The science of brain maintenance: A neurologist's perspective

Over the past 30 years, my career as a neurologist has taken me through some of the most respected institutions in modern medicine. I completed my medical education at St. Petersburg Medical University, followed by a two-year fellowship at the Mayo Clinic and an intensive internship and residency at the University of Mississippi Medical Center. My focus has always been on cardiovascular health and neurocritical care—specialties that emphasize rapid intervention and pharmaceutical management. But as the years passed, I became increasingly disillusioned with the pharmaceutical-only approach to overall brain health.

More and more, I found myself interacting with younger individuals with cognitive concerns, including those who need cognitive function support and have everyday brain fog. While traditional medications could sometimes manage symptoms, they did little to address the root causes of these conditions. This led me on a journey into the world of functional and integrative medicine, where I discovered the critical role of nutrition and lifestyle in brain maintenance. Today, my practice blends the best of both worlds—Western medical expertise and scientifically validated naturally-derived therapies—to support long-term cognitive function.

The Nutritional Foundation of Cognitive Health

We now understand that brain health is deeply connected to what we consume. The neurons in our brain rely on a steady supply of essential nutrients, healthy fats, and antioxidants to function optimally. Deficiencies in key vitamins and minerals—such as B vitamins, magnesium, and omega-3 fatty acids—can impair neurotransmitter production and accelerate cognitive decline.

A growing body of research suggests that targeted supplementation can help maintain cognitive function as we age. Some of the most well-studied nutrients and herbs for brain health include:

• Bacopa monnieri: This herb has a long history of use in Ayurvedic practice as a “medhya rasayana,” or a herb that sharpens the mind and intellect. Bacognize, from Verdure Sciences (Noblesville, IN), is one example of a standardized hydroalcoholic extract of the Bacopa monnieri plant, known for its potential cognitive-enhancing properties.
• Omega-3 Fatty Acids: Found in fish oil and algae, these essential fats help maintain brain cell membrane integrity and support brain health. Studies have linked regular omega-3 intake to cognitive function support and improved memory.
• B Vitamins: Vitamins B₆, B₁₂, and folate play a critical role in reducing homocysteine levels, an amino acid associated with affecting brain and neurological health.
• Magnesium L-Threonate: Unlike other forms of magnesium, this one can cross the blood-brain barrier and is associated with improved synaptic plasticity and memory.
• Curcumin (Turmeric Extract): This potent anti-oxidative compound has been studied for its potential to support age-related cognitive health.
• Resveratrol: Found in red wine and certain berries, this antioxidant activates sirtuins, proteins involved in longevity and cellular repair. I like Cognigrape, from Bionap (Catania, Italy), which contains polyphenolic compounds from grape flavonoids that help maintain a healthy mood and support proper cognitive function.
• Lion’s Mane Mushroom: This medicinal mushroom stimulates nerve growth factor (NGF) production, promoting neural regeneration and cognitive resilience.
• Phosphatidylserine: An important neurosupportive phospholipid, this compound helps transmit messages between nerve cells in the brain.
• Green Tea Leaf Extract: I like green tea leaf extract made from Cameillia sinensis and standardized to 75% polyphenol catechins, that supports a feeling of calm, healthy neural pathway function, and proper memory.

When Should People Start Taking These Supplements?

One of the most common questions I receive is, “When should I start taking brain-supporting supplements?” The answer is—sooner than you might think. Age-related cognitive decline is not an overnight event; it is a gradual process that can begin decades before you realize.

Ideally, individuals should start focusing on brain health in their 30s and 40s, well before noticeable everyday memory loss sets in. This is when oxidative stress and brain discomfort subtly start to affect brain function, even if outward effects aren’t apparent. For those with a family history of needing cognitive function support, early support is even more crucial. However, it is never too late to support cognitive function; even individuals in their 60s and 70s can experience benefits from strategic nutritional interventions.

The Gut-Brain Connection: A New Frontier in Cognitive Care

Emerging research has also shed light on the connection between gut health and brain function. The gut microbiome, a vast community of bacteria residing in our digestive tract, plays a key role in neurotransmitter production and regulation. Dysbiosis—an imbalance in gut bacteria—has been linked to everyday stress, lower everyday mood, and even age-related cognitive health issues.

Probiotics and prebiotic fibers can support a healthier gut-brain axis. Specific strains such as Lactobacillus plantarum and Bifidobacterium longum have demonstrated neuroprotective effects by modulating the brain and producing beneficial metabolites that support brain function.

The Future of Integrative Neurology

As a physician trained in conventional medicine, embracing an integrative approach was not always easy. The medical community often overlooks the role of nutrition and holistic therapies in everyday brain health, focusing instead on more rigorous interventions. However, the landscape is changing. A growing number of neurologists are recognizing the limitations of conventional approaches and seeking out evidence-based comprehensive strategies to complement their practices.

My mission is to bridge the gap between conventional neurology and functional medicine, offering my patients a more comprehensive approach to brain health. By integrating scientifically studied supplements, lifestyle interventions, and cutting-edge research on the gut-brain axis, we can take meaningful steps toward cognitive support and supporting lifelong brain function.

For those looking to maintain optimal cognitive health, the key is proactive maintenance. Whether through dietary changes, targeted supplementation, or lifestyle modifications, we all have the power to influence our brain’s longevity. And in the evolving field of neurology, I believe that embracing an integrative mindset will be the future of brain health care.