Brain Blood Barrier

Beyond the scull and a protective membrane called the meninges, surrounded by cerebrospinal fluid, you have another layer of brain defense known as the blood-brain barrier. This barrier separates your brain’s blood vessels from the brain cells and other tissues that make up your brain.

In essence, a healthy blood-brain barrier acts as your last line of defense, preventing harmful substances from entering your brain while allowing beneficial ones to pass through.

Its main purpose is to carefully regulate the movement of ions, neurotransmitters, and other molecules between your general blood supply and your brain. This precise control ensures that oxygen and nutrients are transported to your brain tissues while eliminating carbon dioxide and other waste products.

Additionally, the blood-brain barrier plays a crucial role in maintaining normal hormone and neurotransmitter signaling, as well as controlling the interaction between your brain and the rest of your body.

However, if the blood-brain barrier becomes leaky, similar to a leaky gut, it can lead to a range of issues. These may include brain fog, memory loss, chronic fatigue, anxiety, and depression. 

In patients with CFS, studies have shown that the permeability of the BBB is altered, allowing substances that would not normally cross into the brain to do so. This is known as increased BBB permeability or BBB dysfunction. When this happens, it can lead to inflammation and damage to the brain, which can further worsen the symptoms of CFS.

One of the major factors contributing to increased BBB permeability in CFS is the presence of pro-inflammatory cytokines. These are signaling proteins that are released by the immune system in response to infection, injury, or stress. In CFS patients, the levels of pro-inflammatory cytokines are often elevated, which can weaken the BBB and make it more permeable.

Another factor that can contribute to BBB dysfunction in CFS is oxidative stress. Oxidative stress is an imbalance between the production of free radicals and the body’s ability to neutralize them. In CFS, the body’s antioxidant defenses are compromised, leading to an excess of free radicals that can cause damage to the endothelial cells of the BBB.

So, how does BBB dysfunction in CFS affect treatment and management? Firstly, it makes it more difficult for medications to reach the brain and have their desired effect. This is because the BBB acts as a protective barrier, preventing most substances from entering the brain. Therefore, medications that are normally effective in treating other conditions may not be as effective in CFS.

Furthermore, BBB dysfunction can also make it challenging to diagnose CFS. In the early stages of the illness, the symptoms may be mild, and the BBB may still be intact. This means that routine blood tests and imaging scans may not show any abnormalities, leading to a misdiagnosis or delayed diagnosis.

The factors which can compromise the normal BBBP in CFS include viruses, cytokines, 5-hydroxytryptamine, oxidative stress, nitric oxide, stress, glutathione depletion, essential fatty acid deficiency, and NMDA overactivity.

Current treatments for CFS focus on managing symptoms rather than addressing the underlying cause. However, researchers are investigating various strategies to improve BBB function and reduce its permeability in CFS. One promising approach is the use of antioxidants to reduce oxidative stress and protect the endothelial cells of the BBB. Studies have shown that antioxidant supplements such as vitamins C and E, CoQ10, and glutathione can reduce BBB permeability and improve symptoms in CFS patients.

Probiotic foods and supplements to keep the gut balanced.

Essential fatty acids, which are vital for the brain, including avocado, coconut oil, flaxseed, hemp seed, oily fish, pumpkin seeds, and walnuts.

Another treatment option is the use of anti-inflammatory agents to reduce the levels of pro-inflammatory cytokines and decrease the permeability of the BBB. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids have been studied for their potential to improve BBB function in CFS. However, their long-term use can have adverse effects, so it is safer to use alternative natural anti-inflammatories.

Nootropics can help with symptoms, but because of leaky BBB, they can be overstimulating, or have no effect at all. However, some of them can be beneficial for other actions such is anti-inflammatory or antioxidant.
   Rhodiola Rosea Extract
   L-tyrosine (preferably in the enhanced N-     Acetyl L-Tyrosine form)
   Citicoline (CDP Choline)
   Phosphatidylserine (PS)
   Maritime Pine Bark Extract – Pycnogenol

Detox from heavy metals and pollution. (Providing refined sugars and oils, processed food and additives are already excluded, as basic care for CFS/ME/SEID and other conditions, as well as for healthy people.)

Stress management.