14 Powerful Ways to Form New Synapses in the Brain

Over the years, I’ve taken several psychiatric drugs, drank too much alcohol, and had numerous concussions – sometimes, all at once. 

In other words, my brain has taken quite the beating. 

Researchers used to think that if you damaged your brain like I did, you simply had to live with it.

But that’s no longer true. 

They now know the brain is plastic and flexible, and it can heal and recover.

You’re not stuck with the brain you have. 

You can actually change and improve it.

One way your brain repairs itself is through a process called synaptogenesis.

Synaptogenesis is the formation of new synapses in the brain.

Synapses are the connecting points between your 100 billion brain cells. You have trillions of synapses in your brain, and your brain cells communicate with one another across them (79). 

The deterioration and loss of synapses is linked to a number of neurodegenerative diseases and mental health disorders, including Alzheimer's disease, depression, poor learning and memory, intellectual impairment and other cognitive deficits (83-87). 

The good news is that researchers now know that synaptogenesis occurs in the brain throughout our entire lives (81-82). 

And there are a number of ways you can support synaptogenesis, promote the formation of new brain synapses and increase brain synapses. 

Below are 15 ways to do that.

Following these strategies can improve your mood, learning, memory and cognition.

Picture of brain and synapses.

1. Omega-3 Fatty Acids, Uridine and Choline

The formation of synapses depends on sufficient brain levels of three key nutrients – uridine, omega-3 fatty acids, and choline. These nutrients are synergistic, and if you take them taken together, they accelerate the formation of new synapses in the brain (66-67, 75-78). 

Unfortunately, most people nowadays don’t get enough of these essential nutrients through their diet because very few foods in the Western diet actually contain them.

In fact, the uridine in food is not bioavailable, and no food has been shown to increase plasma levels of uridine (1).

Picture of salmon and walnuts. Salmon and walnuts and rich in omega-3 fatty acids, which have been shown to form new brain synapses.

That’s why I take a uridine monophosphate supplement sublingually to support the long-term health of my brain. 

At the same time, I take a krill oil supplement and the Optimal Brain supplement, which includes CDP-Choline and Alpha GPC (two high-quality sources of choline). This ensures my brain is getting enough of omega-3 fatty acids and choline.

Several researchers have concluded that supplementing with all three nutrients can increase synaptic formation, increase brain synapses, and improve cognition, learning and memory, particularly in people with Alzheimer's disease (68-74). 

Besides supplementation, I still encourage people to eat foods that contain omega-3 fatty acids and choline. 

The best way to get omega-3 fatty acids from food is by eating more cold-water fish such as salmon, black cod, sablefish, sardines and herring. And the best food sources of choline include grass-fed beef liver and egg yolks. These foods are included in my Free Grocery Shopping Guide for Optimal Brain Health.

Taking uridine, choline and omega-3 fatty acids together can also promote the regeneration of myelin.

 

2. Low Level Laser Therapy

Low-level laser therapy (LLLT), or photobiomodulation, is a treatment that uses low-level (low-power) lasers or light-emitting diodes (LEDs) to stimulate brain cells, helping them function better.

Most doctors don't know about LLLT; but not every doctor.

Man wearing LLLT helmet and using the Vielight device. LLLT and Vielight devices can help form new synapses in the brain.

Dr. Norman Doidge, a physician who teaches at the University of Toronto here in Canada, discusses the amazing effects of LLLT in his book The Brain’s Way of Healing.

One way that LLLT may help the brain is by encouraging synaptogenesis (12-15). 

Researchers have found that LLLT treatment significantly stimulates the synthesis of synapsin-1 (a marker for synaptogenesis) and increases synaptogenesis in the cortex (16-17). 

I previously wrote about my experience with low-level laser therapy here.

I use this device and shine the red and infrared light on my forehead for 5 minutes every day. I also shine it on other parts of my head and on my entire body, including on my thyroid, thymus gland and gut. I experience incredible benefits from doing this.

When I’m travelling, I take this smaller and more convenient device with me and shine it on my forehead.

I’ve also been using the Vielight Neuro Duo, which is a transcranial-intranasal headset with 810 nm of near infrared light. It penetrates deeper into brain tissue and is absorbed better by the central nervous system. If you decide to try a Vielight device, you can use the coupon code JORDANFALLIS for a 10% discount

Before trying LLLT, I highly recommend reading my full article about it first.

LLLT can also support mitochondria function, reduce brain fog, and increase blood flow to the brain

 

3. Bacopa

Bacopa monniera is an adaptogenic herb with cognitive-enhancing effects.

Several studies show that it improves cognition, learning and memory by strengthening communications between brain cells. Both healthy and elderly people who take the herb experience improved attention, learning and memory (2-5). 

Researchers believe that these improvements are because bacopa increases brain synapses and increases specific neuromolecular mechanisms that encourage and enhance synaptogenesis (18). 

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4. Exercise

Exercise is one of the best ways to promote the formation of new synapses.

Researchers have repeatedly found that physical activity encourages synaptogenesis and increases brain synapses (32-33). 

Exercise also increases blood flow to the brain, promotes the regeneration of myelin, and can help reverse brain damage and cognitive decline

So not surprisingly, many brain health experts recommend exercise as their number one piece of advice for optimal brain health.

My usual advice is to find a sport or exercise routine that you enjoy, so that you’ll stick with it consistently.

 

5. Magnesium Threonate

Magnesium is a vital mineral that participates in more than 300 biochemical reactions in your body, including neurotransmitter and hormonal activity, which can have a huge effect on your brain function.

Researchers have found that increasing magnesium levels in the brain improves learning and memory by promoting synaptogenesis and increasing brain synapses (25-26). 

One study concluded that magnesium threonate increases the number of synaptic connections between brain cells and boosts the density of synapses (27). 

Magnesium rich foods, including spinach, avocados, bananas, almonds. Magnesium helps the brain form new synapses.

Unfortunately, lot of people are deficient in magnesium today (6-8).

But there are a number of ways you can make sure you’re consuming enough. 

First, make sure you’re eating magnesium-rich foods on a regular basis, including spinach, chard, pumpkin seeds, almonds, avocado, dark chocolate and bananas. These foods are included in my Free Grocery Shopping Guide for Optimal Brain Health.

Epsom salt baths are another great way to increase your body’s intake of magnesium. 

But I also recommend a high-quality magnesium supplement. 

Magnesium threonate is the best form of magnesium for increasing brain magnesium levels and forming new synapses. 

Since most people are deficient, magnesium is one of the three supplements that I think everyone should be taking.

Magnesium can also help repair a leaky blood-brain barrier.

 

6. Intermittent Fasting

Fasting allows your digestive system to take a break and triggers a number of hormones that boost your body’s ability to repair itself.

On most days, I don’t eat breakfast at all, and then "break my fast" by eating my first meal of the day around 2 or 3 p.m. That means I eat all my food for the day within an 8-hour window.

There are many health benefits to doing this.

It can improve mitochondrial function, reduce brain fog, and help protect you from dementia

And researchers have also found that fasting can trigger and enhance synaptogenesis (28-31). 

The best way to start fasting is simply by eating dinner around 6, not eating anything after that before bed, and then eating a regular breakfast the next day. That should give you about 12-14 hours of fasting time. 

 

7. Ginkgo Biloba

Ginkgo Biloba is a plant that has been used in China for thousands of years to treat a number of health problems. It’s one of the top-selling herbal supplements in the world, and it’s even a prescription herb in Germany.

It’s most commonly used to improve brain health because it’s been shown to increase brain blood flow and improve memory and attention in both healthy and unhealthy individuals. It even reduces the risk of dementia and Alzheimer’s disease and may also improve mood and mental energy (34).

Researchers have also discovered that it stimulates synaptogenesis and increases brain synapses (35). 

Ginkgo Biloba is included in the Optimal Brain supplement.

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8. Motor Learning

Motor learning is essentially when you learn something new that involves movement.

Complex processes occur in the brain in response to practicing or experiencing the new motor skill.

This results in changes to the central nervous system, which allows you to produce the movement again in the future.

Researchers have found that motor learning triggers synaptogenesis and generates new synapses in the cerebellar cortex of the brain (36-39). 

Some activities that involve motor learning include learning how to play the piano, climbing trees, juggling, and playing table tennis. 

When you engage in these activities, motor learning occurs, and you form new synapses in order to learn and solidify the new skill. 

I have personally used a number of different neuroplasticity exercises that involve motor learning to promote synaptogenesis in my own brain.

 

9. Resveratrol

Picture of grapes. Grapes are rich in resveratrol, an antioxidant than help you form new synapses in your brain.

Resveratrol is a beneficial antioxidant and anti-inflammatory compound found in grapes, red wine, raspberries and dark chocolate.

Resveratrol is known to help prevent the development of neurodegenerative diseases.

And researchers are starting to understand why.

Resveratrol can help restore the integrity of the blood-brain barrier, support your mitochondria, and increase blood flow to the brain.

But it can also increase synaptogenesis.

Research shows the resveratrol promotes and enhances synaptogenesis (23-24). 

Resveratrol is included in Optimal Energy.

 

10. Piracetam

Piracetam is a nootropic (cognitive-enhancing) supplement. It provides a mild boost to brain function and has a long history of being used to treat cognitive impairment in Europe, Asia and South America. 

According to researchers, one way it improves cognition is by enhancing synaptogenesis and increasing brain synapses (9-10). 

One study found that rats treated with piracetam had a higher number of synapses than rats not treated with piracetam (11). 

Phenylpiracetam is an advanced version of piracetam and I found it to be even more effective. It also has impressive anti-anxiety and antidepressant effects.

Both piracetam and phenylpiracetam work best if you take them with a source of choline, either CDP-Choline or Alpha GPC.

Both CDP-Choline and Alpha GPC are included in the Optimal Brain supplement

 

11. Quercetin

Quercetin is a bioflavonoid found in fruits and vegetables. It is one of the most widely consumed flavonoids in the human diet. 

Quercetin has potent antioxidant action and is “neuroactive”, meaning it can affect brain function. 

As a result, it can protect brain cells from oxidative stress and inhibit the pro-inflammatory molecules that are associated with many progressive brain disorders (45-46). 

Researchers have also found that it stimulates synaptogenesis (48). 

Red apples, onions and tomatoes have the high levels of quercetin. But you can also supplement with it if you want. 

It’s interesting to note that quercetin increases the absorption of resveratrol, so it’s a good idea to take them both together if you want to increase synaptogenesis and form new brain synapses (47). 

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12. Intranasal Insulin

Insulin is one of the hormones that significantly affects brain function.

It has a number of important functions in the central nervous system, and researchers have found that it passes the blood-brain barrier and acts on insulin receptors directly within the brain.

In a new therapeutic approach, commercially-available insulin (Novalin R) is prepared and added to nasal spray bottles, and sprayed and inhaled through the nose to support brain and mental health.

Intranasal insulin has been reported to significantly enhance learning and memory, increase mental energy, reduce brain fog, improve mood, and lower anxiety and stress levels.

One possible mechanism is by increasing synaptogenesis.

Brain insulin receptors are found primarily in synapses, and insulin signaling contributes to synaptogenesis (19-21). 

And the disruption of insulin action in the brain leads to impaired synaptogenesis (22). 

If you’re interested in learning more about intranasal insulin, I previously wrote a full article about it here.

 

13. Progesterone

Progesterone is a natural steroid and sex hormone involved in the menstrual cycle and pregnancy.

It has a variety of important functions in the body, and even plays an important role in brain function. 

Research shows that progesterone supports the normal development of brain cells and protects them from damage (40).

But many researchers have also found that progesterone promotes synaptogenesis (41-43). 

In addition to its role as a natural hormone, progesterone can be taken as a medication, usually by women during menopause as part of their hormone replacement therapy. 

 

14. Antioxidant Nutrients

Some nutrients have antioxidant effects in the body, and not consuming enough of them can reduce your rate of synaptogenesis. 

Research shows that “synaptic membrane synthesis” depends on sufficient dietary intake of Vitamin C, Vitamin E, and the mineral selenium (64). 

A bunch of antioxidant-rich fruits and vegetables in heart-shaped bowls. Antioxidants can helps the brain form new synaptic connections.

One study found that synaptogenesis was significantly enhanced by supplementing with omega-3 fatty acids, uridine, Vitamin C, Vitamin E, and selenium. But it wasn’t enhanced as much with omega-3 fatty acids and uridine alone, suggesting that Vitamin C, Vitamin E, and selenium play a key role in synaptogenesis (65). 

I get these antioxidant nutrients from a number of sources. 

In addition to getting Vitamin C from fruits and vegetables, I take at least 500 mg of supplemental Vitamin C every day. At one point, I was actually taking up to 10 grams of Vitamin C every day as an experiment, but that’s not necessary unless you find it really helps you.

For selenium, I make sure I eat brazil nuts regularly, as they are the richest source. But I also take some extra selenium in supplement form.

For Vitamin E, good food sources include almonds, spinach, sweet potatoes, avocados, olive oil, sunflower seeds and butternut squash. It’s also included in the Optimal Antiox supplement.

Besides increasing synaptogenesis, antioxidants can also protect your brain from alcohol and help reverse brain damage

 

15. BONUS: 4 Things to Avoid

It’s not just what you do, but also what you avoid that can impact your rate of synaptogenesis. 

Researchers have found that certain compounds can impair synaptogenesis and inhibit the formation of new synapses in the brain. 

So besides trying to implement the 14 steps above, you should also try to avoid:

  • Bisphenol A – This compound is found in plastic bottles and containers, food and beverage cans, and other common consumer products, such as CDs, DVDs and sales receipts. Researchers have found that it impairs synaptogenesis in the brain (49). That’s why I recommend you only eat and drink out of glass, ceramic and stainless steel. Avoid all canned food and plastic containers. BPA-free plastic isn’t much better for you and can still disrupt hormonal health.

  • Lead – Lead is a heavy metal that can accumulate in the body and negatively affect brain function. Research shows that lead exposure can interfere with the formation of brain synapses (55-59). So it’s definitely a good idea to reduce your exposure to sources of lead. One way is by using an infrared sauna regularly.

  • Gabapentin – Gabapentin is a medication used to treat epilepsy, neuropathic pain, hot flashes, and restless legs syndrome. Researchers have found that it halts the formation of new synapses (80).

  • StressChronic stress decreases synaptogenesis and decreases the number of synapse connections (88-89). Here are 20 ways to lower cortisol, your body’s main stress hormone. These two biofeedback devices are my favourite ways to reduce stress.

 

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Live Optimally,

Jordan Fallis

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The 9 Most Promising Psychobiotics for Anxiety

I used to walk around ruminating, struggling with inner turmoil and nervousness all the time. 

It never went away.

It was impossible to shake. 

It wore me down and ruined the quality of my life. 

There’s no doubt that fear and vigilance are helpful when you’re faced with an actual threat. 

But an unnecessarily high state of worry and arousal when there is nothing threatening you? That's a nightmare. 

It doesn’t have to be that way though. 

If you have chronic anxiety, there are ways to manage and reverse it, like I have.

And psychobiotics are one way to do that.

Psychobiotics are probiotics and prebiotics that can improve your mental health by changing the mixture of bacteria in your gut (46-47). 

It is estimated that 100 trillion bacteria, and 500 to 1,000 species of bacteria, live in the human gut. These gut bacteria, collectively known as the gut microbiome, help with digestion. But an increasing amount of research suggests that they also communicate with your brain through the microbiome-gut-brain axis, affecting your thoughts, feelings and behaviour (48-49). 

Gut is playing chess with Brain. Gut says “Gutsy move for a brain…”.

A dysfunctional gut microbiome has been linked to a number of mental health problems and psychiatric conditions, including anxiety.

In fact, anxiety and gut health are very tightly linked. 

Research shows that people who have digestive disorders are more likely to have anxiety, and those with anxiety have higher rates of gastrointestinal disease (50-52).

And studies show that when digestive disorders improve, anxiety improves as well (53). 

Unfortunately, a lot of people have poor gut health today because of the widespread use of antibiotics, medications, herbicides, stress, infections, poor diet, etc. 

But don’t worry. You can improve your gut health and anxiety at the same time with the use of psychobiotics. 

Studies show that psychobiotics can improve anxiety by (54-55):

Here are the nine best psychobiotics that have been shown in human and animal studies to decrease stress and help treat anxiety disorders. 

They are truly the best probiotics for anxiety.

The word psychobiotic.

1. Lactobacillus rhamnosus

Lactobacillus rhamnosus is a bacterium found in the human gut. It is one of the most popular probiotic species found in supplements.

Preliminary research suggests that supplementing with lactobacillus rhamnosus can lower anxiety in humans (3). 

GABA is the main inhibitory and relaxing neurotransmitter in the central nervous system, and studies suggest that lactobacillus rhamnosus may reduce anxiety by changing the expression of GABA receptors (1-2, 4). 

In one study, researchers gave lactobacillus rhamnosus to mice, and it reduced their anxiety-like behaviours. But when researchers removed part of their vagus nerve, lactobacillus rhamnosus did not reduce their anxiety, suggesting that psychobiotics communicate with the brain and improve mental health through the vagus nerve (1-2). 

The mice [given lactobacillus rhamnosus] were more chilled out.
— Dr. John Cryan, researcher and pharmacologist with the Alimentary Pharmabiotic Center at University College Cork, Ireland

Other studies have found that lactobacillus rhamnosus decreases stress-induced anxiety-like behaviour, and researchers have concluded that it can protect against anxiety (5, 7). 

Lactobacillus rhamnosus has also been shown to reduce obsessive-compulsive disorder (OCD)-like behaviour in mice. In fact, researchers found it was just as effective as fluoxetine, an SSRI antidepressant commonly used to treat OCD (6). 

So if you struggle with OCD or obsessive-compulsive tendencies, it’s worth trying this psychobiotic.

Lactobacillus rhamnosus can be found in some yogurt and dairy products, such as fermented and unpasteurized milk and semi-hard cheese. But I typically don’t recommend eating these foods unless you’re sure you can tolerate them.

 

2. Bifidobacterium longum

Bifidobacterium longum is another bacterium present in the human gut. It is often added to food as it can help prevent the growth of pathogenic organisms.

I previously wrote about how it’s been proven to help treat depression.

Bacteria. Bacteria can affect the mind through the gut-brain axis.

But it can also reduce anxiety. 

Researchers have concluded that bifidobacterium longum can reduce cortisol and alleviate psychological distress in humans (including obsessions, compulsions, paranoia, anxiety) (28-30). 

Lots of animal research also shows that bifidobacterium longum can significantly reduce anxiety-like behaviour (31-34). 

One study found that a chronic infection in mice increased inflammation and caused anxiety-like behaviour, but bifidobacterium longum reduced anxiety and normalized behaviour (35-36). 

Researchers have even figured out that it works by acting through the vagus nerve (27). 

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3. Lactobacillus plantarum

Lactobacillus plantarum is another probiotic species that can reduce anxiety. 

In one study, researchers gave lactobacillus plantarum to patients with irritable bowel syndrome and it significantly reduced their anxiety and improved their quality of life (8). 

Animal studies also show that lactobacillus plantarum can cause positive changes in emotional behaviours and significantly reduce anxiety-like behaviours. It does this by increasing dopamine and serotonin, lowering stress hormone levels, and reducing inflammation (9-11). 

As a result, researchers have concluded that lactobacillus plantarum has psychotropic properties without physical side effects, and has great potential for treating neuropsychiatric disorders, including anxiety (9-11). 

Lactobacillus plantarum is also commonly found in many fermented vegetables including sauerkraut, pickles, brined olives, kimchi.

 

4. Lactobacillus helveticus

Lactobacillus helveticus is a probiotic strain that has been shown to reduce cortisol and have anti-anxiety effects in humans (37, 39, 44).

One study found that it can even reduce paranoid and obsessive-compulsive thoughts (38). 

Blue bacteria. Bacteria can influence our anxiety levels.

Animal research shows that a Western-style diet can negatively change the gut microbiome, increase brain inflammation, and contribute to anxiety. But lactobacillus helveticus can protect against this, reducing both neuroinflammation and anxiety (40-42).

One study even found that lactobacillus helveticus works better than citalopram, a common SSRI antidepressant, at reducing anxiety-like behaviour in rats. It also reduced their stress hormone levels and increased their serotonin levels (43). 

Lactobacillus helveticus is also commonly found in American Swiss cheese and Emmental cheese, and sometimes other cheeses, such as Cheddar, Parmesan, Romano, provolone, and mozzarella.

I’m very sensitive to dairy so I can’t eat cheese regularly. But if you’re not and can tolerate them, you could try adding some of these cheeses into your diet. 

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5. Lactobacillus reuteri

Lactobacillus reuteri is a bacterium with anti-inflammatory effects that scientists first discovered in the 1980s. 

It is usually found in the human gut. However, not all humans have it, and some people simply have very low levels of it. Therefore, you may need to supplement with it to introduce and maintain high levels of it.

Research shows that Lactobacillus reuteri can reduce anxiety-like behaviours in animals by reducing stress hormone levels and altering the expression of GABA receptors (13-14).

And one study found that the absence of lactobacillus reuteri causes social deficits in animals.

We found that treatment with this single bacterial strain was able to rescue their social behavior.
— Shelly Buffington, neuroscience researcher at Baylor College of Medicine

By adding it back in to the guts of the animals, the researchers were able to reverse some of their behavioural deficits, which were similar to symptoms of social anxiety and autism in humans (15-16). 

Therefore, lactobacillus reuteri is definitely the psychobiotic strain worth trying if you struggle with social anxiety or symptoms of autism.

It's also found in breast milk, and some meat and dairy products.

 

6. Lactobacillus casei

Lactobacillus casei is another bacterium found in the human gut. It has antioxidant and anti-inflammatory effects.

In one double-blind, placebo-controlled trial, patients with chronic fatigue syndrome and digestive problems took Lactobacillus casei as a daily supplement for two months. At the end of the study, they had a significant decrease in their anxiety symptoms (17-19). 

So this is a good psychobiotic to try if you struggle with a mixture of fatigue, digestive problems and anxiety.

Lactobacillus casei is the dominant species in naturally fermented Sicilian green olives, and can also be found in other fermented vegetables and dairy products. 

 

7. Lactobacillus fermentum

Lactobacillus fermentum is another species that is part of the human microbiome and commonly found in fermented vegetables.

It hasn’t been studied as much as other lactobacillus probiotic species.

Bacteria. Psychobiotics are bacteria that affect our psychological state of mind.

But there still is some evidence that is may be able to help treat anxiety, especially if you have a long history of antibiotic treatment. 

Research shows that antibiotics can trigger anxiety in animals by disturbing the microbiome.

But by giving animals lactobacillus fermentum, researchers can reduce the inflammation and reverse the psychological problems brought on by antibiotics, including anxiety-like behaviour (12).

So if you’ve taken a lot of antibiotics over the years, or noticed that your anxiety got worse after taking a course of antibiotics, taking a psychobiotic supplement with lactobacillus fermentum is worth a try. 

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8. Bifidobacterium breve

Bifidobacterium breve is a beneficial bacterium found in human breast milk and the human gut. The amount in your gut declines as you get older (20). 

Research shows that bifidobacterium breve can reduce anxiety-like behaviour in animals (21). 

Anxious animals also perform better on cognitive tests after being given it (22). 

This makes bifidobacterium breve a great psychobiotic option if your anxiety impairs your cognition and interferes with your ability to complete tasks. 

Bifidobacterium breve can be found naturally in some fermented foods.

 

9. Galacto-oligosaccharides

Not all psychobiotics are simply probiotics.

Psychobiotics can also include “prebiotics,” which are non-digestible soluble fibres that stimulate the growth of good gut bacteria, and therefore improve mental health and reduce anxiety.

Galacto-oligosaccharides (GOS) are a type of prebiotic that have been shown to do just that. 

Picture of intestines. Our intestinal health can significantly affect our mental health.

In one study, GOS significantly decreased the secretion of cortisol, and participants paid more attention to positive information rather than negative information (23).

People who are anxious tend to have high levels of cortisol and often get caught up in negative thinking. So this study suggests that GOS has anti-anxiety effects. 

Other research has demonstrated that people with irritable bowel syndrome (IBS) often have anxiety because of the lack of microbial diversity in their gut. However, when IBS sufferers supplement with a prebiotic mixture containing GOS, it significantly reduces their anxiety and improves the quality of their life (24-26). 

 

What Psychobiotic Should You Take?

Ideally, you should buy and try one probiotic strain at a time to figure out how you respond to each one.

That's what I did over the span of several years. 

I would buy and try one probiotic species and strain, take it for at least one month, and then monitor how I felt during that time.

Sometimes I would stop taking it if I felt worse.

I was my own guinea pig and tested and experimented with so many different probiotic supplements to find the ones that helped. 

I usually recommend people follow the same process because many people like myself often experience a bad reaction to one strain, but a good reaction to another. 

But I understand doing that can be time-consuming and tedious. Plus, clinical studies often demonstrate that probiotic mixtures with multiple strains are better at improving the diversity of gut bacteria than single strains (45). 

So, to make it easier for you, I’ve now created my own psychobiotic supplement, called Optimal Biotics.

I created it because I want to give my clients and readers the very best psychobiotic supplement so that they can experience superior results.

I have found that many psychobiotic supplements on the market fall short and even cause side effects.

But Optimal Biotics doesn't, and it contains the 8 most well-researched and beneficial probiotic strains for your mental health.

I also recommend adding fermented foods into your diet and see how that goes. Fermented foods contain many strains of bacteria that have not been documented in the scientific literature.  That said, the downside is that the bacteria in fermented foods will vary depending on the batch, and there is sometimes the risk of them containing pathogenic bacteria.

Here are some other steps you can take to increase the good bacteria in your gut. 

And this anti-anxiety supplement also includes several other natural compounds that have helped me manage my anxiety over the years. It can help reduce stress and anxiety while you work to improve your gut health.

 

Conclusion

The microbiome and psychobiotics are at the cutting-edge of neuroscience and mental health research and treatment. It hasn’t been that long since researchers first discovered that there is a gut-brain connection. 

Cartoon image of bacteria and psychobiotics.

When I first found out about it several years ago, I started consuming psychobiotics, and they have definitely helped me recover from chronic anxiety. 

But it’s important to point out that psychobiotics alone were never enough.

I also had to make changes to my diet, take key supplements, improve thyroid health, and overcome trauma. There really is no quick fix or magic bullet. 

Yet for some people, psychobiotics can be life changing, especially if you have digestive issues alongside your anxiety and worry. 

Overall, I think they are absolutely worth a try. 

I hope this article helps you, and please share it with anyone you think might benefit from it. 

 

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Jordan Fallis

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References:

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370913/

(2) https://www.ncbi.nlm.nih.gov/pubmed/21876150/

(3) https://www.ncbi.nlm.nih.gov/pubmed/25879690

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934620/

(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225647/

(6) http://www.ncbi.nlm.nih.gov/pubmed/24257436

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200314/

(8) https://www.ncbi.nlm.nih.gov/pubmed/25024629

(9) http://www.ncbi.nlm.nih.gov/pubmed/26620542

(10) http://www.ncbi.nlm.nih.gov/pubmed/26522841

(11) https://www.sciencedaily.com/releases/2016/11/161121160038.htm

(12) http://www.ncbi.nlm.nih.gov/pubmed/25869281

(13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754198/

(14) http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2010.01664.x/full#b28

(15) https://www.sciencedaily.com/releases/2016/06/160616140723.htm

(16) http://www.cell.com/cell/fulltext/S0092-8674(16)30730-9

(17) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664325/

(18) https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-1-6

(19) http://www.ncbi.nlm.nih.gov/pubmed/19338686/

(20) http://journal.frontiersin.org/article/10.3389/fmicb.2016.01204/full

(21) https://www.ncbi.nlm.nih.gov/pubmed/25251188

(22) https://www.ncbi.nlm.nih.gov/pubmed/25794930

(23) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410136/

(24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370913/

(25) http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2008.03911.x/abstract

(26) http://www.ncbi.nlm.nih.gov/pubmed/19053980

(27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413724/

(28) https://www.ncbi.nlm.nih.gov/pubmed/20974015/

(29) http://www.tandfonline.com/doi/abs/10.4161/gmic.2.4.16108

(30) https://www.ncbi.nlm.nih.gov/pubmed/21983070

(31) https://www.ncbi.nlm.nih.gov/pubmed/21683077

(32) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934620/

(33) https://www.ncbi.nlm.nih.gov/pubmed/25251188

(34) https://www.ncbi.nlm.nih.gov/pubmed/25794930

(35) https://www.ncbi.nlm.nih.gov/pubmed/20600016

(36) https://www.ncbi.nlm.nih.gov/pubmed/21988661

(37) https://www.ncbi.nlm.nih.gov/pubmed/20974015/

(38) http://www.tandfonline.com/doi/abs/10.4161/gmic.2.4.16108

(39) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934620/

(40) https://www.ncbi.nlm.nih.gov/pubmed/23566632

(41) http://www.ncbi.nlm.nih.gov/pubmed/26408987

(42) https://www.ncbi.nlm.nih.gov/pubmed/24554471

(43) https://www.ncbi.nlm.nih.gov/pubmed/26408987

(44) https://www.ncbi.nlm.nih.gov/pubmed/23181058

(45) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906699/

(46) https://www.ncbi.nlm.nih.gov/pubmed/23759244

(47) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5102282/

(48) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228144//

(49) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937966/

(50) https://www.ncbi.nlm.nih.gov/pubmed/?term=18819774

(51) https://www.ncbi.nlm.nih.gov/pubmed/219080555

(52) https://www.ncbi.nlm.nih.gov/pubmed/21908055

(53) http://www.ashdin.com/journals/JEM/235910/

(54) https://www.ncbi.nlm.nih.gov/pubmed/27632908

(55) https://www.ncbi.nlm.nih.gov/pubmed/27841940

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How to Stimulate Your Vagus Nerve for Better Mental Health

By developing an understanding of the workings of your vagus nerve, you may find it possible to work with your nervous system rather than feel trapped when it works against you.
— Dr. Arielle Schwartz, Clinical Psychologist

Stimulation of my vagus nerve has played a key role in the management of my anxiety and mental health over the years. 

What exactly is the vagus nerve?

The vagus nerve is the longest cranial nerve in your body.

13 ways to stimulate your vagus nerve for better mental health

It connects your brain to many important organs throughout the body, including the gut (intestines, stomach), heart and lungs. 

In fact, the word "vagus" means “wanderer” in Latin, which accurately represents how the nerve wanders all over the body and reaches various organs.  

The vagus nerve is also a key part of your parasympathetic “rest and digest” nervous system. It influences your breathing, digestive function and heart rate, all of which can have a huge impact on your mental health.

But what you really need to pay special attention to is the "tone" of your vagus nerve.

Vagal tone is an internal biological process that represents the activity of the vagus nerve. 

Increasing your vagal tone activates the parasympathetic nervous system, and having higher vagal tone means that your body can relax faster after stress.

In 2010, researchers discovered a positive feedback loop between high vagal tone, positive emotions, and good physical health. In other words, the more you increase your vagal tone, the more your physical and mental health will improve, and vice versa (5).

It’s almost like yin and yang. The vagal response reduces stress. It reduces our heart rate and blood pressure. It changes the function of certain parts of the brain, stimulates digestion, all those things that happen when we are relaxed.
— Dr. Mladen Golubic, MD, Medical Director of the Cleveland Clinic
An image of the vagus nerve.

What’s interesting is that studies have even shown that vagal tone is passed on from mother to child. Mothers who are depressed, anxious and angry during their pregnancy have lower vagal activity. And once they give birth to their child, the newborn also has low vagal activity and low dopamine and serotonin levels (1-3). 

Your vagal tone can be measured by tracking certain biological processes such as your heart rate, your breathing rate, and your heart rate variability (HRV). 

When your heart rate variability (HRV) is high, your vagal tone is also high. They are correlated with each other (53-55). 

You can increase your HRV by using the EmWave2 device (and this article shares 24 other ways to increase your HRV).

Some researchers actually use the EmWave2 to measure vagal tone in their studies. 

If your vagal tone is low, don’t worry - you can take steps to increase it by stimulating your vagus nerve. This will allow you to more effectively respond to the emotional and physiological symptoms of your brain and mental illness.

Stimulating the vagus nerve and increasing vagal tone has been shown to help treat a wide variety of brain and mental health conditions, including:

For people with treatment-resistant depression, the FDA has even approved a surgically-implanted device that periodically stimulates the vagus nerve. And it works (6-9). 

But you don’t need to go down that route.

You can enjoy the benefits of vagus nerve stimulation naturally by following these 13 steps. 

 

1. Cold Exposure

Acute cold exposure has been shown to activate the vagus nerve and activate cholinergic neurons through vagus nerve pathways (10). 

Image of an old-fashioned, muscular, manly man. It says “Have a cold shower? You mean a shower?”

Researchers have also found that exposing yourself to cold on a regular basis can lower your sympathetic “fight or flight” response and increase parasympathetic activity through the vagus nerve (11).

I often take cold showers and go outside in cold temperatures with minimal clothing.

Try finishing your next shower with at least 30 seconds of cold water and see how you feel. Then work your way up to longer periods of time.

It's painful to do, but the lingering effects are worth it.

You can also ease yourself into it by simply sticking your face in ice cold water. 

 

2. Deep and Slow Breathing

Deep and slow breathing is another way to stimulate your vagus nerve. 

A woman closing here eyes and breathing deeply near the ocean. Deep breathing stimulates the vagus nerve.

It’s been shown to reduce anxiety and increase the parasympathetic system by activating the vagus nerve (51-52). 

Most people take about 10 to 14 breaths each minute. Taking about 6 breaths over the course of a minute is a great way to relieve stress. You should breathe in deeply from your diaphragm. When you do this, your stomach should expand outward. Your exhale should be long and slow. This is key to stimulating the vagus nerve and reaching a state of relaxation. 

The best way to know if you’re on the right track is by using the EmWave2 device. It’s a biofeedback device that assists you in pacing your breathing. I previously wrote about the benefits of using the device here. You can get it through the HeartMath website

 

3. Singing, Humming, Chanting and Gargling

The vagus nerve is connected to your vocal cords and the muscles at the back of your throat. 

Singing, humming, chanting and gargling can activate these muscles and stimulate your vagus nerve.

And this has been shown to increase heart-rate variability and vagal tone (12).

I often gargle water before swallowing it. This is discussed more in Dr. Datis Kharrazian’s book, Why Isn’t My Brain Working?

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4. Acupuncture

Acupuncture is another alternative treatment that has been shown to stimulate the vagus nerve (46). 

A woman’s ear with three acupuncture needles in it. Auricular acupuncture is very effective at stimulating the vagus nerve.

I’m a really big fan of auricular acupuncture. Auricular acupuncture is when needles are inserted into ear. I’d recommend trying to find a health practitioner in your area who provides it, especially if you’re weening off psychiatric medication. It really helped me the first time I came off antidepressants. I was surprised.

Research shows that ear acupuncture stimulates the vagus nerve, increases vagal activity and vagal tone, and can help treat “neurodegenerative diseases via vagal regulation” (45). 

In my experience, ear acupuncture is more effective than regular acupuncture. I’m not sure why. I’ve just personally noticed more benefits from ear acupuncture. 

At the end of each appointment, my practitioner would secure small black seeds on my ear. 

I also use an acupuncture mat at home to relax before bed. 

 

5. Yoga and Tai Chi

Yoga and tai chi are two “mind-body” relaxation techniques that work by stimulating the vagus nerve and increasing the activity of your parasympathetic “rest and digest” nervous system.

A woman practicing yoga or tai chi outside. Yoga and tai chi stimulate the vagus nerve and can improve your mental health.

Studies have shown that yoga increases GABA, a calming neurotransmitter in your brain. Researchers believe it does this by “stimulating vagal afferents”, which increase activity in the parasympathetic nervous system (13-18). 

Researchers have also found that yoga stimulates the vagus nerve and therefore should be practiced by people who struggle with depression and anxiety (19). 

Despite all the great research, I’m personally not a big fan of yoga. A lot of people swear by it but it’s just not for me. I prefer tai chi. 

Tai chi has also been shown to increase heart rate variability, and researchers think this means it can “enhance vagal modulation” (20).

 

6. Probiotics

It’s becoming increasingly clear to researchers that gut bacteria improve brain function by affecting the vagus nerve (27).  

Bacteria. Probiotic bacteria can stimulate your vagus nerve and improve your mental health.

In one study, animals were given the probiotic Lactobacillus Rhamnosus, and researchers found positive changes to the GABA receptors in their brain, a reduction in stress hormones, and less depression and anxiety-like behaviour. 

The researchers also concluded that these beneficial changes between the gut and the brain were facilitated by the vagus nerve. When the vagus nerve was removed in other mice, the addition of Lactobacillus Rhamnosus to their digestive systems failed to reduce anxiety, stress, and improve mood (25). 

Another study found that the probiotic Bifidobacterium Longum normalized anxiety-like behavior in mice by acting through the vagus nerve (26). 

Both Lactobacillus Rhamnosus and Bifidobacterium Longum are included in the Optimal Biotics supplement

I previously wrote about some other ways you can increase the good bacteria in your gut. You can read about that here.

And here are 7 other probiotic strains that can help treat anxiety. 

 

7. Meditation and Neurofeedback

Meditation is my favourite relaxation technique and it can stimulate the vagus nerve and increase vagal tone.        

Research shows that meditation increases vagal tone and positive emotions, and promotes feelings of goodwill towards yourself (22, 23). 

Another study found that meditation reduces sympathetic “fight or flight” activity and increases vagal modulation (21). 

“OM” chanting, which is often done during meditation, has also been shown to stimulate the vagus nerve (24). 

I couldn’t find any research demonstrating this, but in my experience, neurofeedback significantly increased my heart-rate variability and vagal tone as measured by my EmWave2

Now that I’m done neurofeedback, I use the Muse headband to meditate. Similar to neurofeedback, it gives you real-time feedback on your brainwaves. I previously wrote about it here, and you can get it through the Muse website.

Please note: If you’re interested in trying neurofeedback, I recommend becoming a client and working with us to determine the best type of neurofeedback for you and your condition. I have found that some types of neurofeedback are completely ineffective and may even be harmful. So it’s very important to do the right type of neurofeedback that actually works. It’s also critical to work with a qualified neurofeedback practitioner who knows what they are doing. Otherwise, you can get worse. We help our clients find a qualified practitioner in their area.

 

8. Omega-3 Fatty Acids

Omega-3 fatty acids are essential fats that your body cannot produce itself. They are found primarily in fish and are necessary for the normal electrical functioning of your brain and nervous system.

Two pieces of uncooked salmon. Salmon contains omega-3 fatty acids, which have been shown to stimulate the vagus nerve.

They often appear in most of my posts because they are so critical for brain and mental health and affect so many aspects of wellness. 

They’ve been shown to help people overcome addiction, repair a “leaky brain”, and even help reverse cognitive decline.

But researchers have also discovered that omega-3 fatty acids increase vagal tone and vagal activity (35-37, 40). 

Studies shown that they reduce heart rate and increase heart rate variability, which means they likely stimulate the vagus nerve (34, 38, 39). 

And high fish consumption is also associated with “enhanced vagal activity and parasympathetic predominance” (35). 

That's why I eat lots of wild-caught salmon, as well as supplement with krill oil. 

 

9. Exercise

I’ve already discussed how exercise increases your brain’s growth hormone, supports your brain’s mitochondria, and helps reverse cognitive decline.

But it’s also been shown to stimulate the vagus nerve, which may explain its beneficial brain and mental health effects (28). 

A man running near the water. Exercise stimulates the vagus nerve.

Many brain health experts recommend exercise as their number one piece of advice for optimal brain health. 

This is my exercise routine:

  • Lift heavy weights 1-4 times per week

  • High-intensity interval sprinting 1-2 times per week

  • Walk as much as I can (ideally 30-60 minutes every day)

Walking, weightlifting and sprinting are the best forms of exercise, but you should choose a sport or exercise routine that you enjoy, so that you’ll stick with it consistently. 

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10. Zinc

As I’ve discussed before, zinc is an essential mineral for mental health, especially if you struggle with chronic anxiety

One study shows that zinc increases vagus nerve stimulation in zinc-deficient rats (41). 

It’s estimated that 2 billion people in the world are deficient in zinc, and six different studies show that subclinical deficiency of zinc impairs brain function in children and adults (42-44).

Oysters contain zinc, which has been shown to stimulate the vagus nerve.

So, if you struggle with a brain or mental health disorder, it’s quite possible that you’re deficient.  

Some of the best food sources of zinc include oysters, grass-fed beef, pumpkin seeds, cashews, mushrooms and spinach. These foods are included in my Free Grocery Shopping Guide for Optimal Brain and Mental Health.

However, I still recommend at least short-term supplementation to ensure you get enough.

I created and take the Optimal Zinc supplement to make sure my zinc levels are optimal. 

Check out my previous post about zinc and copper if you’re interested in discovering more steps you can take to increase your zinc levels. 

 

11. Massage

Research shows that massages can stimulate the vagus nerve, and increase vagal activity and vagal tone (31-32). 

A woman getting a massage. Massages improve your mental health by stimulating the vagus nerve.

The vagus nerve can also be stimulated by massaging several specific areas of the body.

Foot massages (reflexology) have been shown to increase vagal modulation and heart rate variability, and decrease the “fight or flight” sympathetic response (29). 

Massaging the carotid sinus, an area located near the right side of your throat, can also stimulate the vagus nerve to reduce seizures (30). 

I personally get a massage from a registered massage therapist every couple of months. 

 

12. Socializing and Laughing

I’ve already discussed how socializing and laughing can reduce your body’s main stress hormone.

Two men laughing. Laughter and socializing stimulates the vagus nerve.

And now I’ve learned that they are likely doing this by stimulating the vagus nerve. 

Researchers have discovered that reflecting on positive social connections improves vagal tone and increases positive emotions (47, 48). 

Laughter has been shown to increase heart-rate variability and improve mood (49). 

And vagus nerve stimulation often leads to laughter as a side effect, suggesting that they are connected and influence one another (50). 

So my advice is to hang out and laugh with your friends as much as possible. Although I should probably be taking my own advice here, as I’m an introvert and often avoid socializing too much. 

 

13. Intermittent Fasting

On most days, I don’t eat breakfast at all, and then "break my fast" by eating my first meal of the day around 2 or 3 p.m. That means I eat all my food for the day within an 8-hour window.

An empty plate with a fork and knife beside it. Intermittent fasting stimulates the vagus nerve.

There are many health benefits to doing this. As I’ve discussed before, intermittent fasting can boost your brain’s growth hormone, improve mitochondrial function, and may help some people overcome brain fog and cognitive decline

Research also shows that fasting and caloric restriction increase heart rate variability, which is an indicator that it increases parasympathetic activity and vagal tone (33). 

The best way to start fasting is simply by eating dinner around 6, not eating anything after that before bed, and then eating a regular breakfast the next day. That should give you about 12-14 hours of fasting time. 

 

Conclusion

You don’t have to be controlled by your body and mind. You have the power to tell them what to do. 

By stimulating the vagus nerve, you can send a message to you body that it’s time to relax and de-stress, which leads to long-term improvements in mood, wellbeing and resilience. 

Increasing my vagal tone has allowed me to overcome anxiety and depression, and better manage them when they arise.

Overall, I hope you implement some of the above steps into your daily life, and they allow you to live more optimally.

 
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Live Optimally,

Jordan Fallis

Connect with me

References:

(1) https://www.ncbi.nlm.nih.gov/pubmed/12768648

(2) https://www.https://www.ncbi.nlm.nih.gov/pubmed/12521495/.nlm.nih.gov/pubmed/12521495/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556849

(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705176/

(5) http://pss.sagepub.com/content/early/2013/05/06/0956797612470827.abstract

(6) http://www.webmd.com/depression/vagus-nerve-stimulation#1

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2990624/

(8) https://www.sciencedaily.com/releases/2016/02/160204111728.htm

(9) https://www.elsevier.com/about/press-releases/research-and-journals/new-non-invasive-form-of-vagus-nerve-stimulation-works-to-treat-depression

(10) https://www.ncbi.nlm.nih.gov/pubmed/11447037

(11) https://www.ncbi.nlm.nih.gov/pubmed/18785356

(12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705176/

(13) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111147/

(14) https://www.ncbi.nlm.nih.gov/pubmed/12568274

(15) https://www.ncbi.nlm.nih.gov/pubmed/12090812

(16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2176143/

(17) https://www.ncbi.nlm.nih.gov/pubmed/16641939

(18) https://www.ncbi.nlm.nih.gov/pubmed/15750381

(19) http://www.bu.edu/news/2012/03/07/researchers-find-yoga-helps-ease-stress-related-medical-and-psychological-conditions/

(20) https://www.ncbi.nlm.nih.gov/pubmed/18991518

(21) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546358/

(22) http://healthland.time.com/2013/05/09/why-kindness-can-make-us-happier-healthier/?iid=hl-main-lead

(23) https://www.ncbi.nlm.nih.gov/pubmed/23649562

(24) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099099/

(25) http://www.ncbi.nlm.nih.gov/pubmed/21876150

(26) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413724/

(27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/

(28) http://www.ncbi.nlm.nih.gov/pubmed/20948179

(29) https://www.ncbi.nlm.nih.gov/pubmed/22314629

(30) http://www.ncbi.nlm.nih.gov/pubmed/23962632

(31) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133856/

(32) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844909/

(33) http://www.ncbi.nlm.nih.gov/pubmed/16581971

(34) https://www.ncbi.nlm.nih.gov/pubmed/17326331

(35) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217222/

(36) https://www.ncbi.nlm.nih.gov/pubmed/16616012/

(37) https://www.ncbi.nlm.nih.gov/pubmed/18461305

(38) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483717/

(39) https://www.ncbi.nlm.nih.gov/pubmed/17134636

(40) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653417/

(41) http://www.ncbi.nlm.nih.gov/pubmed/19158231

(42) http://www.ncbi.nlm.nih.gov/pubmed/22664333

(43) http://www.ncbi.nlm.nih.gov/pubmed/21939673

(44) http://www.ncbi.nlm.nih.gov/pubmed/22673824

(45) https://www.hindawi.com/journals/ecam/2012/786839/

(46) https://www.ncbi.nlm.nih.gov/pubmed/24359451

(47) https://www.ncbi.nlm.nih.gov/pubmed/23649562

(48) http://journals.sagepub.com/doi/abs/10.1177/0956797612470827

(49) https://www.ncbi.nlm.nih.gov/pubmed/22894892

(50) http://www.ncbi.nlm.nih.gov/pubmed/12959437

(51) http://www.npr.org/2010/12/06/131734718/just-breathe-body-has-a-built-in-stress-reliever

(52) https://www.hindawi.com/journals/ecam/2013/743504/

(53) http://circ.ahajournals.org/content/118/8/863.long

(54) https://en.wikipedia.org/wiki/Heart_rate_variability

(55) https://en.wikipedia.org/wiki/Vagal_tone

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28 Proven Ways to Promote the Regeneration of Myelin

Myelin is critical for optimal brain function and mental health.

What is myelin?

Myelin sheath.

Myelin is a fatty, white substance that wraps around the end of many nerve cells. It forms an electrically insulating sheath that increases nerve condition speeds.

In other words, it allows your brain to send information faster and more efficiently, making it absolutely essential for the optimal functioning of your nervous system (39, 40). 

So not surprisingly, myelin sheath plays a key role in determining intelligence and improving cognitive performance (41, 42). 

The production of myelin throughout the nervous system is called myelination or myelinogenesis.

But demyelination can also happen. 

This happens when the myelin that insulates your nerves is destroyed or deteriorates, leading to mental health symptoms and neurodegenerative diseases (44). 

Multiple sclerosis is one of the more common demyelinating condition, but a number of neurological and psychiatric illnesses have been linked to demyelination, including (45):

Myelin sheath.

If you have one of these conditions and suspect you might have symptoms of demyelination, don’t worry.

There are dietary and lifestyle modifications that can help your body repair and re-manufacture myelin. Studies show that oligodendrocyte cells are responsible for the formation of new myelin in both the injured and normal adult brains (43).

Here are 28 holistic ways to increase oligodendrocyte cells, promote myelin production and myelin sheath repair, and increase the regeneration of myelin. 

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1. Deep Sleep and Melatonin

Research has found that sleep increases myelination and increases the production of oligodendrocyte precursor cells (OPCs).

One study found that production of OPCs doubled in mice while they slept. The mice that were forced to stay awake had higher levels of stress hormones and higher rates of brain cell death (1-2). 

Researchers believe this means that sleep loss can aggravate symptoms of multiple sclerosis.

Baby sleeping. Sleep and melatonin help regenerate myelin.

That’s why getting at least 7 hours of high-quality, restorative sleep is so critical. 

But it’s not just the amount of sleep you get that’s important. It’s also the quality of your sleep. 

The researchers found that the production of the myelin-forming cells increased the most during deep, rapid-eye movement (REM) sleep. 

Melatonin, your body’s sleep hormone, has also been shown to promote myelination and increase myelin production by significantly reducing inflammation in the brain (46).

This sleep supplement contains magnesium and a number of other natural compounds that I’ve used over the years to promote the production of melatonin.

But I work with my clients so that they can naturally produce more melatonin and maximize the quality of their sleep without so many supplements. We have free online workshop that talks about how you can work with us. You can register for the workshop here.

Deep sleep can also improve your brain’s growth hormone, lower your stress hormone, and slow down the onset of dementia

 

2. Iodine and Thyroid Hormones

Iodine is a key mineral that is required to produce thyroid hormones. Without enough iodine, you may end up with symptoms of hypothyroidism

Research shows that a deficiency in iodine and lack of thyroid hormones can impair myelination (7).

The process of myelination is known to depend on the thyroid hormone. The myelinating cells are the oligodendroglia which appear to stop functioning in MS (and sometimes to a milder degree in Alzheimer’s disease, and other conditions). The cells’ absorption of thyroid hormone is influenced by dietary factors.
— Ray Peat

Other studies show that thyroid hormones stimulate the expression of myelin protein genes, and promote remyelination in the brain by enhancing oligodendrocyte maturation (8, 9). 

So supporting your thyroid and getting enough iodine are key steps towards increasing myelin and optimizing the formation of new myelin. 

You can read more about how to support your thyroid and enhance the production of thyroid hormones here.  

I highly recommend getting a full thyroid panel done regularly.

 

3. Vitamin C

Oranges. The Vitamin C in oranges help regenerate myelin.

Vitamin C is known to participate in myelin formation (10, 11). 

Collagen synthesis, which is dependent on Vitamin C, has also been linked to the formation of myelin sheath (12, 13). 

Vitamin C can be found in foods such as peppers, citrus fruits, green leafy vegetables, broccoli, tomatoes, and berries. These foods are included in my Free Grocery Shopping Guide for Optimal Brain and Mental Health.

You can also take it in supplement form
 

 

4. Zinc

As I’ve discussed before, zinc is an essential trace mineral that activates several hundred enzymatic reactions, including neurotransmission.

It’s estimated that 2 billion people in the world are deficient in zinc, and six different studies show that subclinical deficiency of zinc impairs brain function in children and adults (14-16).

Oysters. The zinc in oysters help regenerate myelin.

So, if you struggle with a brain or mental health disorder, it’s quite possible that you’re deficient.  

Zinc also affects myelination.

The mineral is needed for myelin proteins to work properly, and research shows that a deficiency in zinc leads to a reduction in myelin formation and myelin recovery (17). 

Some of the best food sources of zinc include oysters, grass-fed beef, pumpkin seeds, cashews, mushrooms and spinach. These foods are included in my Free Grocery Shopping Guide for Optimal Brain and Mental Health.

But I still recommend at least short-term supplementation to ensure you get enough to increase myelination.

I created and take the Optimal Zinc supplement

Check out my previous post about zinc and copper if you’re interested in discovering more steps you can take to increase your zinc levels.  

 

5. Cholesterol

Cholesterol is a waxy, fat-like substance that’s found in all cells of the body.

Your body needs cholesterol to make hormones and vitamin D.

And it’s an indispensable component of myelin. 

Butter. The cholesterol in butter helps regenerate myelin.

Without it, myelin membrane growth is “severely perturbed” (18). 

So just like you shouldn’t be afraid of saturated fat, you shouldn’t be afraid of eating cholesterol-rich foods.

Some of the best sources of cholesterol include grass-fed butter or ghee, beef liver and pastured egg yolks. These foods are included in my Free Grocery Shopping Guide for Optimal Brain and Mental Health.

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6. Lithium 

Lithium is predominantly known as a medication given to bipolar patients to manage their symptoms. 

However, it’s also an essential mineral.

Bipolar patients are often given high doses of lithium carbonate.

But low doses of lithium orotate can be safely supplemented to support the brain and improve mental health.

Research shows that lithium stimulates the expression of myelin genes, restores the myelin structure, and promotes remyelination (19). 

As I discussed before, lithium orotate can also increase your brain’s growth hormone (BDNF)

So it’s definitely something you want to consider taking if you want to increase myelin in the brain.

 

7. Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is a treatment that enhances healing and recovery after injury to the central nervous system.

Patients inhale 100% oxygen in a total body chamber. 

Usually, oxygen is transported throughout the body only by red blood cells. But with HBOT, oxygen is dissolved into all body fluids, including the fluids of the central nervous system.

This leads to oxygen being  carried to areas of the body where circulation is diminished or blocked. As a result, extra oxygen can reach all damaged tissues, including areas that need to heal.

Researchers have found that HBOT can cause "significant remyelination" (83-84). 

Other studies show that it can alleviate myelin damage (85). 

You’ll need to find a practitioner or clinic in your area that provides this treatment.

 

8. Ketogenic Dieting

A ketogenic diet is a very low-carb diet – less than 50 grams of carbs per day.

When you restrict carbohydrate-rich foods – such as grains, sugar, and even potatoes, legumes and fruit – your body enters ketosis, a metabolic state in which your body and brain run on fatty acids and “ketones” instead of glucose.

Foods incorporated in a ketogenic diet. A ketogenic diet and ketones can help repair myelin.

Ketones are an alternative source of energy for your brain cells. And several studies show that when you increase the production of ketones, you improve myelination and increase myelin production (3-6). 

So if you’re trying to rebuild myelin sheath, you should consider a cyclic ketogenic diet. 

As I’ve discussed before, ketones can also increase your brain’s growth hormone, help you overcome brain fog, support your brain’s mitochondria, and slow down cognitive decline

 

9. Iron

Iron is an essential mineral that is present in all cells and plays a role in several vital functions, including oxygen consumption and ATP production.

It’s also important for myelin production.

Studies show that low iron levels lead to a reduction in myelination, and normal iron levels support the formation of myelin and increase myelin (20). 

In most cases, I don’t recommend supplementing with iron. Instead, get it from food.

Beef liver is the best source, and it’s included in my Free Grocery Shopping Guide for Optimal Brain and Mental Health.
 

 

10. Low Level Laser Therapy

Low-level laser therapy (LLLT), or photobiomodulation, is a treatment that uses low-level (low-power) lasers or light-emitting diodes (LEDs) to stimulate brain cells, helping them function better.

Most doctors don't know about LLLT; but not every doctor.

Dr. Norman Doidge, a physician who teaches at the University of Toronto here in Canada, discusses the amazing effects of LLLT in his book The Brain’s Way of Healing.

Researchers have found that LLLT can increase myelination and increase the total number of myelinated axons (79-81). 

LLLT has also been shown to restore normal levels of myelin in animals (81-82). 

I previously wrote about my experience with low-level laser therapy here.

I use this device and shine the red and infrared light on my forehead for 5 minutes every day. I also shine it on other parts of my head and on my entire body, including on my thyroid, thymus gland and gut. I experience incredible benefits from doing this.

When I’m travelling, I take this smaller and more convenient device with me and shine it on my forehead.

I’ve also been using the Vielight Neuro Duo, which is a transcranial-intranasal headset with 810 nm of near infrared light. It penetrates deeper into brain tissue and is absorbed better by the central nervous system. If you decide to try a Vielight device, you can use the coupon code JORDANFALLIS for a 10% discount

LLLT also supports mitochondria function, reduces brain fog, promotes synaptogenesis, and increases blood flow to the brain

I encourage you to check out my full article about it for more information.

 

11. Phosphatidylserine

Phosphatidylserine is a fat-soluble amino acid compound that plays a key role in optimal cognitive function. High amounts of phosphatidylserine can be found within the brain, and supplementation has been shown to improve attention and memory, especially in the elderly (21-23).

…consumption of phosphatidylserine may reduce the risk of dementia and cognitive dysfunction in the elderly.
— Food and Drug Administration

Researchers have also concluded that phosphatidylserine is required for healthy nerve cell membranes and myelin in the brain (24). 

I take phosphatidylserine every day. It's part of the Optimal Brain supplement

Make sure you read this article to learn more about the remarkable benefits of Phosphatidylserine.

 

12. Pregnenolone

Pregnenolone is a steroidal hormone manufactured by the body, but it can also be taken as a supplement.

Picture of a human brain.

It’s been shown to enhance memory and reduce stress-induced fatigue.

It’s the precursor to almost all other steroid hormones, including DHEA, progesterone, testosterone, estrogens, and cortisol.

Pregnenolone and other steroid hormones regulate, repair, rebuild, and increase the production of myelin (25-28). 

I personally tried pregnenolone. It did give me a boost in brain function and mental energy. However, it also made me angry and irritable so I stopped taking it. This happens to some people, but a lot of people don't experience this. It's worth trying to see how you react.
 

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13. Uridine 

Uridine is a nucleotide base found in beer.

I don’t recommend drinking beer, but supplementing with pure uridine can protect the brain, enhance cognition, and increase mood and motivation. 

It’s been proven to help treat “myelin sheath lesion” in several experimental and clinical studies (29, 30). 

 

14. Herbs That Increase Myelin

Ashwagandha helps regenerate myelin.

Ashwagandha is a popular Indian herb commonly used to prevent anxiety.

Withanoside IV is one of the main therapeutic compounds in ashwagandha and research shows that it can increase myelin levels in the nervous system (31).

I take ashwagandha during periods of high stress. It’s included in this supplement.

Ginkgo Biloba is another common herb, which is taken for cognitive enhancement or to alleviate cognitive decline.

It’s beneficial effects of cognition may be because it significantly increases the number of myelinated axons (34).  

Ginkgo Biloba is included in the Optimal Brain supplement

 

15. Inositol

Inositol is a small molecule structurally similar to glucose that is involved in cellular signalling. 

At high doses, it reduces anxiety. 

Research shows that animals treated with inositol have significantly fewer demyelinating lesions (32). 

I took high doses of inositol powder when weening off psychiatric medication.

I previously wrote a full article about inositol here

 

16. Lion’s Mane 

Lion’s mane mushroom helps regenerate myelin.

Hericium Erinaceus – better known as Lion’s mane mushroom – might be my favourite way to regenerate myelin. 

Research shows that lion’s mane increases the rate of myelination production, and the process of myelination begins earlier in the presence of the mushroom (33). 

I used to take this lion’s mane mushroom. It’s one of the highest-quality lion’s mane mushroom supplements that I could find from a reputable brand. I spent a lot of time researching and looking into different sources because not all lion's mane supplements are high-quality and effective, and I settled on this one.

 

17. Consume Flavonoids

There are several flavonoids, a diverse group of phytonutrients found in fruits and vegetables, that have been demonstrated to promote myelination. 

Research shows that the flavonoids luteolin, quercetin and fisetin significantly decrease myelin phagocytosis and may be able to limit the demyelination process during multiple sclerosis (35). 

Quercetin, one plant flavonoid in particular with potent antioxidant action, has been shown to increase the number of oligodendrocyte precursor cells and myelin basic protein cells (36). 

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18. Learn or Experience Something New

You can also generate new myelin by learning something new and exposing yourself to novel life experiences.

Guitar. Learning the guitar can help you form new myelin.

For example, one report showed that learning a new instrument leads to increased myelin in areas of the brain involved with musical performance. 

The researchers explain that myelin increased proportionately to the number of hours each person had practiced the instrument (38).

So the more you practice and try to learn something, the more myelin you generate.

 

19. Exercise

I’ve already discussed how exercise increases your brain’s growth hormone, supports your brain’s mitochondria, helps reverse cognitive decline, and stimulates your vagus nerve.

It clearly does so much good, so it’s not too surprising that it also supports myelin formation. 

Woman lifting weights. Exercise can help with the regeneration of myelin.

Research shows that long-term exercise improves memory by increasing and restoring myelin (47). 

Running has also been shown to increase myelination and delay the progression of demyelination, and therefore delays the progression of Alzheimer’s disease (48). 

Lastly, researchers have found that exercise increases mitochondrial activity, which then increases myelination in the brain (49). 

This is exercise routine I try to follow consistently:

  • Lift heavy weights 1-4 times per week

  • High-intensity interval sprinting 1-2 times per week

  • Walk as much as I can (ideally 30-60 minutes every day)

  • Walking, weightlifting and sprinting are the best forms of exercise, but you should choose a sport or exercise routine that you enjoy, so that you’ll stick with it consistently

 

20. Brain-Derived Neurotrophic Factor (BDNF)

Brain-derived neurotrophic factor, also known as BDNF, is a naturally-occurring hormone in the brain that improves brain function and lowers your risk of mental disease. 

It also regulates the myelination process. 

Research shows that BDNF produces a long-term increase in both the rate and extent of myelination, and enhances and accelerates myelin formation (50). 

I previously provided 21 ways to boost BDNF in this post.  

 

21. Testosterone

When I lived in a moldy home, suffered multiple concussions and was placed on antidepressants, my testosterone plummeted. 

Very muscular man looking angry. Testosterone can increase myelin formation.

No conventional doctor tested my testosterone because they assumed every a man in his 20s would have healthy levels. 

But they were wrong. 

Eventually I saw a smart doctor and he found out that I had the testosterone levels of an old man.

I was put on testosterone replacement therapy for almost one year to get my levels back to normal. And over that time, I saw a huge increase in my brain and mental health.

This may be because testosterone has been shown to stimulate the formation of new myelin and reverse myelin damage (51). 

Researchers have also concluded that hormone replacement should be a considered treatment for males who have multiple sclerosis, as it can stall (and perhaps even reverse) the neurodegeneration associated with MS (52). 

That's why it's so important to test. Make sure you check both total testosterone and free testosterone

You can test your total and free levels here. 

 

22. Omega-3 Fatty Acids

Omega-3 fatty acids are essential fats that your body cannot produce itself. They are found primarily in fish and are necessary for the normal electrical functioning of your brain and nervous system.

Cooked piece of salmon. The omega-3 fatty acids in salmon can help with the regeneration of myelin.

They appear in most of my posts because they are so critical for brain and mental health and affect so many aspects of wellness.

They’ve been shown to help people overcome addiction, repair the blood-brain barrier, stimulate the vagus nerve, and even reverse cognitive decline.

And now researchers have found that they also increase myelin production, helping your body produce more myelin (53, 54). 

According to Judy Graham, author of the book Managing Multiple Sclerosis Naturally: A Self-Help Guide to Living with MS, myelin cell membranes that contain omega-3 fatty acids are more fluid, which improves the efficiency of nerve impulse conduction. 

She also points out in her book that rates of multiple sclerosis are lower in areas of high fish consumption. 

I eat lots of wild salmon and sometimes supplement with krill oil.

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23. Vitamin D and Vitamin K2

Vitamin D is a fat-soluble vitamin that our skin synthesizes when exposed to the sun.

Sun shining through the clouds. Vitamin D from the sun can help repair myelin.

Research shows that the Vitamin D receptor boosts the regeneration of myelin (55). 

Vitamin D also significantly increases myelination in rats (56). 

It’s best to get your Vitamin D from sunlight, but most people can’t get enough, especially during the winter. 

That’s why I take a Vitamin D3 supplement.

If you decide to supplement, it’s a good idea to also take some Vitamin K2 with it, as it has also been shown to support myelin (57). 

I also highly recommend checking your Vitamin D levels. It's one of the most important tests you can take for your health.

 

24. Choline

Choline is an essential B vitamin that most people don’t consume enough of, because very few foods in the Western diet contain it.

It’s also a component of myelin and supports myelin production.

Egg yolk. Egg yolks contain choline, which can help repair myelin.

Research shows that the choline pathway promotes remyelination, and enhances the repairing and rebuilding of myelin sheath (64). 

Citicoline (also known as CDP-Choline) is the most bioavailable form of choline. 

One study found that citicoline enhances myelin regeneration and increases remyelination in the central nervous system. The researchers concluded that citicoline could become a promising substance for patients with multiple sclerosis because of its regenerative action combined with its excellent safety profile (63). 

That’s why I recommend supplementing with it. It’s one of my favourite supplements for optimal brain and mental health. I personally take citicoline every day now, and I find it improves my focus and mental energy. It's included in the Optimal Brain supplement

You can also find some choline in beef liver and egg yolks, but citicoline is more impactful. 

And as I’ve discussed before, citicoline can also help you overcome brain fog and support the blood brain-barrier.

Make sure you read this article to learn more about the remarkable benefits of Citicoline.

 

25. Reduce Inflammation 

Reducing inflammation throughout your entire body is a key step towards protecting and regenerating myelin. 

Man experiencing inflammation in the brain. Reducing inflammation can increase myelin formation.

Researchers have found that inflammatory cytokines reduce myelination, and high levels of inflammation are often found in people with multiple sclerosis (65). 

The best way to reduce inflammation is by following an anti-inflammatory diet.

You should strive to eliminate all gluten, refined carbohydrates (particularly flour), and processed food from your diet, and increase your intake of vegetables, fruits, wild fish, grass-fed beef and pastured chicken.

My free Grocery Shopping Guide for Optimal Brain Health contains a bunch of healthy anti-inflammatory foods that you can eat on a regular basis. 

Taking curcumin and krill oil supplements can also significantly reduce inflammation in the body and brain. 

Make sure you also check out this article for 23 effective ways to reduce inflammation in the brain.

 

26. B Vitamins and Methylation

A number of different B vitamins can increase myelin and help your body regenerate myelin. 

Vitamin B12 plays a key role in the generation and function of myelin.

Researchers have found that low vitamin B12 levels are significantly associated with myelin degeneration (66, 68). 

Other studies have also shown that people with multiple sclerosis often have abnormally low levels of vitamin B12, and vitamin B12 injections significantly improve their symptoms (67). 

The B Vitamins, including B1, B2, B5, B6 and B12. B Vitamins can help the body form new myelin sheath.

According to Dr. Perlmutter, author of Brain Maker and Grain Brain, vitamin B12 deficiency enhances the destruction of myelin and compromises the ability of the body to repair and rebuild damaged myelin sheath. 

Folate is another B vitamin that plays an important role in the maintenance of myelin. Studies have shown that a deficiency can lead to reduced levels of myelin (69-70). 

S-adenosylmethionine (SAMe) isn’t a B vitamin, but along with folate and B12, it is involved with methylation, and has been shown to increase the development of myelin (71). 

One amazing study found that biotin (Vitamin B7) activates enzymes involved in myelin synthesis and 91% of patients with multiple sclerosis improved with high doses of biotin. Two multi-centric double-blind placebo-controlled trials are currently underway (72). 

Lastly, pantothenic acid (Vitamin B5) can indirectly help with myelin formation because it helps with the synthesis of fatty acids and myelin is mostly made up of fat. Myelin has been shown to degenerate in chickens that are deficient in B5 (73). 

 

27. Probiotics and Prebiotics

It is estimated that 100 trillion bacteria, and 500 to 1,000 species of bacteria, live in the human gut.

These gut bacteria, collectively known as the gut microbiome, help with digestion.

But an increasing amount of research suggests that gut bacteriaalso communicate with your brain through the microbiome-gut-brain axis.

And probiotics and prebiotics can improve your brain health and support myelin production by actually changing the mixture of bacteria in your gut.

Probiotics are live microorganisms with health benefits when consumed, generally by improving or restoring the gut microbiome.

Meanwhile, prebiotics are substances that humans can't digest, so they pass through our gastrointestinal tract and promote the growth of many different strains of good bacteria in your gut. Essentially, prebiotics are food for the probiotics in your intestines.

Research has found that your gut microbes affect the structure and function of the brain by regulating myelination. Probiotics and prebiotics can help upregulate the genes linked to myelination and myelin plasticity (86).

Prebiotic-rich foods include sweet potatoes, carrots, onions, asparagus and squash. These foods are included in my free grocery shopping guide and you should try to eat them as much as possible.

To increase my probiotic intake, I take Optimal Biotics, which is a premium probiotic supplement that improves my mental health.

I also like to drink kombucha and eat fermented foods regularly.

Check out this article to learn more about probiotics and prebiotics, and how you can use them to improve your brain function.

 

28. Reduce Exposure to Electromagnetic Fields (EMFs)

“I have no doubt in my mind that, at the present time, the greatest polluting element in the Earth’s environment is the proliferation of electromagnetic fields.” - Dr. Robert Becker, Nobel Prize nominee and author of The Body Electric: Electromagnetism And The Foundation Of Life

You won't hear many people talk about this but it needs to be acknowledged.

An increasing amount of research is showing that electromagnetic frequencies emitted from Wi-Fi, laptops, and cellphones can negatively affect the brain and produce widespread neuropsychiatric effects including depression (59). 

It’s an inconvenient truth that needs to be talked about, rather than downplayed, ignored and dismissed.

Image of EMFs surrounding a home. EMFs can reduce myelin formation, so you are best to avoid them or limit your exposure to them.

Some people are more sensitive to them than others. I’m one of them. 

Two environmental doctors have told me that I’m sensitive to environmental radiation, and some of my symptoms can be traced back to EMF hypersensitivity. It's likely why I benefited so much from neurofeedback, as EMFs can affect brainwaves (74-78). 

I suspect a lot of people are dealing with the same problem. 

This research paper explains that there is an association between EMF exposure and myelin deterioration, which may account for many of the symptoms that people with EMF hypersensitivity experience (58).

So if you’re trying to rebuild myelin, it’s a good idea to limit your exposure to EMFs.

How do you that?

I'm still learning about how to manage and combat them, but here are some initial steps you can take:

  • Get an EMF meter to determine your exposure. I use this one. It's the best option that is currently available. It measures electric, magnetic and radiofrequency fields. It's like having three meters in one.

  • Put your phone on airplane mode when you’re not using it. Or use a radiation-blocking phone case such as Safe Sleeve. I did a lot of research into radiation-blocking cases and Safe Sleeve is the best on the market. They are manufactured with materials that have been 3rd-party tested to block 99.9% of radiation coming off a cell phone.

  • Turn off Wi-Fi at night while you’re sleeping.

  • If you have a laptop, don’t touch it. Use a wired keyboard and wired mouse instead.

  • Supplement with the herb Rhodiola. It has radioprotective effects (60-62). I previously wrote about Rhodiola here.

This is just the tip of the iceberg. There are many other steps you can take, and I plan on writing more about this soon because it isn’t discussed enough.

This may seem like “woo-woo” but it’s a real issue. And I suspect it will eventually become one of the biggest issues of our time.

 

Conclusion

You don’t have to let your brain deteriorate over time. 

You have the power to maintain it and rebuild the myelin within it. 

Overall, the above 27 steps can help your body regenerate myelin. They have really helped me.

I hope you implement some of them into your daily life and you notice your brain functions more optimally. 

 

Enjoy This Article? You Might Also Like My FREE Food Guide for Optimal Brain Health!

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Live Optimally,

Jordan Fallis

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References:

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874087/

(2) http://www.bbc.com/news/health-23932577

(3) https://www.ncbi.nlm.nih.gov/pubmed/20504680

(4) https://www.ncbi.nlm.nih.gov/pubmed/26401995

(5) https://www.ncbi.nlm.nih.gov/pubmed/3884391

(6) http://www.jbc.org/content/249/1/72.full.pdf

(7) https://www.ncbi.nlm.nih.gov/pubmed/21802524

(8) https://www.ncbi.nlm.nih.gov/pubmed/26725831

(9) https://www.ncbi.nlm.nih.gov/pubmed/1383426

(10) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179190/

(11) https://www.ncbi.nlm.nih.gov/pubmed/3624305/

(12) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2649700/

(13) https://www.ncbi.nlm.nih.gov/pubmed/3624305/

(14) http://www.ncbi.nlm.nih.gov/pubmed/22664333

(15) http://www.ncbi.nlm.nih.gov/pubmed/21939673

(16) http://www.ncbi.nlm.nih.gov/pubmed/22673824

(17) https://www.ncbi.nlm.nih.gov/pubmed/1382522

(18) https://www.ncbi.nlm.nih.gov/pubmed/15793579

(19) https://www.ncbi.nlm.nih.gov/pubmed/22355115

(20) https://www.ncbi.nlm.nih.gov/pubmed/18837051             

(21) http://www.ncbi.nlm.nih.gov/pubmed/22017963

(22) http://www.ncbi.nlm.nih.gov/pubmed/21103034

(23) http://www.ncbi.nlm.nih.gov/pubmed/20523044

(24) https://www.ncbi.nlm.nih.gov/pubmed/25933483

(25) https://www.ncbi.nlm.nih.gov/pubmed/18373277

(26) https://www.ncbi.nlm.nih.gov/pubmed/9291163

(27) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237628/

(28) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3274763/

(29) https://www.ncbi.nlm.nih.gov/pubmed/24835269

(30) http://wurtmanlab.mit.edu/static/pdf/1037.pdf

(31) https://www.ncbi.nlm.nih.gov/pubmed/18670181

(32) http://jnen.oxfordjournals.org/content/65/1/37.long

(33) https://www.ncbi.nlm.nih.gov/pubmed/12675022

(34) https://www.ncbi.nlm.nih.gov/pubmed/15381788

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