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Step Out of Brain Fog: Official Guide

Using this guide

Use this guide to organize your notes, follow the webinar replay, and capture some of the highlights of Guido Masé’s class. A link to the replay and slideshow is at the bottom of the guide for easy reference. 

This guide is a sample of the student support I will be providing throughout Biohacking Your Brain. Guido packs a lot into every class, and I’m here to help you make the most of it.

Before you dive into this guide, I want to ask you to take a self-assessment test…

In Guido Masé’s webinar, Step Out of Brain Fog, he talked about the value of self-assessments.

In a holistic approach, assessments reveal the dots that need to be connected. It’s a way of documenting what is going on now, choosing the best way to get from where you are to where you want to be, and then re-assessing in order to track progress.

An assessment is a moment to ask questions.

All of these questions point to brain fog and the need to support better brain function.

If you answered ‘Yes’ to any of these questions, it’s important to follow up with more questions: How often does this occur? Daily, weekly, monthly? How long does it take for me to recover from one of these periods?

Recording your answers before implementing a protocol, and then again six-eight weeks later, help define your journey, and helps you note and log improvement. This feedback is invaluable as you work to deeply understand how plants interact with your unique physiology.

Guido adds,

“The human being is like a garden, and we, as herbalists, are gardeners working with a living, intelligent ecology.”

Tending the garden begins with an assessment of its current condition and its needs.


Guido: “As we think about the journey of stepping out of brain fog and being able to kind of get a horizon or a vista to work towards, instead of feeling this creative impulse and not having the direction and ability to put the pieces together to get us from point A to point B… as we step out of that haze and that fog, we want to think about doing it in a way that honors cyclical patterns inside us and applying that support in cycles.

We want to do it in a way that honors the fact that we’re not just a brain in a vat. We are actually full human beings that live in a context, both outside of us and inside of us.

And I’m going to ask you to do this – this is my clinician’s mind as we go through the different pieces that I feel are relevant to stepping out of brain fog and getting on this journey to finding this vista, getting the clearing – let’s think about how we can measure success, and how we can be observant of shifts and changes that are happening so that we can get a sense of, ‘Yes, things are improving. Yes, these herbs, these mushrooms, these interventions, the daily walk that I’ve committed to…they’re all making a difference.’”

What is brain fog?

Guido: “Brain fog affects people of all ages. You can see symptoms from memory disruption and difficulties with learning or recalling memories.

One of the most profound things is a deficit in creativity and imagination, the ability to visualize possibilities and create, which is to me, such an important part of finding meaning and purpose in life. So that then motivation and resilience, and the ability to handle life, which often comes with this important sense of purpose, that keeps us moving forward. That becomes really difficult for folks who experience brain fog.

And in some cases, there can be anxious symptoms or depressive symptoms. I just want to emphasize one more time, that these can be subtle symptoms – even to folks who are in your life who love you and who know you – may not be immediately obvious that you’re experiencing this on an almost daily basis.”

Is caffeine okay?

Guido: “I do want to talk about ‘stimulants,’ or to put it better, botanical agents, that can help us get a boost when we need a boost, with the realization and the understanding that our creative performance is never meant to be full throttle 24/7.

We have to be able to say, ‘Hey, I understand that modern American culture might expect us to be top performers all the time. But that’s neither realistic nor healthy, right?’

So how can we think about using boosts when we need them in cyclical ways, in order to create this sort of virtuous cycle, right, where we improve our cognitive performance, little by little, give ourselves a little nudge, perform, effectively rest and repeat?”

What is awareness?

Guido: “We tend to identify very profoundly and deeply with our mind. And what that definition of mind or consciousness truly is is something that we can spend a lot more time on. I do want to get into it a little more deeply. But for tonight, simply recognizing that the mind and our thoughts and our creative power – our integration centers – have a range of different inputs and influences, right?

Whether those are cultural, whether those are from the people we love, or the environment we live in, or from the bugs that live inside our guts, for Pete’s sake, right? So many different influences impact our mood and our mind and our cognitive ability.

And then the brain has this incredible ability to kind of create a gestalt or an overview picture of all of that, and register it as a cognitive process, register it as a series of thoughts, as a creative impulse, or conversely, not be able to piece together all of that in a way that makes sense. And that’s the situation that we often encounter when folks complain of brain fog or cognitive dysfunction.”

Areas of brain support

Guido: “It will be important to spend a little bit of time on some of the key areas that are outside of the brain that are part of our physiologic process and part of ourselves that I have found to have profound impacts on the way we think, the way our mood works, the way our brain is able to retrieve memory and learn and create.

Those primary areas we’ll look at: our hormone balance and endocrine function, immunologic balance, which has a little bit to do with infections, right? When we think about, for example, COVID, or Lyme disease in the context of brain function, you might see where I’m going with this, right?

Vascular health, or the health of our blood vessels and blood flow – the brain consumes, even at rest, somewhere like 20% of our resting blood flow, oxygen and glucose. So there’s a hugely disproportionate need for good circulation in the brain, and neuronal tissue, perhaps not specifically the nerves themselves, but these amazing supportive cells called glial cells that orchestrate neuronal regeneration, help nerves rewire and create and stabilize pathways. And crucially, now, and this is something we didn’t even know 20 years ago, help with lymphatic drainage and immunologic movement and cleaning of the brain, especially when we’re sleeping, especially when we’re in deep restorative sleep.”

Our brain is not a CEO

Guido: “Brain fog is termed a disorder of, ‘executive function’ and what does that mean? It’s loaded language that’s borrowed from corporate America. And it presupposes that there’s this sort of executive CEO sitting up here somewhere, pulling all the levers.

And there’s something profoundly wrong with the CEO today.

What it (brain fog) does is – it doesn’t necessarily impair your ability to do simple cognitive tasks – it makes it really difficult to string those tasks together for a prolonged period of time to achieve an important goal.

So that’s how executive function is summarized as – the ability to coordinate a lot of different inputs, make value based decisions and keep the ship moving forward, to achieve the goal, to reach a destination.

Of course, a ship in fog, with no navigational systems is going to have a much harder time doing that.

But I also want to push back on the idea that there is an executive up there, that we’re trying to make the CEO happy. That’s not the case.

What we’re trying to do is make sure that the integration centers of the brain are humming along the way they should and that all of the other processes in our body are not creating a situation that the brains integration systems have to ongoingly fight against.”

Diagnosis can be tricky

Guido: “Folks who tell me that they’re experiencing brain fog on a regular basis will go into a neurologist’s office, or they’ll take a series of cognitive tests, and they’ll perform great – they’ll perform great in the short term.

And the doctor will say, ‘I can’t see anything wrong with you. It must just be stress.’

And in fact, there is something wrong, even though it doesn’t show up on the standard tests that are meant to assess things like dementia.

The executive function issue means that even though you have the tools, even though you can do your math tables, even though you can remember something for a short period of time and repeat it back, it’s the stringing together of multiple demands in order to achieve these complex goals, that becomes really, really difficult.”

The Blood Brain Barrier

Guido: “There are projections that form what is called the blood brain barrier. These projections wrap around the blood vessels preventing immune cells, viruses, and bacteria from getting inside the brain, as well as preventing a lot of chemicals from getting inside the brain too.

But that blood brain barrier is sensitive. It’s connected to living breathing, neuronal tissue or glial tissue. And it really deserves tending, right?

So not only have we found that these cells participate in the blood-brain barrier, a crucial protective layer that separates the brain from a lot of stuff in the bloodstream that could cause a lot of inflammation and neurodegeneration, but it also secretes nerve growth factor, helping to stimulate new connections and rewiring of the brain, especially after injury or trauma, when there has been atrophy and shrinking of nerves.

How can they regrow back? They do it in part because of this support from the glial cells.

Every night when we’re sleeping, and our brain turns down, and electrical waves go into their slowest state, deep into the theta restorative sleep. That’s when these glial cells really get to work. And they scour the cerebral spinal fluid, and they clean out all the space between the neurons, removing toxins, sending them out of the brain and central nervous system into the lymphatic system for processing and elimination.”

Benefits of getting outside

Guido: “Being outside is so important. We’re starting to see, particularly for stabilizing mood, but also for creating experiences that spark what I call a ‘gift cycle’ – this process of being inspired, then stopping and learning, and then being able to grow and share from that learning process out into the world.

And this cycle of creativity really is part of how the natural world engages with itself, literally thinks and dreams as a big ecosystem writ large.

And we can participate in this by simply stepping out into it. There’s no training required. There’s no classes you have to take or exams, you have to pass. It’s a birthright of existing on this biosphere – stepping outside into the natural world, wherever you may be.

Whatever that natural world looks like is going to be very helpful to your cognitive function, your mood, and your mental state.

And yes, being out in a vegetable garden counts.

Being out on a balcony with a geranium and lemon balm in a pot counts, right?

Feeling the sun feeling the wind, all of that counts.

Walking or moving your body when you’re outside delivers even more benefits than just sitting calmly there. It doesn’t have to be walking. It can be gentle stretching. It can be Tai Chi. It can be an upper-body workout. The key is that it elevates your heart rate beyond what your heart rate would normally be when you’re sitting calmly. That gentle elevation of the heart rate puts your cardiovascular system through its paces. And by delivering a cardiovascular benefit, you also see a neurologic benefit.”

Phosphatidylcholine benefits

Guido: “There’s a crucial ingredient called phosphatidylcholine, that I have found to be a helpful building block that, if it’s not present in adequate amounts in one’s diet, can just make it a little harder to build that neurologic health.

Anything that has lecithin in it, whether eggs, ghee or butter – these sources of lecithin are loaded with phosphatidylcholine, which is an important component of the cell membranes of nerves, and also a building block for neurotransmitters, particularly the neurotransmitter acetylcholine, which is connected to choline.

This is crucially important for folks I’ve worked with who experience brain fog following injury, like a traumatic injury, for example. But I’d say for anyone at all ages, getting those sources of phospholipids in your diet, helps normalize sleep helps normalize mood, and supports good cognitive function.”

Benefits of Lion’s Mane

Guido: “Many medicinal mushrooms are so good for us for so many reasons. And I’ll say that Lion’s Mane takes it a step further. It’s got the immune modulating polysaccharides. It has some some triterpenoids that help with immunologic balance that we see in mushrooms like Reishi, or Turkey Tail. It has certainly been used in things like immune dysregulation and cancer.

But the really unique constituents in this mushroom are diterpenes known as hericenones.

And these are consistently showing the ability to stimulate nerve growth, regeneration, support healthy nerve tissue and increased nerve conduction pathways to the point where folks who consume lion’s mane on an ongoing basis – and neuronal tissue that experiences these hericenones – they start to make a greater density of dendritic spikes, which means little projections coming out of the input area of the neurons.

They’re feathering out more, they’re listening more, they’re connecting more. These are all things that for a healthy human would support greater creativity.”

Benefits of Turmeric

Guido: “Another polyphenol that’s crucially important is curcumin from Turmeric. This is another great example of an anti inflammatory, blood brain barrier supportive, neuro tonic that can be taken on a daily basis and really supports healthy inflammation across the whole body.

We use it all the time for recovery from traumatic brain injury, as well as recovery from other traumatic events, to rebuild new nerve pathways and emerge again from that brain fog by reducing the sort of inflammatory load and ongoing pressure on the brain that follows many different traumatic events.”

How caffeine works

Guido: “Over time, as you’re awake for multiple hours, a neurotransmitter called adenosine begins to build up in the brainstem and in these initiating (arousal) areas of the reticular activating system (RAS). Adenosine inhibits this pulsing, it slows it down. So this is the main mechanism of how we get drowsy over the course of the day. Adenosine levels build, and they suppress the RAS, which begins to pulse more and more slowly. Then all the other nerve tissues not getting stimulated begin to go offline. Eventually, if we don’t go to sleep, our eyes will literally close, and we’ll pass out right as adenosine levels get high.

Caffeine blocks adenosine, so adenosine cannot get into the RAS and suppress it anymore. So by consequence, caffeine makes us feel alert because it takes that drowsiness signal off the table. So caffeine suppresses the activity of adenosine, and as a result, we see everything that’s connected to the RAS boost up. Unfortunately, it also resets our circadian rhythm.”

More about caffeine

Guido: “Nowhere in the day will our adenosine levels be so low, except first thing in the morning when we just got up from a great night’s rest. By blocking adenosine, caffeine tricks us into thinking that we just got up. And this is the reason why – even though caffeine has only about a five-hour half-life – and after 10 hours should basically be completely out of your system – a person who drinks coffee at noon still feels wide awake at midnight. Because at noon, your adenosine levels were perceived to be zero, your brain got tricked into thinking it was first thing in the morning, and it expects a good 18 hours of ongoing productive activity, right?

So be careful with caffeine because of the suppressive effect it has on adenosine and the false sense of wakefulness it gives to the reticular activating system – really important. So I counsel folks to use caffeine, which is an amazing, effective way to pull yourself out of brain fog for a short period of time but to use it judiciously, only once in a while. And it’s so incredibly effective when you do it that way. So the question comes, ‘What should I use instead? If I can’t use amphetamines and caffeine, I’m stuck!’  I encourage you to think about the neurotransmitter acetylcholine.”

What’s acetylcholine?

Guido: “I encourage you to think about the neurotransmitter acetylcholine. So here on the right, we have a diagram of the projections of the cholinergic system, or acetylcholine-based neurotransmitters of the brain. They’re coming from the limbic system, including areas like the hippocampus, where memories from the day are both processed, emotional content is added to them, and then they’re stored forward in the frontal lobe of the central nervous system – this happens all through acetylcholine.

When we remember something, acetylcholine connects the nerves that take our memories from the frontal lobe and bring them back into our conscious experience. So both learning and recall are largely governed by this neurotransmitter acetylcholine. So I really would encourage you to consider herbs that support that part of the brain for encouraging cognitive function, memory, recall, and helping to boost yourself out of brain fog, rather than stimulants (like caffeine).”

Bacopa monnieri – a brain-booster

Guido: “I want to mention Bacopa, because it crosses over a little bit between this idea of a short-term boost and the background hum of neuro-tonification (a long-term, slow acting tonic for the nervous system).  Bacopa seems able to do both. And what’s interesting about it is that, rather than focusing on suppressing adenosine and making us more wakeful, like caffeine does, bacopa supports acetylcholine, the memory, learning, storage, and retrieval pathways of the brain. It also helps support the glial cells that are involved in neuro-tonification, nerve growth factor secretion, et cetera.

There are other alkaloids in plants, like both tea and cacao, or chocolate, that generally have a gentle, calming effect. And so if you get a little stimulation from cacao, I think that’s great. And it’s very, very gentle compared to coffee or even black tea. But some folks definitely get a little boost from it. If used judiciously, the presence of all those other alkaloids like theophylline and theobromine, as well as euphoria agents, also buffer some of that stimulation from the little bit of caffeine in there. But I really, really do want to turn you on to Bacopa, if you haven’t tried this agent already. Good clinical research, good long-term safety profile, folks at all ages, memory, and learning – one dose and even better effects from long-term supplementation, you know, for four to six weeks.”

Sage – a brain-booster

Guido: “A common but really useful acetylcholine supportive herb is Sage, and Sage is…’ sage!’ It’s about wisdom. It’s about memory. And it totally lives up to that reputation. Just a simple infusion of the leaves with a little bit of honey, or a sage tincture as part of a formula, maybe with Bacopa, supports the activity of the neurotransmitter acetylcholine, and it does it in a gentle, reliable way. Six to eight grams of sage leaves dried and fused on a daily basis shows really promising research evidence for cognitive dysfunction across the board.

And it’s one of my go-to’s. It’s something that is good to take on a regular basis, for three or four days at a time, if you want that little bit of a boost. And it has an amazing safety profile, although we might want to use some caution for folks who might be pregnant. Other than that, Sage is a really useful and healthy neurotransmitter support for that ‘Memory-Learning-Association pathway’ area of the brain.”

Cycles of energy and creativity

Guido: “It is unrealistic for us to expect to be creative, powerful, awesome, and fully on top of everything 100% of the time. We have circadian rhythms that govern our sleep and wakefulness. Cortisol and melatonin fluctuate on a daily basis for us. Our own creative expression is in cycles, too, from when we get inspired with a new thought to when we spend time learning and engaging with that thought to eventually be able to share our own gifts out into the world.

That’s the Gift Cycle. And it involves periods of feeling super jazzed and creative and then feeling like frustrated and searching. And then times when we just have to be fallow, and be open and ready and waiting for inspiration. So we have to honor the fact that those cycles exist. And the worst thing we can do is think about caffeine, or even Galantamine and think about taking it on a daily basis all the time. They’ll lose their effects. And I think it’s rooted in this idea that is partly based on Western corporate performance culture, where we’re supposed to be amazing all the time. And I’ll just tell you, that’s not true. It’s not true of anyone.”

Your brain is an athlete

Guido: “The mind is a screen onto which influences project. You are so much more than your mind and your thoughts. And this is something we notice when we’re in deep meditative practice, or when we’re experiencing the effect of entheogens, or when we’re experiencing music, and totally lost in music or lost in someone we love that we’re spending time with – we realize that it is more than just the thoughts we’re having that US is deeper than that, right? That’s the part we want to honor.

And we want to support good healthy patterns where we have great creative thoughts on a regular basis. But to expect them to be all the time, I’m sorry, we just can’t. And it’s okay to push back against that if you see it in your life. You’d never expect an athlete to do a little bit more intensive workout tomorrow, and then a little more intensive workout the day after that, and just keep getting more and more and more intense, or keep that same level of intensity all the time. Absolutely not.

Athletes have goals. They work towards their goals. And they do it in training arcs. Right? There’s periods of rest built in, and there’s periods of growth built in. So as we step out of brain fog, we want to think the same way, right? We want to think about honoring rest periods, expecting rest periods, and using stimulants in a cyclical fashion that have rest periods built in.”

Aromatic plants as a brain boost

Guido: “Aromatics can give us a ‘tension training.’ We can use aromatics on rest days to remind us – if they’re calming, like lavender, that this smell is associated with calm. And on stimulating days, when we’re really trying to perform, we can use Pine essential oil or Tulsi essential oil. Fascinating studies show that when students sniff Rosemary while studying, and then sniff it while taking a test, they consistently perform better than students who sniff Rosemary only while taking a test, or only while studying. The association that the smell brings as well as the cognitive boost can give you this really safe, non invasive way to give you a short term boost in brain power, or a short term relaxing effect.”

The endocrine system impacts brain fog

Guido: “We can all handle a certain amount of stress. A certain amount of stress is actually good for us. It’s when they pile up from multiple different angles, and exceed our capacity to cope that you start to see things like ‘wired and tired’ all the time. Feeling that you can’t, if you’re in the collapse, tolerate exercise – you get more brain fog and pain when you try to do simple activities that you normally love, like going for a walk around town for with your friends.

And if you notice that your brain fog crops up, when you get an extra chunk of to-do list from your work, or when your partner interrupts with a sort of demanding or unexpected request that breaks your flow. You start to feel stressed, you start to feel anxious, and that’s when the brain fog kicks in. You can be pretty sure that the endocrine system is playing a role in your experience of brain fog and deserves a little bit of tending.

So simple ways to tend our endocrine response really comes down to adaptogens. I love the combination of Rhodiola in the morning and ashwagandha in the afternoon and evening. Part of the reason you feel wired and tired all the time is that from ongoing stress, you have switched the way those hormone secretion curves are working in your body. And often they’re very low in the morning when they should be high and very high in the evening when they should be low. This combination of Rhodiola ashwagandha helps shift that.”

Gut Test for SIBO

Guido: “A really great way to assess whether there is either an overgrowth of gut bugs in the upper part of the small intestine or a disruption in the lower part, both of which are relevant because disruptions in the gut’s mucous membrane can lead to material entering the bloodstream and impacting our blood-brain barrier and our brain function. So we want to make sure the gut is healthy and the gut flora is balanced because we know that they impact mood and cognitive function.

So, Burdock root powder, one full tablespoon in a glass of water, empty stomach. Try it. 30 minutes later, some folks will experience profound bloating pain and spasm right here in the upper part of their GI tract, right after the stomach. And that’s because they potentially have small intestine bacterial overgrowth (SIBO), a presence of bacteria in the duodenum where they shouldn’t be  – causing fermentation and inflammation that not only feels distressing and painful and gassy but also impacts the gut mucous membrane and can lead to things like leaky gut, the spillover bacterial endotoxin, into the bloodstream and the disruption of the blood-brain barrier.”

Gut reset protocol

Guido: “I want to just share a brief GI tract reset protocol with you this is something that’s pretty easy to do at home, if you do experience 30 minutes after eating that burdock root powder, that sort of distress and bloating and the epigastric area up here right under the bottom of the breastbone (see Gut Test for SIBO). Temporarily take a break from starches and grains, and carbohydrates. The FODMAP diet, which has to do with removing or eliminating fermentable starches from your diet, that’s going to be great for like at least ten, maybe fourteen days.

During this time, you start with a bitter, antibacterial, and anti-parasitic powder of goldenseal, black walnut, and wormwood. It’s nasty, so a lot of times, folks prefer to encapsulate this. But if you’re willing, you can put a little bit, four grams, which is a little bit less than a teaspoon, and just wash it back with water before eating. Then have your meal, and avoid those starches and grains. After about five to six days of this, start the soothing tea of meadowsweet and calendula – an amazing gut restorative tea.”

Sleep and the brain

Guido: “I can’t overemphasize how important sleep is. And of course, I don’t have to tell you this, you’re trying to step out of brain fog, and you’re not sleeping properly. That’s going to be very, very difficult. Unfortunately, sleep is often compromised. In this pattern, which makes it really difficult to pull yourself out of the whole thing, we talked about endocrine support and being able to shift the cortisol curve with a combination of Rhodiola and Ashwagandha, for example.

But we can also use concerted sleep support in the form of everything from daytime naps all the way to the specific use of calming but not deeply sedating herbs. I want to draw a difference, I’ll skip right to the bottom line: Lemon Balm, Passionflower and Ashwagandha. I find this to be an incredible combination. I typically use Lemon Balm in high doses, like 6-8 grams a day of dried Lemon Balm leaf, which is a lot. But the evidence is building for Lemon Balm. This very humble plant is actually remarkable.

Just like with Sage, we’re starting to see evidence of neuro-protection. We’re starting to see that it has a calmative and anxiolytic effect that is very similar to benzodiazepines without any of the side effects or issues of dependence that’s associated with benzodiazepines.”

Crafting your brain fog protocol

Guido: “Bring in cycles of gentle stimulation and restoration once in a while. And then pick one or two of these other areas that really resonate with you, like in those assessment slides that we looked at. Don’t try and do all four – pick one or two that speak to you the most, and focus on those for two to four weeks. Putting it all together, you’ll find that it may not be dramatic to you. But it might be more dramatic to the folks in your life who know you and who should see the shift happening.

And if you track and record what’s happening to you today and what’s happening to you in two weeks, and in four weeks, and in six weeks, you’ll find a steady progression. And that is a source of hope.

You begin to see that there is a vista, there is a goal at the other end of that fog that you can start to see. And when you can start to see it, you can start to move towards it with plants and mushrooms as your allies. I firmly believe, having seen it happen multiple times, that we can step out of brain fog.”


Watch the full webinar replay in the BotanicWise Community:


Review the slideshow:

Slideshow-Step Out of Brain Fog with Guido Masé.pdf

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Webinar Resources

Choline (as part of phosphatidylcholine)

  • Lecithin, fish, Avena (milky oats), legumes, eggs
  • TONIC – important B vitamin, also building block for nerve tissue Especially indicated for recovery: after brain injury, stroke
  • Dose: 1g-2g for long periods: 4-6 months
  • Research base: Clearly an important nutrient – esp. fetal neurodevelopment. Poor clinical evidence for cognitive enhancement; limited evidence for improved recovery post-injury.

Hericium erinaceus – Lion’s mane, yamabushitake

  • Edible fungus, 2-phase extracts, mycelial extracts
  • Primarily neuroregenerative tonic, most useful in dementia and for recovery after injury. But also neuroprotective during times of stress, low sleep; stabilizing to mood.
  • Dose: 3-5g daily, 5mL tincture BID
  • Research base: Strong experimental research and well-defined mechanisms, via Nerve Grown Factor and ACh modulation. Limited, but promising clinical research on memory/cognition/mood.

Quercetin (+Q-glycoside) (common flavonoid)

  • Apples, onions, Solidago. Isolated too.
  • Vascular tonic and protective agent. Also may support wakefulness and cognition if fatigued – adenosine antagonist
  • Dose: 120-400mg QD-BID. Best taken as a complex of glycosides for absorption.
  • Research base: Experimental evidence points to anti-inflammatory, neuroregenrative effects; also adenosine antagonism (=alert, fewer allergies). Clinical research is mixed – military trials show no effect. May be due to supplementation with de-glycosylated flavonoid, or too-low dosing.

Curcuma longa – Turmeric, curcumin

  • Whole powdered rhizome, tincture, curcuminoid extracts
  • Supportive: CNS / neuronal anti-inflammatory most indicated for cognitive recovery after TBI/stroke. Also slows neurodegeneration and may improve cognitive parameters in dementia.
  • Dose: 4-20g powder daily, w/ black pepper & food. 600mg-1,200mg curcuminoids QD-BID Safety: rule out CNS bleeding. Do not mix with anticoagulants
  • Research base: Extensive as a general anti-inflammatory. More limited as a neuronal anti-inflammatory, and scant (though promising) clinical research for dementia

Camellia sinensis, Ilex (paraguayensis, vomitoria, guayusa), Cola nitida (Cola nut), Paullinia (Guarana), Coffea arabica

  • Infusion, tincture, extracts
  • Proven short-acting cognitive performance enhancer. Most useful as a targeted boost for short-term memory, reaction times. Safety: can aggravate anxiety, palpitations. Strong diuretic. Can cause GI upset. Can cause jitters – combine with L-theanine, calming adaptogens Dose: 30-600mg (30mg = approx 1g Camellia / Ilex / Coffea)
  • Research base: Extensive. Well-described mechanisms: adenosine antagonism, circadian clock reset

Bacopa monnieri – Brahmi, Bacopa

  • Infusion of leaves, tincture, proprietary extracts (BacoMind – full spectrum bacosides+flavonoids, alcohol-based)
  • Non-specific: both tonic and neurotransmitter modulator, used in dementia but also effective in children/adults. Improves attention, focus, memory, cognition. Best results over time (4-6 weeks).
  • Dose: 5-10g daily, 5mL tincture TID, 350mg-400mg BacoMind
  • Research base: Extensive experimental evidence of neuroprotection, cognitive and memory enhancement. More limited, but consistently positive clinical research for attention, focus, memory and cognition at all ages.

Salvia officinalis – sage leaves

  • Infusion of leaves, tincture
  • Neurotransmitter modulator for ACh. May support good mood as an aromatic plant; supports focus, cognition and memory in dementia.
  • Dose: 5-8g infused daily, 2-3mL tincture BID
  • Research base: Promising clinical research in Alzheimer’s, limited but positive clinical research on cognition, memory and mood / stress in healthy adults

Galanthus spp. – snowdrops, source of galantamine (alkaloid)

  • Bulb tinctures are effective, but more nauseating than the isolated alkaloid
  • Enhances cognition, focus, memory and motivation. Decreases anxiety. Powerful. Safety: causes strong cholinergic reactions in overdose: nausea, vomiting, sweating, delirium. 16mg QD MAX!
  • Dose: 4mg-8mg galantamine QD-BID, 5-8mL tincture QD-BID (made at 1:3, 80% ethanol, approx. 0.5mg/mL galantamine but also includes other nauseating alkaloids which limits the tincture dose).
  • Research base: Extensive. Galantamine is FDA-approved for treating dementia. Historically used for polio, cognitive enhancement. Very effective but very powerful.


Endocrine Support

Primarily adaptogens. These help modulate stress-response neurotransmitters, conserving resources and buffering disruptive effects

  • Rhodiola AM, Ashwagandha PM: wired-and-tired, scattered frantic energy
  • Oats, Licorice, American Ginseng AM, Ashwagandha PM: exhausted, collapsed state, exercise intolerance
  • Nervine tonics and aromatic herbs can offer secondary support. Spritzers especially (lavender for calm, pine for energizing) can help with quick re-adjustment. Skullcap especially with spasm, tremor, palsies

Immune Support

This often relates to clearing lingering infection or removing environmental insults. Tonification can help increase resilience to these types of challenges

  • Astragalus and medicinal mushrooms (Reishi esp.)
    • Repeated infections, unresolving infections (use with caution in cases of active, hot presentations)
  • “Cooling” herbs if appropriate: Baikal skullcap
    • Signs of inflammation, recurrent fevers, fluctuating redness, areas of pain

Attention to the gut microbiome and gut lining is an important part of maintaining immunologic balance and protecting the blood-brain-barrier (and neuro tissue)

  • Fermented foods and prebiotic starch
    • If burdock root powder “test” causes minor symptoms 3-4 hours later; history of antibiotic use
  • GI “reset” protocol
    • If burdock root powder “test” elicits symptoms quickly, after +/- 30 minutes
    • GI RESET (2 weeks):
      • Goldenseal 1 g B. Walnut 2 g Wormwood 1 g
      • Take 4 g twice a day before meals
      • Avoid starch and grains
      • Start tea at day 5-6
  • Soothing gut tissue: meadowsweet + calendula tea
    • Appropriate in all cases

Vascular Support

The state of health of the heart and blood vessels, along with good circulation and endothelial health

  • Garlic, guggul / Boswellia, hawthorn
    • Metabolic syndrome, endothelial health support
  • Ginkgo, Vinca minor (periwinkle – 3-5 mL 2x/d)
    • Poor circulation, pallor on tongue
    • Vinca slightly reduces blood pressure
    • Weak carotid pulse with strong radial pulse

Neuroglial Support

General neurotonification helps, but here we give attention to glial cells by reducing BBB inflammation and supporting deep, restorative sleep.

  • Triterpenes from Boswellia and Bacopa
    • Cross-reference vascular and immunologic areas for other strategies to manage BBB inflammation
    • All polyphenols are helpful here as well
  • Consider a sleep study and sleep apnea
  • Lemon balm, passionflower, ashwagandha
    • Nervine – adaptogen combination helps encourage deeper sleep cycles, also neuroprotective
    • For wired-and-tired, cross-reference endocrine area

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