinyourbowelforfiveto10minutes.Youwillhaveurgestohaveabowelmovement,butholdthecontentsaslongasyoucan.STABILIZEBLOODSUGAR(CHAPTERFIVE)Balancingbloodsugarisvitallyimportanttobrainhealth.Symptomsofbothlowbloodsugarandhighbloodsugararesignsyourbrainmaybesufferingfromdamagecausedbyabloodsugarimbalance.19 SYMPTOMSOFBLOODSUGARIMBALANCESReactivehypoglycemiasymptoms(lowbloodsugarspikes):•Increasedenergyaftermeals•Cravingforsweetsbetweenmeals•Irritabilityifmealsaremissed•Dependencyoncoffeeandsugarforenergy•Becominglightheadedifmealsaremissed•Eatingtorelievefatigue•Feelingshaky,jittery,ortremulous•Feelingagitatedandnervous•Becomingeasilyupset•Poormemory,forgetfulness•BlurredvisionInsulinresistancesymptoms(highbloodsugarspikes):•Fatigueaftermeals•Generalfatigue•Constanthunger•Cravingforsweetsnotrelievedbyeatingthem•Musthavesweetsaftermeals•Waistgirthequaltoorlargerthanhipgirth•Frequenturination•Increasedappetiteandthirst•Difficultylosingweight•MigratingachesandpainsStabilizingbloodsugar•Eatabreakfastofhighqualityproteinandfats.•Ifyouhavehypoglycemia,eatasmallamountofproteinand/orhealthyfateverytwotothreehours.20 •Findyourcarbohydratetoleranceandsticktoit.Ifyoufeelsleepyorcravesugarafteryoueat,youhaveeatentoomanycarbohydrates.Youcanalsouseaglucometertocheckyourfastingbloodglucose,whichideallyshouldbeinthemid-tohigh-80s,andatleastbetween80–100.•Nevereathigh-carbfoodswithoutsomefiber,fat,orprotein.Thesewillslowdowntherateatwhichtheglucoseisabsorbedintothebloodstreamandhelpprevent“insulinshock.”•Donoteatsweetsorstarchyfoodsbeforebed.Thisisoneoftheworstthingsthehypoglycemicpersoncando.Yourbloodsugarwillcrashduringthenight,longbeforeyournextmealisdue.Chancesareyouradrenalswillkickintoaction,creatingrestlesssleeporthat3a.m.wakeupwithanxiety.•Avoidallfruitjuicesandcarrotjuice.Thesecanbemoresugarythansoda,andwillquicklyhaveyoucrashing.•Avoidorlimitcaffeine.•Eatawell-balanceddietconsistingmostlyofvegetables,andqualitymeatsandfats.•Eliminatefoodallergensandintolerances.NutrientstosupportbloodsugarbalanceYourdietisthemostprofoundwaytostabilizebloodsugar.However,certainnutritionalcompoundscanhelpstabilizehypoglycemiaorinsulinresistance.Nutrientstosupportahealthyresponsetohypoglycemia(lowbloodsugar)•Chromium•Bovineadrenalgland•Cholinebitartrate•Bovinelivergland•Bovinepancreasgland•Inositol•L-carnitine•CoQ1021 Nutrientstosupportahealthyresponsetoinsulinresistance(highbloodsugar)•Gymnemasylvestre•Banabaleafextract•Maitakemushroom•Bittermelon•OpuntiastreptacanthaLemaire•Guargum•Pectin•Chromium•Vanadium•Alphalipoicacid•VitaminE(tocopherols)•Magnesium•Biotin•Zinc•Inositol•Niacin•L-carnitineSometimesapersonwillswingbackandforthbetweeninsulinresistanceandhypoglycemia.InthesecasesIrecommendtakingnutritionalcompoundsforinsulinresistancewithmeals,andnutritionalcompoundsforhypoglycemiabetweenmeals.It’simportanttoworkwithaqualifiedhealthcarepractitionersoyoutaketherightnutrientsandbotanicalsintherightamounts.Takingthewrongnutrientsforyourbloodsugarconditionhasthepotentialtomakeyourconditionworse.DAMPENSTRESS(CHAPTERSIX)Ifyousufferfromthesymptomsbelow,stressmaybenegativelyimpactingyourbrainhealth:22 •Alwayshavingprojectsandthingsthatneedtobedone•Neverhavingtimeforyourself•Notgettingenoughsleeporrest•Nothavingenoughtimeormotivationtogetregularexercise•Notaccomplishingyourlife’spurposeReducinginflammationanddampeningthestressresponseareacoupleofwaystoaddresstheeffectsofstressonbrainhealth.Thismeansreducingdietarystressorswiththeleakygutdiet,managinglifestylestressors,andaddressinghealthimbalancesthatcontributetostress.Nutritionalcompoundstohelpmanagestress•Phosphatidylserine:Dampenstheinfluenceofstressonthebrain.Youcantakeitorally,butIpreferliposomalmethodsofphosphatidylserinedeliveredthroughtheskin.•Herbaladrenaladaptogens:Powerfulsupportwhenchronicstressisaproblem.Theseherbsworkonthestresspathwaysonthebrain,particularlyinthehippocampus.Youcanusethemindividually,buttheyhaveagreatersynergisticeffectwhenusedincombination.•Panaxginsengextract•Ashwagandha•Holybasilextract•Rhodiolarosea•EleutheroIMPROVEBRAINCIRCULATIONANDOXYGEN(CHAPTERSEVEN)Oneofthemostvitalnutrientsforthebrainisoxygen.Ifyousufferfromanyofthesymptomsbelowyourbrainmaynotbegettingoptimalamountsofoxygen:•Lowbrainenduranceandpoorfocusandconcentration•Mustexerciseordrinkcoffeetoimprovebrainfunction•Coldhandsandfeet•Poornailhealthorfungalgrowthontoes•Mustwearsocksatnight•Whitenailbedsinsteadofbrightpink23 •ColdtipofnoseChronicstress,anemia,smoking,lowbloodpressure,highbloodpressure,poorlungfunction,poorcardiovascularfunction,andanymechanismthatimpairsbloodvessels,suchasdiabetes,canimpairtheflowofbloodtothebrain.NutritionalcompoundsforbrainoxygenationAlthoughtheseherbalcompoundshavebeenshowntodilatecerebralarteries,theydonotincreasebloodpressure;infacttheycandotheopposite.•Feverfewextract•Butcher’sbroomextract•Ginkgobiloba•Huperzine•VinpocetineNitricoxideNitricoxideisachemical-signalingmoleculeinthebodyinvolvedwithcommunicationinthenervous,immune,andvascularsystems.eNOSandnNOSareanti-inflammatoryformsofnitricoxidewhileiNOSisinflammatoryandassociatedwithtissuedamagefromautoimmunedisease.Raisingyourheartratethroughhigh-intensityaerobicexerciseforatleastfiveminutesinthemorningisonewaytoreleaseanti-inflammatoryeNOS.Usegoodjudgmenttoworkwithinyourlimitsandnotharmyourself.Nutritionalcompoundsthatsupportnitricoxidemodulation•ATP(Adenosine5’-triphosphate)•HuperzineA•Xanthinolniacinate•Alpha-Glycerylphosphorylcholine(AlphaGPC)•Vinpocetine•N-acetylL-carnitine24 BloodpressureBothlowandhighbloodpressurecanimpacttheamountofoxygendeliveredtoyourbrain.Yourbloodpressureshouldbearound120/80.Ifthefirstorsecondnumberishigherorlowerby10points,thenyourbloodpressureisabnormal.Thegreatertheamountofdeviationfrom120/80theworseitis.LowbloodpressureForpatientswithlowbloodpressureIrecommendglycyrrhiza,anaturalcompoundfromlicoricethatincreasesthehormonealdosterone,whichhelpsyouretainyoursodiumandcanhelpraiselowbloodpressure.Manypeoplecanalsoraisetheirbloodpressuretonormalbysaltingtheirfood,supplementingwithlicoriceroot,andmanaginghypoglycemia.HighbloodpressureIfyouhavehighbloodpressureyoumustcutsaltfromyourdiet,exerciseroutinely,andreduceyourstress.Youcanalsotakenaturalcompoundssuchasmagnesiumandpotassiumtohelpbringyourbloodpressuredown.Supportingnitricoxidemodulationmayalsohelpreduceyourbloodpressure.DAMPENBRAININFLAMMATION(CHAPTERTEN)Inflammationinthebraindoesn’tcausepain,somostpeoplearen’tawareitmaybeanissueforthem.However,itacceleratesbraindegenerationandisassociatedwiththefollowingsymptoms:•Brainfog•Unclearthoughts•Lowbrainendurance•Slowandvariedmentalspeeds•Lossofbrainfunctionaftertrauma•Brainfatigueandpoormentalfocusaftermeals•Brainfatiguepromotedbysystemicinflammation25 •Brainfatiguepromotedbychemicals,scents,andpollutants.Braininflammationisconsideredamodelforchronicdepressionandothermooddisorders.Becausethebrain’simmunecells,microglia,havenooffswitch,inflammationinthebraincancontinuelongaftertheinsult.Factorsthatcausebraininflammationinclude:•Diabetesandhigh-carbohydratediets,whichleadtotheproductionofglycosylatedendproductsthatactivatethemicrogliacells•Lackofoxygenfrompoorcirculation,lackofexercise,chronicstressresponse,heartfailure,lungdisorder,anemia•Previousheadtrauma•Neurologicalautoimmunereaction•Dietaryglutenforthosewhoareglutenintolerant•Lowbrainantioxidantstatus•Alcoholanddrugabuse•Environmentalpollutants•Systemicinflammation•Inflammatorybowelconditions•Compromisedblood-brainbarrierLeakybrainchallengeYoucanperformtheLeakyBrainChallengetodeterminewhetheryourblood-brainbarrierispermeable.Take800–1,000mgofGABAandgiveyourselfatwo-to-threehourwindowtoseewhetheritaffectsyou.ItisbesttotakeGABAbetween6p.m.and9p.m.,soyoucansleepitoffifitsedatesyou.IfGABAcausesrelaxation,calming,andsedation,doesnotkeeptakingitregularlyoryouriskshuttingyourGABAreceptorsitesandaretestwon’tbeaccurate.IftheGABAcausesanxiety,irritability,orpanicthisalsoindicatesapermeableblood-brainbarrier(forreasonsexplainedintheneurotransmittersection).Eatingsomeproteinmayhelpalleviatethesesymptoms.FeelingnochangeaftertakingGABAisagoodsignyourblood-brainbarrierisintact.GABAshouldproducenosymptoms,asGABA“bouncesoff”ahealthyblood-brainbarrier.26 TamingbraininflammationThemostimportantstepstoreducingbraininflammationaretoaddressfoodintolerances,bloodsugarimbalances,gutinfectionsandinflammation,unmanagedautoimmunedisease,poorbrainoxygenation,chronicstress,hormonalimbalancesanddeficiencies,andmore.Whileaddressingthesefactorsyoucanuseflavonoidsthathavebeenshowntodampenthemicrogliacellsandbraininflammation.Theyinclude:•Apigenin•Luteolin•Baicalein•Resveratrol•Rutin•Catechin•CurcuminMANAGENEUROLOGICALAUTOIMMUNITY(CHAPTERELEVEN)Acommonareaofautoimmuneattackisthebrainandthenervoussystem,whichcancreatediversesymptoms,includingweakness,poorbrainfunction,dizziness,burningsensationsinthehandsandfeet,obsessivecompulsivedisorder,andmore.Thingstolookforinclude:•Brainandneurologicalsymptomswithahistoryorfamilyhistoryofautoimmunedisease•Brainandneurologicalsymptomsatanearlyagenotassociatedwithage-relatedbraindegeneration•Historyofceliacdiseaseorglutensensitivity•Brainandneurologicalsymptomsandsignswitharelapsingandremittingpatternassociatedwithstress,poorsleep,orimmuneactivationThemaincluesapersonmaybesufferingfromNeuroautoimmunityareahistoryofanotherautoimmunedisease,glutensensitivityorceliacdisease,andsymptomsofneurologicaldysfunctionthatappearearlyinlife.Thisincludeschildrenandadultsundertheageof50,theearliestsymptombeingautism.27 Threestagesofautoimmunity•Silentautoimmunity:Theimmunesystemisattackingbodytissuebutdoesnotresultinanysignificantlossoftissueorevensymptoms.Wecanidentifysilentautoimmunitythroughelevatedtissueantibodiesintheblood.•Autoimmunereactivity:Theautoimmunereactionshaveprogressedtothepointthatenoughtissuehasbeendestroyedsothatsigns,symptoms,orlossoffunctionarenoticeable.However,theconditionisnotsoadvancedastobelabeledanautoimmunedisease.•Autoimmunedisease:Symptomsandlossoftissuearesignificant.Thelossoftissueisalsoadvancedenoughtobeidentifiedwithimagingstudiesandothertests,suchasnerveconductionstudies.Manypeoplestayintheautoimmunereactivitystageforyearswithoutadiagnosis.Somemayneverdevelopenoughdestructionoftheirnervoussystemtobediagnosed,yetsuffersignificantsignsandsymptomsthatimpairqualityoflife.Manyeventuallyprogresstovariousneurologicaldiseases.TestingforneurologicalautoimmunityWeidentifyautoimmunitybyscreeningforantibodiesagainsttheproteinsofvariousnervecellstructures.Manylabsoffertestsforneurologicaltissueantibodies,butIhavefoundthatCyrexLabsdoesthemostcompleteandsensitiveevaluation.Theirneurologicalautoimmunitypanelincludes：•Myelinbasicproteinantibodies:autoimmunereactionstotheoutercoveringofnervecells•Asialogangliosideantibodies:autoimmunereactionstosugarandproteinchainclustersonthesurfaceofnervecells•Alphaandbetatubulinantibodies:autoimmunereactionstoproteinsfoundinneurons•Synapsinantibodies:autoimmunereactionstochemicalproteinsfoundwithinnervecellsthatregulatenervecellcommunicationcalledasynapse•Glutamicaciddecarboxylase(GAD)antibodies:autoimmunereactionstotheenzymeinthebodythatproducestheinhibitoryneurotransmitterGABA28 •Cerebellumantibodies:autoimmunereactionstoaspecificpartofthebraincalledthecerebelluminvolvedwithbalanceandmusclemovementcalibrationGADautoimmunityGADautoimmunityisthemostcommonneuroautoimmunityandcreatesthemostspecificsymptomsbecauseitpreventsproductionofGABA,whichisresponsibleforcalmingthenervoussystem.ElevatedGADantibodiesarelinkedtoOCD,motionsickness,vertigo,autism,and“stiffmansyndrome.”Inadditiontoavoidinggluten,peoplewithpositiveGADantibodiesshouldalsoavoidfoodshighinartificialglutamates.AnautoimmunereactiontoGADismorecommonamongthosewithaglutenintoleranceorceliacdisease.GlutenintoleranceandceliacdiseaseshouldalwaysbeconsideredinthecaseofpersistentsymptomsofpoorGABAactivity.Howhighareyourneurologicalantibodies?Antibodylevelstypicallyarenotclinicallysignificantbecauseantibodiesthemselvesdonotdestroytissue.However,researchershavefoundneurologicalantibodiesthemselvesaredestructive.Thisisuniqueinimmunologybecauseitmeanstheantibodycountindicatesthedegreeofdestructionthatmaybeoccurring.ManagingneurologicalautoimmunityAlthoughthereisnocureforautoimmunityitcanbemodulated,or“tamed”withproperlifestyle,dietary,andnutritionalstrategies.Youmayneedtomakesignificantchangestopreserveyourbrainhealth,suchaschangingyourjob,relationship,whereyoulive,orsomeotherimportantpartoflife.Itisimportantforyoutopayattentiontowhattriggersanddampensyourautoimmunity.StrategiestodampenautoimmunityIncreaseopioids:NaturalopioidsactivateTH-3cells,whichhelpsdampenautoimmunity.Apositivementalattitude,love,appreciationforlife,positiveself-esteem,andhealthylevelsof29 exercisearewaystoincreaseopioids.Ontheotherhand,anegativeattitude,violence,poorrelationships,andinternalmentalstressareexamplesofwaystopromoteIL-6,whichactivatesTH-17andpromotesautoimmunity.Stabilizebloodglucoselevels:Ifyouhaveautoimmunityyoucannotletyourbloodglucosespikeordropsharply.BloodsugarspikesanddropsraiseIL-6andTH-17,promotingautoimmunity.Avoidgluten:Glutenisapotenttriggerforneurologicalautoimmunityformanypeople.Improvegut-brainaxis:Thehealthofthebraindependsonguthealth.Addressinggutinflammationandthegut-brainaxiscanhelpmanageneurologicalautoimmunity.NutritionalcompoundstodampenneurologicalautoimmunityVitaminD:VitaminDhasbeenshowntoincreaseTH-3activity,thusdampeningautoimmunity.TypicaldosesofvitaminDforautoimmunitycanbeanywherefrom5,000to10,000IUperday.TestyourvitaminDlevelswithaserum25-hydroxyvitaminDtest.MostpeoplewithautoimmunityhavelowlevelsofvitaminDwhentested.Yourlevelshouldbearound50ng/mL.Levelsabove100ng/mLmayindicateavitaminDoverload.Glutathione:Glutathionepreservesandprotectsneuronsagainstinflammation,supportsTH-3responses,supportsregenerationoftheblood-brainbarrierandtheintestinalbarrier,andisanaturalchelatorthatcanbindtoenvironmentalcompoundssuchasheavymetalsandpollutants.Glutathionerecyclingrecyclesexistingglutathioneforreuseandraisesglutathionelevelsinsidethecells.Compoundsthathavebeenshowntosupportthismechanisminclude:•Cordyceps•N-acetylcysteine•Gotukola•Milkthistle30 •L-glutamine•AlphalipoicacidTheseareallTH-1andTH-2neutralandbecausetheysupportTH-3,theyhavethepotentialtodampenanoveractiveTH-1orTH-2responseinautoimmunity.Toboostoveralllevelsofglutathione,IuseS-acetyl-glutathione,aformthatcanbeabsorbedorally.Oraldosescanstartat300mgandperdayandgouptoseveralthousandmilligrams.However,itisnotcheapandtheamountusedmaydependonwhatyoucanafford.Isuggestusingabout1000mgadayinmostcases,althoughIsuggestmuchhigherdosesincertainconditions.Istillrecommendliposomalglutathionecreamforuseinlocalizedareas,suchasoveraninflamedjointoroverthethyroidofsomeonewithanautoimmunethyroidcondition.Resveratrolandcurcumin:Curcuminandresveratroldampenthetwomajorinflammatorypathwaysinautoimmunity,TH-17andNF-kappaB.Youhavetotakehighenoughamountsofeachoftheseinordertonoticeaneffect.Instudiessubjectsweregivenupto400mgofresveratroland800mgofcurcumindaily,howeverthenecessarydoseisdifferentforeveryone,sodon’tassumethatisthecorrectdoseforyou.Compoundstosupportgutrepairandbraininflammation:Youmayalsowanttotakecompoundstosupportintestinalpermeabilityanddampenbraininflammation,explainedinChapterNine,thegut-brainaxischapter.Supplementstoavoid:Besuretoavoidsupplementsmadewithimmune-reactiveingredients(oftenusedasfillers),whole-foodsupplementsthatmaycontaingluten,stimulatetheTH-1orTH-2systems.BotanicalsthatstimulateTH-1includeechinacea,astragalus,lemonbalm(melissaofficinalis),andmaitakemushrooms.BotanicalsthatstimulateTH-2includepinebarkextract,grapeseedextract,greenteaextract,acaiberryextract,andPycnogenol.®Theseareantioxidantcompoundswithimmuneactivatingproperties;however,mostflavonoidsandnutritionalantioxidantsdonotstimulateimmunity.31 NEUROTRANSMITTERSUPPORT(CHAPTERTWELVE)Althoughneurotransmittersupportcanoftenpromotebrainhealth,itshouldnotbeviewedasaone-size-fits-allapproachthatwillworkforeveryoneoreverycondition.DosingneurotransmittersupportSupportingneurotransmitteractivityisdependentonsymptoms,notbodysize.Graduallyincreaseyourdoseuntilyounoticeanimprovement.Onceyounolongerfeelanyimprovement,gobackthepreviousdoseatwhichyoufeltimprovement.Howoftenyoutakesupportalsovarieswiththeindividual.Whatifyoucrashandburnonneurotransmittersupport?Ifsupportingneurotransmitteractivitycausesintensefatigueorothersymptomsitmaymeantheneuronsaretooclosetothreshold.Inthesecases,useevenlesswhileaddressingsuchissuesasbraininflammationandoxygenation.SUPPORTACETYLCHOLINE(CHAPTERTHIRTEEN)Symptomsofimpairedacetylcholineactivityinclude:•Lossofvisualandphotographicmemory•Lossofverbalmemory•Memorylapses•Impairedcreativity•Diminishedcomprehension•Difficultycalculatingnumbers•Difficultyrecognizingobjectsandfaces•Slownessofmentalresponsiveness•DifficultywithdirectionsandspatialorientationFoodsthatimpactacetylcholineactivityarehighinnaturalfats,particularlyanimalfats(processedvegetableoilsarenotbeneficialtoacetylcholineactivity).32 Foodsrichincholineinclude:•Liverandorganmeats•Eggyolk•Beef•Tofu•Nuts•Cream•Milkwithfat(notnon-fatorskimmilk)•FattycheesesNutritionalcompoundsthatsupportacetylcholineactivity:•Alpha-GPC•HuperzineA(fromastandardizedextractofHuperziserrate)•N-acetylL-carnitinehydrocholride•Pantothenicacid(ascalciumpentothenate)SUPPORTSEROTONINACTIVITY(CHAPTERFOURTEEN)Symptomsofimpairedserotoninactivity:•Lossofpleasureinhobbiesandinterests•Feelingsofinnerrageandanger•Feelingsofdepression•Difficultyfindingjoyfromlifepleasures•Depressionwhenitiscloudyorwhenthereislackofsunlight•Lossofenthusiasmforfavoriteactivities•Notenjoyingfavoritefoods•Notenjoyingfriendshipsandrelationships•Unabletofallintodeeprestfulsleep33 EstrogenandserotoninEstrogenincreasesserotoninactivityinthebrain.Withsymptomsofhighserotonin,excessestrogenshouldbeconsidered.Likewise,lowestrogenlevelscancausesymptomsoflowserotoninactivityanddeficiency.Nutritionalcompoundsthatsupportserotoninactivity:Thefollowingbotanicalstoincreasereceptorsitesensitivity,ensurethebreakdownofusedserotonin,andprovidenecessarycofactorsforserotoninproduction:•5-HTP•Tryptophan•St.John’swort•SAMe•Niacinamide•Magnesiumcitrate•MethylB12•FolicacidAserotonin-healthydietAlthoughcertainfoodsarerichintryptophan,mostAmericans,withtheexceptionperhapsofpoorlypracticingvegansorjunk-foodvegetarians,eatenoughprotein-richfoodstosupplyprecursorsforalltheiraminoacids,includingserotonin.Thebiggerissueisgeneralbrainhealth,stress,andbloodsugarimbalances,whichaffecthowwellthebrainisabletouptakeanduseserotoninprecursors.SUPPORTGABA(CHAPTERFIFTEEN)SymptomsassociatedwithGABAimbalances:•Feelingsofanxiousnessorpanicfornoreason•Feelingsofdread•Feelingsofinnertensionandinnerexcitability•Feelingsofbeingoverwhelmedfornoreason•Restlessmind34 •Difficultyturningyourmindoffwhenyouwanttorelax•Disorganizedattention•WorryaboutthingsyouneverhadthoughtofbeforeNutritionalcompoundsthatsupportGABAactivity:•Valerianroot•Lithiumorotate•Passionflowerextract•L-theanine•Taurine•magnesium,zinc,manganeseAutoimmuneGABAdisorderGlutenintolerance,celiacdisease,andautoimmunediseasescantriggeranautoimmunereactionagainsttheenzymeGAD,whichisresponsibleformakingGABA.PeoplewithaGADautoimmunityarealsomorepronetoglutenataxia,aformofglutenintolerancethatmanifestsinthebrain.AswithTypeIdiabetes,positiveGADantibodiesareanearlyscreeningtoolforglutenataxia.PeoplewithpositiveGADantibodiesshouldavoideatingglutenandfoodshighinartificialglutamates,suchasMSG.ManypeoplewithGADautoimmunitycanreacttofoodshighinglutamateswithextremeanxiety,nervousness,migraines,andmore.ThismechanismshouldbeconsideredwhenpeoplehaveanautoimmunediseaseandsymptomsofpoorGABAactivity,especiallyifthosesymptomshavebeenhappeningforalongtime.GeneticGABAconversiondisorder—alpha-ketoglutaricacidchallenge.SomepeoplehaveageneticdisorderthatimpactstheproductionofGABA,thuscausingincreasedanxiety.ThisisaconsiderationforsomeonewhohashadlifelongGABAdeficiencysymptomsorahistoryofanxietyinthefamily.HowdoyouknowifaGABAdeficiencyisgenetic?Take3,000to4,000mgofalpha-ketoglutaricacid.ForsomeonewithnogeneticGABAabnormality,takingthissupplement35 willnotproducemuchinthewayofsymptoms,perhapsaslightenergyincrease.Forthepersonwiththegeneticdisorder,however,thissurgeofglutamatescombinedwiththegeneticinabilitytoconvertthemtoGABAwillcausesymptomsofexcitability,nervousness,anxiety,andotherGABA-deficiencysymptoms.Forthisperson,takingGABAsupportonaregular,lifelongbasismaybehelpful.SUPPORTDOPAMINE(CHAPTERSIXTEEN)Symptomsoflowdopamine:•Inabilitytoself-motivate•Inabilitytostartorfinishtasks•Feelingsofworthlessness•Feelingsofhopelessness•Losetemperforminorreasons•Inabilitytohandlestress•Angerandaggressionwhileunderstress•Desiretoisolateoneselffromothers•UnexplainedlackofconcernforfamilyandfriendsNutritionalcompoundsthatsupportdopamineactivity•Mucunapruriens•Beta-phenylethylamine(PEA)•Blueberryextract,selenium,alphalipoicacid,N-acetylcysteine•D,L-Phenylalanine(DLPA)•N-acetylL-tyrosine•VitaminB6DopamineandhormonesAcommonpresentationoflowdopamineisheavymenstrualcyclesinwomenorlowtestosteroneinmen,aswellaslowlibido,erectiledysfunction,andaninabilitytogainmusclemass.Depressionmayalsobeasymptom.Dopaminestimulatesluteinizinghormone(LH),a36 hormonethattriggersthereleaseofprogesteroneinwomenandtestosteroneinmen.WhenIseelowLHandlowprogesteroneinwomenandlowtestosteroneinmenIalwayslookfordopaminesymptoms.DopamineandcompliancewithaprotocolAdopamine-deficientpersontendstobenon-compliant,whichisproblematicwhenthereisaneedtotransitionintoanewdietorlifestylechange.Althoughunderlyingissuesmostlikelydriveadopaminedeficiency,Imaystartwithdopaminesupportrightawaywiththesepatientstoboosttheirmotivationsotheycanfollowthroughwiththerestoftheprotocol.Iaskthespouseoranotherfamilymembertocreateastrictscheduleofwhentheyneedtotaketheirdopaminenutritionalcompounds,leavingaslittleaspossibletotheirowndirection.ADDRESSHORMONALIMBALANCES(CHAPTERSEVENTEEN)Symptomsofhormoneimbalanceinmen(anyage):•Lowlibido•Fluctuationsinmood,brainfunction,andfocus•Lossofmusclemass•Sweatingattacks(hotflashesinmen)Symptomsofhormoneimbalanceinperimenopause:•Alternatingmenstrualcyclelengths•Hotflushesandspontaneoussweating•Fluctuationsinmood,brainfunction,andfocusSymptomsofhormoneimbalanceinmenopause:•Vaginaldryness,itching,orpain•Deteriorationinmood,brainfunction,andfocus•Lossofbonedensity•Mentalfogginessafterperimenopause37 Whenhormonesbecomeimbalancedyouloseneurotransmitteractivity,whichaffectshowyoufeel,function,andviewyourlife.Hormonalimbalancessignificantlyimpactbraininflammationanddegenerationandconsiderablyspeedagingofthebrain.HormonesandneurotransmittersPoorneurotransmitteractivitymaystemfromahormonalimbalance.Forinstance,simplyuppingnutritionalcompoundstoboostserotoninactivitywon’tgothedistanceinanestrogen-deficientwoman.•Estrogenimpactsserotoninreceptorsinmenandwomen•ProgesteroneimpactsGABAreceptorsinmenandwomen•Estrogenimpactsdopaminereceptorsinwomen•Testosteroneimpactsdopaminereceptorsinmen•Estrogenimpactsacetylcholinereceptorsinwomen•Testosteroneimpactsacetylcholinereceptorsinmen•ThyroidhormonesimpactallneurotransmitterreceptorsinmenandwomenHormonesandbrainfunctionandinflammationHealthyhormonelevelshavebeenshowntofacilitateneuronbranchingandplasticity,dampenbraininflammation,slowdegeneration,andplayaroleinneuronalmigration,themovementofneuronsfromoneplacetoanothertoparticipateinactivityandrepair.BloodsugarandhormonesHormonereplacementtherapycancreatedangerouslyhighlevelsofhormonesthatcancauseahostofotherproblems,suchasreceptorsiteresistanceandpoorcommunicationbetweenthebrainandthehormoneglands.It’sbettertofirstaddresstherootcauseofthehormonalimbalances,whichthemajorityofthetimeisabloodsugarimbalancefromahighcarbohydratediet.38 HighestrogeninmenAhigh-carbohydratedietcreatesinsulinsurgesthatincreasetheenzymearomataseinmen.Foundinbodyfat,aromataseconvertstestosteronetoestradiol,aformofestrogen.Theexcessestradiolcausesinsulinresistanceinaviciouscycle.Testosteronecreamscanincreasetheproductionofestrogen.Thesemenmaydevelopbreastsorhips,cryeasily,andexperiencechangesintheirmotivation,drive,andpersonality.HightestosteroneinwomenInwomeninsulinsurgesfromhigh-carbdietsincreasetheenzyme17-20lyase,whichincreasestestosteroneproduction.Excesstestosteronecausesinsulinresistanceinaviciouscycle.CommonsymptomsincludePCOS,excessfacialhair,andthinninghaironthescalp.Thehightestosteronealsoknocksestrogenandprogesteronelevelsoutofbalance,affectingneurotransmitteractivityinthebrainandasaresultdrive,motivation,andpersonality.CholesterolandhormonesHormoneproductiondependsonadequatecholesterol.Thisisaconcerntodayasthetrendincardiologyistopushcholesterollevelsbelow100.Infunctionalmedicinewebelievecholesterolunder150istoolowforhealthyhormone,brain,andimmunefunction.Clinicallyweseedepressionandpoorcognitionandmemorydevelopinpatientswithlowcholesterol.AdrenalstressandhormonesMicrogliacellsuseDHEAtomaketestosteroneandestrogen.DHEAismadethroughoutthebody,includingbytheadrenalglands,theliver,thetestes,andtheovaries.However,themajorityofDHEAcomesfromtheadrenalglands.ManypeoplesufferfromlowDHEAduetochronicstress.AlthoughDHEAisnecessary,supplementingwithDHEAisonlyrecommendedforashortperiodoftimeandwhenlabtestingshowschronicadrenalfatigue.UnnecessarilysupplementingwithDHEAcanexacerbatetheconversionoftestosteronetoestrogeninmenandtheproductionoftestosteroneinwomen.39 PregnenolonestealPregnenoloneisasubstancetheendocrinesystemandthebrainusetomakehormones.Inpregnenolonesteal,thebody“steals”pregnenolonefromcholesteroltomakemorecortisolinsteadofsexhormonesbecausetheadrenalsarefatiguing.ThismechanismcommonlyunderliesPMS,infertility,malemenopause,andPCOS.Abloodsugarimbalanceisthemostcommoncauseofpregnenolonesteal.Lowcholesterol,chronicstress,bloodsugarimbalances,lowDHEA,andpregnenolonestealarefactorsthatimpacthormonebalance.Functionsthatsufferasaconsequenceincludeneuronaltransmission,myelination(theprotectivecoatinggliacellsoffertoneurons),synapticactivity,neuronalrepair,andneuronalmigration(themovementofneuronstoareaswherethey’reneededforactivityorrepair).EstrogenandthebrainStudieshaveshownestrogentobeveryprotectiveofthebrain.Estrogenthatdeclinestoosteeplyorrapidlycancausedepressionandlossofsomecognitivefunction,suchasspatialmemory,andfinemotorskills.Thesefactorsarebehindmanymenopausalsymptoms,includingirritability,brainfog,forgetfulness,depression,fatigue,anxiety,stress,insomnia,andaworseningofexistingconditions.HormonereplacementtherapyhasrisksandIbelievetheunderlyingmechanismoftheimbalanceordeficiencyshouldbeinvestigatedfirst.Also,estrogenreplacementtherapyhasnotbeenshowntobeprotectiveofthebraininmenstruatingwomen.However,forpostmenopausalwomenorwomengoingthroughmenopausewhohavesteepdipsinestrogenorchronicallylowestrogen,hormonereplacementtherapycanbeveryprotectiveofthebrain.ProgesteroneandthebrainProgesteronedeficiencyinwomencanresultincompromisedGABAanddopamineactivity.Progesteronealsodampensmicrogliacells.Administeringprogesteronetoamanorwomanwhohasjustsufferedfromaheadinjuryorstrokehelpswiththerepairprocessinthebrainandremyelinationofnerves(myelinisaprotectivenervecoating).40 TestosteroneandthebrainTestosteroneisessentialforhealthyfunctionofthemalebrain.Symptomsoftestosteronedeficiencyincludelossofcognitivefunction,memoryproblems,andtheprogressionofdementiainAlzheimer’sdisease.Lessadvancedsymptomsincludedepression,lackofdriveormotivation,andgeneral“grumpiness.”Becausetestosteroneinfluencesdopamineactivity,testosteronedeficiencycanincreasetheriskofParkinson’sdiseaseinaman.TestosteronealsoinfluencestheactivityofacetylcholineandadeficiencycanincreasetheriskofdementiaandAlzheimer’sdisease.Researchshowslowtestosteroneincreasesthesecretionofbetaamyloidprotein,whichcontributestoAlzheimer’sdisease.HypothyroidismandthebrainThemostcommonsymptomsamongthosewithlowthyroidfunctionaredepression,fatigue,andbrainfog.Thyroidfunctionaffectsbrainplasticity,neurotransmitteractivity,andgeneralbrainfunction.Thyroidhormonesalsoplayavitalroleindampeningbraininflammation.Goodsynapsesforserotonin,dopamine,GABA,andacetylcholinealldependonhealthythyroidfunction.Infact,manyoftheneurologicalsymptomsthataccompanyanunmanagedthyroidcondition,suchasdepressionorlossofmemory,canbetracedbacktoabreakdownintheneurotransmitter-thyroidconnection.Hashimoto’sencephalopathy(HE)isperhapsaworst-casescenarioforpeoplewithHashimoto’s.Alsoknownasautoimmunedementia,HEisanautoimmuneinflammatorybraindisorderthatcausesmemorylossandotherdementia-likesymptoms.HEissuspectedwhenanindividualpresentswithbothhighTPOantibodiesandsymptomsofdementiaorotherneurologicaldisorders.However,because20percentoftheolderpopulation,especiallywomen,mayhaveTPOantibodies,andbecausemyriadotherfactorscancauseneurologicalsymptoms,apractitionershouldexercisecautionindiagnosingHE.Anunmanagedthyroidconditionmayacceleratebraindegeneration,whichiswhyitisimportanttoappropriatelymanagehypothyroidismandHashimoto’s,anautoimmunethyroidcondition.SimplytakingthyroidhormonesdoesnothingtoaddressadeterioratingthyroidconditioncausedbyHashimoto’s,whichisresponsiblefor90percentofhypothyroidcasesintheUnitedStates.Nordoesitaddressothercausesforthefailureofthyroidfunction,suchaschronic41 stress,hightestosteroneinwomen,orenvironmentaltoxicity.Asexplainedinmythyroidbook,theunderlyingcauseofpoorthyroidfunctionshouldalwaysbeaddressedtopreventfurtherdeclineinbrainhealth.HOWTOGETMOREOUTOFACUPUNCTURE,CHIROPRACTICCARE,MASSAGE,ANDOTHERFORMSOFBODYWORKANDALTERNATIVECARE(CHAPTEREIGHTEEN)Music,yoga,massage,acupuncture,chiropracticspinalmanipulation,aromatherapy,andothertherapiesstimulatethebrain.Bothpractitionersandpatientshaveseenimprovementsinimmunestrength,mood,energy,digestion,hormoneregulation,andmorethroughtheuseofvarioustherapies.Butwhetheranytherapywillpositivelyimpactthebraindependsonitspre-existingstate.Poordiets,hormonalimbalances,autoimmunity,braininflammation,environmentalpollutants,andotherfactorsdegeneratethebrainandalteritschemistry.Asaresult,suchtherapiesmaynotworkwellbecausethebraincannotrespondsignificantlyenoughtoaffecthealth.Orthebrainmaybesodegeneratedandpronetobeingoverwhelmedthatoneofthesesensorystimulatingtreatmentsmayfatiguethebrainandmakethepersonfeelworse.ESSENTIALFATTYACIDSFORGOODBRAINHEALTH(CHAPTERNINETEEN)Symptomsandsignsassociatedwithessentialfattyaciddeficiency:•Poorbrainfunction•Limitedconsumptionoffattyfish,rawnutsandseeds,uncookedoliveoil,oravocados•Regularconsumptionoffriedfoods•Painfuljoints;chronicpainandinflammation•Regularconsumptionofprocessedfoodswithpartially•hydrogenatedfats•Dryorunhealthyskin•Dandruff•Hormoneimbalances42 Processedvegetableoilsandhydrogenatedfatscanmakethemembranesofyournervecellsrigidandunresponsive,leadingtoimproperneuronfunction,braininflammationanddegeneration,andsymptomsofpoorbrainfunction.Essentialfattyacids(EFAs),ontheotherhand,arecriticalforhealthybrainfunction.INCONCLUSION:THEBRAINHEALTHATTITUDEANDAPPROACHThisbookisnotabout“fixing”or“curing”yourbrainorchronichealthproblems.Pleasebewaryofhealthcarepractitionerswhomakesuchclaims.Itisalsonotadefinitivesourceofinformation—researchiscontinuallyevolving.Wehavelearnedmanynewthingsabouthowtomanagechronicconditionssincemythyroidbookwaspublishedinearly2010,andwillsurelylearnmuchmoreintheyearstocome.Mybooksaremerelystoppingpointsalongtheway,addingtoanever-growingpoolofhealthawareness.Thisbookisalsonotanti-medicine.Donotdoggedlyrefusemedicaltreatmentthatcouldimproveyourqualityoflifeorpreventaworseningofyourhealth.Instead,thisbookisaboutisexploringtheunderlyingcausesofwhyyourbrainisn’tworking,whyyouhaveachronichealthproblem,orwhyyoudon’tfeelasgoodasyouoncedid.Fartoomanypeople—thousands—havecontactedustosaytheirdoctorsbrushthemoff,tellthemtheyhavedepression,orsaytheirlabtestsandexamsarenormalandthey’refine.Allofthesepatientsareclearlysufferingandnotfunctioningwell.Justbecausemedicinedoesnothaveadiagnosisoracureforyourconditiondoesnotmeanitdoesn’texist!Manyimportanttopicswerenotincludedinthisbook,andyourinvestigationsmayneedtodelveintothoseareas.However,Iendeavoredtosharenewinformation,theresultofyearsofexhaustiveresearchandclinicalapplication,whichhashelpedmanypatientswith“mysterious”andchronicconditions.Althoughwehavemanysuccessstories,therearealsothosepatientsforwhomlittlecouldbedone.Wehavemuchyettolearn.However,Ihavefoundwhenapersonknowswhytheyarelosingfunctionorhavingsymptoms,thiscanprovideanenormoussenseofrelief.Themindneedssomethingtowrapitselfaroundinordertomakesenseofthechaos.Itismysinceresthopetheinformationinthisbookhashelpedyouoralovedonefeelandfunctionbetteroratleastmakesenseofyourcondition.Youarenotcrazy,makingitup,orsufferingfromananti-depressantdeficiency.Weareexperiencingacriticallackofawarenessand43 carefortheexplosionofchronicneurologicalandautoimmunecases—the“mystery”conditions—inourpopulationtoday.Medicineisindesperateneedofarevolutiontoaddressthispopulationanditcanonlycomefromoneplace:you.Ourhealthcaremodelneedsaneducatedandempoweredpopulacetogoverntheirownhealthandexpectmorefromtheirdoctors.ItismysinceresthopeIhavehelpedyoubecomeoneofthosepeople,andthatyouinturnwillhelppractitionerslikemyselfcontinuetolearnandgrowsowecanserveyoubetter.44 Appendix2.TargetText《为什么我的大脑不好使了》第二十一章大脑健康参考指南本章我会简要重温一下如何使大脑正常运转的基本知识。本人之前所著的那本关于甲状腺的书出版之后，听到最多的抱怨要么就是太难理解，要么就是太难实施。事实上这类材料本身就复杂难解。我已竭尽全力将极其繁杂的免疫和神经机制简化到适用于大多数人的文字。但我同意，刚开始是有可能觉得它不易理解，甚至一些执业医师也会有同样的想法。这也是好的执业医师不去研讨会显摆学问反而不断学习的原因。尽管寻求一名合格执业医师的帮助是非常必要的，但你得意识到自己肩上的担子也非常重。希波克拉底（希腊名医）说过：“食即药，药即食。”当关系到大脑健康的时候，首先，最重要的一步，也是最难的一步，就是改变你的饮食习惯。通过控制自己的饮食习惯来控制大脑如果你希望自己的大脑能正常运转的话，就必须得改变自己的饮食习惯。改变饮食习惯绝非易事，外出就餐，如去朋友家吃饭、吃快餐或垃圾食品都会影响你的计划。如果你不停地抱怨，这个计划可能就不适合你，因为负面情绪会增大压力水平并刺激炎症性细胞因子的分泌。如果是你自己不注意引起了发炎，即使你寻求了执业医师的帮助，他或她也不可能给你最佳的治疗。如果你在饮食上还有失调的现象，这会让你的计划难上加难。这是另一本书的讨论范畴，每种方法都有一定的价值，这些方法最好都在专业指导下或团体活动中进行。上述是此计划的劣势，它的优势就是许多人在遵循了严格的饮食计划之后，身体状况得到了大大的提升，并得以喜欢上了这项计划。但也有人在偷懒或偶尔吃了垃圾食品后，有严45 重的反弹，这也使得人们更加相信这项计划。另一个好处就是大家可以在网络上寻求专业指导或“病友”。吃不含谷蛋白的食物最最起码，你也要遵循一套严格的不含谷蛋白的饮食计划。含谷蛋白的食物最易造成脑神经失调和自身免疫失调。标准的谷蛋白实验测试并不可信，因为大多数实验室是测试的是α-醇溶蛋白和转谷氨酰胺酶抗体。我们需要的是更加全面的测试，比如Cyrex实验室的第三项小麦/谷蛋白过敏度和自身免疫测试，具体包括的蛋白包括：•α-醇溶蛋白•ω-醇溶蛋白•γ-醇溶蛋白•脱酰胺醇溶蛋白•麦胚凝集素•谷吗啡•强啡肽原•转谷氨酰胺酶2•转谷氨酰胺酶3•转谷氨酰胺酶6如果你的大脑运转缓慢，食用不含谷蛋白的食物是提高大脑运转的第一步。肠漏症（肠漏症是肠道因感染、过敏、发炎或失去健康的菌群相平衡时，肠粘膜受到破坏而失去完整性，此时肠道内许多未被消化的大分子、代谢所产生的废物或微生物毒素等物质，会透过渗漏的肠壁进入血液循环中，今而刺激自身免疫系统，危害肝脏胰脏等器官，从而引起各种疾病。）许多案例显示，光吃不含谷蛋白的食物是远远不够的。许多人，特别是对于那些自身免疫和神经系统不调的人，因交叉过敏和肠漏，他们对其它的一些食物也非常敏感。这是我为大脑机能出现问题的患者推荐的饮食计划，这个计划会帮助患者的免疫系统和肠道逐步恢复，从而对大脑健康产生积极的影响。46 遵循此饮食计划的时长你可以在一周内的少数几天里坚持这份饮食计划，因为有时可能会意外食用到一些本应避免食用的食物。对于这份饮食计划，你也可以坚持一个月或更长的时间，这样便可治好的你肠漏症。通过Cyrex实验室的肠道抗原渗透率筛查可以检查出你是否患有肠漏症。但也有很多免疫失调或大脑健康有问题的人们也通过遵循此份饮食计划或其变通计划，优化了生活质量。坚持此饮食计划的频率——最重要的是保持血糖稳定这份饮食计划中重要的一个方面就是要保持血糖稳定，意思就是你要保持非饥饿状态，你的身体不能有饥饿感和缺乏能量感，那会增大压力水平继而引发炎症。你的血糖越稳定，饥饿感来的就越慢。保持身体的整体碳水化合物消耗低于标准美国饮食消耗水平，这是稳定血糖的重中之重。由于人们生活方式和健康问题的不同，每人需要的碳水化合物与他人所需都不尽相同。避免食用的食品应避免食用下列食物，因为它们造成了多起炎症和压力的发生，而炎症和压力激增又会加重自我免疫失调、炎症和大脑健康等问题。•所有的糖类食物，包括蜂蜜、龙舌兰蜜、枫蜜、椰子糖、蜜枣等食物。不要被食物包装上的“低糖”字眼所蒙蔽，它们的含糖量依旧非常高。•高糖水果：西瓜、芒果、菠萝、葡萄干、提子、水果罐头、枣、果脯等。•西红柿、土豆或蘑菇。•谷物：小麦、燕麦、大米、大麦、荞麦、玉米、藜麦等。•乳制品：牛奶、奶油、奶油、黄油、乳清。大多数人吃酥油是没问题的，但这也要分个人情况。•鸡蛋或含鸡蛋的食物，如蛋黄酱。•豆制品：豆奶、豆酱、豆腐、豆豉、豆蛋白等。•酒•凝集素（肠漏的主要催化剂），在坚果、豆类、豆制品、土豆、西红柿、茄子、辣椒、花生油、花生黄油和豆油中都有发现。•速溶咖啡:许多牌子的速溶咖啡都包含谷蛋白。47 •加工食品。•罐装食品。应选择的食物你应该多花点时间购买准备合适的食物，外出时也应随身携带食物，更多详情请访问我的网站。•大多数蔬菜(除了西红柿、土豆和蘑菇)：芦笋、菠菜、生菜、西兰花、甜菜、花椰菜、胡萝卜、芹菜、洋蓟、大蒜、洋葱、西葫芦、冬瓜、大黄属植物、黄瓜、红萝卜和西洋菜及其它蔬菜。•发酵食物：德国泡菜、韩国泡菜、泡姜、腌黄瓜、椰子酸奶和红茶菌等。这些食物可自制也可购买，但一定要注意，在选购时应选择完全发酵的无任何添加剂和糖的食物。•肉类：鱼肉、鸡肉、牛肉、羊肉、动物内脏等•低血糖水果：杏、李子、苹果、桃子、梨子、樱桃、浆果等•椰子：椰油、椰黄油、椰奶、椰奶油•草药茶•橄榄和橄榄油敏感性食物名单你还得制作一份个人敏感性食物名单，确认哪些食物会对你个人造成免疫反应。Cyrex实验室的不含谷蛋白食物以及第四项交叉反应食物可测试人体对不同食物的反应。适用于肠漏症患者的食谱（第九章）这份食谱本身就对人体非常有益了。但你可以在这份食谱的基础上再添加一些营养物和植物复合物，来彻底消灭炎症，为肠漏症的修复提供条件。增强肠内壁动力的营养物：•左旋谷氨酰胺（营养增补剂，调味增香剂。医药上用作治疗消化器官溃疡、醇中毒及改善脑功能。L-谷氨酰胺是构成人体蛋白质所必需的20种氨基酸之一。）•甘草48 •芦荟提取物•凤梨•药蜀葵提取物（多年生草本，含粘液质，果胶质，淀粉和糖类，有解表散寒，利尿，止咳，消炎解毒之功。）•二甲基砜(是一种有机硫化物，是人体胶原蛋白合成的必要物质。)•伽玛-谷维素（谷维素属于植物维生素，是从米糠油中提炼出来的，主要作用于间脑的植物神经系统与分泌中枢，从而改善和调节植物神经功能失调、内分泌平衡障碍及精神失调等症状。）•榆树树皮•德国洋甘菊•万寿菊萃取物益生菌益生菌对调节肠道免疫系统以及修复肠道菌群的健康平衡起着重要的作用。•布拉酵母菌•芽孢乳酸菌•DDS1乳酸杆菌嗜酸乳杆菌•阿拉伯半乳聚糖酵母、超标细菌、寄生物的排毒体内酵母、超标的细菌以及寄生物的排毒，有时对肠道健康的修复是极其必要的。但排毒的过程也需得十分谨慎，如果用药太猛，身体可能会出现恶心、呕吐、腹泻等不良反应。在排毒的时候，用药剂量一定要小，要有一个循序渐进的过程。酵母及细菌的增生物•十一碳烯酸•辛酸•过滤元素•猫爪草49 •保哥果寄生生物•苦艾萃取物寄生生物•橄榄叶萃取物寄生生物•大蒜萃取物寄生生物•黑胡桃萃取物寄生生物幽门螺杆菌及细菌增生物•黄连素•假银莲花•牛至叶萃取物刺激交感神经我们知道，肠道的健康对大脑的健康运转有着深刻的影响。同样，大脑在亚健康的状况下，交感神经的系统活动会降低，也可以对肠道健康造成影响。大脑与肠道的之间的联系就是通过交感神经完成的。交感神经紊乱的症状包括：肠动力不足（便秘）、消化酶分泌不足（腹胀、消化不良）、腹泻或不消化以及肝脏排毒不畅。可通过一些简单的锻炼提升交感神经的适应性和功能：•漱口：每天饮用几大杯水，每喝一口水都进行漱口。漱口时间应足够长，深度应足够深。坚持几个星期后，就会强化交感神经的通道。•大声练嗓子：寻找个适当的时间大声吊吊嗓子。吊嗓子会使喉咙后部的肌肉充分活动起来，以此来刺激交感神经。•呕吐刺激：用压舌板压住舌头，刺激呕反射。用压舌板刺激呕反射，与上推交感神经的道理相同;而呕吐刺激和吊嗓子就与短跑的道理相同。这些锻炼和减肥锻炼一样，须得坚持几周才会看到效果。50 用咖啡灌肠法提高肠动力，提高迷走神经可塑性遇到大脑有退化迹象并经常便秘的人，我鼓励他们在日常选择咖啡灌肠疗法。你需购买灌肠袋、肛门插管和润滑剂（如KY胶）。将有机咖啡煮熟后，放至室温后使用（速溶咖啡中可能含有谷蛋白，所以在灌肠时要避免使用速溶咖啡）。灌肠袋内装满咖啡，将肛门插管前端涂上润滑剂，身体朝右躺，进行灌肠。最好在浴缸内进行操作，预防液体溢出。将插管插入肛门，用手将灌肠袋举高，超过头顶，举得越高，灌肠速度越快。待灌肠液滴完后，坚持5到10分钟。在这个过程中不时会有便意，请尽量坚持，时间越长越好。稳固血糖值血糖值的平衡对大脑健康至关重要。无论是高血糖还是低血糖，血糖不平衡都会有损大脑健康。血糖不平衡症状反应性低血糖症状（低血糖峰值）：•餐后体能增强•正餐间喜食甜食•空腹易兴奋•体能依赖于咖啡•空腹易头晕•进食以缓解疲劳•虚弱、神经过敏、胆小•易怒、易紧张•易心烦•记忆力差、忘性大•视线模糊抗胰岛素性症状（高血糖峰值）：•饭后疲劳51 •一般性疲劳•常有饥饿感•喜食甜食•饭后定吃甜食•腰围等于甚至大于臀围•尿频•食欲和口渴感增大•减肥困难•疼痛转移如何稳固血糖值•早餐需摄取优质蛋白和脂肪。•患有低血糖症的病人，每隔两三个小时需食用少量蛋白质或健康脂肪食物。•测出你的糖耐量（人体对葡萄糖的耐受能力），并努力将血糖维持在正常范围内。如果你在饭后感到困倦或喜食甜食，是因为你食用了过多的碳水化合物。你也可以用血糖仪来测试空腹血糖，正常值应为70～110毫克/分升，最起码也应该为80～100毫克/分升。•食用含有纤维素、脂肪或蛋白质的高碳水化合物。这些成份会减缓血液吸收葡萄糖的速度，并可阻止因胰岛素过高而引发的低血糖休克。•就寝前不要吃甜食或含大量淀粉的食物，这对低血糖病人的身体非常不利。你的血糖会在夜间猛升，一直持续到第二天的早餐过后。你的肾上腺激素的分泌也有可能增加，导致休息不好或凌晨3点左右因兴奋醒来。•禁止喝水果汁和胡萝卜汁。它们比苏打水含糖量还大，会迅速提升血糖值。•禁止或限制咖啡因的摄取。•均衡饮食：食用以蔬菜、优质肉类和脂肪居多的餐食。•杜绝食物过敏源和食物不耐受维持血糖平衡的营养物饮食对血糖值的稳固有着至关重要的影响。但食用固定的营养物对稳定低血糖症或胰岛素抵抗症也起着帮助作用。52 稳定低血糖（血糖过低）症的营养物•铬•牛肾上腺•重酒石酸胆碱（有促使磷脂转变、加速脂肪的运转及利胆作用的口服药品。）•牛肝•牛胰腺•纤维糖•左旋肉碱（是一种促使脂肪转化为能量的类氨基酸。）•辅酶Q10（辅酶Q10是一种脂溶性抗氧化剂，能激活人体细胞和细胞能量的营养，具有提高人体免疫力、增强抗氧化、延缓衰老和增强人体活力等功能。）稳定胰岛素抵抗（高血糖）的营养物•匙羹藤（匙羹藤是一种印度传统草药，2000多年前就用来治疗糖尿病）•大花紫薇提取物•灰树花蘑菇•苦瓜•扭刺仙人掌茎提取•瓜尔豆胶•果胶•铬•矾•脂肪酸•维他命E•镁•维生素H•锌•纤维糖•尼克酸•左旋肉酸53 有时会出现病人在胰岛素抵抗和低血糖症两种病症间反复的状况。这种情况下我会推荐胰岛素抵抗病人在用餐时食用营养物，低血糖症病人在两餐间食用营养物。寻求合格医护工作者的指导非常重要，这样患者才会摄取正确的、适量的营养物与植物类萃取药物。如若摄取不当的营养物则会影响血压，从而对身体造成影响。降压如果你符合以下几种现象，就说明你的压力水平已经对大脑健康造成了负面的影响。•总有未做完的工作•从没有独处的时间•睡眠、休息不足•没有日常锻炼的时间或动力•没有完成自己的人生目标消炎和降压反应都强调了压力水平对大脑健康的影响。这意味着患者要减少在治疗肠漏症的日常饮食中的压力因素、要正确处理生活压力以及重视因健康失衡而导致的压力。控制压力水平的营养物•复合神经酸（是一种天然存在于食物中的成分，主要功能是改善神经细胞功能，调节神经脉冲的传导，增进大脑记忆功能）：可减小压力水平对大脑的影响。可口服，但更推荐通过皮肤吸收磷脂酰丝氨酸脂质体的这种方法。•草本肾上腺适应源：可有效缓解慢性应激症状。这类草本药物能深入大脑的压力源，尤其可以深入海马体中。可单独服用这些草本药物，但数种药物混合后，效果更佳。•人参提取物•冬樱花（拥有显著的抗氧化能力和增强免疫力的草药。）•圣罗勒提取物（圣罗勒在心血管,肝脏,肺脏疾病方面有突出的疗效,并帮助调节血压和血糖.）•红景天（能够补气清肺，益智养心，是一味作用广泛的中药。亦有很大的美容效果，可作护肤品，也可食用。）•刺五加（补气药，具有补虚扶弱的功效，可来预防或治疗体质虚弱之症候，滋补强壮，延年益寿。）54 促进大脑循环、改善大脑氧气质量氧气是大脑最重要的营养之一。如果你有以下症状，就说明你大脑里吸入的氧气质量不佳并且分量不足。•大脑易疲劳、注意力难以集中•需锻炼或咖啡才能提高大脑运转能力•手脚冰冷•指甲不健康或有脚气•夜间需穿袜子•甲床呈白色而不是亮粉色•鼻尖冰冷慢性应激、贫血、吸烟、低血压、高血压、肺功能退化、心血管功能下降以及任何损害血管的疾病，如糖尿病都会对血液流向大脑造成不利的影响。提升脑氧含量的营养物经研究证明，尽管下列药物可使脑动脉膨胀，但它们却不会使血压提高，事实上，它们还具有降压的功效。•野甘菊提取物•金雀花萃取物•杏•石杉碱甲（可增强记忆）•长春西汀（本品改善脑梗塞后遗症、脑出血后遗症、脑动脉硬化症等诱发的各种症状.）一氧化氮一氧化氮是身体里的一种化学信号分子，它可与神经、免疫以及血管系统相连接。内皮型一氧化氮合酶和神经元型一氧化氮合酶都是一氧化氮的抗炎分子形式，而诱导型一氧化氮合酶是一种发炎的与组织损伤关联的自身免疫性疾病。每天早上，通过至少5分钟的高强度有氧运动来提升心率是减少内皮型一氧化氮合酶发炎的一种有效方式。运动时准确判断你的身体承受极限，千万不要伤害到自己。55 一氧化碳的逆转药物•三磷酸腺甙•石杉碱甲A（可增强记忆）•烟酸占替诺(烟酸占替诺适用于治疗脑血管障碍性疾病)•甘油磷脂酰胆碱(消化系统药物)•长春西汀（脑血管扩张药）•乙酰左旋肉碱（能改进记忆，主要用于治疗老年性痴呆症等）血压高血压和低血压都会影响大脑摄取足够的氧气。理想的血压值应该在120/80左右。如果收缩压比这个值高或低10个值，你的血压是正常的。你的血压数值离120/80越远，情况就越糟糕。低血压我推荐低血压患者食用甘草属植物，甘草属植物分为多种甘草，可刺激醛固酮激素的分泌。醛固酮可防止体内钠的流失并能稳固低血压患者的血压。许多人通过这三种方法：给食物增加咸度、辅食甘草以及加大对低血糖症的治疗，使自己的血压得以恢复到正常状态。高血压如果你患有高血压症，除饮食必须清淡外，还要进行日常锻炼来降低血压。此外，还可补充天然的如镁、钾之类的元素，来降低血压。一氧化碳逆转药物也对降低血压有一定的帮助。脑部炎症的治疗脑部炎症无疼痛感，所以大多数人根本察觉不到身体的这一毛病。然而，这种症状却会加重大脑退化，还会引发下列症状：•脑雾•思维不清晰•大脑易疲劳56 •大脑运转速度慢、速度多变•受创后脑部功能丧失•饭后大脑易疲劳注意力不集中•因系统性炎症引发的脑部疲劳•由化学药品、气味和工业污染物质引起的脑部疲劳大脑炎症被看做是慢性抑郁症和其它情绪异常的一种，因为大脑的免疫细胞、小胶质细胞都会持续不断地分泌，脑部一旦发炎，就会持续很长时间。引发脑部炎症的因素包括：•糖尿病和高碳水化合物的饮食，它们都会促使糖基化终产物的产生，这样一来，小胶质细胞就会被激发•因身体系统循环不佳、缺少锻炼、慢性应激反应、心力衰竭、肺脏疾病或贫血造成的脑部缺氧•先期头部受创•神经自身免疫性反应•对蛋白过敏患者的误食蛋白•大脑抗氧化能力低•酒精和药物滥用•环境污染物•系统性炎症•炎症肠道•无抵抗力脑血管屏障脑漏（血脑屏障开始具有渗透性、病菌入侵的现象）挑战测试你可进行一项脑漏挑战来测试你的血脑屏障是否有渗透性。服用800–1000毫克的伽马氨基丁酸（一种重要的抑制性神经递质，广泛分布于动植物体内），待2到3小时候观察自身反应。口服伽马氨基丁酸的最佳时间段是下午6点至9点，如果它对你起到镇静的作用，你可趁此机会休息一下。若有此类放松、镇静的反应，这表明你不适合经常性地服用它。若经常服用的话，你的伽马氨基丁酸感官腺会被强制关闭，再次进行测试的话，数据会出现偏差。57 若服用伽马氨基丁酸后，有焦躁、兴奋或惊慌失措的反应，这表明你的血脑屏障具有渗透性，食用一些蛋白质会缓解以上症状。若服用伽马氨基丁酸后没有反应，这表明你的血脑屏障无渗透性，细菌不会入侵。服用伽马氨基丁酸后正常的反应就是没有反应，因为伽马氨基丁酸的“反射内容”就是健康的血脑屏障。改善大脑发炎状况改善大脑发炎状况最重要的一步就是改善食物的不耐受性、血糖失衡、肠道感染和发炎、非管理型免疫性疾病、大脑受氧不良、慢性应激、荷尔蒙失调和缺乏等疾病。在改善这些病症的同时，为进一步改善大脑发炎状况，还可服用类黄酮药物。类黄酮可以减少小胶质细胞的分泌，缓解大脑炎症。这些类黄酮药物包括：•芹菜素•毛地黄黄酮•黄芩黄素•白藜芦醇•芦丁•儿茶酸•姜黄色素对付神经系统自身免疫(对自身构成成分产生排斥的免疫反应)的办法在自身免疫攻击中，很常见的一个攻击区域是大脑和神经系统。这会衍生出许多不同的症状来，包括软弱无力、眩晕、手脚灼烧、强迫症等等。需特别注意的病症包括：•历史性大脑神经性症状或家庭遗传自身免疫病史•幼年大脑神经性症状•有腹腔疾病乳糜泻历史或对谷蛋白过敏•大脑及神经病症有复发的迹象以及压力、睡眠不足或免疫激活的微型病症。患有神经性自身免疫疾病的患者也可能患过其它自身免疫疾病、谷蛋白过敏症、乳糜泻以及在幼年才会发病的神经机能障碍疾病。这包括年龄小于50岁的人群，最早的症状是自闭症。58 自身免疫的三个阶段:•无声自身免疫：免疫系统会攻击机体组织，但并不会造成任何明显的组织损伤或症状。我们可通过提升血液中的机体组织抗体来识别无声自身免疫。•自身免疫反应：自身免疫反应已经发展到了太多的机体组织已经被损坏，一些坏的迹象、症状或功能的损坏都显现了出来的状况下。但是，我们现有的条件却不能治疗自身免疫性疾病。•自身免疫疾病：到了这个阶段，病症更加明显，机体组织损坏也更加强烈。在现有的医学条件下，可以通过影像学研究和其它测试，如神经传导检查来识别机体组织的损坏。许多人的身体状况在没有诊治的情况下，会在自身免疫反应阶段停留数年。也有些人的神经系统可能永远不会达到严重损坏的程度，因此也无需去诊治，但病症严重的情况下还是会影响到生活。许多人的神经系统疾病最后会转变成多种神经性疾病。神经系统自我免疫测试我们可通过对多种神经细胞结构的蛋白质抗体进行筛查来检测是否患有自身免疫性疾病。许多实验室都提供神经性组织抗体，但Cyrex实验室的测试最为全面、最为有效。它们的神经性自我免疫测试包括：•髓鞘碱性蛋白抗体：测试对神经细胞外皮进行的自我免疫反应•无唾液酸神经节苷脂抗体：测试对神经细胞表皮上的糖和蛋白质簇合物进行的自我免疫反应•α和β微管蛋白抗体：测试对神经原里蛋白质进行的自我免疫反应•突触素抗体：测试对一个名叫突触的调节神经细胞交流的神经细胞里化学蛋白质进行的自我免疫反应•谷氨酸脱羧酶抗体：测试对身体里产生抑制性神经传导物伽马氨基丁酸的酶进行的自我免疫反应•小脑抗体：测试对大脑中维持大脑平衡和肌肉运动校准的小脑进行的自我免疫反应59 谷氨酸脱羧酶自身免疫谷氨酸脱羧酶自身免疫是最常见的神经自身免疫性疾病，它还会引发最特别的一种症状，因为自体神经免疫阻止了伽马氨基丁酸的产生，伽马氨基丁酸的作用是使神经系统得以镇静。新研发的谷氨酸脱羧酶自身免疫抗体与强迫性神经官能症有一定的相似之处，会使人行动缓慢、眩晕、自闭和患有“僵人综合症”。为了避免谷蛋白的食用，体内有阳性谷氨酸脱羧酶抗体的患者应避免食用含有大量人工谷氨酸的食物。对谷氨酸脱羧酶的自身免疫反应在患有谷蛋白耐受性疾病或乳糜泻的患者中非常常见。谷蛋白耐受性和乳糜泻患者应在缺乏伽马氨基丁酸的持续症状下格外小心。你的神经性抗体多到什么程度？抗体水平并不具有典型的临床意义，因为抗体自身不会损坏组织。但经研究调查发现，神经性抗体自身就带有破坏性。这在免疫学中也是一个特例，因为神经性抗体数量的多少与即将到来的破坏性的程度成正比。神经性自身免疫的解决办法虽然目前还没有能治愈自身免疫的方法，但我们可通过调节或合理的生活方式、饮食和营养补给来“驯服”它。为保持大脑健康，你可能需要作出很大的改变，如换工作、结束恋情、换住所或改变其它生活中重要的事物，对引发并削弱你自身免疫的原因应格外重视。削弱自身免疫的方法提高类阿片的分泌量：天然类阿片会激活TH-3细胞，它可削弱自身免疫。积极的精神态度、关爱、对生活的理解、健康的自尊心和健康的锻炼水平都可以促使类阿片的分泌。但反过来说，负面情绪、暴力、不合适的恋情以及内部精神压力都对促使IL-6细胞的产生，它会激活TH-17细胞并加重自身免疫。稳固血糖浓度：如果你患有自身免疫性疾病，一定要注意血糖浓度，不能让它大起大落。若起伏太大会刺激IL-6和TH-17的产生，继而加重自身免疫。60 禁食谷蛋白：对许多人来说，谷蛋白是一种潜在的刺激神经性自身免疫性疾病诱因。提升肠-脑轴（将肠胃道与中枢神经系统连接起来的神经）的健康程度：大脑的健康取决于肠道健康，对肠道的消炎和提高肠-脑轴健康程度对神经性自身免疫疾病的治疗有帮助作用。削弱自身免疫的营养物维他命D：临床证明，维他命D有助于刺激TH-3细胞的产生，因此可削弱自身免疫。为削弱自身免疫，每人每天所需的维他命标准为5,000到10,000IU。可通过血清25-羟基维他命D测试来测试你体内的维他命D含量。测试显示，大多数患有自身免疫疾病的病人体内维他命D含量都很低。正常的维他命D含量应该维持在50ng/mL左右。若超过100ng/mL，则表明维他命D含量过量。谷胱甘肽：谷胱甘肽的作用是保存和保护抗炎的神经原，为TH-3细胞反应提供动力，为血脑屏障和肠屏障的再生提供条件，是一种天然的中和解毒之物，能与人体中的重金属及污染物等环境复合物结合，并促使其排出体外。谷胱甘肽的循环使得现有的谷胱甘肽在细胞内得以再使用和增长。可为此循环机制提供动力的复合物包括：•冬虫夏草•n-乙酰半胱氨酸•积雪草•奶蓟草•左旋谷酰胺•α硫辛酸这些都是TH-1和TH-2中性细胞，正因为它们可为TH-3细胞的产生提供动力，所以它们可削弱对自身免疫反应非常强烈的TH-1或TH-2细胞。为了提升谷胱甘肽I的使用效率,可使用S-乙酰-L-谷胱甘肽，一种可完全吸收的口服药物。这种口服药剂可在刚开始时每天服用三百mg，之后逐日递增到几千mg。但这种药物价格昂贵，是否能用足药量完全取决于你的收入状况。所以我建议在平日里每天服用61 1000mg，当然在特定条件下越多越好。我还推荐有局部自身免疫性疾病的患者食用脂质体谷胱甘肽奶油，比如说关节性发炎或甲状腺发炎。白藜芦醇和姜黄素：姜黄素和白藜芦醇会削弱自身免疫的两大发炎通路，TH-17细胞和核内转录因子.。为削弱自身免疫，患者需大量服用这两类营养物。我们在研究过程中，给患者服用的量分别为400mg的白藜芦醇和800mg姜黄素，但用量因人而异，无需严循次用量。修复肠道以及为大脑消炎的复合物：患者也可能希望寻找一些提升肠道通透性并为大脑消炎的复合型药物，请查看第九章，肠-脑轴章节。需避免食用的营养补给品：一定要避免食用由免疫反应成分（通常会制成填充剂）制成的和可能含有谷蛋白的天然补给食物，它们会刺激TH-1细胞或TH-2细胞的产生。可刺激TH-1细胞产生的植物萃取类药物包括紫锥花属、黄芪属植物、蜜蜂花（柠檬薄荷）以及灰树花。可刺激TH-2细胞产生的植物萃取类药物包括松树皮提取物、葡萄籽萃取物、绿茶提取物、莓提取物和碧萝芷。这些都是具有免疫激活属性的抗氧化剂的复合物；但大多数黄酮类和营养抗氧化剂都不具有激活自体免疫的属性。补充大脑神经递质的方法（神经递质在突触传递中是担当“信使”的特定化学物质，简称递质。）尽管为大脑补充神经递质可提升大脑的健康程度，但这并不适用于所有情况，它不是万全之策。增加营养的补充要依据个人的症状而不是体型的大小来增加对神经递质的营养补充。逐步增加营养量等待情况好转。若逐步增加营养量后情况并无继续好转，则返回情况刚有所好转时的用量。增加营养的频率需取决于自身的状况。若增加营养量用量后身体无法承受怎么办？如果增加营养量用量后，身体出现了发福或其它症状，则表明你的神经原离临界值非常近。在这种情况下，为减轻如脑炎和脑氧化之类的症状，需降低用营养补充量。62 为大脑补充乙酰胆碱（一种神经递质）乙酰胆碱活度低的症状如下：•视觉记忆和影像记忆损失•言语记忆损失•短暂失忆•创造力受损•理解力下降•算数能力下降•识别物体和人脸的能力下降•反应下降•方向感和空间感下降天然脂肪，尤其是动物脂肪对乙酰胆碱活度的影响最大。（加工过的的植物油对乙酰胆碱活度也无益处）富含胆碱的食物包括：•动物的肝脏或器官•蛋黄•牛肉•豆腐•坚果•奶油•有脂牛奶（不是脱脂牛奶）•脂肪奶酪可增加乙酰胆碱活度的营养物：•α-甘油磷酸胆碱（防止胆碱缺乏、增加神经递质、促进促生长激素的分泌等的食品药物）·石杉碱甲（一种从植物石杉碱千层塔中提取出的有助于改善记忆力和治疗老年痴呆的化学物质）•n-乙酰左卡尼汀盐酸盐63 •泛酸（如泛酸钙）增加血清素活度血清素活度低的症状：•对事物提不起兴趣•易愤怒•易沮丧•认为人生无乐趣•天气不好时感到压抑•对最喜欢的事也提不起兴趣•不喜最爱的食物•不喜与友人交流•难入睡睡眠浅雌激素与血清素的关系雌激素会刺激大脑中血清素的增多。若血清素过高，则需特别注意雌激素的分泌情况。同时，雌激素分泌过少则会导致血清素活度降低并造成血清素的缺乏。可增加血清素活度的营养物下列植物性药物可增加受点敏感度，帮助失效血清素的排出，并能为血清素的产生提供辅因子。•5-羟色氨酸•色氨酸(脊椎动物日常食物中一种主要的氨基酸)•贯叶连翘•S-腺苷甲硫氨酸（是一种改善细胞代谢的生化药物）•烟酰胺（可促进生物氧化过程和组织新陈代谢，对维持正常组织(特别是皮肤、消化道和神经系统的完整性具有重要作用）•柠檬酸镁（补充人体镁元素）•维生素B12（又叫钴胺素，是唯一含金属元素的维生素）64 •叶酸（维生素B9，预防胎儿神经管畸形）可维持血清素健康的膳食尽管只有部分食物中富含色氨酸，但大多美国人，除了一些不严格遵循素食主义或吃垃圾食物的素食主义者，都可以从食物中摄取了足够的蛋白质为氨基酸，包括血清素提供前体细胞。需引起我们注意的是大脑的健康、压力水平和血糖平衡，这些都影响着大脑是否能摄取足够的血清素并对前体细胞加以使用。伽马氨基丁酸的补充：伽马氨基丁酸不平衡的症状：•无缘故感到焦虑或惊慌•感到恐惧•内心感到紧张和兴奋•无缘由感到被打击•心中焦躁不安•想放松时精神却高度紧张•注意力紊乱•对之前根本没想过的事感到担忧可稳定伽马氨基丁酸的营养物•缬草根•乳清酸锂•西番莲萃取物•茶氨酸•牛磺酸•镁元素锌元素锰元素65 自体免疫伽马氨基丁酸失调谷蛋白不耐受、乳糜泻以及自我免疫性疾病都会引发谷氨酸脱羧酶的自我免疫反应，而谷氨酸脱羧酶的主要功能就是生产伽马氨基丁酸。患有谷氨酸脱羧酶自我免疫性疾病的患者常常对谷蛋白不耐受。和I型糖尿病一样，阳性谷氨酸脱羧酶抗体也是用来检测早期谷蛋白不耐受病症的一个重要指标。体内有阳性谷氨酸脱羧酶抗体的患者应避免食用谷蛋白以及高含谷氨酸成分的人工食品，如味精。许多患有谷氨酸脱羧酶自我免疫性疾病的患者食用高含谷氨酸成分的食品后会出现焦躁、不安、偏头痛等症状。患有自我免疫性疾病的患者和伽马氨基丁酸活度低的患者，尤其是患病时间较久的患者采取此种治疗方法时需十分谨慎。遗传性伽马氨基丁酸转换障碍—α酮戊二酸有些患者有遗传性转换障碍，这影响了伽马氨基丁酸的产生，因此会导致压力逐日上升。对长期缺乏伽马氨基丁酸或有历史性焦虑性疾病的患者来说，这点要尤其注意。怎样才能判断伽马氨基丁酸缺乏病症是遗传性的呢？方法就是服用3000-4000毫克的α酮戊二酸。α酮戊二酸对并不患有马氨基丁酸缺乏病症的人不会造成多大影响，或许只会增加一些体能。但对那些患有遗传性失调病症的患者来说，服用α酮戊二酸会导致伽马氨基丁酸的一系列病症，如兴奋、紧张、焦虑和其它伽马氨基丁酸缺乏症状。对于这种情况，则需长期、定期摄取伽马氨基丁酸。多巴胺（多巴胺是一种神经传导物质，多巴胺是一种神经传导物质）缺乏多巴胺的症状：•难以自我激励•拖延症•感到毫无价值•感到毫无希望•因很小的事情绪失控•无法降低自己的压力•压力大时易怒•不喜欢与人交流•对家人和朋友毫不关心66 可补充多巴胺的营养物•黧豆(属于刺桐亚族物种植物)•β-苯基乙胺(人在恋爱时会产生一种最基本的物质,巧克力是最典型的富含苯基乙胺的食物)•蓝莓提取物、硒元素、α硫辛酸、N-乙酰半胱氨酸•苯丙氨酸（是人体必需氨基酸之一）•N-乙酰-L-酪氨酸（蛋白氨基酸之一，属于非必须氨基酸）•维生素B6多巴胺与荷尔蒙的关系女性常见的缺乏多巴胺症状为月经严重不调。而男性的症状则是睾酮低，并发症包括性欲低、性功能下降、肌肉密度低。抑郁症也是缺乏多巴胺的一种可能性症状。多巴胺刺激黄体生成素的生成，它则会刺激女性孕酮的产生以及男性睾丸激素的生成。女性的黄体生成素低以及男性的睾丸激素低通常都是缺乏多巴胺的症状。多巴胺和严格执行一份协议的关系缺乏多巴胺的人脾气往往难以趋向顺从，这在需要改变膳食或改变生活习惯时是一个难题。尽管潜在的问题大都有导致多巴胺的缺乏趋向，但我对刺激多巴胺生成的建议是患者应努力提高自身动力来遵循一份改变家庭膳食或生活习惯的协议。我像我的家庭成员征求了一份严格的日程表，当他们缺乏多巴胺的时候，这份日程表就派上了极大的用场。荷尔蒙失衡的后果男性荷尔蒙失衡症状（任何年纪）：•性欲低•情绪、脑功能以及注意力波动幅度大•肌肉密度低•出汗量大（热潮红）67 女性停经期前症候的荷尔蒙失衡症状：•月经循环长度交替往复•热潮红及出汗•情绪、脑功能以及注意力波动幅度大女性更年期的荷尔蒙失调症状：•阴道干、痒或疼痛•情绪、脑功能以及注意力恶化•骨密度降低•绝经后有脑雾的症状当人体体内的荷尔蒙失衡时，大脑中的精神递质活动也会停止，继而会影响你的感觉、身体功能和对生活的看法。荷尔蒙失衡对脑炎和大脑退化影响巨大，还会严重加速大脑的老化。荷尔蒙和神经递质的关系荷尔蒙的失衡会导致神经递质的活度降低，反之则不成立。例如，单纯地增多对提高血清素（一种神经递质）营养物的用量并不会使已经缺乏雌激素的女性更加严重。•雌激素影响人体的血清素受体•孕酮影响人体的伽马氨基丁酸受体•雌激素影响女性体内的多巴胺受体•睾丸激素影响男性体内的多巴胺受体•雌激素影响女性体内的乙酰胆碱受体•睾丸激素影响男性体内的乙酰胆碱受体•甲状腺激素影响人体内的所有神经递质受体荷尔蒙和脑功能以及脑炎的关系正常的荷尔蒙水平会为神经元分支和神经元可塑性提供保障、为大脑消炎、减缓退化过程并在神经元迁移中起到重要的作用，神经元的迁移会促进大脑的自我修复活动。68 血糖值和荷尔蒙的关系激素取代疗法会导致人体内荷尔蒙的含量增多，这也会导致一系列的问题，如受点抵抗以及大脑和荷尔蒙分泌腺之间的连接度降低。直接最根溯源的效果最好，荷尔蒙失衡首要的原因就是大量的碳水化合物饮食导致的血糖失衡。男性体内雌激素过高大量的碳水化合物饮食会导致人体内胰岛素的升高，继而会导致男性体内芳香化酶（它是雌激素生物合成的限速酶）的增多。芳香化酶存在于脂肪中，可将睾丸激素转化成雌二醇（睾丸激素的一种）。过多的雌二醇则会导致体内的抗胰岛素性进入恶性循环。这样一来，睾丸激素就会刺激男性体内雌激素的增多。男性体内雌激素过高的话，胸部或臀部会变大、情绪不稳定，而且在情感上，能动力甚至个性上都会发生改变。女性体内睾丸激素过高大量的碳水化合物饮食会导致女性体内酶17-20溶酶的增多，这会导致女性体内睾丸激素的增多。过量的睾丸激素会使体内的抗胰岛素性进入恶性循环。常见的症状包括多囊性卵巢综合征、面部毛发过多、头发稀薄。同时，也会使女性体内的雌性激素和孕酮失衡，继而影响大脑中的神经递质活度，也会导致能动力、情感，个性上的改变。胆固醇和荷尔蒙的关系荷尔蒙的产生取决于体内是否有足够的胆固醇。现如今心病学的研究主张胆固醇要低于100。而在功能医学中，我们的标准是胆固醇低于150就会对荷尔蒙的正常分泌、大脑以及免疫系统的正常运转造成威胁。临床中也常见病人因低胆固醇引起认知力和记忆力下降的病例。肾上腺素应力和荷尔蒙的关系小神经胶质细胞通过脱氢表雄酮生成睾丸激素和雌激素。脱氢表雄酮可经由人体内的肾上腺、肝脏、睾丸或卵巢产生，但脱氢表雄酮的主要来源还是肾上腺。许多人因为长期的压力而导致低脱氢表雄酮。尽管脱氢表雄酮是人体内必不可少的成分，但不建议进行长期补充，或只在实验测试结果表明肾上腺长期疲劳的情况下进行少量的69 补充。若对脱氢表雄酮进行不必要的补充可能会扩大男性体内睾丸激素转化成雌性激素的数量，或增加女性体内的睾丸激素。窃取孕烯醇酮孕烯醇酮是内分泌系统和大脑用来产生荷尔蒙的物质。孕烯醇酮偷窃是指肾上腺在疲惫的状态下，身体从胆固醇里“窃取”孕烯醇酮来制造更多的皮质醇来取代性荷尔蒙。这种办法通常会发生在经前综合症、不孕不育症、男性更年期和多囊性卵巢性综合症的情况下。血糖不平衡最容易导致孕烯醇酮偷窃这种情况的发生。低胆固醇、慢性压力、血糖不平衡，低脱氢表雄酮和孕烯醇酮偷窃都是引起荷尔蒙失衡的几大因素。荷尔蒙失衡会引起神经元传递、髓鞘形成（保护涂层胶质细胞提供神经元）、染色体结合、神经元修复和神经元迁移（神经元自动迁移到需要修复的区域）等行为的功能性失衡。雌激素和大脑的关系经研究表明，雌激素对大脑有很大的保护作用。雌激素波动太大或太快可能会导致一些认知功能，如空间记忆和小肌肉运动技能的降低与丧失。这些认知功能的降低与丧失也可由其它更年期症状引起，包括易怒、脑雾、健忘、沮丧、易疲劳、焦虑、压力大、失眠以及已有病症的恶化。激素取代疗法有一定风险，我认为应检查雌激素是否不平衡或缺乏是才首要的措施。同时，激素取代疗法也对经期妇女的大脑有一定程度的损伤。但对于那些雌激素波动大或长期低雌激素状态的已绝经妇女或正来月经的妇女来说，激素取代疗法对她们的大脑有非常大的保护作用。孕酮和大脑的关系女性体内缺乏孕酮可导致伽马氨基丁酸和多巴胺功能受损。孕酮同时会削弱小胶质细胞。对脑部受伤的患者（无论是男性还是女性）进行孕酮的补充会帮助患者大脑的修复以及神经的髓鞘再生（髓磷脂是神经的保护外衣）。70 睾丸激素和大脑的关系睾丸激素对男性的大脑健康起着非常重要的作用。睾丸激素缺乏的症状包括：认知功能的丧失、记忆力下降以及向阿尔茨海默症（老年痴呆症）发展的过程。症状较轻者也会有压抑、缺乏激情或动力以及脾气暴躁等症状。因为睾丸激素影响多巴胺的活度，所以睾丸激素的缺乏会增加男性患帕金森病症的风险。睾丸激素同时也影响着乙酰胆碱的活度，前者的缺乏会增加男性患阿尔茨海默的风险。经研究表明，睾丸激素水平过低会增加人体内的β淀粉样蛋白，这类物质则会进一步导致阿尔茨海默症。甲状腺机能减退症和大脑的关系最常见的甲状腺机能减退症状包括压抑、疲劳和脑雾。甲状腺功能影响着大脑的可塑性、神经传递素活度和普通脑部功能。甲状腺激素对大脑的消炎起着十分重要的作用。血清素、多巴胺、伽马氨基丁酸和乙酰胆碱神经元突触的好坏都取决于甲状腺功能是否健康。实际上，许多神经学症状都会伴随着一些甲状腺的病症，如压抑、记忆力丧失以及神经传递素与甲状腺的连接中断。桥本脑病可能是桥本病症中情况最坏的一种疾病了。桥本脑病又名自身免疫性痴呆病，是一种大脑自身免疫的发炎性紊乱疾病，会使患者丧失记忆力或得其它痴呆性疾病。当病人体内既有高甲状腺过氧化物酶抗体，又有一些痴呆症状或其它神经性疾病时，就很有可能患桥本脑病。然而百分之20的年老患者，尤其是女性，她们体内可能有高甲状腺过氧化物酶抗体，但因为造成神经性疾病的因素有许多，所以我们执业医师在诊断桥本脑病时需要格外小心。甲状腺出现问题的情况下可能会加重脑部的退化，这也是我们需恰当地对待甲状腺机能减退症和桥本脑病的重要性。简单地服用甲状腺荷尔蒙对桥本脑病造成的甲状腺机能减退并不管用，美国90%的患有甲状腺功能疾病的人都适用此规则。简单服用甲状腺荷尔蒙对因慢性压力，女性睾丸激素偏高，或环境有害性等导致的甲状腺功能减退也不起任何作用。在我另一本著作中有解释过，造成甲状腺功能减退的潜在原因一般都应阻止大脑健康的进一步减退。71 在针灸、捏脊、按摩及其它身体护理的基础之上，如何进一步提高大脑健康程度？听音乐、练瑜伽、按摩、针灸、脊椎推拿按摩、香薰按摩一级其它的疗法都会对大脑有一定的刺激作用。运用多种治疗方法都不同程度对人体的免疫力、情绪、精神、消化力、激素调控等起到了良好的效果。但无论任何治疗方法是否对大脑健康现有的状况上起积极作用都依靠于个人的现状。饮食不均匀、荷尔蒙失调、自体免疫、大脑发炎、环境污染等其它因素都会使大脑有一定程度的退化并改变大脑化学情况。因此，因大脑本身就有一定损坏，类似的治疗方法也有可能起不到良好的作用。或因大脑已严重退化，趋向于完全萎缩，这些感官刺激治疗法不仅起不到治疗作用，还会导致大脑更加疲劳，使大脑进一步恶化。维持大脑健康所必需的脂肪酸缺乏大脑必需脂肪酸的症状和迹象：•大脑功能不佳•难以消化脂肪鱼、生坚果和瓜子、生橄榄油或牛油果等食物•经常食用油炸食品•关节痛、慢性疼痛和炎症•经常食用人工脂肪•皮肤干燥不健康•头皮屑多•激素失衡加工过的植物油和氢化油都会使神经细胞的薄膜硬化并失去刺激反应，继而导致神经元功能下降，大脑发炎及退化，以及大脑功能退化。所以说，必需脂肪酸对脑功能的健康起着非常重要的作用。总结：保持大脑健康的态度和方法本书的作用并不是“修复”或“治愈”你的大脑或慢性健康疾病，若有医生声称他们可以“治愈”你的大脑疾病，一定要谨慎。为维护患者的大脑健康，无需只遵循本书的建议患者仍需不断地查询相关方法。72 从本人2010年出版的那本关于甲状腺的书籍中，我们知晓了许多关于如何处理慢性疾病的方法。而在这本关于大脑健康的书籍中，我们会学到更多方法。在我的书籍中很少有反对他人的意见，而是主要致力于提高人们对健康的重视程度。本书也并不是反药物书籍，不要顽固地拒绝那些能提高生命质量或可以阻止身体情况下降的药物治疗。本书的主要目的是探索造成大脑不好使、为什么你患有慢性健康疾病以及为什么你感觉身体每况愈下的潜在原因。大约几千人都曾告知我，他们的医生要么告诉他们精神抑郁，要么告诉他们的实验测试都很正规，身体没有问题，无需治疗。其实些病人都不同程度患有功能性障碍疾病，你的医生没有对症的治疗方案并不意味着就不存在治疗方法！这本书中并不包括非常细节的重点，如若要彻底对症下药，则需仔细钻研相关方法。但我致力于分享新的信息，分享多年来的一些详尽的研究和临床应用，这些研究都成功帮助过多名患有不明病症或慢性疾病的患者。尽管我们有许多成功的案例，但仍有少数病症无从下手。我们仍需不断学习。但我发现只要患者知道他们身体功能丧失或其它病症的原因，他们的精神就会放松一大半。患者的心理只要得到一些慰藉，就会有足够的力量对抗病魔。我真诚地希望您或家人能从这本书中得到一些帮助，身体机能得到提升或至少了解到你自身的情况。您的精神并没有问题、也并没有捏造病情，也不需服用抗抑郁药物。许多人都严重缺乏对慢性精神性疾病和自我免疫性疾病的患病意识，大多数人都以为患了不明病症。这些人对药物的依赖性急需改变，唯一有效的药物来源只有一个：你自身。在我们现有的保健模式下，需要民众自身去多多了解医学知识并多咨询医师的建议才能使自身健康得以提升。真诚地希望您可以通过我的帮助成为了解自身疾病患者的一份子，这样您会反过来帮助像我这样的医生继续学习和成长，我们也会为您提供更好的医治服务。73'