Transcriptly

How to Recover From a Concussion | Dr. Tommy Wood & Dr. Andrew Huberman

Huberman Lab Clips13:07Added Aug 31, 2026

Dr. Tommy Wood and Dr. Andrew Huberman discuss evidence-based protocols for recovering from mild to moderate concussions, emphasizing the importance of tempe...

Watch on YouTube →
Contributed by 刘嘉琪

Transcript

Transcript format

  1. Immediate Post-Concussion Care

  2. 00:00Are there anything
  3. 00:03that people should do and or take in the
  4. 00:06immediate aftermath of a head hit? Now,
  5. 00:08I'm not talking about uh hopefully
  6. 00:11people are getting checked out for brain
  7. 00:12bleeds and things like that. So, I'm I'm
  8. 00:14talking about moderate concussion.
  9. 00:16Someone got their quote unquote bell
  10. 00:17rung. Uh they slipped and fell. Uh they
  11. 00:21got clipped in soccer practice. Um their
  12. 00:24kids a little dizzy. Now, of course,
  13. 00:26somebody young or old is vomiting or,
  14. 00:29you know, not able to sleep or real
  15. 00:31issues. I mean, everyone should probably
  16. 00:32be checked out in in the first case, but
  17. 00:35I get asked this question all the time.
  18. 00:36Is there anything that people can take
  19. 00:37to kind of get over mild concussion or
  20. 00:39moderate concussion?
  21. 00:41The evidence base on this is a little
  22. 00:44shaky, but I think for most things, it
  23. 00:48it kind of fits into this idea of
  24. 00:51positive asymmetry, right? Low risk,
  25. 00:53high potential for benefit. And there
  26. 00:54have been lots of you there have been
  27. 00:55randomized control trials that kind of
  28. 00:57look at some of these things. So we a
  29. 00:58couple years ago we published a paper
  30. 00:59looking at different nutritional
  31. 01:01supplements after concussion that you
  32. 01:05know we have some reasonably good
  33. 01:06evidence for. So um yes you should be
  34. 01:09seen by a doctor. You should get
  35. 01:11whatever scans and you know immediate
  36. 01:13medical care that you need. Absolutely
  37. 01:15right. That's we're assuming all of that
  38. 01:16is done or will be done. Yeah.

  39. Managing Body Temperature

  40. 01:19Immediately. There are a couple of
  41. 01:20things that I think we know um from sort
  42. 01:25of um animal studies that translate
  43. 01:27fairly well onto onto humans but also
  44. 01:29some you maybe some observational
  45. 01:30studies in humans but a couple of things
  46. 01:32are important. So one is temp
  47. 01:34temperature management temperature
  48. 01:35regulation. There have been this is what
  49. 01:38my PhD was actually in hypothermia after
  50. 01:40acute brain injury.
  51. 01:41Hyperthermia
  52. 01:42hypothermia yeah so cooling down
  53. 01:45although I did do some studies where we
  54. 01:47you know heat it up and that makes
  55. 01:48things worse. So this kind of pertains
  56. 01:50to what I can imagine. Brain doesn't
  57. 01:52like to get too hot.
  58. 01:53That's essentially what I'm about to
  59. 01:54say. So there have been lots of studies
  60. 01:55where they've done cooling hypothermia
  61. 01:58in people after traumatic brain injuries
  62. 02:00and concussions hasn't really shown much
  63. 02:02of an effect. What seems to be important
  64. 02:05is preventing hyperothermia. So um one
  65. 02:10of the effects of cooling somebody down
  66. 02:11is that they don't get hot. So that's
  67. 02:14probably something that's really
  68. 02:15important. So often concussions happen
  69. 02:18in a heat stressed environment. You're
  70. 02:19on a football pitch. It's August in
  71. 02:22Alabama, it's 40°, right? Get inside,
  72. 02:25get cool as quickly as you can because
  73. 02:27there are there are studies that and
  74. 02:28that doesn't mean you have to get in an
  75. 02:29ice bath. Just don't be really hot. If

  76. Blood Sugar & Stimulants

  77. 02:32you get a fever, which you might might
  78. 02:33do after a more significant injury, you
  79. 02:36know, Tylenol or something like that to
  80. 02:37help maintain thermmore regulation will
  81. 02:40be really important. The next is uh
  82. 02:42blood sugar regulation. So we know that
  83. 02:45after a significant brain injury, you
  84. 02:46have increases in in blood sugar. That's
  85. 02:48associated with worse outcomes. Some of
  86. 02:50it's like what's caused? What's
  87. 02:52consequence? Is the injury driving the
  88. 02:53blood sugar? Is the blood sugar driving
  89. 02:54the injury? I think an easy thing to
  90. 02:56just say is I would avoid any super
  91. 03:00sugary refined carbohydrates that might
  92. 03:02just sort of, you know, uh kind of pile
  93. 03:05on for one of a better word. Right.
  94. 03:06What about alcohol? So alcohol um I
  95. 03:09would avoid as well mainly because it
  96. 03:11impairs sleep and we know that sleep is
  97. 03:13going to be critical to recovery. Some
  98. 03:15people would say something similar about
  99. 03:16caffeine acutely after injury because
  100. 03:18it's a it's a stimulant. Um one thing
  101. 03:20that the reason why hyperothermia or
  102. 03:23getting too hot makes the injury worse
  103. 03:25is because it um you know simply
  104. 03:28speaking increases the gap between
  105. 03:31energy requirements and energy
  106. 03:32production. So like one of the hallmarks
  107. 03:35of these acute brain injuries is a
  108. 03:36deficit in energy production with you
  109. 03:38know mitochondrial failure or
  110. 03:39mitochondrial dysfunction. And so if you
  111. 03:42get too hot or you stimulate the brain
  112. 03:44you're asking for more energy when the
  113. 03:46when the when your neurons can't produce
  114. 03:48it. And that is a trigger that kind of
  115. 03:52deficit in energy production is a
  116. 03:53trigger for cell death and
  117. 03:54neuroinflammation and some of these
  118. 03:55other processes that then may happen. So

  119. Creatine Dosing & Protocols

  120. 03:58avoid alcohol, avoid caffeine. Both of
  121. 04:00those potentially related to improving
  122. 04:02sleep. Then uh things that we have some
  123. 04:05you know reasonable evidence for um
  124. 04:07immediately after concussion are
  125. 04:09creatine.
  126. 04:10At what dosage?
  127. 04:11The best trial was actually done um in a
  128. 04:13p like pediatric group although very
  129. 04:16broad. It was like one year old to 18
  130. 04:18years old. Um but they gave 4 g per kilo
  131. 04:22per day. So
  132. 04:23Whoa.
  133. 04:24Yeah. So it's it's a pretty it's it's
  134. 04:26like double a traditional loading dose
  135. 04:27if you're a 100 kilo person. But like if
  136. 04:30you're 7 if you're 70 kilos um you know
  137. 04:32155 lbs or something like that then
  138. 04:35that's 28 grams of creatine. So like
  139. 04:38it's a lot but
  140. 04:39extra trips to the bathroom could be
  141. 04:40expected but you may just spread it out
  142. 04:42across the day right.
  143. 04:43Yes. So well one thing I'll say about
  144. 04:45that is um the most recent meta analyses
  145. 04:48show that you actually don't get is
  146. 04:51actually quite rare to get more GI side
  147. 04:53effects uh with creatine compared to
  148. 04:55placebo. Some of it is probably related
  149. 04:57to the quality of the supplement. So
  150. 04:58poor quality creatine supplements have
  151. 05:00more adulterance that may cause some of
  152. 05:01those GI side effects. Some of it is can
  153. 05:04be due to high um um you can saturate
  154. 05:08the creatine transporters. It doesn't
  155. 05:10get absorbed. Water gets drawn into the
  156. 05:12gut that can that can then write cause
  157. 05:15diarrhea or something. Um but some of
  158. 05:18the GI issues that people experience are
  159. 05:20probably due to poor quality products
  160. 05:22that they're taking. For the non uh head
  161. 05:25injured individual, is there any reason
  162. 05:28to go back to the old loading protocols
  163. 05:30of taking 20 grams per day, putting it
  164. 05:32in a little bit of grape juice or
  165. 05:33something else to spike blood sugar for
  166. 05:35this very reason that it could um
  167. 05:37augment the the passage of creatine into
  168. 05:40your cells as opposed to drawing water
  169. 05:42into the gut? In the '9s, we would take
  170. 05:45five grams of creatine four times a day
  171. 05:48in an ounce or two of pure grape juice.
  172. 05:51Um, and you draw a lot of water into
  173. 05:54your muscle cells. You put on, you know,
  174. 05:57it varies, but for me, anywhere from 5
  175. 05:59to 8 pounds of it's water weight, but
  176. 06:02it's mostly in the muscles. It's not
  177. 06:04insignificant. Translates to big
  178. 06:06strength increases. I don't take nearly
  179. 06:07that much now. I just do the 10 grams
  180. 06:09per day. But is there any reason to go
  181. 06:11back to those traditional loading?
  182. 06:13So, if you're just like long like
  183. 06:15long-term creatine supplementation, pro
  184. 06:17probably not. um in this kind of setting
  185. 06:21I think a a you know the the evidence is
  186. 06:23for a loading style protocol right so
  187. 06:26for most people it might be 20 to 30
  188. 06:29grams of of creatine spread spread
  189. 06:30across the day you know for if anybody's
  190. 06:32just like taking creatine for other
  191. 06:35reasons you know this a standard dosing
  192. 06:37protocol I think is fine
  193. 06:39I thought you were going to tell me I
  194. 06:40could get it to work that way
  195. 06:42so so like the the some of the studies
  196. 06:44that use traditional like creatine
  197. 06:45monohydrate and look at creatine levels
  198. 06:46in the brain they did use the loading
  199. 06:48protocol for for a week and then you see
  200. 06:50significant increases in brain creatine.
  201. 06:52But creatine having other effects on the
  202. 06:54brain, you know, potentially improving
  203. 06:56mood, improving uh memory and in older
  204. 06:58adults. Um some of those benefits happen
  205. 07:01at just like a traditional creatine
  206. 07:03doses. So you don't need to take massive
  207. 07:04doses, you know, think load loading
  208. 07:06doses. You can actually see some
  209. 07:07benefits of like 5 to 10 grams. So
  210. 07:08that's creatine. So magnesium, so 400

  211. Magnesium & Omega-3 Fats

  212. 07:11milligrams once or twice a day. There've
  213. 07:13been some trials that shown um
  214. 07:14what form
  215. 07:15those studies actually use magnesium
  216. 07:16oxide. surprisingly. Um, but I would
  217. 07:20probably use magnesium glycinate. Um,
  218. 07:23the it's very bioavailable. Um, athletes
  219. 07:27usually need a bit more glycine anyway,
  220. 07:30but any bioavailable form will will be
  221. 07:32fine than omega-3 fatty acids. Um the
  222. 07:36evidence is is is a little bit better
  223. 07:38for like um there are now several
  224. 07:40studies in like America in like
  225. 07:41collegiate American football players
  226. 07:43where they take a couple of grams of
  227. 07:46omega-3s every day and across a season
  228. 07:48you see um less accumulation of uh
  229. 07:52biomarkers of of injury like
  230. 07:53neuropilament light that are circulating
  231. 07:55in the blood. So that's something that I
  232. 07:56would just take long like
  233. 07:58longitudinally. If you're somebody who's
  234. 08:00at risk of a concussion uh because of
  235. 08:02your sport or your job, I would just,
  236. 08:04you know, take a reasonable omega-3
  237. 08:06supplement just long term because we
  238. 08:08have some reasonable evidence for that.

  239. Sleep & BCAA Support

  240. 08:10Then other things might become a little
  241. 08:13bit specific to
  242. 08:16uh the symptoms that you're
  243. 08:17experiencing. So if you have sleep
  244. 08:18issues, then uh there's studies that
  245. 08:20have used melatonin and that's that's
  246. 08:22shown improvements. Branch chain amino
  247. 08:24acids at high doses uh for sleep. And
  248. 08:27that's interesting because outside of
  249. 08:29TBI, high doses of branch chain amino
  250. 08:31acids may actually impair sleep because
  251. 08:33they compete for tryptophan uptake into
  252. 08:35the brain, decreasing potentially
  253. 08:37decreasing serotonin, melatonin uh
  254. 08:38production. But in TBI, there are two
  255. 08:41studies that suggest improvements in
  256. 08:42sleep with high doses of branch chain
  257. 08:44amino acids.
  258. 08:46If somebody's going to take branch chain
  259. 08:47amino acids, presumably they're going to
  260. 08:49look at how much leucine is there for a
  261. 08:51variety of reasons. Um, so do you recall
  262. 08:54how much leucine to get this effect post
  263. 08:56TBI?
  264. 08:57So I I don't think they at least I don't
  265. 08:59remember the leucine dose, but they were
  266. 09:01taking up to 60 g of branches.
  267. 09:066.
  268. 09:07Okay. Cuz a typical kind of
  269. 09:10suggested supplement bottle gym dose
  270. 09:12would be 3 to five grams. That's usually
  271. 09:14about six capsules. Yeah.
  272. 09:16So Okay. So like one study they did in
  273. 09:19veterans they had um [snorts] I think it
  274. 09:22was three
  275. 09:24doses of 20 grams AC spread across the
  276. 09:26day.
  277. 09:27Are you curious about um these uh
  278. 09:30Ibagain studies that are looking at uh
  279. 09:33you know TBI and brain recovery? I mean
  280. 09:35Iane is a it's a a whole other thing
  281. 09:38because it's a the the most powerful
  282. 09:40long-lasting psychedelic at least that
  283. 09:42I'm aware of. But it seems like there's

  284. Psychedelics & Choline Research

  285. 09:44some interesting data coming out.
  286. 09:46Absolutely. Um and then you know in
  287. 09:49people with a history of brain trauma
  288. 09:51and PTSD and I think some of these other
  289. 09:54psychedelics are going to be um very
  290. 09:56interesting um there as well potentially
  291. 09:58due to their neuroplastic um effects
  292. 10:02that tend to particularly happen in like
  293. 10:04macro doses right in in um in the
  294. 10:07psychedelic doses. I think that there's
  295. 10:09a lot more to come there, but certainly
  296. 10:10the trials that have been done so far
  297. 10:12are quite compelling, but that's
  298. 10:13obviously in in a very controlled kind
  299. 10:15of clinical heart rate monitor. Again,
  300. 10:18it's not legal in the United States,
  301. 10:19although things things are shifting, but
  302. 10:22choline is another thing, particularly
  303. 10:23aceticoline. So, um uh best evidence is
  304. 10:26for 1 to two grams a day um
  305. 10:29of choline
  306. 10:29of choline, you know, in the form of CDP
  307. 10:32choline or citoline, which is which is
  308. 10:34the same thing. Um those are the main
  309. 10:37ones. Then there's some other like Nisha
  310. 10:39supplements that do have some evidence.
  311. 10:40The one that's probably has the most
  312. 10:41evidence for it is Boswellia.
  313. 10:43Boswellia.
  314. 10:44Yeah. Which is Frank Indian
  315. 10:46frankincense, but there's an extract of
  316. 10:47Boswellia that's been tested in I think
  317. 10:49three different clinical trials after
  318. 10:50TBI showed some benefit. Enzogenol,
  319. 10:53which I think is a pine extract,
  320. 10:54slightly less evidence than Boswellia.
  321. 10:57I typically would recommend people stick
  322. 10:59to the first group of kind of
  323. 11:00nutritional type supplements. um but in
  324. 11:02very specific um use cases based on
  325. 11:05specific symptoms some of those other
  326. 11:07things might be beneficial. Then beyond
  327. 11:09that we know that phys return to
  328. 11:11physical activity as soon as possible is
  329. 11:12really important after
  330. 11:13without getting another head injury.

  331. Returning to Physical Activity

  332. 11:15Without getting another head injury and
  333. 11:16you know so so this really changed over
  334. 11:18the last few years. You know maybe 5 10
  335. 11:21years ago people like you know rest is
  336. 11:22what you need to do. Go lie in a dark
  337. 11:25room. If you got a concussion in sports,
  338. 11:28you you would expect the team to have a
  339. 11:31rigorous return to play protocol that
  340. 11:33included lowlevel aerobic activity as
  341. 11:36soon as you're able to tolerate it u two
  342. 11:39or three times a week at a level just
  343. 11:41below what might make your symptoms
  344. 11:43worse. And then first you do sort of
  345. 11:46like non-specific aerobic exercise and
  346. 11:47then you start to bring back skill
  347. 11:49specific exercises, sports exercises,
  348. 11:51then go back into full training and then
  349. 11:53um go back into into playing kind of in
  350. 11:55that order and that should be quite
  351. 11:57systematized now. So I would expect
  352. 11:59sports teams to kind of have have that
  353. 12:01in place. So like the standard of care
  354. 12:03is generally phys physical therapy. if
  355. 12:05you have any ongoing cognitive or
  356. 12:07physical symptoms sort of a month plus
  357. 12:10after uh any kind of traumatic brain
  358. 12:12injury. Um there's some evidence that
  359. 12:15like virtual reality or augmented
  360. 12:17reality uh physical uh activity uh might
  361. 12:20improve cognitive symptoms. uh
  362. 12:22vestibular therapy for balance and
  363. 12:25dizziness issues. And then increasingly
  364. 12:29uh you know there's um a focus on sort
  365. 12:32of ocular motor training for like
  366. 12:34convergence or other eye like um eye
  367. 12:38issues that are very common after
  368. 12:40concussions but aren't picked up as
  369. 12:42often as as people might like.
  370. 12:44increasingly kind of eye tracking and
  371. 12:47these kinds of things are done
  372. 12:49particularly in professional sports or
  373. 12:51other arenas after brain injuries to
  374. 12:53kind of ideally you'd have a baseline
  375. 12:54you figure out what's changed and then
  376. 12:55you would track that over time and you
  377. 12:56can you can train that depending on the
  378. 12:58deficit
  379. 13:00[music]
  380. 13:05[music]