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How Not to Treat Brain Fog

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By Richard Podell, MD, MPH • www.ProHealth.com • April 4, 2017


How Not to Treat Brain Fog
by Richard Podell, M.D. MPH

Dr. Richard Podell is Clinical Professor in the Department of Family Medicine at Rutgers-Robert Wood Johnson Medical School. His website is DrPodell.org

Q: Does Resveratrol Help Cognition?

A: It Might Actually Do Harm.


KEY POINTS
  • Resveratrol, a nutritional supplement, extends life span in animals; but, no studies clearly prove benefit for humans.

  • A placebo controlled study using Resveratrol to treat Alzheimer’s found possible benefit, but not certain benefit for cognition. BUT, THE RESVERATROL GROUP HAD MORE ATROPHY OF THE BRAIN THAN THOSE TAKING PLACEBO.

  • My advice: Until we know more, remove Resveratrol from your wish-list of nutrients.


Resveratrol is a natural product found at low doses in grape skin and wine--especially red wine. Animals treated with Resveratrol might live longer and be less prone to cancer. But, we have no controlled studies in humans that show clear benefit for any health problems.

Many people take Resveratrol hoping for health benefits. Several of my chronic fatigue and fibromyalgia patients take Resveratrol hoping it will reduce their “brain fog.”

New Published Research: Clinical scientists from Georgetown and other prestigious medical schools reported the first placebo controlled study using Resveratrol to treat people with mild to moderate Alzheimer’s disease. After one year on Resveratrol, cognitive decline was modestly less than among subjects who were taking placebo. But, the difference was not statistically significant.

And now the bad news: Those taking Resveratrol had MORE atrophy (shrinkage) of their brains compared to those on placebo. This difference was statistically significant. Some atrophy of the brain “normally” occurs as we age. Atrophy gets worse among persons with Alzheimer’s.

I was alarmed that Resveratrol might shrink the brain. But, to my surprise, the Georgetown researchers were not too concerned. They wrote: “The etiology and interpretation of brain volume loss observed here and in other studies are unclear, but they are not associated with cognitive or functional decline.” (I think this means that the degree of brain atrophy did not track closely with the amount of cognitive decline.)

Still it’s very hard to see brain shrinkage as a virtue. Add in the fact that no human studies have yet shown clear benefit from taking Resveratrol, my advice for now is — Don’t Take Resveratrol.

Strengths of the Study: This was a well-designed study done by reputable scientists.

Weaknesses: The number of subjects was fairly small — just 119 persons split between Resveratrol and placebo. The study ‘s one year duration is reasonably long, but might not be long enough to judge the long term benefits (or harms) caused by the treatment.

A counter argument: People who regularly drink modest amounts of wine are less likely to have heart attacks compared to those who never drink alcohol and also to people who drink to excess. Might the Resveratrol in wine contribute to this benefit? Possibly, though wine also contains many kinds of polyphenols and other components.

More important, the dose of Resveratrol available from wine, grapes and other foods is very much less than the dose sold in health food stores. Five ounces of red wine has just one or two milligrams (mgs) of Resveratrol. The Georgetown study treated with 500 to 2000 mgs per day. These extremely different dose levels should not be expected to create the same biological effects.


Dr. Richard Podell Richard Podell, M.D., MPH, is a graduate of Harvard Medical School and the Harvard School of Public Health. He has been treating patients with ME-CFS and Fibromyalgia for more than 20 years.

A clinical professor at New Jersey's Robert Wood Johnson Medical School, Dr. Podell see patients at his Summit, NJ and Somerset, NJ offices. His website is DrPodell.org



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