Hope for brain atrophy reversal?

[accordingnature495]

I was doing pretty well a decade from diagnosis, and with the pandemic and personal issues experienced a tremendous amount of stress that has now culminated in a flare-up with new motor symptoms.

But the worst is the gradually worsening depressive, spaced out and low energy feeling I have in my brain. I feel like I have dementia. Nothing that I tried was worked for it, lots of high intensity exercise, dieting, supplements, nothing. The feeling is I would describe as having been lobotomized. Feels like a part of me is gone. I didn't even know about non relapse neurodegeneration in MS before. I am in a highly cognitively demanding field and I feel I can't function anymore. But worst of all is the feeling itself. It really feels like dementia, it affects my multitasking ability, my memory, my learning, ability to enjoy things and emotional stability.

I suffer greatly. To be honest I don't want to go on if this is going to be my life from now on, only worsening.

But I'm not posting this to talk about that, I'm seeking, ideally, informed hope in the form of, even speculative, future advances in medical technology that would allow for regeneration / repair of the damage MS is doing to the brain. Everything I read is "permanent", "irreversible". Where is the hope?

[NHE]

Welcome to ThisIsMS. Regarding brain atrophy, there are many articles published that show that exercise increases the production of brain derived neurotrophic factor (BDNF). Several of these articles have been posted to the exercise forum. BDNF promotes the growth of new neurons. The exercise doesn't need to be extreme. For example, you could just go for a vigorous walk every day. Ginkgo has also been found to upregulate BDNF. viewtopic.php?p=260907#p260907

Diet also affects brain health. A diet high in sugar and processed food increases the risk of dementia. viewtopic.php?t=32253

In addition, a diet that includes dark leafy greens, e.g., kale, spinach, collard greens, etc, promotes brain health by increasing neuronal magnesium which promotes synaptogenesis. viewtopic.php?t=32251

Omega-3 oils, i.e., DHA and EPA, are also good for the brain and have been found to reduce the risk of Alzheimer's Disease. Fatty fish, such as salmon, is the best way to get omega-3 oils as they're the most absorbable. viewtopic.php?p=262340#p262340 Be careful with fish oil capsules. Many of the lower priced brands contain oxidized oils. These can promote disease including cancer. You should be able to bite into a fish oil capsule and find that it has a mild fish flavor. However, if it tastes like the floor of a fish market, then throw it away.

Lipoic acid has also been shown to reduce brain atrophy. A group of researchers at Oregon Health and Science University in Portland, OR have been studying it in MS for ≈ 20 years. In a phase II study they found that it reduced atrophy by 68%. Compare that to Ocrevus which reduces atrophy by just 18%. https://www.medicalnewstoday.com/articles/318225 I take Na-R-Lipoate as it's a more highly bioavailable form.

Curcumin is also good for the brain. Be careful though. Most cucumin supplements are poorly absorbed. Longvida curcumin encapsulates the curumin in a solid lipid shell. It's the only curcumin that has been shown to cross the blood brain barrier.

I take several of these supplements. Links can be found in the following post.
viewtopic.php?p=262050#p262050

[accordingnature495]

Thank you very much

I have tried alpha lipoic acid several times and even up to a week and always get the worst insomnia, even if I take it early in the day... I don't see everyone mentioning this so it probably varies with the person. Or maybe I just need to take it consistently and at some point this resolves? It gets very bad, one of the strongest effects on sleep of any supplement.

[NHE]

I have tried alpha lipoic acid several times and even up to a week and always get the worst insomnia, even if I take it early in the day... I don't see everyone mentioning this so it probably varies with the person. Or maybe I just need to take it consistently and at some point this resolves? It gets very bad, one of the strongest effects on sleep of any supplement.

I also have difficulty sleeping. I take melatonin and GABA. Both are sublingual. Neither alone does much, but in combination they seem to work better.

Melatonin, GABA

[NHE]

I have tried alpha lipoic acid several times and even up to a week and always get the worst insomnia, even if I take it early in the day...

Alpha lipoic acid is a 50/50 mixture of r-lipoic acid and s-lipoic acid. The r form is natural while the s form is a byproduct of synthesis. The two forms are called enantiomers. The s enantiomer has some negative physiological effects. You can read more about the difference between the two enantiomers in the following post.

Note, regular r-lipoic acid is rather sensitive to heat and readily forms a polymer which inactivates it. See this journal paper. Several companies sell a stabilized form which is either the sodium or potassium salt of lipoic acid. This is the form I use, Na-R-Lipoate. It has the advantage that it has much greater bioavailability.