Are Individuals with Brain Injury Absorbing Needed Nutrients?

By Brent Masel, M.D., BIAA National Medical Director, and Mark Ashley, M.D., Centre for Neuro Skills

A recent study, supported by Centre for Neuro Skills in conjunction with the University of Texas Medical Branch at Galveston, found abnormal reactions between the brain and gastrointestinal tract (gut-brain axis) in individuals with moderate to severe chronic traumatic brain injury (TBI). The result is that they may not be absorbing nutrients properly and treatments need to be developed to address these issues.

The study was conducted at the University of Texas Medical Branch in the Department of Neurology in Galveston, Texas (under the supervision of Dr. Brent Masel) and the Centre of Neuro Skills in Bakersfield, California (under the supervision of Dr. Mark Ashley). Dr. Masel is also the vice president of Medical Services at CNS.

The controlled study followed 10 people diagnosed with a traumatic brain injury in Galveston, where Dr. Masel is a clinical professor at the University of Texas Medical Branch in the Department of Neurology. Researchers had the participants fast, then blood was drawn, then they would eat a specific meal and blood was drawn again.

Researchers discovered the following:

• Individuals with a TBI had low baseline levels of essential amino acids. Even after eating a meal, their levels remained lower than the non-injured study participants. Researchers determined that they weren’t absorbing essential amino acids.
• Dr. Masel and his colleagues made this determination and then wondered if it was the local diet or geographical location. He called Dr. Ashley and suggested an identical study at CNS in Bakersfield. The results were the same – this issue wasn’t related to diet, location or lifestyle.
• Dr. Masel’s observation: “The commonality is TBI. Essential amino acids are not being absorbed from the gut and those molecules are critical to TBI recovery.”
• After administering the fasting/eating/blood draw protocol, they added stool sample analyses.
• The study then focused on the microbiome and its relation to bacteria in the gut. The gut can say “OK” to a healthy system and absorb essential amino acids or can “gobble up” the same molecules.

“The bacteria in the gut (microbiome) for the two groups were similar—but abnormal when compared to the two control groups,” Dr. Masel explained. “This suggests that perhaps the TBI is interfering with the brain-gut axis, which causes an abnormal microbiome – which causes the body to not absorb the essential amino acids needed for normal function, growth and perhaps impeding rehabilitation.”

The study’s distinction is that the two groups, thousands of miles apart, produced the same outcome and the same deficit of non-absorption. The CNS patient study group was part of CNS’ Long Term Care program, so the organization will be able to study them now and in the future.

“Clearly there are abnormalities in the microbiome of the gut of those with a TBI,” commented Dr. Masel. “The majority of what we do is treat the symptoms of TBI, as opposed to the underlying causes of those symptoms, which would be far more effective. Perhaps by correcting the malabsorption of the essential amino acids, we can advance the recovery from TBIs. We will be studying how altering the diet in these individuals may change their amino acid absorption. Our hope is that this will assist in identifying long-term risks and treatments.”

Click here to read the full study.