Innovative Approaches to Restoring Brain Function After Concussion and TBI

The brain’s ability to recover after trauma is astonishing—and often overlooked in conventional care. In this episode of New Frontiers in Functional Medicine, I sit down with Dr. David Musnick, a long-time friend and brilliant clinician, to explore how we can unlock the brain’s full potential for healing. Dr. Musnick challenges the standard of care for traumatic brain injuries and post-concussion syndrome, introducing a functional medicine approach that integrates advanced tools like Frequency-Specific Microcurrent, targeted nutritional strategies, and personalized interventions.

His insights into the stages of recovery, the importance of addressing neuroinflammation, and the role of the gut-brain connection were a true “aha” for me. We also dive into groundbreaking methods for reversing secondary brain damage, a concept that could change everything for patients and practitioners alike. This conversation is packed with actionable takeaways and hope for those navigating brain injuries, cognitive impairment, or persistent post-concussion symptoms. You don’t want to miss it.~DrKF

Innovative Approaches to Restoring Brain Function After Concussion and TBI

Traumatic brain injuries (TBIs) are often approached with a narrow focus on survival and basic recovery, leaving behind unresolved symptoms and untapped potential for true healing. In this episode of New Frontiers in Functional Medicine, Dr. Kara Fitzgerald interviews Dr. David Musnick, a leading expert in functional medicine and brain health, who shares his comprehensive and groundbreaking approach to TBI recovery and cognitive impairment.

From understanding how pre-existing comorbidities—like long COVID, Lyme disease, and mold exposure—impact brain recovery, to exploring the role of EMFs in damaging the blood-brain barrier, Dr. Musnick delivers actionable insights that challenge conventional thinking. He dives deep into tools like Frequency-Specific Microcurrent (FSM), targeted supplements, and dietary strategies to reduce neuroinflammation, promote neurogenesis, and repair the gut-brain axis.

This episode is packed with practical takeaways for clinicians and anyone supporting patients with brain injuries or cognitive challenges. Tune in to learn how a truly integrative approach can transform outcomes—even in the most complex cases.

In this episode of New Frontiers, learn about:

Dr. Kara Fitzgerald: Hi everybody, welcome to New Frontiers in Functional Medicine where we are interviewing the best minds in functional medicine, and of course today is no exception. If you’re on YouTube you can see that I am sitting next to, in the virtual space anyways, Dr. David Musnick, a long time friend and colleague from the Institute of Functional Medicine. We’re going to be talking about his approach, a functional approach, to traumatic brain injury today. You’ll have lots of notes. He’s brilliant, he’s funny, he’s cutting edge, so let me give you his background and we will jump right in.

Dr. Kara Fitzgerald: Dr. David Musnick, MD, has been in practice for over 30 years. His field of expertise includes functional medicine, sports medicine, and internal medicine. He’s a leader in cutting-edge sports medicine treatments, which include prolotherapy, scar therapy, low-level laser therapy, Frequency-Specific Microcurrent, and chronic pain management. He’s also been working with TBI patients in particular for over 20 years and published a great chapter in Oxford University Press, Integrative Neurology in 2020. We’ll be touching on some of that content as well and we’ll link to it in the show notes. He is on faculty, as I mentioned earlier, at the Institute for Functional Medicine for many, many years. He teaches sports medicine at Bastyr. He’s faculty at University of Washington Sports Medicine and Orthopedics. He’s also author of multiple textbook chapters, including this Oxford University Press Chapter and he is the author of the book Conditioning for Outdoor Fitness. Dr. Musnick, welcome to New Frontiers.

Dr. David Musnick: Thank you.

Dr. Kara Fitzgerald: Alright, so let’s jump right in to traumatic brain injury. First, let’s just talk about a standard of care approach.

Dr. David Musnick: The standard of care approach is, if someone has a concussion– I mean, we’d probably at some point want to differentiate what’s the difference between a concussion and a TBI— But if someone has a concussion and they do go to the emergency room, then the main job there is to rule out a brain bleed. They’re probably doing a CAT scan to rule out a brain bleed and oftentimes the ER docs will tell the individual, or the parent of the individual, to have them rest. Literally have them rest and if they have headaches to come back and if they have any major symptoms, go to a neurologist.

Dr. David Musnick: So if they go to a neurologist, the neurologist does not actually work off a pathophysiology model of what actually goes on in the brain. What they do is they just label it, yes, you had a concussion, or yes, you have post-concussion syndrome, or label it as yes, you have TBI, but that’s past the time of post-concussion syndrome. And then they will either refer them for speech therapy or not, and then they’ll have them come back in a month. I’ve had so many patients say, what does this come back in a month program? And they literally go back every month and they just literally document their symptoms.

Dr. David Musnick: Now in the sports arena it’s a slight bit different because they want to make sure you’re outside the two week zone. Because if a person gets another concussion within two weeks they can have fatal brain edema. And that’s why there’s been all this business about, let’s decrease the risk of another concussion within two weeks because of brain edema. There are specific types of testing that are done before they might let a person who’s an athlete go back into a contact sport, but basically, the pathophysiology is not addressed.

Dr. Kara Fitzgerald: Okay, thanks for that overview. Let’s just define a couple terms since you brought them up. Concussion, post-concussion syndrome, and traumatic brain injury. Let’s just tease them out.

Dr. David Musnick: Okay. A concussion can be a direct head injury or it can be indirect, because you will hear about people that have a whiplash injury and auto accident or they fall but they don’t hit their head and then they have concussion type symptoms. In other words, it’s a mechanical stress to the brain. And sometimes people report seeing stars, they report lightheadedness, and then they can start reporting what would be called post-concussion syndrome symptoms. And the list is pretty long, but it starts with fatigue and sleepiness where people will literally want to sleep for 12 or more hours for days on end. Headaches, and I do want to differentiate that headaches can also be related to the neck. They can be related to the head injury, but people have to look at the upper cervical spine.

Dr. David Musnick: It’s almost impossible to get an actual head injury without injuring your neck. So I would say there’s sort of a crossover between upper cervical spine injury and post-concussion syndrome symptoms like headache, nausea, dizziness, that’s interrelated with upper cervical injury as well. So sometimes it’s appropriate to get an open mouth X-ray because remember, a regular two view X-ray does not show all of the upper cervical spine. And then there could be visual issues and there could be nausea, and as I said, fatigue and sleepiness. Those are the most common things. Post-concussion syndrome.

Dr. Kara Fitzgerald: What’s the timeline for post-concussion syndrome?

Dr. David Musnick: The post-concussion syndrome usually starts right away. And then I’ve seen probably more than 500 concussion patients, so I’d say even on the basis of my own experience, usually they’re either gone or they’re still there. It depends if they get treated for this. Because like I said, most of time they don’t get treated for it. And it depends. If they see a chiropractor, they’re going to get treated for the cervical malalignment issues. If they see someone who could deal with the craniosacral or the cranial things, they’ll get treated for that. But they can also have vagus nerve injuries. You’d expect most post-concussion syndrome symptoms to be gone by six weeks. The definition of TBI, especially MTBI, which is mild TBI, is that it’s brain-related symptoms, specifically. It’s not headache, not nausea, not dizziness. It’s brain dysfunction in any number of brain regions, whether it’s the forebrain, the midbrain, the hippocampus, it’s specific brain region dysfunction. So I think it’s very important that anybody treating this or dealing with this has a way to assess brain regions.

Dr. David Musnick: There’s a really good three-page questionnaire that Datis Kharrazian developed originally and it’s called a Brain Region Localization Questionnaire and it’s excellent because in about 10 to 15 minutes someone can answer all the questions and you can look and see what brain regions are actually dysfunctional in TBI.

Dr. Kara Fitzgerald: Okay. We’ll link to his page or if we can access the document, we’ll link to that, but folks, we’ll chase it down for you and we’ll put it on the show notes. So, post-concussion syndrome, so the concussion happens, the brain bleed would be ruled out at the emergency department, but then they are in or transitioned into post-concussion syndrome, which you described. And then TBI is specific to the brain, and that’s going to kick in maybe immediately, I would imagine, or later, and this is what can keep going until there is a holistic approach.

Dr. David Musnick: Yes. I would say the term TBI, or MTBI which means mild TBI, is usually used as a diagnostic term. Either you’re billing insurance or you’re not, but it’s used as a diagnostic term. And then the term concussion can be used or post-concussion syndrome can be used. But when you’re really working, especially if you’re working with someone who’s past 10 to 12 weeks from the event, then you’re talking primarily about mild TBI in regard to the brain dysfunction that you would find from doing a history and from doing the brain region localization, as well as a physical exam, because you do have to do a physical exam.

Dr. Kara Fitzgerald: Let’s move into the pathophysiology because it’s extensive and there are areas of imbalance that we in functional medicine have thought about for the most part, but it’s extensive. So I want to talk about that. And I’m also curious, David, if you can layer in the different brain regions, what might be lighting up of the various mechanisms given a particular region. Just as it comes to you. We don’t have to be super exhaustive.

Dr. David Musnick: Do you mean in terms of what might—I mean, let’s just take an example. A person could have difficulty creating words. That’s Broca’s motor speech, but they can have difficulty finding words, and that could be in the parietal and temporal areas. So just getting people to answer questions about these things will categorize these brain regions. The other thing that’s really important, Kara, is when you take a history of a person who had a head injury, you want to find out, okay, what part of your head did you hit?

Dr. David Musnick: Let’s say someone fell backwards and hit the occipital area. Then you would expect, potentially, an injury to the cerebellum and you might expect balance problems or coordination. But the interesting thing is there’s often problems on the other side of the brain. So you’ve got to think, okay, there’s a problem maybe in occipital region and the frontal region. But what’s also interesting is in the anatomy of the skull, the temporal regions of the brain, because of the bony anatomy, are often impacted in almost any concussion.

Dr. Kara Fitzgerald: Wow. That’s interesting. Okay, let’s talk about the pathophysiological mechanisms. They’re extensive.

Dr. David Musnick: They are, and it’s totally fascinating when you learn that all these mechanisms are potentially going on and they’re being completely ignored in a conventional approach. Either someone sees a primary care provider, the pediatrician, the neurologist, they’re all ignoring it because they’re working on a model—which you’re familiar with—which is label it and then think of one thing for it. Label it and–

Dr. Kara Fitzgerald: They confirm the individual is going to survive, or if they need to be hospitalized and they’re in a coma, etc., etc. There’s a direction. There are tools in the toolkit for those more severe head injuries.

Dr. David Musnick: Right. But for the vast majority of people, they don’t have a brain bleed, they don’t need to be hospitalized, they don’t need an operation. They need this approach that you and I are going to be talking about because if they don’t get this approach— and this is really important before we go into pathophysiology, is that there’s a concept of the actual mechanical sheering of the neurons and the synapses and the synaptic anatomy which damages it. But then there’s something called secondary brain damage, which is if the pathophysiology is not managed, there will be more loss of neurons and synaptic networks than there needs to be. And sometimes, believe it or not, the secondary brain damage is as much or more than the initial trauma, which has been fascinating to me ever since I studied this.

Dr. Kara Fitzgerald: Yeah. Yeah.

Dr. David Musnick: Okay, so you want to go into pathophysiology? Okay. And then interrupt me if you want more details on something, because I definitely want to give more details on neuroinflammation and certain things. And neuro excitotoxicity is really interesting. So, you get the mechanical shearing forces, and then you have what’s called brain edema. You actually have increased fluid in the brain, you have brain edema, and then we have damage to the blood brain barrier. And I do want to talk about that a little bit more, but I just want to list these things right now so people can see all these things that they potentially have to deal with.

Dr. David Musnick: So damage to the blood brain barrier, and then eventually you can have what’s called blood brain barrier permeability, which is similar to tight junction protein issues in the gut happening in the brain. Then you have relative hypoxia in regard to damaged areas, but now what I’ve been seeing in the past number of years is hypoxia where you wouldn’t even expect it. Dysfunction where you wouldn’t even expect it and I’m starting to look into this red cell viability issue and what’s happening to our red cells in terms of oxygen delivery.

Dr. Kara Fitzgerald: Interesting. That’s a teaser. You’re going to have to circle back to that. I’ll just make a note.

Dr. David Musnick: That’s fascinating. And then you have mitochondrial dysfunction, which is quite significant in brain injury, with decreased ATP production, damage in mitochondria, and then you have oxidative stress, which damages mitochondria, the blood brain barriers– So a lot of these things are interrelated. Something that’s also fascinating is protein folding abnormalities. And then you have an issue regarding neurogenesis and synaptogenesis, which I would say are pathophysiological pathways because the clinician needs to figure out, how do I enhance neurogenesis? How do I enhance synaptogenesis? And then you have other issues and one of the subcategories of brain inflammation is microglial dysfunction. We’ll probably talk about that.

Dr. David Musnick: Hormones. Then there’s other issues that can occur, like the pituitary can actually get damaged. You can have pituitary dysfunction, sex hormone dysfunction. You can even, and I’ve seen this, have dysfunction of antidiuretic hormone, where people start having frequent and polyuria because they don’t have enough antidiuretic hormone. And I’ve actually seen that in long COVID, but I’ve been seeing it in concussion patients.

Dr. David Musnick: The other issue which gets interesting is in pathophysiology. And it really comes to the question, what kind of brain did someone bring into this concussion? Was it a normal brain or was it someone that had prior concussions? Because if they had prior concussions, they lost neurons already. They have what’s called primed microglial networks. Or do they have mold biotoxins? Do they have Lyme? What else did they have? Heavy metals? Because that’s something that needs to dealt with in regards to the more chronic case. If they’re slow to heal or they’re not getting better as you think they should, you have to start dealing with those other functional medicine factors.

Dr. Kara Fitzgerald: So, somebody comes to you who’s a football player, maybe they played college, pro, or an athlete in high school where they’ve had repeated head injury, I think they’re vulnerable to more head injuries. And correct me if I’m wrong that one can beget another, beget another… But they also have some of that residual damage, especially if they’re only working within the conventional arena that’s basically just making sure they’re alive.

Dr. David Musnick: Yeah, right. You brought up an interesting point, because say someone has multiple head injuries. You can think that each head injury someone’s had, they’ve lost certain neurons and they’ve lost certain synaptic networks and they’ve got what’s called primed microglial populations. I’ve had patients that had, let’s say, two concussions that were worse than the most recent one, but now they’re having big problems from the most recent one. It’s sort of like, okay, you’ve already had a decrease in brain reserve. Brain reserve is a key concept. Brain reserve is related to each area of the brain, how much reserve there is, because below a certain line, if you want to draw an X and Y axis, you’re going to have symptoms. But you have to have lost a certain amount in an area, say, Broca’s motor speech, before you have trouble speaking, right?

Dr. David Musnick: So you have to have lost a certain amount there. But a lot of people, depending on what’s going on in their brain, they’re hovering right around the line of brain reserve. So they’re just a little bit above, then they get a little head injury and they drop below and they say, why am I having so many symptoms? That’s because they didn’t come into it with a normal amount of brain reserve in that area of the brain. And I’m seeing this even more. You do see this more in older people. You see this more in people that have had concussions. But you also see this in people that have had other brain insults. I consider long COVID, in a lot of people, a brain insult and then the post-vaccine injury, a brain insult, mold, biotoxin issues or Lyme… It just depends what they’re coming in with in terms of how much brain reserve they actually have. So, we might hit another pathophysiology pathway because there’s about 14 of them. I’m not looking at my slideshow right now because I’m on my PC.

Dr. Kara Fitzgerald: We made you get on your PC, that’s so funny. Well, can you just speak a little bit, because I know it’s in people’s brains, a little bit about CTE and where that falls here.

Dr. David Musnick: CTE stands for chronic traumatic encephalopathy. That is a diagnosis in a person that’s had multiple concussions. Usually, in order to make the diagnosis, the person has had multiple concussions. It’s usually associated with the hippocampus and medial temporal lobe problems, memory issues, a lot of brain dysfunction, but a lot of issues regarding emotional instability: anger management, depression, and oftentimes, people are suicidal. There was a lot of notoriety regarding this. There was a movie called Concussion and there’s been a number of professional athletes that have committed suicide.

Dr. David Musnick: So I think it’s important for people to understand that if you’re dealing with someone that’s had multiple concussions, you’ve got to think about this and then you really need to apply everything we’re talking about to this because it can be treated. I’ve treated a bunch of these patients and I’ve gotten them to pretty good shape, but there’s no drug for it. You have to use this pathophysiology approach and really ask yourself some questions. In those people, you have to deal with limbic system issues and stabilize the emotional stuff so they don’t commit suicide.

Dr. Kara Fitzgerald: I want to hear some cases from you around that. It’s funny, we’re digressing a little bit, which we should be. Maybe we’ll circle back to some cases. But I want to just point out, I just want to underline something you said that was really crucial to the conversation. One needn’t actually have a head injury to have a head injury. You could have long COVID. You could have Lyme. You could perhaps layer on APOE4. You could have…

Dr. David Musnick: Yeah, but let me differentiate this because I think it’s important. I want to use the term head injury for a mechanical issue. So you can have a direct head injury, you slip and fall. I’ve had kids or someone kicked a soccer ball to their head. I had a guy today who fell off a surfboard one time and hit his head on a rock, another time the surfboard hit him. So that’s a direct mechanical insult that leads to these shearing forces and then all the pathophysiology that I talked about. Then you could have someone that has an indirect head injury, like a motor vehicle accident with a whiplash and so you can have people that did not have a direct head injury complaining of head injury symptoms, post-concussion syndrome.

Dr. David Musnick: If you have someone who has something that causes a brain infection, or brain inflammation, or brain toxicity, I do not call that a head injury. I call it a brain insult, but some of these pathophysiology mechanisms still apply, like microglial morphology changes and the damage to neurons, the need to induce synaptogenesis and neurogenesis. There is a big overlap with these things and some of the patients who hit their head have some of this other stuff going on. Or I’ve had people that stopped my program too early—and I’ll tell you what too early is— and then they had a virus and the head injury symptoms “came back” because it appeared that the virus was affecting the central nervous system as well as their body, and they went into what I call “below the line” that I was talking about where they go, yeah, I’m having symptoms.

Dr. David Musnick: That’s why I finally decided with my patients to say, you’re adhering to the brain diet that I developed and you’re taking these supplements until three months after you don’t have any brain related symptoms. And when I started putting that into place, I wasn’t having people relapse unless they had a new head injury.

Dr. Kara Fitzgerald: I want to go into the protocol, but you could use this for a brain insult or a brain injury. Would you say that’s correct? You could use the protocol that you’ll talk to us about?

Dr. David Musnick: Yeah. What I would say, and this is fascinating. You probably know that I started developing this in 2016, but for about 15 years before that I was treating a lot of brain injuries referred to me from the ER. So I was piecemeaing things together that were “integrative or functional”. But when you start looking at the brain insults, you can categorize some of this stuff as, what’s the pathophysiology of “long COVID”? What’s the pathophysiology of aluminum toxicity, or Lyme or whatever it is. There are some crossovers, and also the key point I want to make for any clinician trying to manage these people, is if someone isn’t considerably better within twelve weeks of the original head injury, you’ve got to start looking at what I call these comorbidity issues.

Dr. David Musnick: Because you may have an issue with spike protein in the brain or you may have an issue with heavy metals. I mean, you’ve just got to decide what it is and what to go after. We’ll also talk about the relationship with insomnia and sleep problems, but one thing I want to say that’s fascinating is that there’s a lot of information that I’ve uncovered here that’s in tune with the Bredesen approach to cognitive impairment, but goes beyond it in some ways because I’ve adapted my program to patients with mild cognitive impairment and early dementia and it works. It helps them considerably, so there is a crossover with that too.

Dr. Kara Fitzgerald: There are plenty of clinicians listening to this and there’s regular people who probably want to bring this to their clinicians’ attention. In terms of a good history, are you using a modified functional medicine intake? We’ll have IFMCP people here and they’ll have access to some of those tools. Is that a resource or is there anything that you’re willing to share on our show notes?

Dr. David Musnick: Yeah, so I always do the Brain Region Localization Questionnaire, but I’ll just sit there and ask the parent or the patient. I want the mechanism. I want to know the mechanism. If it’s a car accident, you know, all the mechanism issues. What way did your head move? If it’s following hitting your head, what part of your head did you hit? We use the IFM initial questionnaire, but I will tell you this, a lot of patients, if they had a head injury and it’s not their parents filling it out, they can’t even fill out a lot of those forms. There’s too much of it.

Dr. Kara Fitzgerald: So you will work with them on it?

Dr. David Musnick: So yeah, I’ll still work with them because some of these people, you’ve just gotta get them in because they have so much brain fatigue. You know what that is? It’s like they can only use their brain for half an hour and then they’re done. It depends on their brain energy as to how much of these forms they can fill out. I like to know what the pre-existing comorbid conditions are because then I know if I need to start dealing with them right away. We talk about staging and a timeline. What are you going to do? How are you going to introduce things? I like to know about that. But in general, I want to know the mechanism of injury from the person, from the parent, whoever it is.

Dr. Kara Fitzgerald: Yeah. I think in these cases where there’s pretty severe trauma, they need a support person, just like when you’re working with somebody who’s got cognitive impairment of any extent there needs to be—

Dr. David Musnick: Right. The other thing is if they have a video, I want to see the video. I saw the other week—I could not believe this— a 14-year-old boy who was kind of small for his age and had an ice hockey head injury where some kid, and I think the kid that did it was one and a half times his size, came up and pushed him and his head hit the glass. He fell to the ground and he hit his head again. I mean, talk about a mechanism of injury. I could see it directly because he had two hits to the occipital area. So, certainly if someone has a video you want to see that too. You want to see the mechanism. The main thing is I want to know how severe it is, I want to know how aggressive I need to be, and I want to be able to impress upon people how important it is to do this program.

Dr. Kara Fitzgerald: And folks, we’ll hound Dr. Musnick for any tools he might send our way and I’ll put them on the show notes. Or any papers, we’ll link to the book that he’s got a chapter in. But the other piece, and I guess this is why I’m harkening back to the intake questionnaire that we created at IFM, is that it’s going to cast that wide net of comorbidities, as you said. We’re going to be thinking about vaccines, we’re going to be thinking about incidence of COVID or Lyme disease or mold or toxin exposures. We’re going to be looking at diet and all of those secondary pieces. We’ll be looking at family history and whether there’s a pattern of dementia or neurodegenerative conditions, APOE status.

Dr. David Musnick: Right.

Dr. Kara Fitzgerald: And if you’re working with an individual who’s too damaged to relay a history of that depth, then you either hold on it or you talk to their support person.

Dr. David Musnick: Yeah, but you brought up some good points. And I would add a few other things. I would add, what do you do for exercise? Because sometimes they’re going to start doing stuff that could re-injure themselves. So I always want to know what sporting activities do you do? What contact activities do you do? What kind of competitive events are coming up that you want to do? And then I take a really in-depth electromagnetic field history. Because there’s a lot of information on how electromagnetic fields damage the blood brain barrier. And so I want the history to know that I’m going to advise them on how to mitigate the electromagnetic fields. I also want to know their dietary history.

Dr. Kara Fitzgerald: When are you going to be flagged that EMF has played a role in what you think is a blood-brain barrier pathology?

Dr. David Musnick: The way I do this is I make EMF suggestions to all these patients because I don’t know that I’m going to be able to diagnose if their blood brain barrier is also damaged with this, except to tell them there’s studies that show that EMF— And remember, EMF is broken down into three parts: radio frequency, electrical and electromagnetic fields. And most, but not all of the EMF is the radio frequency from the cell phone and from wifi. So in general, because I know that everybody’s using their cell phone, I will make recommendations. And I say look, these recommendations are called brain protection. We’ve got to protect the neurons and the connections that you have. We’ve got to protect the blood brain barrier, so I want you to adhere to as many of these as you can.

Dr. David Musnick: Keep the cell phone away from your head. Don’t sleep next to a cell phone. You would be surprised how many people sleep with the cell phone two feet away from their head all night long. And then turn the wifi router off at night because wifi is damaging to the blood brain barrier and directly to neurons. And so I basically give everybody these EMF mitigation suggestions. There’s some patients that are really struggling with their head injury symptoms and I will send a technician to their home to do the measurements and then give even more specific EMF mitigation suggestions. These would be the more severe people.

Dr. Kara Fitzgerald: And what are some of those EMF mitigations? Would you do the various cages we can put around our Wi-Fi? Like, what are you recommending?

Dr. David Musnick: There’s actually something someone can wear that creates a scalar field. So that’s one thing. I don’t know if I can mention the name of companies, but there is a company that makes the device that you can wear that creates a scalar field. And the interesting thing about that is that it will not change the readings that a technician does, but it will decrease the biological harmful effects of the EMF and radio frequency that person’s being exposed to. So I might recommend that to somebody, either a room version or something they wear. I think the little things that you put on cell phones, I don’t think they do that much. I just want the cell phone as far away from them as possible. I show them this and I don’t want them wearing any Bluetooth in their ears. I don’t want any Bluetooth devices, so I tell them everything has to be wired and then if you want an earphone, it has to be an air tube earphone. All these suggestions just go on their note to please do these things. And if it’s a kid, the parents have to of course get involved with this.

Dr. Kara Fitzgerald: Before we move into your program and some cases, I would like to discuss some cases, I just want to talk about gastrointestinal involvement and the microbiome involvement in head injury.

Dr. David Musnick: It appears that even within 24 hours of a moderate significant head injury there’s going to be microbiome dys-ecology and dysfunction. And I don’t know that you characterize it as IBS or SIBO or something like that, but there’s definite changes in the microbiome. It’s been shown, it’s been proven. There are a number of possible mechanisms, but one of the mechanisms is via the vagus nerve, and another mechanism is just via the brain. I do think it’s also important to test people for vagus nerve dysfunction by looking to see how the palate elevates, see if they gag. I’ve been seeing people, the palate elevates, they don’t gag at all. But I’ve been seeing people, their palate doesn’t elevate and they don’t gag, they definitely have a vagus nerve dysfunction. So I think we have to check for that.

Dr. David Musnick: And then it seems like intestinal permeability will change. But the funny thing is, and you know this, how many people have normal intestinal permeability? They might be going into this with abnormal intestinal permeability anyway, but it seems like there’s been some information that intestinal permeability can get worse or start acting up. Like I said, there’s a number of mechanisms, so what I usually do is I ask people, okay how’s your digestion and you’re gut been since this event? Are you having any gas or bloating? Are you having normal bowel movements? Try to just figure out if I could see if there’s any dysfunction thereof. And if I determine they have a vagus nerve problem, I’m going to treat that with vagus nerve exercises and Frequency-Specific Microcurrent, because I want the vagus nerve to go fully functional.

Dr. Kara Fitzgerald: And again, for our show notes, my team will grab your contact information. Are clinicians able to shadow with you? Are you taking patients?

Dr. David Musnick: I’m taking patients. Yeah, if wants to come to my clinic in Eagle, Idaho they can shadow me.

Dr. Kara Fitzgerald: You’ve got a lot to offer. You’ve been working in this arena for a long time. Let’s talk about the program you designed when you first started and some elements of it.

Dr. David Musnick: It’s really important to look for orthopedic musculoskeletal injuries and then deal with that because if someone has pain, you have to deal with that. And I find that fairly common. I’m not going to go into how to deal with that, but it’s very important because sometimes people develop sensitization of the actual nervous system that changes and then they can develop worsening pain, more chronic pain.

Dr. David Musnick: You have to assess sleep and get people sleeping a minimum of eight hours because six or less hours is associated with blood brain barrier permeability and actual brain inflammation. So you’ve got to get people sleeping and I can go into that if you want me to, but you got to assess that. And then you say, okay, where’s this person? Because I’ve broken it down into acute, subacute, and chronic. And then I say, when you get into the chronic version of it, you then have to break it down even more. Chronic with significant comorbidities, like we’ve been talking about, mold biotoxins, Lyme, co-infections, reactivated Epstein-Barr, you know, all of it. Post-vaccine issues, long COVID issues, whatever— so either chronic with no comorbidities or chronic with comorbidities that you have to address. And then I say, okay, what stage are they in? When I give slideshows on this, I actually have slides of the acute stage, and this is what you need to think about. You need to think about edema. You need to decrease edema. You need to think about oxygenation.

Dr. David Musnick: And what’s also interesting about the acute stage, you might say the acute stage is anywhere from two to five days. A lot of people wait for hyperbaric oxygen until like three, four months and they’re not doing well and they say, maybe we should add this. No, you should do it early because issues regarding brain hypoxia is an earlier issue. So if in doubt, hyperbaric oxygen, which has a lot of studies in regards to TBI showing that it can be very helpful. In the initial stages, we’re trying to limit bleeding. There’s actually Frequency-Specific Microcurrent (FSM), approach to the acute stage, versus the subacute, versus the chronic. And I can talk more about FSM because it’s extremely valuable. It’s changed my practice starting in 2009. Since then I’ve designed about 25 programs to address different brain regions and all that.

Dr. David Musnick: In the subacute phase, which might be from about five days to about six or seven weeks out, you’ve really get addressed the blood-brain barrier, you’ve got to address neuroinflammation, you’ve got to address neuro excitotoxicity, mitochondrial dysfunction… I mean those are big deals then. You need to introduce what I would call a healthy brain plan in terms of the diet at that point, in terms of certain flavonoids that I can talk about. I like to introduce things they can do with diet, supplements, the microcurrent and other things and brain challenges. And so what I would say is that you don’t start thinking about neurogenesis. Neurogenesis means actually nerve stem cells migrating from places in the brain where they exist to the injured areas.

Dr. David Musnick: You don’t really start thinking about encouraging that too much, probably until about six or seven weeks out. Then you’ve really gotta think a lot about neurogenesis and synaptogenesis. How do I encourage that? How do I get the survival of these nerve stem cells? How do I encourage synaptic branching and survival? But during the whole process, you’ve got to be thinking about microglial cells and neuroinflammation in regard to that. And then in the chronic phase, you’ve got to start thinking more about hormones and some of the things we said that could go on chronically with the comorbid factors.

Dr. Kara Fitzgerald: Talk to me about interventions for each of these stages. You don’t have to go through your whole program. I’m sure that it’s massive.

Dr. David Musnick: So let’s just say you’re lucky enough to see someone within the first two to three days, which many people are not. I used to get that because I get them right from the ER. I mean, the next day, two days later. I do homeopathy in my practice and I studied in the French School of Homeopathy, because for long time, I saw the utility of it in terms of sports medicine and then I started using it in terms of brain stuff. I would say if you get someone early besides, of course, ruling out a brain bleed, then you want to start Arnica 6C, five pellets under the tongue every 15 minutes for four times and then every two to three hours. It will actually limit, probably, brain hemorrhage. And then if I see someone early, I’m going to start the acute brain protocols with Frequency-Specific Microcurrent.

Dr. David Musnick: And then you’ve got to limit things that might inhibit platelets too early because you don’t want more brain bleed. You have to start limiting neuro-excitotoxicity so I tell people, you’re off your calcium supplements actually during the whole period of time we’re doing this because I don’t want the NMDA receptor issue going with the excitotoxicity. I talk to them about limiting neuro-excidotoxicity. I see people coming in chewing gum and I want to know what the sweetener is. We talk about aspartame and limiting that. I usually put them on magnesium threonate right away. Otherwise, I’ll put them on a different type of magnesium. But the threonate seems to be better for the brain to limit neuro-exitotoxicity. We talk to them about how to avoid hidden sources of MSG. But then get into pretty quickly about how to sleep, how to get enough sleep and then how to modulate neuroinflammation.

Dr. Kara Fitzgerald: Let me stop you. So MSG for the glutamate and the excitotoxicity. But sleep– You say that you’ve got to get them sleeping. What are you doing? I mean, are you using medication or is it sleep by all means necessary? How are you doing the sleep piece? Because I would imagine that insomnia kicks right in for some of these individuals.

Dr. David Musnick: It does. I’m going to say something funny, Kara, then I’ll tell you. So if you want the hour version of that, I’m giving a presentation on sleep at the Advanced Frequency-Specific Microcurrent meetings in Chandler, Arizona in early March. But–

Dr. Kara Fitzgerald: Okay, awesome. We’ll link to resources as we can for you, for sure.

Dr. David Musnick: Yes, well, that’s an incredible meeting anyway. But what I would say is I will often put people on low dose melatonin. I always tell them, 1.5 hours before you want to go to sleep, I’ll put them on blue-light blocking glasses because we’ve got to get deep sleep going on here. And then I set a bedtime. Of course, most people don’t have a bedtime. Most adults, they don’t have a bedtime. The kids say they have a bedtime and then they stay up all night on their devices. So I’ll limit devices and use blue-light blocking glasses. And then there are certain things that I’ll do to encourage sleep. I’ll tell people, look, I don’t want you just lying there if you can’t fall asleep. I want you reading. I just found that reading with a low blue light source is the best thing to put people to sleep and I don’t want them on a device within half an hour of that. And then I found a couple of homeopathic medicines that are incredible to get people sleeping, if you want to know what they are.

Dr. Kara Fitzgerald: Yeah, tell me.

Dr. David Musnick: One is coffea cruda. Have you heard of that?

Dr. Kara Fitzgerald: Mm-hmm, I have, Yeah, coffee.

Dr. David Musnick: It’s actually fascinating. It’s a homeopathic remedy related to coffee, but it stops a racing mind. What I find with a lot of people after concussion, or other functional medicine patients, is they they can’t fall asleep because their mind is racing and they’re worrying about stuff. They wake up in the middle night and same thing So I will have them take five pellets of Coffea Cruda. And then there’s also a product by Boiron called SleepCalm, which is a combination homeopathic, which I find works pretty good. I don’t usually have to put people on trazodone, but occasionally if I can’t get them sleeping any other way I’ll either use trazodone or Lunesta, but I don’t like doing that if I can get them sleeping normally.

Dr. David Musnick: The other thing to help them sleep is to get physical activity during the day, and in the morning wake up and look at the sky and the blue light in the morning. That could be helpful. And then no caffeine after 12 noon. There’s a lot of things here.

Dr. Kara Fitzgerald: Yeah, the usual sleep hygiene tips, dark room, cool room, and all of that I’m sure is a part of it. You had said you weren’t going to get into pain, but I know that’s going to be a question. Can you just give me an idea? Someone comes with a head injury and they’ve got… or maybe it was a motor vehicle, but they come to you with pain and you said that’s got to be dealt with immediately. Just give me a basic rundown of what you might be thinking about instead of just leaving it empty.

Dr. David Musnick: Well, yeah. I do a complete neck examination, especially neck and head, because a lot of times what I find is trigger points in muscles that connect the head to the neck and that creates headaches. You can’t always assume a headache is related to the brain. It may be related to a referred pattern, so I want to check for all the hypertonic muscles, and then I’ll palpate the posterior joint capsules and I’ll palpate the anterior muscles. I’ll do spinal cord tests too because I don’t want to miss a spinal cord injury. I do think it’s really important to do that. But I think most of the pain that I see is coming from muscles and tendons and joint capsules, in general.

Dr. David Musnick: I deal with that primarily with Frequency-Specific Microcurrent because it works so quickly and so well and because I find a lot of people, if they have too much pain, it’s going to make them more fatigued and it’s going to lead to them not sleeping, and we get to all these vicious cycles. So I do think it’s important to control the pain. Now, if the neck is out of alignment, chiropractic can be really helpful. Osteopathic can be really helpful. Physical therapy can be really helpful. Those things can be helpful in terms of pain. I may even use a low level laser, but most of the time I’m using Frequency-Specific Microcurrent to heal the structures that are causing the pain so we don’t keep having problems with that.

Dr. Kara Fitzgerald: What if they come to you on some kind of a pain management protocol? I’m sure you’re wanting to transition them out of it…

Dr. David Musnick: Do mean if they come to me already on a narcotic? Is that what you mean?

Dr. Kara Fitzgerald: Yeah.

Dr. David Musnick: Well, that gets tricky because narcotics slow the GI tract, they decrease motility, and there’s some information that narcotics lead to more pain sensitization so I really prefer to taper the narcotics. The other thing is a lot of people don’t know that if you use Frequency-Specific Microcurrent, you actually have to treat for narcotic interference with frequencies on channel 1 in order for it to even work. So I really prefer to wean people off those medicines. I don’t like them on those medicines very long at all.

Dr. Kara Fitzgerald: Yeah. I would imagine similar with non-steroidal anti-inflammatories as well. I mean, that’s going to slow the healing process down also, even as they help.

Dr. David Musnick: I try to get them off those very quickly because I think they can contribute to intestinal permeability, a GI bleed, even increased coronary events, so I don’t want them on those drugs.

Dr. Kara Fitzgerald: What does the diet look like in the program? What kind of a dietary pattern are you prescribing?

Dr. David Musnick: I’ve got like a three or four page handout on the healthy brain diet. I actually give it to people with cognitive impairment and concussion. It’s based on a lot of issues, so let’s just go through them. Okay. There’s all this information and Aristo Vojdani developed a lot of this basic information on autoimmunity and molecular mimicry. So they’re off of dairy and gluten for eight weeks, whether or not they have an immune reaction to it, because the immune system will see certain dairy proteins and certain gluten proteins and go after aquaporins in the brain and other structures. So, in this diet, in this program, they’re off of gluten and dairy for eight weeks.

Dr. David Musnick: Then I put them on certain foods to increase choline, because not everybody’s going to take phosphatidylcholine and I don’t want them just relying on that anyway. But phosphatidylcholine is a good supplement for the brain in regard to building back neurological membranes. You probably know that eggs are an incredible source of choline. So I have a list of all these foods that have choline in them and I want them to choose from those foods, including believe it or not, chicken. So part of the program is increase your choline.

Dr. David Musnick: Another part of the program is to eat certain things that have biochemicals in them that will help microglia shift from the M1 phase, which is inflammatory and where they don’t produce growth factors, to the M2 phase where they’re more functional. So it turns out that the molecule apigenin is very important for that phase shift to occur.

Dr. Kara Fitzgerald: Interesting.

Dr. David Musnick: Guess what food has the highest amount of apigenin in that we never eat. Parsley.

Dr. Kara Fitzgerald: Oh, is that right?

Dr. David Musnick: I wasn’t going to give you a chance to answer it because nobody can answer it.

Dr. Kara Fitzgerald: Is that right? It’s funny. I was going to say capers. Do capers have any? That’s what popped into mind.

Dr. David Musnick: Oh, guess what capers have. Quercetin. Capers are the highest food source of quercetin and quercetin has some effect on brain inflammation and in regard to the microglial shift. Apigenin and luteolin are the best, but quercetin has some effect. So I want them to eat foods with quercetin, like apples and red onions and the little green things that you just mentioned— capers. And then I want them to use parsley. I’ll tell people, look, take either a whole head of organic parsley or a half a head and you put it in a smoothie with wild blueberries. because the wild blueberries have some kind of neuroprotective effect with the anthocyanins. Wild blueberries have more of the purple than the regular blueberries. I always tell people, look, you want the stressed out blueberries because they produce the purple pigment more.

Dr. David Musnick: And so I’ll have them make what I call a brain smoothie, which basically is wild blueberries and parsley, and then plant-based protein powder that’s organic, and then things to taste. And I’ll actually ask them if they’re willing to pour in phosphatidylcholine. So I’ll have them get some liquid phosphatidylcholine to put into it. Then, if they’re willing to make a brain pesto, I’ll have them actually make a pesto that is mostly parsley and cilantro. Cilantro for the heavy mercury and parsley for the apigenin, and then organic olive oil, no dairy and basil. You can still put the basil in there to taste and then they can put it on vegetables or anything. They’re going to get a lot of the apigenin that way. Of course it’s low toxin, mostly organic, non-GMO. There’s other things in the diet, but those are the big deals.

Dr. Kara Fitzgerald: Awesome, awesome. So they’re going to transition onto that. Let’s talk about supplements. In IFM, I deliver one of the lectures on fatty acids, on fish oil. And I always bring up the handful of case reports in the literature where massive amounts of fish oil were used. I want to talk about your supplements and if you’re thinking about very high dose amounts of fish oil or anything specific.

Dr. David Musnick: I kind of know where that’s coming from in terms of the very high amounts, but this is the way I would say— I have to prioritize supplements for my patients. I try to identify what’s most important because I find if you have too many of them, they won’t take any of them. The other thing I find that is that if too many things are in a capsule, they won’t take them. There’s a lot of people in functional medicine practices, they’re already on 6, 7, or 8 capsules and so I’ve got to think about what alternative forms can get these things into people? I’m going to tell you what I think would be the most important supplements to think about for treating concussion and traumatic brain injury, okay?

Dr. David Musnick: One is in the category of neuroinflammation, which I would think that you have to address in every head injury, in every stage of it, and chronic stages, and you’ve got to address that in cognitive impairment. I mean, you’ve got to address that a lot these days. So probably most important supplement thereof would be a highly absorbable curcumin because of all the mechanisms of action. One of the things curcumin will do is activate the NRF2 gene response to activate endogenous antioxidants and anti-inflammatories. But the curcumin has to be in certain highly absorbable forms. There’s a number of studies. One of the forms that seems favorable is the Longvida form—Longvida—in terms of going into the brain. And the interesting thing about that is that there’s a company that makes gummies out of it. So if you have a kid with a concussion, they’re more prone to chew the mango gummies. They’re called curcumin gummies.

Dr. David Musnick: That’s how I get the curcumin into kids. I don’t find most people start swallowing capsules until after at least 12 to 14. So I’d say curcumin is a number one thought in terms of neuroinflammation. And then DHA and omega-3, but primarily the DHA component, I think, is really important. I don’t use mega doses of it because I usually combine it with phosphatidylcholine and a diet that’s encouraging choline. Now, I will tell you this, if someone says, doc, finances are not the issue, I will do anything. I’ll actually put them on plasmalogens.

Dr. Kara Fitzgerald: Oh, okay. Yep.

Dr. David Musnick: You’re probably familiar with Prodrome Science. At that point, I will use the ProdromeNeuro™, which you think of more for neurons, and then I’ll use in the evening ProdromeGlia™, I’ll use the loading doses. But because those things are so expensive, I won’t go to that initially, I’ll go to the omega-3s. And I’ll definitely use higher doses than I use for other issues, but I don’t know that I’m going to go to these mega doses of 15 to 20 grams. Then I think you have to start balancing it out with primrose oil or borage oil or something. I just haven’t had to do it. But I think in some of cases you’re probably talking about, someone was in the hospital, they didn’t have access to Microcurrent, they didn’t have access to phosphatidylcholine or whatever it was, so I would say that I do combine things and by combining things, I’m getting the results that I want.

Dr. David Musnick: And then I’d say another supplement is taurine, believe it not. The amino acid taurine. It has a lot of protective effects in the brain. It’s pretty important right away. A lot of people don’t think about it until they’re chronic, but it’s important right away. It helps to regulate osmolar balance and helps with decreasing edema, but it also helps with nerve stem cell survival, so it’s good at any time, and I usually use doses about a thousand milligrams twice a day.

Dr. David Musnick: Another supplement that I find incredibly helpful is the mineral lithium. Not the drug lithium, but primarily lower-dose lithium. There are so many mechanisms of action in the central nervous system that have actually been explored. Lithium was known for a while to have an effect on mood instability and anger, but it’s incredibly neuroprotective. But I would tell anybody that is going to recommend this to a patient, you have to say, look, this is a mineral. We’re going to use it in a low dose. You’ve probably heard of it for bipolar where they use it for a high dose, like 600 milligrams. We’re going to use 10 to 20 milligrams. The other thing I say is, don’t go around telling everybody that my doctor put me on lithium, because then they’ll say, well, you probably have bipolar. As long as I explain it that way, they don’t have a problem with the lithium. I’ve never actually had anybody have a problem with low dose lithium, except the perception of it. It’s incredibly neuroprotective. I use it for literally every, neurodegenerative problem, cognitive impairment, but especially for TBI.

Dr. David Musnick: And then you start getting into specialty supplements, like supplements that will increase blood flow, like Ginkgo. That can be appropriate to increase blood flow. Then you start looking at, how do I heal the blood brain barrier? There is some information that glutathione is helpful for this–we use liposomal glutathione– and high-dose, alpha-lipoic acid. I’ll usually use the R form for that. I will say for every one of these jobs, I’m going to use Frequency-Specific Microcurrent (FSM). I’ve developed program to seal the blood brain barrier and decrease neuroinflammation, but I always integrate the supplements with the FSM, if they can do the FSM.

Dr. David Musnick: Then we get into specific problem areas. Do they need specific supplements to help them sleep? Do they need Bacopa or are they having so much problem with their memory that I’m going to put them on a number of things, specifically Acetyl-L-Carnitine. I actually have a formula called Brain Memory that has most of what I want in it. And then there’s another formula that has mushroom extracts and Bacopa, and I find Bacopa very helpful for the brain. But what I find is for most people, if you start adding more than five of these, they’re not taking anything.

Dr. David Musnick: So I always tell them what the top priority is and in the note, I tell them what it’s for. I find the average patient will stop a supplement after a month if they don’t know what the purpose of it is. So I’ll say curcumin for neuroinflammation, or lithium for brain protection, taurine for encouragement of survival of stem cells, that kind of thing, and then they’re more likely to stay on them. The other thing I think I told you at the beginning is that I tell people, unless I say differently, you’re going to be on these for three months after you don’t have any symptoms, which then encourages full healing.

Dr. Kara Fitzgerald: Yeah, so tuck in. This is the journey ahead.

Dr. David Musnick: You’re going to create a better brain.

Dr. Kara Fitzgerald: I think just really having as much disclosure on the program and the duration and all of that is incredibly important for getting adherence.

Dr. David Musnick: Yeah, it is.

Dr. Kara Fitzgerald: So you’re seeing patients remotely. Well, I guess my question first of all is, if you’re doing Frequency-Specific Microcurrent, you’re seeing them in office quite a bit. But I know you’re also doing…

Dr. David Musnick: Yeah, I see them. I do telemedicine and I do in office.

Dr. Kara Fitzgerald: Yeah, so what are you doing in place of Frequency Specific? Well, I guess two questions. How often do you do Frequency-Specific Microcurrent in office with a patient? I would imagine it depends on how acute the situation is.

Dr. David Musnick: I’ll tell you. Let’s say it was that kid that was literally thrown against the glass. I was really worried. I’ve had a bunch of people I was really worried about. I’ve had kids that were in the neurointensive care in the hospital where the pediatrician and the pediatric neurologist said, there’s a 90% chance you’re going to have serious brain damage. And at the end of my program, no brain damage, nothing, no symptoms, nothing.

Dr. David Musnick: And you know, of course then they go back there and occasionally the neurologist will say I was wrong. They don’t usually ask what they did. If they do ask what they did, they go, I don’t understand that. But if it’s a bad injury, it’s twice a week for two to three weeks. If it’s less bad, twice a week for two weeks, and then once a week for four more weeks, and then every other week for two weeks, something like that. I like to go out 10 to 12 weeks.

Dr. Kara Fitzgerald: What are you doing with your remote patients?

Dr. David Musnick: Well, that’s when we do one of two things. I get online and put their zip code in to find out if there’s someone nearby. I usually end up coaching them because there’s only a few people that have as many brain programs as I’ve developed and there’s a few practitioners in the world that have developed brain programs. The average practitioner doesn’t have many of them. They have some of them. So then I have to call the practitioner wherever they are within 25 miles and say what kind of brain programs do you have? Do you do it? How current are you? If I can have them establish with someone, I do. Otherwise, I will program a microcurrent unit, we’ll mail it to them and train them how to use it.

Dr. Kara Fitzgerald: Okay, Okay. It’s just a fundamental part of your intervention.

Dr. David Musnick: It is. Yeah, I started using it in 2009 and my results for the brain were significantly better than before I started training in it.

Dr. Kara Fitzgerald: That’s extraordinary. I got to shadow Dr. Carol McMakin when I was a student and I just consider her a mentor and adore her and it was quite an honor to be able to see the work that she did and some of the patients that she just turned around in an extraordinary way.

Dr. David Musnick: Yeah, and since you were shadowing, it’s gotten much more sophisticated and advanced. In terms of treating the brain, it was very early back then when you were shadowing, but now it’s gotten extremely sophisticated, because it’s a two channel microcurrent system. The first channel is the conditions. So we’ve gotten even more sophisticated in terms of channel 1 frequencies, because they are actually channel 1 frequencies for virus, for mold biotoxins, for toxins and metals, and even COVID. And so we got more sophisticated with that. And now we’ve got protocols for the vagus nerve. So you can actually restore the vagus nerve and get it back functioning again, as well as you can treat the blood brain barrier and the GI tract and augment treating permeability. So yeah, I do think it’s extremely important if a patient can get this treatment.

Dr. Kara Fitzgerald: I want to do a case, but before we go into a case, give me what kind of labs you’re doing. And given the gut involvement that you routinely see, are you doing a stool test? What kind of labs are you doing?

Dr. David Musnick: I think it depends on the symptoms. I would say the labs would be more common in the chronic stages. Past 8 to 10 weeks, they’re still having symptoms, I’m going to do sex hormones, because I’ve seen all kinds of things. I’ve seen low antidiuretic hormone and I’ve seen thyroid disorders, because you can have pituitary injury. So I want to run those. I may run a heavy metal challenge test. If there’s any suspicion of mold biotoxins, then I’ll run the mold biotoxin labs. There are specific tests for something called S-100B. It’s an antigen from the brain and the blood brain barrier. Cyrex lab does that, LabCorp does it, ARUP Labs does it, and Vibrant America Lab does it.

Dr. David Musnick: Vibrant America Lab does more blood brain barrier testing than anybody else. They actually even have an Anti-Microglia Antibody Test. A number of things— So they have a basic test called the Neural Zoomer, and they have another test called Neural Zoomer Plus. The Neurozoomer Plus is almost like a Cunningham Panel or more, with a lot of brain autoantibodies, and so I will run that. If I think someone’s got a lot of issues, I want to know, do they have brain autoimmunity?

Dr. Kara Fitzgerald: Sure.

Dr. David Musnick: And then sometimes I’m going to run an Epstein-Barr panel because I’ve had people that have cognitive dysfunction a little too far into that head injury and I want to know, did they have reactivated Epstein-Barr? I will run a CRP, I’ll run an anti-nuclear antibody, and of course, I’ll just run a regular hematocrit. I’ll run iron studies. It really depends on what the other problems are.

Dr. Kara Fitzgerald: Okay. Why don’t you give me a case that comes to mind? Maybe if you want to walk us through this boy who was checked into the wall playing hockey or another one that comes to mind.

Dr. David Musnick: Yeah, the other one is quite similar. There’s a lot of them. So the other one is perhaps an even better case because it was a 14-year-old that was riding his bike. If you ever go to Boise, if it’s not winter, you want to ride the Greenbelt Trail because the Greenbelt is this 25 mile trail along the Boise River. It’s quite scenic. Anyway, that puts Boise on the map because you and I were laughing before we started about some people don’t even know where Idaho is. If you asked them what’s a city in Idaho, they wouldn’t know. I must state that before I moved here three years ago, I didn’t know either. I thought Boise was here and it is.

Dr. David Musnick: But anyway. So there’s a part of the Greenbelt Trail that you can go off on the side and do some little mountain bike things. This kid didn’t have a helmet on. He did these little mountain bike things and he fell over and hit his head. He lost consciousness and they brought him to the emergency room and he had a brain bleed. So this is an actual example of a more serious head injury. Not that everybody’s going to see these brain bleed cases, but you know, it’s important. So he was in the hospital for a number of days. They actually did an operation and they evacuated the brain bleed. And then he was in the hospital and they weren’t doing anything in the hospital, really just like lying there, sleeping, or eating. And I’m telling you, you don’t get very much sleep in the hospital.

Dr. David Musnick: So they contacted me and I said, look, if he’s stable, you got to get him out of the hospital and in here. This is the case where I told you that the pediatric neurologist pulled the parents aside and said, we’re really sorry, but we’ve done what we could. Your son is going to have serious brain damage. And I don’t know why anybody tells people this. He probably won’t do well in school, he probably won’t go to college, I mean the whole thing and the parents said, well give us a percent on that, and he said 90 percent. That was that one So I evaluated this teenager when he got in here he didn’t look right. I could tell something was wrong with him he wasn’t creating words well.

Dr. David Musnick: So he had a problem with his Broca’s. He couldn’t find words. His short-term memory was not working well. He had problems with focus of attention. He couldn’t really function very much in school, so they just took him out of school for a while. His brain energy was really decreased, he was having trouble sleeping and he was having nightmares and all that. So that’s when he came in. The brain region localization showed problems in almost every area of his brain. And so that gives an interesting thing here that you can have a brain bleed and then you could have larger areas involved. So what we started doing, I think I got him seven to nine days from the event. He was having headaches, dizziness, nausea.

Dr. David Musnick: I forgot to mention that there’s a really interesting homeopathic medicine that has a good effect on a lot of post-concussion syndrome symptoms. It’s called Naturum Sulfuricum. So, I evaluated him. His balance was also off, so I knew there was something wrong with his cerebellum. I used some of the methods that I already talked to you about getting him sleeping. They got him some blue-light blocking glasses, got him to stop using any kind of iPad or anything after nine, and got this kid sleeping. We did use Coffea Cruda and the SleepCalm with him and then I did put him on the curcumin gummies because his mother already said he doesn’t like swallowing things.

Dr. David Musnick: Then, because it was serious, I put him on liquid phosphatidylcholine and we gave them the diet and said, look, load him up on eggs and let’s start making the brain smoothies with the wild blueberries and the parsley. He went on the curcumin. I put him immediately on the low dose lithium and the taurine. Some of these they just emptied out and some of them he was willing to swallow. I did put him on high dose DHA, and we immediately started a Frequency-Specific Microcurrent. So we started–

Dr. Kara Fitzgerald: What’s high dose for the DHA? What did you use?

Dr. David Musnick: Most of the DHA capsules, you’re lucky if you can get 500 milligrams in a capsule, so I put him on three twice a day. And then the phosphatidylcholine, I had him on at least a gram to two per day. I had him continue on the Naturum Sulfuricum. And then he was in for Frequency-Specific Microcurrent, initially doing what we call a basic concussion protocol. And I’m not going to go through all of them, but you have to sequence this. You have to treat the blood brain barrier and you have to treat for neuroinflammation, so I did all that with the programs that I designed. Also his vagus nerve was not working well, he was having GI problems and he was kind of constipated. So I started also treating the vagus nerve. I had him do high intensity gargling to try to get the vagus nerve to work better.

Dr. David Musnick: And then we started getting him exercising as soon as he could. A lot of people don’t realize this, but rest is not good for the brain. Sleep is, but not doing nothing. So getting someone to do some cardioaerobic exercise without headaches is important. So we started getting him doing that to generate brain drive nerve growth factors.

Dr. Kara Fitzgerald: Do you have them ride a stationary bike?

Dr. David Musnick: Ride a stationary bike. Ride a regular bike. This was during the summer, so he could ride a regular bike and just get his heart rate up 30 to 40 minutes. Gradually he progressed to the point where the Brain Region Questionnaire had all zeros. Nothing. His personality was weird initially because it was dull and his parents said, he’s not acting like my kid. But eventually, when I said, okay, you’re done but you’re going to take these supplements for another three months, his personality was totally back. He started laughing. Everything got back to normal and we made sure that school was normal. Now, I’m going to tell you about something else that’s rather interesting. There is a type of treatment— Oh. I got him in hyperbaric right away as well. I forgot to say that.

Dr. Kara Fitzgerald: Awesome. Good.

Dr. David Musnick: I don’t usually need 20 sessions, but sometimes even 6 to 10 sessions is fine. They don’t need 20 necessarily, if you’re doing everything else. There’s a treatment called audiovisual entrainment which is really interesting. This is light stimulus and sound stimulus and it entrains the brain to go into certain brain wave patterns. This kid could not focus for a while. So we used audiovisual entrainment. The nice thing about that is that some of the systems are very inexpensive. If it works and you want them to use it for half an hour it can help sleep, focus, and mood. That’s the way I would say it. So that could be very helpful, too.

Dr. David Musnick: So the kid got back to completely normal. They did go to a neurology appointment just to go and tell the neurologist, completely in private, I want you to know, even though you said there was a 90% chance that he was going to have serious brain injury problems, wasn’t going to be able to do school, wasn’t going to be able to do sports, my kid’s completely normal. And the neurologist said, yeah, apparently he is. So, they did at least go back and tell the neurologist that. At some point, I actually would like to give a talk to the pediatric neurologists in the group, because I think they need to know about this, because I don’t think it’s okay to say, 90% chance your kid’s going to have serious brain damage and we don’t know what to do.

Dr. Kara Fitzgerald: No. I mean it’s terrifying just listening to you say that as a parent. I mean, yeah, that’s not okay.

Dr. David Musnick: But what I would say is, this is a case of a serious head injury that was taken from serious brain symptoms and serious personality and mood, to normal everything. But what I would say is that it went smoothly because I have the Frequency-Specific Microcurrent and I have the audiovisual entrainment equipment. But it gets complicated when you’ve got people that aren’t resolving after twelve weeks. Then you’ve really got to put your functional medicine thinking cap on and think about all these comorbidity issues and what you might have to do— Checking the viruses, checking the hormones, checking all this stuff— What you might have to do to really improve things. And I always tell people there’s room for hope. It doesn’t matter how many head injuries you’ve had. And it does bring up another point that I want to tell you.

Dr. David Musnick: Where they have the dysfunction, like word finding. Let’s just use that. You have to challenge them on a daily basis with brain exercise because what you need in order to create synaptic networks is BDNF plus brain challenge and then you’re going to get the synaptic networks in the branching. So almost every one of my patients gets specific brain challenges to do. We try to make it fun. For the people that are having trouble with memory they just do the animal matching card games and the Simon game. There’s a whole range of these brain challenges you’ve got to do with people to complete the program.

Dr. Kara Fitzgerald: Well, listen, we are at time, but this has just been a great conversation. It’s just really nice to talk to you. I don’t think that I’ve seen you in person for a while. Were you at this year’s annual AIC? Were you at the AIC?.

Dr. David Musnick: No, I haven’t. I’m not sure if I’ve been to the IFM. I used to speak every other year at that, but I don’t think I’ve been since COVID.

Dr. Kara Fitzgerald: Right, yeah, I don’t remember seeing you and we would have had at least a few minutes chat where I know you would make me laugh, as you have forever. Well, thanks for coming, David, and just sharing your brilliance and your hope. I love how you’ve looked at this. You’ve shaped it through the functional lens, but then you’ve got some serious expertise. My team will reach out to you and kind of pick your brain to get access to your website and any references that you think are important, your books and so forth and add them to our show notes.

Dr. David Musnick: Sure.

Dr. Kara Fitzgerald: So circle over to the show notes folks on the website to access all of it and again, thank you.

Dr. David Musnick: Yeah, and then if there’s a clinician that ever needs help, then I can do a peer-to-peer with them and guide them through that.

Dr. Kara Fitzgerald: Awesome, awesome, that’s great. And then you do telemedicine and you also do on-site. So yeah, you’re an awesome resource. Thanks so much.

Dr. David Musnick: Okay, thank you.

David Musnick MD is a Sports Medicine and Functional Medicine MD who practices in Eagle Idaho and Bellevue WA.  In 2016 he developed the first program to heal the brain after Concussion based on the Pathophysiology mechanisms that go on after a Concussion and TBI.   He has healed hundreds of patients and is published on his approach in the book Integrative Neurology.

In his practice he defines the brain areas that have been injured and develops a detailed approach to healing these areas.  His approach integrates food choices, supplements, sleep, exercise, EMF protection, HBOT and Frequency Specific Microcurrent.   He has expanded his approach to also treat Cognitive Impairment and other Neurological disorders such as MS and Parkinson’s. He sees patients in both Idaho and Washington but can see patients from other states on Telemedicine via a Peer to Peer consultation.

Dr. David Musnick

Integrative Neurology published in 2020 by Oxford University  Press

Conditioning for Outdoor Fitness by Mark Pierce A.T.C.  and  David Musnick M.D.

Datis Kharrazian, creator of the Brain Region Localization Questionnaire

Study: Effects of radiofrequency exposure on in vitro blood-brain barrier permeability in the presence of magnetic nanoparticles

Study: Electromagnetic fields and the blood-brain barrier

Aires Tech EMF Protection

Study: Alterations to the gut microbiome after sport-related concussion in a collegiate football players cohort: A pilot study

Study: The gut reaction to traumatic brain injury

Study: Systematic Review and Dosage Analysis: Hyperbaric Oxygen Therapy Efficacy in Mild Traumatic Brain Injury Persistent Postconcussion Syndrome

Study: Hyperbaric oxygen: B-level evidence in mild traumatic brain injury clinical trials

Study: Protective effects of curcumin against traumatic brain injury

Study: Curcumin attenuates acute inflammatory injury by inhibiting the TLR4/MyD88/NF-κB signaling pathway in experimental traumatic brain injury

Aristo Vojdani

Dr. Carol McMakin

Tests Mentioned

S-100B protein test

Neural Zoomer Plus

Podcast: AI-Driven Brain Imaging: A Game Changer in Preventing Cognitive Decline with Owen Phillips, PhD

Blog: Brain Health 101: How To Nutritionally Support A THRIVING Mind For Years To Come

Podcast: Gut Healing in Aging & Disease: Emerging Roles of the Microbiome and Diet in Intestinal Barrier Regeneration with Tom Fabian, PhD, CNTP

Podcast: Tackling Alzheimer’s Disease Head On – the Inspiring Work of Dr. Heather Sandison

Blog: Harnessing the Microbiota-Gut-Brain Axis to Improve the Stress Response

DrKF Clinic: Patient consults with DrKF physicians including Younger You Concierge

Bio Age Lab Test

Bio Age Self Assessment Quiz

Younger You Group Program

Younger You book

Better Broths and Healing Tonics book

Interview: Past, Present, and Future of “Biological Aging” with Dr. Fitzgerald

Video Blog: Does Multivitamin Use Increase Mortality Risk?

Podcast: Decoding Aging: The Science Of Cellular Rejuvenation With Dr. Vittorio Sebastiano

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