Maintaining the Brain

Designing an evidence-based protocol for patients, with supplements proven to protect cognitive function, promote brain fitness and enhance overall quality of life.

As the command center for the nervous system, the human brain coordinates thoughts, emotions, movement and memory, essentially regulating every facet of daily life.  “The brain is the control center of the body and the main regulator for mood and cognitive performance,” says Neil Edward Levin, CCN, DANLA, co-founder and former officer of the American Nutrition Association. “This organ, largely made of fat and various types of nerve cells, requires a tremendous amount of energy and is responsible for collecting, producing and directing neurotransmitters and hormones that affect memory, focus, cognitive and executive functions, stress management, sleep cycles and mood.”

Optimal brain health is paramount for balanced mood, cognitive performance and overall quality of life. But environmental factors, lifestyle influences, poor nutrition and age-related changes impact neurotransmitter production, cognitive function and other aspects of brain fitness.

“Because of its nonstop activities, the brain requires a constant supply of not only energy, but also materials that neurotransmitters are made from,” says Levin. “Choline is required to manufacture the important neurotransmitter acetylcholine, and other neurotransmitters require amino acids as precursors in the transformation of these nutrients to actual neurotransmitter compounds. That conversion process also requires vitamins C and B6 as cofactors. Stress can deplete these neurotransmitters, and negatively affect the neuron network as well.”

Age in particular takes its toll. Unlike some organs and tissues, brain cells don’t have the ability to regenerate. Cerebral volume declines at a rate of around 5 percent per decade after 40, rapidly accelerating over the age of 70. Age-related brain atrophy results in a range of cognitive impairments including memory loss, difficulty with language processing, reasoning and motor skills, mood swings and dementia—a process that’s further aggravated by inflammation, free radical damage, arteriosclerosis, hypertension, cerebrovascular disorders and other diseases of aging.^{1, 2, 3, 4}

While quality nutrition and lifestyle interventions are important, those alone may not sufficiently protect the brain from daily damage or the ravages of time. “Nutrient-poor diets combined with aging, which may also be accompanied by digestive challenges, are some reasons people are not getting sufficient nutrients from their meals,” says Levin. “Analysis of the government-mandated NHANES surveys have shown that many folks simply do not even get the Recommended Daily Allowance of essential nutrients from food, but that supplementing will tend to eliminate most nutrient deficiencies with very little risk of overdosing. When there is a family history, genetic predisposition, food insecurity, environmental or emotional stresses, the likelihood of having insufficient nutrients to produce the compensating factors in the body increases dramatically and strongly suggests supplementation may be needed.”

A comprehensive regimen that includes evidence-based supplements is vital for maintaining the brain, enhancing neurotransmitter production and supporting cognitive wellness, especially during aging.  Ten brain-protective ingredients proven to work.

1. Choline serves as the precursor to acetylcholine, a cholinergic neurotransmitter involved in memory, learning, muscle control and other cognitive functions. Brain choline levels decline with age and are thought to contribute to the development and progression of neurodegenerative diseases, including Alzheimer’s. Increased choline intake may help prevent dementia and mild cognitive impairment, and in adults and the elderly, higher choline is linked with improved verbal memory, better performance in cognitive functions and a lower incidence of dementia.^{5, 6, 7, 8}

One form of choline, L-alpha-glycerylphosphorylcholine (alpha GPC), is considered significantly more bioavailable than regular choline supplements. Its unique structure allows it to easily cross the blood-brain barrier, promoting the synthesis of acetylcholine and offering neuroprotective effects to preserve brain health.

In studies, alpha GPC has been shown to increase acetylcholine levels in the brain and enhance motivation, cognitive function, memory and learning. Other research suggests alpha GPC boosts exercise endurance, performance, isometric strength and force and speeds recovery. During aging, alpha GPC may protect the brain against cognitive decline and in clinical trials, supplementation improved cognitive impairment in patients with Alzheimer’s disease and vascular dementia.^{9, 10, 11, 12, 13}

2. Tyrosine and phenylalanine are crucial in the synthesis of dopamine, epinephrine and norepinephrine, neurotransmitters involved in mood, memory, alertness and learning. Phenylalanine serves as the precursor to tyrosine, and adequate levels are known to promote neurotransmitter synthesis and support cognitive function, especially during situations of stress or fatigue.^{14, 15, 16}

Through a separate pathway, phenylalanine is also converted into phenylethylamine (PEA), a central nervous system stimulant that acts as a neurotransmitter and neuromodulator. PEA heightens dopamine and, along with phenylalanine, is thought to have mood-elevating and antidepressant benefits.^{17, 18, 19}

While tyrosine can be produced from phenylalanine, direct supplementation with tyrosine often appears to have noticeable and immediate effects on cognitive function. Tyrosine crosses the blood-brain barrier more readily than phenylalanine, supporting neurotransmitter synthesis and replenishing depleted catecholamine levels in the brain. In studies, tyrosine treatment has been shown to improve cognitive performance in young adults, especially during stressful or demanding situations, enhancing working memory and executive functions.^{20, 21}

3. Vitamin C acts as an important cofactor in the conversion of phenylalanine to tyrosine and the syntheses of several neurotransmitters. Along with these activities, vitamin C plays other prominent roles in brain health and cognitive performance, regulating neuromodulation, neurotransmission and angiogenesis. As a powerful antioxidant, vitamin C protects the brain from oxidative stress and neuronal damage. Vitamin C is involved in collagen synthesis, essential for maintaining vascular integrity, a primary factor in cognitive function, especially during aging.^{22, 23, 24}

A number of studies link inadequate vitamin C to neurocognitive dysfunction, depression, confusion and greater impairment. Vitamin C deficiency is thought to influence age-related cognitive decline as well as stroke risk and severity. In one review, vitamin C concentrations in cognitively intact participants were significantly higher compared to the impaired group. In another study of older patients, vitamin C deficiency was 2.9-fold more likely to be associated with cognitive impairment. Overall, a large body of evidence suggests maintaining optimal vitamin C levels has a protective function against age-related cognitive decline and Alzheimer’s disease.^{25, 26, 27, 28, 29}

4. Vitamin B6, like vitamin C, is involved in converting phenylalanine to tyrosine and synthesizing key neurotransmitters. Beyond neurotransmitter production, vitamin B6 has a direct impact on brain health, cognitive performance and mood, and deficiencies have been linked with poorer mental function, cognitive impairment and neuropsychiatric disorders, including depression.^{30, 31}

Vitamin B6 is required for the metabolism of homocysteine, serving as a co-factor for enzymes that facilitate the conversion of homocysteine to methionine and cysteine. Vitamin B6 deficiencies disrupt homocysteine metabolism and can lead to elevated homocysteine levels, associated with impaired cognitive function and a higher risk for cerebrovascular disease and neurodegenerative disorders. Poor vitamin B6 status and elevated homocysteine is also thought to be a cause or mechanism in the development Alzheimer’s and other forms of dementia.^{32, 33}

5. Ginkgo biloba extract has long been used in China for various health conditions and is a prescribed in France and Germany to treat dementia and cognitive issues. Its therapeutic benefits are attributed to a combination of effects, including dilatation of blood vessels, inhibition of platelet‐activating factor, modification of neurotransmitter systems and antioxidant activities that shield brain cells from free radical damage.^{34, 35, 36}

Ginkgo’s neuroprotective properties against neurodegenerative disorders like Alzheimer’s and Parkinson’s have been widely research, with many studies finding ginkgo had a positive effect on cognitive function, memory, thinking, learning, social behavior, depression and daily activities, and may slow cognitive decline in an elderly population.^{37, 38, 39, 40}

Ginkgo extract shows potential for protecting nerve cells  damaged in Alzheimer disease, and may improve cognitive performance, neuropsychiatric symptoms, functional abilities, daily living and social behavior in patients with Alzheimer’s. Other studies suggest gingko treatment in patients with normal cognitive health may reduce the risk of developing Alzheimer’s dementia and may be as effective as some prescription medications in delaying the symptoms. While results are inconsistent, research points to the benefits of ginkgo biloba extract on mental functions and quality of life in healthy adults.^{41, 42, 43, 44, 45}

6. DMAE (dimethylaminoethanol) is an analog of choline and a precursor of acetylcholine. Because of its ability to optimize the production of acetylcholine, the primary neurotransmitter involved in learning and memory, DMAE is thought to enhance cognitive fitness. As the immediate precursor to choline, used to synthesize phosphatidylcholine, DMAE plays a role in cell membrane structure and function, especially in the brain. Research also demonstrates its antioxidant effects and its potential to protect brain cells from free radical damage.^{46, 47}

In animal studies, DMAE increased choline and acetylcholine extracellular levels in the brain’s prefrontal cortex, improving spatial memory and memory retention, reducing memory deficits and enhancing working memory performance. In human trials, a DMAE supplement containing vitamins and minerals increased alertness and attention and boosted mood. Another study showed DMAE improved sleep quality and induced lucid dreams, and some research suggests it may be effective in decreasing memory deficits in patients with cognitive impairment and producing positive behavioral changes in patients with senile dementia.^{48, 49, 50}

7. Taurine, the second most abundant endogenous amino acid in the central nervous system, plays prominent roles in brain and cognitive health. Taurine is involved in regulating intracellular calcium levels, crucial for proper neuronal function and communication, mitigating neuroinflammation, promoting mitochondria biogenesis, reducing oxidative stress and increasing neurogenesis and synaptic activity.^{51, 52, 53}

Research highlights taurine’s positive impact on cognitive performance, especially in tasks requiring memory and learning, and protect against neuropathology. In animal studies, taurine has been shown to benefit neuronal proliferation and synaptogenesis, suggesting its effects on synaptic plasticity and improving learning and memory.^{54, 55, 56}

In other research, age-related decreases in circulating taurine levels are associated with a greater risk for dementia and Alzheimer’s. Earlier studies show a lack of taurine in the brains of patients with Alzheimer’s, and higher blood taurine levels are linked with lower risk of dementia. Taurine supplementation has displayed therapeutic potential against neurological disorders, including Alzheimer’s, with research demonstrating its ability to significantly improve and restore cognition and function in patients with dementia through multiple mechanisms. Taurine appears to bind to beta-amyloid plaques and may prevent neurotoxicity and cognitive impairment, and data hints that taurine may be a valuable protective agent against Alzheimer’s.^{57, 58, 59, 60, 61, 62}

8. Grape seed extract (GSE) is rich in antioxidants, including flavonoids, phenolic compounds and proanthocyanidins, widely studied for their benefits for brain health and cognitive function. Antioxidants in grapes promote vascular integrity, shield brain cells from oxidative stress and free radical damage and dampen inflammation, linked with cognitive decline. GSE has also been shown to significantly increase blood flow and may protect against age-associated reductions in cerebral blood flow, a known risk factor for dementia and Alzheimer’s disease.^{63, 64, 65, 66}

In animal research, GSE was found to heighten brain antioxidant levels, improves cognitive status, preserves short- and long-term memory, and plays a critical neuroprotective role, minimizing risk of cognitive loss with aging. In one study, GSE markedly inhibited amyloid beta-protein aggregation and mitigated cognitive deterioration, hinting at its potential for preventing or treating Alzheimer’s disease.^{67, 68, 69, 70}

While findings are mixed, human trials on GSE’s brain-supportive effects suggests GSE can promote memory, motor skills, executive functions, reaction time and overall cognitive performance. Related studies using grape juice show antioxidants and other constituents from grapes increased memory, motor skills and mental performance in healthy adults, enhanced cognitive function in older adults with early memory decline, and significantly improved mood, depression and anxiety.^{71, 72, 73, 74}   

9. Coenzyme Q10 (CoQ10) facilitates ATP production, vital for maintaining optimal brain function, and acts as a powerful antioxidant, reducing oxidative stress, mitigating inflammation and promoting cell survival in the brain, important for preventing cognitive decline and neurodegenerative diseases. Oxidative stress also plays a prominent role in the pathogenesis of Alzheimer’s and dementia, as well as normal age-associated declines.^{75, 76, 77}

CoQ10 supplementation significantly increases brain mitochondrial concentrations and exerts neuroprotective properties and is effective in treating various mitochondrial diseases and neurodegenerative disorders, including Alzheimer’s, Parkinson’s, Huntington’s, amyotrophic lateral sclerosis and other conditions like autism, depression and bipolar disorder.^{78, 79, 80}

The neuroprotective effects of CoQ10 on neurological diseases has been widely researched. Adequate CoQ10 is associated with cognitive health and executive skills in older adults, and low serum levels indicate a greater risk of dementia. In studies, CoQ10 improved cognitive function, learning and memory and prevented oxidative stress, inflammation and cellular death, suggesting CoQ10 has significant therapeutic value in the treatment of Alzheimer’s type dementia.^{81, 82, 83, 84, 85, 86}

CoQ10 supplements typically occur as ubiquinone, which must be converted to ubiquinol, its active form. Ubiquinol, the reduced form of CoQ10, does not require conversion by the body and can be readily utilized—especially important for older adults as aging decreases the body’s efficiency in absorbing and converting CoQ10.42 Research demonstrates ubiquinol’s superior bioavailability, with studies showing ubiquinol forms of CoQ10 were three to four times better absorbed than ubiquinone forms, resulting in significantly higher plasma increases in CoQ10.^{87, 88}

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