Concussion/TBI Recovery Protocol

TBI causes primary injury (immediate impact) and secondary injury (neuroinflammation, excitotoxicity, oxidative stress over days-weeks) - treatment targets secondary injury. Pituitary vulnerable to shearing forces - hormonal dysfunction common after moderate-severe TBI and even "mild" concussions (test hormones). Mark Gordon and Andrew Marr's work shows hormonal replacement transforms TBI recovery in many cases. Omega-3 is most evidence-based - loading dose in acute phase. DHA is brain structure, EPA anti-inflammatory. Creatine provides brain energy (ATP). Ketogenic diet offers alternative fuel when glucose metabolism impaired. Hyperbaric oxygen emerging as powerful therapy - stimulates neuroplasticity, mitochondrial biogenesis, stem cells. Best if started early but benefits even years after injury. Post-concussion syndrome (symptoms >3 months) affects 10-20% - comprehensive protocol often helps. Complete rest beyond 48-72 hours may be counterproductive - graded return to activity now recommended. Nutrient depletion (magnesium, antioxidants) occurs during injury. Progesterone studied in TBI (neuroprotective but clinical trials mixed results). Screen contact sport athletes regularly for subclinical HPA dysfunction. Multiple concussions increase dementia/CTE risk - prevention and thorough recovery crucial.