March 12, 2025

Red Light Therapy & Traumatic Brain Injury

    What is Traumatic Brain Injury? Traumatic Brain Injury (TBI) occurs when the brain is damaged by an external force, like an impact, blast, or rapid acceleration/deceleration. Common causes of TBI include falls, sports injuries, vehicle accidents, and physical assaults. Damage from TBI’s can lead to long-lasting and even permanent impairment of brain function. TBI’s are common injuries in the US, with approximately 1.5 million Americans experiencing a TBI annually.    TBI is considered an umbrella term that refers to any brain injury caused by an external source. TBI’s can be categorized by severity, ranging from mild to severe, and have unique characteristics: Mild TBI – Causes temporary confusion and headache. Moderate TBI – Causes prolonged confusion and cognitive impairment. Severe TBI – Causes significant cognitive deficits and long-term complications. TBI’s can also be categorized by timeframe, including both acute (short-term) and chronic (long-term) effects. The acute phase last from hours to weeks, while the chronic phase lasts from weeks to years, depending on the severity of the TBI.    Two TBI-related terms that may be familiar to people are concussions and Chronic  Traumatic Encephalopathy (CTE). Concussions are a type of mild TBI, and although symptoms usually resolve within days to weeks, they can still have long-term effects, especially with multiple incidents. One potential long-term consequence of repeated concussions is CTE, a progressive neurodegenerative disease believed to be caused by repeated head injuries, including multiple mild TBIs.  Treatment for TBI varies greatly depending on the severity of the injury. In general, it involves stabilization, symptom management, and rehabilitation. The primary goal of treatment during the acute phase is to protect brain tissue and focuses on cognitive rest and addressing symptoms. In the chronic phase, the primary goal of treatment is to restore cognitive, motor, and emotional function.  Emerging treatments such as Red Light Therapy may be beneficial in supporting the brain during both the acute and Shop Red Light Therapy Head Wrap   How does TBI affect the Brain Before we consider how Red Light Therapy may be used to support brain health following TBI, let’s take a closer look at the three major pathological processes that occur in the brain during this type of injury.    Neuroinflammation: TBI causes neuroinflammation, which occurs in the hours to days following the injury. Neuroinflammation is inflammation of the brain, which can be helpful in the short term but is harmful when prolonged, leading to chronic neurodegeneration. Excess neuroinflammation is linked to brain fog, mood disorders, and an increased risk of neurodegenerative diseases such as CTE. Oxidative stress: Following a TBI, the brain produces excessive amount of reactive oxygen species (ROS), which can lead to oxidative stress. Oxidative stress can overwhelm our antioxidant defenses and cause damage to cells in the brain, worsening brain injury.  Impaired brain energy metabolism: TBI impairs brain energy metabolism, particularly the ability of the brain to use glucose, which leads to a metabolic crisis where neurons are deprived of energy. After an initial phase of excessive glucose use, there is a decrease in glucose availability that can last from days to weeks, which makes neurons more vulnerable to damage and impairs healing. These three factors interact and include many overlapping molecules. For example, both neuroinflammation and impaired brain energy metabolism can lead to an increase in ROS production, further worsening oxidative stress. Similarly, impaired energy metabolism exacerbates neuroinflammation. This creates a self-perpetuating cycle of damage, which is why TBI recovery can be slow and why some people experience persistent symptoms for weeks, months, or even years following the injury. How does Red Light Therapy support brain function? Red Light Therapy is a promising tool for supporting the brain during TBI because it targets all three foundational brain pathologies, including neuroinflammation, oxidative stress, and impaired brain energy metabolism. Using both red and near infrared light (especially near infrared, which has deeper penetration), Red Light Therapy delivers wavelengths that interact with light sensitive molecules inside brain cells.      Here's how Red Light Therapy affects neuroinflammation, oxidative stress, and brain energy metabolism:  Neuroinflammation: Red and near infrared light wavelengths have anti-inflammatory effects, and unlike anti-inflammatory medications (such as NSAID’s), do not cause side effects. Studies have found that light therapy affects levels of many molecules involved in inflammation, including ROS, reactive nitrogen species, and prostaglandins. Red and near infrared light therapy have specifically shown to reduce neuroinflammation.  Oxidative stress:  Light is absorbed in cells by molecules called chromophores, many of which are found inside the mitochondria. Mitochondria are involved in regulating the production the ROS that cause oxidative stress when present in high amounts. Light therapy has been shown to modulate oxidative stress and ROS production. Impaired brain energy metabolism: Through its impact on mitochondria, light also affects metabolism. In addition to regulating ROS production, mitochondria also make ATP, which is the energy currency of the cell, via a chain of molecules that includes cytochrome c oxidase. Cytochrome c oxidase is activated by both red and near infrared light, which increases ATP synthesis and provides more energy to brain cells. As well, there are additional effects of Red Light Therapy in the brain that may help to support healing from TBI. This includes increasing brain blood flow, supporting brain adaptability, and regulating neuron cell death. Collectively, there are many ways in which Red Light Therapy may be used therapeutically in TBI, and these have been explored in several clinical and pre-clinical studies of both acute and chronic TBI.   Is there evidence to support the use of Red Light Therapy in TBI? Yes! Red Light Therapy has been investigated in several studies of TBI using a range of different experimental approaches. These studies can be broken down by timeframe into both acute and chronic TBI, as well as by study type, including clinical (using humans as subjects) and pre-clinical (using animals as subjects).   Acute TBI The acute phase of TBI immediately follows the onset of injury. Unfortunately, this creates some challenge in coordinating and executing research studies, since it is difficult to recruit human subjects into a research study who have just experienced a head injury. As a result, most of the research in this TBI phase has been done using animals given a head injury in a controlled environment. In a 2023 systematic review of 17 animal studies that used Red Light Therapy immediately post-TBI, it was found that early light therapy intervention could improve neurological outcomes and reduce the size of trauma-associated brain lesions. Optimal results were associated with both red and near infrared light, initiation within 4 hours post-injury, and up to three daily treatments. One human study was included in the review of Red Light Therapy for acute TBI, which suggested safety and feasibility, but treatment efficacy could not be determined.     Chronic TBI Many more human studies have explored the use of Red Light Therapy in the chronic phase of TBI, which occurs weeks to months after the initial trauma. In a 2024 review of 16 human studies, overall improvements in neuropsychological outcomes and increased cerebral blood flow following transcranial PBM were observed. Here are some highlights of the clinical research findings:         How can I use Red Light Therapy in TBI? 2019 study of 12 military veterans with chronic TBI lasting more than 18 months – Following six weeks of application of both red and near infrared light to the head using LED lights, neuropsychological scores and brain blood flow were improved.  2020 case report of 23-year professional hockey player with a history of concussions, and symptoms of headaches, mild anxiety, and difficulty concentrating - Following 8 weeks of application of near infrared light to the head using LED lights, many positive findings were observed, including increased brain volume, improved brain connectivity, increased brain blood flow, and improved neuropsychological test scores. 2023 study of four retired professional football players with suspected CTE – Following application of near infrared light to the head using LED lights three times per week for six weeks, a wide range of improvements were noted, including improved sleep, reduced depression, decreased PTSD, and decreased pain. Analysis of brain function showed several improvements.    Collectively, research looking at the use of Red Light Therapy to support healing from TBI has yielded positive outcomes, both subjective (such as improved mood and decreased pain), and objective (such as increased brain volume and blood flow). There is stronger support for the use of Red Light Therapy in chronic TBI, but pre-clinical evidence supports the potential for benefit during the acute phase of injury.    TBI Recovery Managing TBI involves a combination of stabilization, symptom relief, and rehabilitation, each playing a crucial role in recovery. Red Light Therapy is a safe and effective tool that can support healing throughout all three stages. While it can be conveniently done at home using a Red Light Therapy device, professional supervision is recommended during the acute phase to ensure safe and effective application.   When exploring the range of available options, here are four things to consider: Light wavelength – The wavelength of light determines its color, with red light in the range of 620-700nm and near infrared light in the range of 700-1100nm. Although near infrared has been used most often to support healing from TBI, some studies have also found benefit from red light. Light with wavelengths between 600 and 1300nm have been found to penetrate maximally into the brain. So, look for products that provide both RL and NIRL in combination. Light intensity - Light intensity refers to the amount of light being delivered by a device, also referred to as power density. Studies of Red Light Therapy and TBI have used a range of intensities, from 10-100mW/cm2, and there is no clear indication that a particular intensity must be used. Devices across a range of intensities may provide benefit, and consumers aren’t limited to a specific intensity range. Type of device - Your personal level of comfort with a device is important. If it isn’t easy to use, and if it doesn’t feel good on your body, you probably won’t use it consistently. Many consumers find the most convenient devices to use are wireless, with a rechargeable battery. It is also important to use a device that can be adjusted to fit snugly on the head. Think about your personal preferences and choose a device that fits your criteria. Light Source - Light therapy is administered using either laser or LED lights. While early light therapy research was done using lasers, LED lights have become much more popular over the last decade. For at home use, look for a device that uses LED lights as safe and affordable option.   The next step after selecting a Red Light Therapy device is to determine the treatment protocol. During the acute phase of TBI, it is recommended to consult with your health care provider to get their professional guidance regarding the most appropriate protocol for your case. During the chronic phase of TBI, support from a health care professional is also recommended, but people may be more independent during this period. Based on available clinical research, 10-40 minute treatment sessions, 3 to 5 times a week, are recommended. Do not exceed more than one session every 24 hours.   Conclusion Red Light Therapy is a safe, affordable, and highly effective tool for supporting at-home recovery from TBI. By targeting the three core drivers of brain injury—oxidative stress, impaired metabolism, and neuroinflammation—it offers a scientifically backed approach to healing. Research suggests benefits across all stages of TBI, from the critical early hours to years post-injury. When choosing a device, look for red and near-infrared LED technology that aligns with your needs for comfort and convenience, empowering you to take an active role in your recovery.   Shop Red Light Therapy Head Wrap   For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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December 20, 2024

Light Therapy & Menopause

Menopause Menopause is the natural transition that occurs when a woman stops menstruating, which usually happens between the ages of 40 and 58. The term “transition” refers to a change from one state to another, which is a very apt descriptor for what happens during menopause. Hormonally speaking, menopause marks a shift to an entirely new hormonal milieu, which not surprisingly, can be quite challenging.  Hormonal Changes During Menopause The hormonal changes that accompany menopause are dramatic. From perimenopause (the stage leading up to menopause) to post-menopause (the stage following menopause), levels of estrogen and progesterone drop to a fraction of their previous levels. This sharp decline is not linear, instead showing fluctuations that can create a whirlwind of physical and psychological symptoms. Levels of testosterone also decrease during this transition.   The effects of menopause The effects of menopause on the brain and body are similarly dramatic. Although these vary widely between individuals, there are many common symptoms, including hot flashes, loss of libido, vaginal dryness, sleep issues, weight gain, dry skin, hair thinning, digestive changes, sexual dysfunction, urinary symptoms (including incontinence) and mood disturbances. Some menopausal symptoms are local, occurring mainly in the pelvic region, while others (such as hot flashes) are felt throughout the body. Similarly, some symptoms are transient while others cause persistent and long-term physical changes.  The experience of menopausal symptoms is extremely common. Overall, it is estimated that 75-80% of women suffer from symptoms related to menopause, of which 20-30% are considered severe. Approximately 75% of women worldwide experience hot flashes, while 40-60% suffer from sleep issues. As many as 83% of women report experiencing vaginal dryness, often with associated pain during intercourse. Research has found that 9 in 10 women weren’t educated about menopause, and since talking about these symptoms has long been viewed as “taboo”, women often suffer menopause symptoms in silence, leaving them unable to access tools that might help to alleviate them.  Improving access to supportive tools during menopause is a critical public health issue. This includes natural and alternative therapies, as well as novel tools such as light therapy. Light - including red, near infrared, and blue light – may help to alleviate several of the challenging symptoms of menopause, including sleep and mood issues, vaginal dryness and atrophy, hair loss, overactive bladder, sexual dysfunction, cognitive and digestive changes, and skin problems. Read on to learn how light therapy can be used to support women’s health during this important transitional period. Light therapy Before we can explore how light therapy can be used to support women’s health during menopause, we first need to answer the question: what is light therapy? The answer is really quite simple. Light therapy (also known as photobiomodulation) is the application of light with specific wavelengths to the body for the purposes of influencing biology. In theory, light therapy can use any wavelength of light, but the most commonly used are red, near infrared, and blue. The use of red and near infrared light is commonly referred to as “red light therapy”. All three wavelengths of light may be useful in supporting women during menopause, although red and near infrared light have the greatest utility.   Research has shown that light therapy has many effects on a cellular level. Briefly, with red and/or near infrared light, the most notable observed effects include an increased production of cellular energy, reduced inflammation, decreased oxidative stress, decreased pain, increased blood flow, enhanced collagen and supportive tissue production, and improved microbiome health (gut and vagina). Blue light is mainly used to destroy pathogenic microorganisms like yeast and bacteria.  Light Therapy & Menopause Given that there is such a wide range of menopausal symptoms (note that for simplicity, symptoms related to peri-, meno- and post-menopause are being considered here as “menopausal” symptoms), it is likely that the various physiological effects of light therapy will be more or less relevant for certain ones.  For example, some of the changes seen during menopause – such as vaginal atrophy, dryness, and urinary incontinence - are due in part to a decrease in blood flow and loss of connective tissue in the pelvis. While specific research into using light therapy to treat these symptoms is still sparce, researchers have proposed that based on existing scientific evidence, red light therapy may alleviate these symptoms by stimulating the production of collagen and elastin, supporting bladder function, and enhancing blood flow.    Many symptoms of menopause are also experienced in other states, and we can look to those conditions for clues regarding how to use light therapy to alleviate the same symptoms during menopause. This includes anxiety and depression, hair loss, sleep disturbances, acne, digestive issues, and infections. While research specific to these symptoms in menopausal women is lacking, there is clear evidence that light therapy (with red, near infrared, and/or blue light) can be helpful in other conditions, and we can extrapolate from there to the menopausal state. Based on the known physiological effects of light therapy, and the evidence of benefits in a range of clinical conditions, we propose that the use of red, near infrared, and/or blue light may help to alleviate several of the most common symptoms experienced by women during this life transition, including: Mood: Mood changes are a common experience during menopause, with many women reporting increases in anxiety and depression. Light therapy (with red and near infrared light) has been shown to reduce depressive symptoms in both humans and animals, likely due to improvements in mitochondrial function, increased brain blood flow, and decreased neuroinflammation. A 2009 clinical trial found a reduction in symptoms of depression and anxiety in as little as a single session. The effects of light therapy on mental health are so compelling that a recent systematic review concluded that it is “strongly recommended” as a treatment for moderate depressive disorder and is “recommended” for the treatment of anxiety disorder. Studies of red light therapy and depression often apply light therapy directly to the skull, while some use an intranasal approach. Cognition: Cognitive changes, such as memory loss, are also commonly experienced by women during menopause. Researchers have shown in a series of controlled clinical studies that near infrared light therapy improves cognition in young and middle-aged healthy adults when applied to the prefrontal cortex of the brain. Cognitive improvements were accompanied by changes in brain function, including increased brain blood flow. In 2019, a meta-analysis of all the research looking at the effects of light therapy (including near infrared light, or near infrared and red light in combination) found that the overall effect on cognition was positive, leading the authors to conclude that light therapy is a “cognitive-enhancing intervention in healthy individuals”.                                    Hair Loss: Menopausal women frequently report hair loss and thinning. The ability of light therapy to induce hair growth was observed in studies conducted more than 50 years ago. Early clinical trials used primarily red light, and the effectiveness of these studies led to the development of several red light therapy devices for hair loss. Subsequent studies have shown that near infrared light also stimulates hair growth, with red and near infrared light improving hair growth in androgenetic alopecia, which is the most common type of hair loss that affects both men and women. Light impacts hair growth through effects on mitochondria, which lead to increases in the length of time the hair follicle spends in the growth phase.                                                                                             Overactive Bladder: Overactive bladder, involving a frequent urge to urinate, is a urinary symptom experienced during menopause. Overactive bladder often results in urinary incontinence. Although research related to light therapy and overactive bladder is limited, one study found that application of red light to the abdomen three times per day for 12 weeks resulted in a reduction of urinary incontinence as compared to a control group, suggesting a potential benefit in this condition.    Skin Changes: During menopause, many women report skin changes, including acne, dryness, altered pigmentation and wrinkles. Light therapy has been widely used in spas and dermatology clinics for its effects on skin health, in addition to at-home use. Red and near infrared light is helpful in the treatment of wrinkles,  psoriasis, acne, hyperpigmentation, and rosacea, while blue light is helpful in the treatment of acne. Studies show results such as smoother skin; wrinkle reduction and improved skin elasticity; and normalization of skin pigmentation. The effect of red light therapy on wrinkles can be quite dramatic, with one study showing a 30% decrease in eye wrinkle volume. Gut: Gut dysbiosis, involving changes in the gut microbiome, are common around the time of menopause. Estrogen is known to affect the gut microbiome and similarly, some of the microbes in the gut microbiome (called the estrobalome) are able to influence levels of estrogen in the body. Keeping the microbiome healthy during menopause is essential, and light therapy (with red and near infrared light) may provide some support. Animal research has shown that when red or near infrared light was applied to the abdomen of mice, the composition of the microbiome shifted to include more of a bacterial strain that is associated with better health. In humans, red and near infrared light applied to the abdomen of Parkinson’s disease patients modulated the composition of the gut microbiome, with a shift towards more “healthy” bacteria, and in a case report of a patient with breast cancer, application of near infrared light to the abdomen was associated with increased diversity of gut microbes, which is considered to be a healthy change Vaginal Dysbiosis: Similar to the gut, the vagina has a microbiome, and menopause can cause dysbiosis in this region as well. Hormone-induced dysbiosis can increase the vaginal pH and change the composition of the microbes, which is associated with bladder dysfunction and bladder pain syndrome. Light therapy, particularly with red and near infrared light, is proposed as being a positive modulator of the vaginal microbiome. There are several proposed mechanisms, including modulation of nitric oxide. Nitric oxide is important for the lactobacillus species that dominate in the vagina that are known to decrease during menopause.                                                                                                                                    Sleep: As already mentioned, sleep disturbances are experienced by 40-60% of menopausal women. Light is a primary regulator of the body’s circadian rhythm, so it is not surprising that light therapy has effects on sleep. Application of red and near infrared light during wakefulness improves sleep quality in people with cognitive decline, Guillain-Barré Syndrome, fibromyalgia and stroke. When red light therapy is applied during sleep, there is an increased clearance of waste products from the brain and improved flow of cerebrospinal fluid, which are required for optimal brain health. Blue light triggers wakefulness, suppressing melatonin, so direct exposure of the eyes to blue light should be limited to daytime hours. Vaginal Infections: Vaginal infections with yeast and bacteria are more common during menopause due to the changes in estrogen, vaginal pH, and vaginal dryness that occur. In addition to their positive effects on the microbes in the gut and vagina, red and near infrared light have also been shown to have effects on pathogenic (harmful) microorganisms in the female pelvis. Red light has been shown to be helpful in treating vaginal candida, as has blue light. Specifically, blue light at 415nm (the same wavelength as in the Fringe Pelvic Wand) had the most potent anti-candida effects. Blue light has also been shown to be helpful in the treatment of vulvovaginitis. Vaginal Atrophy: Vaginal Atrophy, Dryness & Sexual Dysfunction: The loss of estrogen during menopause causes many changes to the integrity of tissues in the vagina. This results in tissue atrophy and dryness, which can cause great discomfort, especially during sex. The main structural connective tissues are collagen and elastin, which provide strength and flexibility to the vagina. These changes occur for a variety of reasons, including a decrease in blood flow which results from the loss of estrogen. Application of red and near infrared light is known to increase blood flow by increasing levels of nitric oxide. It has also been shown to increase the synthesis of collagen and other supportive connective tissue including elastin. Suggesting that red and near infrared light may help with tissue support and rejuvenation during menopause.  Light Therapy Products for Menopause While early research on light therapy used primarily lasers, more recent research has found that LED’s can also be used, which also have the advantage of applying light to a larger area of the body as well as an improved safety profile. The use of LED in red/near infrared/blue light therapy devices has also greatly reduced the cost of treatment, making it something that can be done in the comfort of one’s own home. A wide range of products are available, each of which is uniquely suited to address specific needs. The four most useful light therapy products to address the symptoms of menopause are: Red light therapy panel Panels usually deliver red and near infrared light, ideally with the option to use separately or in combination. Panels can be used to treat most body parts, including the face, chest and back. They’re great for supporting sleep and mood, when light should be entering through the eyes. They can also support digestion when directed towards the skin of the abdomen, as well as the skin on the face. The Fringe Red Light Therapy Panel delivers both wavelengths of light at the same “sweet spot” intensity as the sun. shop our panel Red light therapy wraps Red Light Therapy Wraps deliver light directly to the skin and can be applied to specific body parts, such as the head and abdomen. They should also deliver both red and near infrared light. Wraps have the advantage of being cordless and very convenient to use. The Fringe Red Light Therapy Head Wrap delivers light to the head (including red and two wavelengths of near infrared light) and is ideally suited to support mood, cognition, and hair loss. The Fringe Red Light Therapy Wrap has a rectangular shape and can be applied to the abdomen to support bladder function and digestion. shop our wraps           Light therapy face mask Like wraps, face masks deliver light directly to the skin but are specifically contoured to the face. Due to the antimicrobial effects of blue light, it should be included in face masks for the treatment of acne along with red and near infrared light. The Fringe Red Light Therapy Face Mask delivers all three wavelengths of light to support skin health, including acne, wrinkles, pigmentation, and more. shop the mask               Light therapy pelvic wand Light therapy pelvic wands are inserted directly into the vagina, delivering light directly to the vaginal tissues that are affected by menopausal hormonal changes. The Fringe Light Therapy Wand delivers red, near infrared, and/or blue light to support blood flow and tissue rejuvenation, which may help alleviate vaginal dryness, atrophy, and sexual dysfunction. shop the wand       To recap Menopause is a time of dramatic hormonal changes, which create uncomfortable symptoms for many women. Light therapy is a safe and effective tool that may be used to alleviate a wide range of menopausal symptoms in the comfort of one’s own home. Red and near infrared light provide support for symptoms including sleep and mood issues, cognitive changes, hair loss, gut and vaginal dysbiosis, skin problems, and vaginal tissue changes, while blue light may provide antimicrobial activity for menopausal acne and vaginal infections. Many different light therapy products are available - including panels, wraps, face masks, and pelvic wands – that provide light therapy support for different symptoms. Choose products that use LED lights to deliver red, infrared red, and blue light (where appropriate) at approximately the same intensity of the sun for best results.  For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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December 17, 2024

Should I Take a Vitamin D & K Supplement?

Should I Take a Vitamin D & K Supplement? The short answer to this question is, “almost definitely, yes!” Vitamin D is the “sunshine vitamin”, and since modern humans spend so much time indoors, most of us are woefully deficient in this critically important vitamin. And while vitamin D is found in some foods, surveys of dietary intake have shown that almost everyone consumes inadequate amounts. Some people are also deficient in vitamin K, and because vitamin D and K work synergistically, they should always be taken together. Read on to learn more about how these important nutrients work in our bodies to support health, and why Fringe’s unique vitamin D and K formulation is ideally designed to meet our needs.  shop fringe vitamin D & K   What is vitamin D & K? Vitamins are nutrients that our bodies require in small amounts for proper growth and metabolism. Since they’re required in amounts as low as milligrams (mg) or micrograms (mcg), they’re referred to as micronutrients. This contrasts with macronutrients, which are needed in larger amounts, and include carbohydrates, proteins and lipids (fats).  Vitamins D and K share the unique characteristic of being fat-soluble. The absorption of fat-soluble vitamins requires dietary fat, which makes it more complex than the absorption of water-soluble vitamins. Fat-soluble vitamins are also stored in the body, while water soluble vitamins are not. Examples of water-soluble vitamins are vitamin C and the B vitamins.            What is vitamin D & K? Technically, vitamins are obtained from the diet – but as already mentioned, vitamin D is the “sunshine vitamin”. While all vitamins (including D) can be ingested through food, vitamin D is also made when the skin is exposed to the UVB light from the sun. In fact, the amount of vitamin D that can be made from the sun far exceeds the amount that is normally consumed from food sources. And since UVB rays don’t pass through windows, direct sun exposure is required for vitamin D synthesis. + More  Since our modern lifestyles now have us spending up to 90% of our time indoors, dietary intake of vitamin D has become really important, with dietary supplements taking centre stage. This is because it’s hard to match the amount of vitamin D made from sun exposure from vitamin D rich foods. Thirty minutes of midday sun in the summer results in the body making around 10,000 to 20,000IU of vitamin D –  which is the equivalent of consuming 50 to 100 servings of sardines, one of the best food sources of vitamin D! In the absence of sun exposure, dietary supplements are really the only way to ensure that you’re consuming sufficient vitamin D to support optimal health. Vitamin D is so important that many governments recommend, and even mandate, that it to be added to certain commonly consumed foods. When vitamin D is added to food, these are called fortified foods. In the United States, vitamin D is often added to fluid milk and other dairy products, calcium fortified fruit juices, and breakfast cereals and grains. The amount of added vitamin D is usually limited to around 100IU per serving. Clearly, this falls way short of the 10,000 to 20,000IU we generate from 30 minutes in the midday sun! In addition to fortified foods, good food sources of vitamin D include egg yolks, fatty fish (such as sardines, salmon, arctic char, herring, mackerel and rainbow trout), and beef liver. Since both fortified and natural vitamin D containing foods are usually animal-based, vegans and vegetarians are more likely to be deficient. Vitamin D2 comes from plants and fungi, while vitamin D3 comes mainly from animal sources, or less commonly, non-animal sources like lichen. Fortified food may contain either form. Like vitamin D, there is also some uniqueness in terms of how we obtain vitamin K, at least one of its two forms. The two forms of vitamin K are phylloquinones (vitamin K1) and menaquinones (vitamin K2), with K2 being produced by bacteria in the human gut. Vitamin K2 produced in the gut is absorbed into the body, and does contribute to our overall vitamin K status. However, the amount produced in insufficient to meet our needs, and some dietary intake is also required. Dietary intake of vitamin K1 comes mainly from leafy green vegetables, such as spinach, broccoli, and lettuce, as well as some oils such as canola and soybean. Vitamin K2 is mainly produced by bacteria and is found in some animal-based foods like meat, dairy, and eggs, as well as fermented foods. Since K1 in plants is tightly bound to chlorophyll, it is less bioavailable than K2, with less than 20% being absorbed into the body.           What do vitamins D & K do in the body? Vitamins D and K each have critical biological functions. Here’s a look at what each one does to support our health: + Vitamin D     Maintains Bone Health – Vitamin D is required for the absorption of calcium from the intestine and the mineralization of bone. Supports Muscle Strength – Vitamin D increases protein synthesis in muscle cells, thereby helping to support muscle strength. Decreases Inflammation – Vitamin D is associated with reduced inflammation, at least in part by shifting the profile of immune cells from a pro-inflammatory to an anti-inflammatory state. Regulates Immune System Function – Vitamin D is a powerful regulator of the immune system, and supports protective immunity. Protects Against Oxidative Stress – Vitamin D reduces oxidative stress, and can protect cells and tissues against oxidative damage. Supports Brain Function – Vitamin D supports brain function by protecting it against damage from inflammation and oxidative stress. This “neuroprotective action” occurs across multiple regions of the brain. + Vitamin K   Maintains Bone Health – Vitamin K is required for the activation of proteins involved in bone assembly, in a process known as carboxylation. Without vitamin K, these proteins remain inactive and bone structure is compromised. Regulates Blood Clotting – Vitamin K is required for proper blood clotting, also known as coagulation. Here, vitamin K activates proteins involved in the blood clotting cascade, again via the process of carboxylation. Decreases Inflammation – Vitamin K reduces the expression of pro-inflammatory molecules, which may reduce overall inflammation. Protects Against Oxidative Stress – Vitamin K has antioxidant activity that can reduce oxidative stress by inhibiting the buildup of damaging reactive oxygen species. This is a poorly understood role of vitamin K, but it may have important health implications. Regulates Glucose & Insulin Metabolism – Vitamin K helps to regulate glycemic status, affecting both glucose and insulin metabolism. This occurs via activating effects on proteins, which are dependent on vitamin K.  Regulates  Immune System Function – Although a minor player relative to vitamin D, vitamin K plays a role in immune system regulation, as evidenced by its ability to affect levels of certain immune cells.        How do vitamin D & K work together to support health? It’s obvious from this list that vitamin D and K overlap in some of their biological roles. And it turns out that when it comes to maintaining bone health, they actually work together as a team. Simply put, vitamin D increases the absorption of calcium from the intestines into the blood, which ideally should be delivered to bones (as well as teeth). The transfer of calcium from the blood into bones first requires vitamin D dependent synthesis of specific proteins. However, these proteins are synthesized in an inactive form. This is where vitamin K comes in... + More  As previously mentioned, vitamin K activates proteins involved in bone assembly, turning these inactive proteins into active ones which can then shuttle calcium into bone. In the absence of vitamin K, calcium won’t be deposited where it should be – in the bones and teeth. When calcium isn’t deposited into the bones and teeth, it is also a problem for the cardiovascular system. If calcium builds up in the blood, which is what happens when vitamin D is present without sufficient vitamin K, this calcium gets deposited in the arteries – which can cause atherosclerosis and cardiovascular disease. So, vitamins D and K must be taken together to ensure that calcium gets deposited into bones, and not arteries, and to support optimal bone and cardiovascular health.   How much vitamin D & K do I need? Vitamin D The issue of optimal vitamin D intake is highly controversial. The Institute of Medicine (which sets the dietary intake recommendations for all nutrients as recognized by the US government) recommends 400 international units (IU) for children up to age 12 months, 600 IU for people ages 1 to 70 years, and 800 IU for people over 70 years. However, this recommendation only considers amounts needed to prevent serious bone disease, not to support optimal health. According to a scientific article published by authors including Harvard University’s Chair of Nutrition, the Institute of Medicine’s recommended intake of vitamin D “may be insufficient for important disease outcomes” and recommends a higher daily intake of up to 4,000IU per day, which has also been recommended as the “prophylactic” daily dose for most adults. Notably, total body sun exposure provides the equivalent of 10,000IU per day. The conflict over optimal vitamin D intake is based on disagreement over what target levels of blood vitamin D should be. While the Institute of Medicine states that 20ng/mL of 25-hydroxyvitamin D is sufficient, this is solely based on evidence related to bone health, which ignores the multitude of other biological roles for vitamin D. In contrast, the Endocrine Society recommends having blood levels over 30ng/mL, the American Association of Clinical Endocrinologists recommends 30-50ng/mL, and the D* Action Project suggests 40-60ng/mL.  With so much controversy, how should the average person approach vitamin D supplementation? Our advice is to work with a health care provider who can monitor your blood vitamin D levels and tailor recommendations accordingly. Many people have genetic polymorphisms or medical disorders that affect their vitamin D levels, so it’s difficult to make blanket recommendations that apply to everyone. People also have different lifestyles, including time spent outdoors, and live at latitudes with varying sun exposure. Body weight is also an important factor for vitamin D recommendations, as is skin color. Working with a health care provider who can consider your unique variables and do appropriate lab work is the best way to ensure you meet your personal needs. Vitamin D needs will also vary depending on your level of seasonal sun exposure. In general, vitamin D needs go up in the winter months, especially for people who live at northern latitudes.  Vitamin K The recommended intake for vitamin K is 120mcg for males and 90mcg for females aged 19 and over. Since disturbance of the gut microbiome (called dysbiosis) decreases intestinal vitamin K2 synthesis, people with gut issues may have increased dietary requirements for vitamin K.              Am I at risk of vitamin D or K deficiency? There are several groups that are at an increased risk of vitamin D deficiency, including: Groups at an increased risk of vitamin K deficiency include: People taking blood thinners, which antagonize vitamin K People taking antibiotics, which destroy vitamin K producing gut bacteria (cephalosporin antibiotics may be especially problematic) People with malabsorption disorders including celiac disease, ulcerative colitis and Cystic Fibrosis, who have difficulty absorbing vitamin K People who have undergone bariatric (weight loss) surgery      Can I take too much vitamin D & k? Vitamin D The main concern about excessive vitamin D intake is that it may increase calcium to dangerous levels. However, research suggests that hypercalcemia is unlikely to occur in healthy adults when blood vitamin D is below 700ng/mL, which far exceeds the recommended targets of 20 to 60ng/mL previously described. A 2007 scientific analysis of vitamin D intake and toxicity found no evidence of toxicity at an intake of 10,000IU per day and suggested that the currently recommended upper limit of 4000IU per day be revised. Subsequently, the Institute of Medicine revised their “No Observed Adverse Effect Level” to 10,000IU per day. Vitamin K There is no recognized upper limit to the amount of vitamin K1 or K2 that can be consumed. The Office of Dietary Supplements states that “no adverse effects associated with vitamin K consumption from food or supplements have been reported in humans or animals”. A synthetic form of vitamin K, called menadione, has caused toxicity in infants, but in the US this form is generally only used at present in animal food.         What is the prevalence of vitamin D & K deficiencies? + Vitamin D The prevalence of vitamin D deficiency depends on what level of intake is targeted. The most conservative recommendation is the “official” recommendation from the Institute of Medicine, which as mentioned recommends 400IU for children up to age 12 months, 600 IU for people ages 1 to 70 years, and 800 IU for people over 70 years. Even at this low level of recommended intake, the most recent national analysis of vitamin D intake in the US found that daily intake of vitamin D from food was only 204 IU in men and 168 IU in women. This is only about a third of the Institute of Medicine recommended intake, and about 5% of the 4000IU per day recommended by other experts. At the population level, approximately 92% of men, 97% of women, and 94% of people ages 1 year and older consumed less dietary vitamin D than is estimated to meet the needs of at least half the US population. Many people do take vitamin D supplements, which increases the overall observed combined daily intake from food and supplements to 692 IU in men and 1204 IU in women, with more women taking supplements than men. Supplements are clearly helpful at increasing daily vitamin D intake, but at the current level of supplementation most people still fall well short of the higher intakes recommend by some experts. + Vitamin K The average daily intake of vitamin K according to the most recent national dietary analysis shows that men consume 118mcg and women consume 121mcg. This increases to 125mcg and 129mcg for men and women, respectively, when vitamin K supplements are also considered. These results show that most people are meeting their recommended daily intake of vitamin K intake. However, low levels of vitamin K intake have been observed in older adults, where they are associated with an increased death rate.  These results show that most people are meeting their recommended daily intake of vitamin K intake. However, low levels of vitamin K intake have been observed in older adults, where they are associated with an increased death rate.  Because increasing intake of vitamin D results in the synthesis of proteins that must be activated by vitamin K to prevent deposition of calcium in the arteries, vitamin K should always be supplemented along with vitamin D, regardless of whether dietary intake is sufficient. Especially considering that there is no upper limit of intake for vitamin K, combining these two vitamins in a supplementation regimen is prudent.           What are the health risks of vitamin D deficiencies? Identification of health risks from having low vitamin D depends in part on what value of blood vitamin D (specifically, 25-hydroxyvitamin D) is determined as the level of deficiency. The “deficiency level” ranges from less than 12ng/mL to less than 30ng/mL, depending on which organization you follow. This will reflect a wide range of dietary and supplemental vitamin D intake. Because of this variation, the health risks of vitamin D deficiency will vary based on the deficiency level cutoff being used. + More  If we broadly consider vitamin D deficiency to include anything below 30ng/mL of 25-hydroxyvitamin D, some of the associated health risks are: Loss of calcium from bones and increased risk of osteoporosis Increased risk of bone fractures Reduced muscle strength and increased risk of falling Increased blood markers of inflammation  Increased risk of autoimmune disease, such as inflammatory bowel disease Increased susceptibility to infection Increased risk of dental cavities Increased risk of cancer Increased oxidative stress and related diseases such as diabetes and cardiovascular disease Increased risk of brain diseases such as dementia and depression Low circulating levels of vitamin D have also been associated with an increased risk of death from all causes, called “all-cause mortality”, as well as deaths from cardiovascular disease and can     What are the health risks of vitamin k deficiencies? Although rare, vitamin K deficiency is associated with several notable health risks, including: Increased risk of osteoporosis Increased risk of bleeding disorders Increased risk of diseases with an inflammatory component, such as diabetes Increased risk of cardiovascular disease Low circulating levels of vitamin K have also been associated with a 19% increased risk of all-cause mortality. How could taking a vitamin D & K supplement help me? Vitamin D Multiple scientific studies show benefits from taking supplements of vitamin D. These include: Reduced incidence of viral infections Reduced incidence of dental cavities Reduced incidence of cancer (when administered daily) Reduced symptoms of Polycystic Ovary Syndrome (PCOS) Increased bone mineral density (when supplemented with calcium) Reduced risk of falling (especially when combined with calcium) Reduced depressive symptoms Reduced mortality in critically ill patients Improved blood markers in patients with ulcerative colitis Reduced insulin resistance in non-diabetic pregnant women Reduced C-reactive protein, a biomarker of inflammation Reduced systolic blood pressure Reduced exercise-induced muscle cell damage Improved non-verbal memory in healthy adults Improved glycemic control in diabetics Vitamin K For vitamin K, scientific studies also show benefits of supplementation, including: Decreased risk of bone fractures Improved bone mineralization and strength Reduced risk of developing diabetes Improved glycemic control Reduced C-reactive protein, a biomarker of inflammation Reduced wound healing time (when applied topically) Reduced symptoms of peripheral neuropathy (in patients with vitamin B12 deficiency or Type II Diabetes) Improved markers of cardiovascular disease Importantly, supplementation with vitamin K2 and vitamin D in combination has shown positive effects on bone mineral density when compared to a control group eating a regular diet.        Should I take a calcium supplement when taking vitamin D & K? One of the main effects of vitamin D is to increase calcium absorption from the intestine, which – along with vitamin K – will allow calcium to be deposited into bone. But for this to occur, dietary or supplementary calcium must be ingested as well, or else there won’t be any calcium present to absorb! + More  Some research has shown that bone mineral density improves when taking vitamin D supplements, provided it is taken along with calcium. Research has also shown that supplementation with vitamin D and calcium reduces the risk of total fractures by 15%, and the risk of hip fractures by 30%. However, not all studies have shown these benefits, leading some researchers to conclude that taking calcium (with vitamin D) for the prevention of osteoporosis and fractures is unwarranted. Some research has also suggested that taking supplemental calcium can have adverse effects on the cardiovascular system. This has led to a debate over whether taking calcium supplements to prevent osteoporosis has more benefits than risks. There’s no doubt, however, that calcium is an essential mineral. Ideally, it should be obtained from foods, such as dairy foods, almonds, and sardines. A little-known fact is that natural water also often contains calcium, which is removed with many modern filtration systems. Drinking calcium-rich mineral water in place of filtered water can be source of dietary calcium intake. Interestingly, the daily target range of calcium intake from diet and/or supplements varies widely among health organizations, from a minimum of 400mg to up to 1300mg per day, depending on age and gender. These recommendations have also changed across time, which shows a lack of clarity regarding optimal intake. If you consume very little calcium in your diet, then taking a supplement may be warranted. Many supplements on the market are quite high in calcium, with 500-1000mg per serving. These should be avoided. It’s better to take a supplement that more closely mimics dietary intake, at 250mg or less. If your calcium intake is extremely low, a low dose supplement could be taken 2 to 3 times per day.   Are there nutrients other than calcium and vitamin K that interact with vitamin D? Yes! Magnesium is another nutrient that is interacts with vitamin D. Many enzymes that synthesize and metabolize vitamin D are dependent on magnesium for proper functioning, so optimal magnesium status is important for vitamin D. Most people do not consume sufficient dietary magnesium, and due to depletion of magnesium from our soil and foods, supplementation may be necessary to meet our daily needs.  Vitamin A is another nutrient that interacts with vitamin D. Some vitamin D binds to vitamin A, forming a unit called a “heterodimer”. This A/D heterodimer can regulate the expression of many different genes, including several involved in bone health. Vitamin A is found in foods like liver, fish, eggs, and dairy, while pre-vitamin A (also known as carotenoids) are found in plant foods like leafy greens, peppers, and carrots.  Ensuring adequate intake of vitamin A is important when supplementing with vitamin D. Vitamin A can be consumed through foods and supplements, and it is also added to some foods (like breakfast cereals) via fortification. Survey data has shown that 22% of the US population suffers from vitamin A deficiency, while 33% consume an excess. Since there are serious risks (like birth defects) associated with taking too much vitamin A, widespread supplementation is not recommended, although it is certainly warranted in some cases. shop fringe vitamin D & K   What should I look for in a vitamin D & K supplement? (1) Read the ingredients – Most dietary supplement will contain both active and inactive or “other” ingredients. You need to pay attention to both. The active ingredients are the ones that you are looking for, and a vitamin D and K supplement will contain at least one form of each as an active ingredient. Choose the form that best meets your needs (see #3 in this list for more details!). Although this information may be hard to find, it’s helpful to know where these active ingredients are sourced from. Naturally sourced ingredients are always better than artificial ones. + More  The inactive ingredients are usually there to: (1) provide bulk (filler), (2) hold the product together (binding agents, coatings), (3) add flavor or sweetness, or (4) keep the product from clumping together (flow enhancers). Sometimes this list is long, and it’s often where some undesirable ingredients sneak in, such as potassium sorbate, artificial colors, or titanium dioxide. It’s best to keep this list short and naturally sourced. (2) Verify product purity – Only choose high quality products that verify their purity via an unbiased chemical analysis performed by a third-party lab. These analyses should be reported in a Certificate of Analysis (COA) that is readily available to consumers, often through a QR code link. COA’s should be available for each batch of products, and will measure contaminants such as heavy metals, microbes, and pesticides. (3) Consider the form(s) of vitamin D & K in the supplement – There are two forms of vitamin D that are found in dietary supplements, vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is sourced mainly from animals, although lichen is a vegan source of D3. Vitamin D3 is the form made in humans following exposure to UVB light. In contrast, vitamin D2 is sourced from plants. Vitamin D3 is largely recognized as being more “bioavailable”, meaning more of the vitamin that is ingested gets delivered to body tissues. Studies that directly compare the bioavailability of D3 to D2 show that vitamin D3 raises blood levels of 25-hydroxyvitamin D more than vitamin D2, so it is preferable to choose a supplement containing vitamin D3. If you are vegan, choose a supplement that contains D3 sourced from lichen. As previously described, there are also two forms of vitamin K, vitamin K1 (phylloquinone) and vitamin K2 (menaquinones). Vitamin K1 comes mainly from plants, while vitamin K2 is made by bacteria and is found in animal-based and fermented food. Vitamin K2 is further subdivided into MK-4 through MK-13. Each of these subgroups of vitamin K2 has a slightly different molecular structure. Dietary supplements usually include MK-4 or MK-7. MK-4 occurs naturally in foods including liver, butter, and cheese, while MK-7 is made through fermentation, with the best source being Japanese fermented soybeans (called Nattō). Studies have shown that vitamin MK-7 is more bioavailable than vitamin MK-4, so it is preferable to choose a supplement containing vitamin MK-7. (4) Choose the supplement form you prefer – Supplements come in three main forms: capsules/tablets, powders, or liquids. Which one you choose is really a personal preference. Powders and liquid can be added to liquids, like smoothies, and are a great option if you don’t like swallowing pills.        How is Fringe Essentials Vitamin D & K different from other supplements? Fringe Essentials Vitamin D & K has three highly unique attributes that make it superior to other products on the market: + Water Solubility Water Solubility – We’ve already covered that both vitamin D and K are fat-soluble vitamins. The absorption of fat-soluble vitamins is complex, which results in a lower bioavailability than water-soluble vitamins (recall that bioavailability refers to how much of the ingested nutrient is delivered to body tissues). The bioavailability of fat-soluble vitamins can be increased significantly through a safe and simple conversion process that makes them water-soluble and able to readily be absorbed through the walls of the small intestine. Research has demonstrated that water-soluble vitamin D is about twice as bioavailable as fat-soluble vitamin D. Another advantage to making vitamin D and K water-soluble is that it will eliminate the competition that occurs for the absorption of fat-soluble vitamins. And when you supplement with water-soluble vitamin D and K, you don’t need to consume them with food (especially food that contains some fat) to optimize absorption, like you do with fat-soluble vitamins.As a water-soluble powder, Fringe Essentials Vitamin D & K can be added to any liquid where it will dissolve easily without residue.    + Vegan D3 Vegan D3 – Research has clearly demonstrated that vitamin D3 is superior to vitamin D2 at raising blood levels of 25-hydroxyvitamin D. The vast majority of vitamin D3 supplements source the vitamin from sheep’s wool, which produces a waxy substance called lanolin. Lanolin is extracted from sheep’s wool and put through a process which creates and extracts vitamin D3 using UVB light and chemical solvents. Because it is animal based, lanolin-derived vitamin D3 is not suitable for vegans. Fringe Essentials Vitamin D & K uses the only vegan source of vitamin D3, which is lichen. Lichens are living organisms that consist of fungus combined with algae or cyanobacteria. Lichen also make vitamin D3 following exposure to UVB. Lichen-derived vitamin D3 is identical to that produced from sheep’s wool, but is non-animal based, making it suitable for everyone.    + Vitamin MK-7  Vitamin MK-7 – Fringe Essentials Vitamin D & K contains vitamin MK-7, the most bioavailable form of vitamin K. It is derived from the fermentation of Nattō, which is plant-based and suitable for vegan diets. The other ingredients in Fringe Essentials Vitamin D & K water-soluble powder are all natural and non-GMO. They include inulin and myo-inositol (also sometimes called vitamin B8) to help with dosing, medium chain triglyceride (MCT) oil to help with emulsification, and licorice extract for increased bioavailability.                Dosing & Safety Fringe Essentials Vitamin D & K contains 2500IU of vitamin D3 and 130mcg of vitamin K2 (as MK-7). Because our vitamins are water soluble, they are more readily absorbed than most vitamin D and K supplements on the market, which means you don’t need to take as much to have the same effect.   + Learn more  For adults, we recommend using 1 scoop of Fringe Essentials Vitamin D & K per day as a maintenance dose when sun exposure is limited. A maintenance dose is meant to maintain blood levels of 25-hydroxyvitamin D within the range of 40-60ng/mL. However, if your blood vitamin D is very low, it may be necessary to take more until you reach this target range. The only way to know for certain how your body is responding to supplementation is to have your blood tested. This inexpensive test can be ordered by your health care provider, and home testing kits are also available. Lesser amounts can be taken when direct sun exposure is higher because skin synthesis of vitamin D will be much higher. Kids can also take Fringe Essentials Vitamin D & K. Based on age, the recommended doses are: for children aged 1-3 years old, ¼ scoop per day; ages 4-8, ½ scoop per day; ages 9-13, ¾ scoop per day; ages 14+, 1 full scoop per day. As with adults, the only way to know for certain how a child is responding to supplementation is to have their blood tested. For children under 1 year of age, please consult a health care provider before using. Vitamin D and K are safe to take when pregnant and breastfeeding. Of course, consult your doctor before beginning a supplement regimen. Fringe Essentials Vitamin D & K is incredibly safe. We use high quality ingredients and test every batch of our final product to ensure safe levels of toxic ingredients, including heavy metals, molds, and pesticides. We also leave out all the stuff you don’t want like artificial sweeteners, additives, gums, and ‘natural flavors’.     Is there anyone who should not take a vitamin D & K supplement? One group that needs to be cautious about vitamin K supplementation is people taking anticoagulant, or blood thinning, medications. Taking high levels of vitamin K when on anticoagulants can decrease the effectiveness of the drug, which could increase the risk of blood clot formation. This is because of vitamin K’s important role in the blood clotting cascade. To recap Vitamin D deficiency is rampant in modern society. Sunshine provides us with a free and natural source of this essential vitamin, but on average, we spend 90% of our time indoors, leaving this vital resource untapped. Since it’s difficult to consume enough vitamin D from the diet, adding a high-quality supplement to your daily health regimen is an easy fix. Fringe Essentials Vitamin D & K combines vitamin D with vitamin K, a duo that is needed for optimal bone and cardiovascular health. In contrast to most supplements on the market, ours is water-soluble, which means more of it gets to where it’s needed. It’s also naturally sourced, non-GMO, and vegan – containing only what you need, without unnecessary additives and fillers. Simply mix 1 scoop of Fringe Essentials Vitamin D & K into your water, smoothie, coffee, tea, or favorite beverage daily. You can also take a bit more or less, depending on the season and your unique needs!      The contents in this blog; such as text, content, graphics are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider.

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March 15, 2024

Light Therapy for Brain Health

Light Therapy for Brain Disorders Our understanding of brain health as being fundamental to our overall well-being dates to the time of the ancient Greeks. “Mens sana in corpore sano”, which translates to “a healthy mind in a healthy body”,  was a foundational part of the Hippocratic philosophy. Hippocrates introduced the first classification of mental disorders and believed that the brain was the organ responsible for mental illnesses. His classes of mental disorders included melancholia, mania, insanity, and others. While those terms are no longer in use today, many modern brain disorder, such as depression and dementia, are foundationally like those ancient classifications. Importantly, Hippocrates believed that “natural” treatments would cure diseases. One such therapy was the use of sunshine, known as “heliotherapy”. shop red light therapy head wrap   Brain disorders In modern society, brain disorders are becoming increasingly prevalent. Also referred to as neurological disorders, these conditions are estimated to be the second leading cause of death, causing 9 million deaths globally each year. While these diseases yield a massive economic burden in terms of health care costs, they also have an enormous impact on our quality of life. The prevalence of brain disorders is expected to increase significantly over the next several decades as the population both ages and grows.      Categories of brain disorders There are several different categories of brain disorders. These include: autoimmune diseases (such as multiple sclerosis – MS), epilepsy, psychiatric disorders (such as depression and anxiety), neurodegenerative diseases (such as Alzheimer’s and Parkinson’s disease), neurodevelopmental disorders (such as ADHD and autism), stroke, traumatic brain injuries (such as concussions and chronic traumatic encephalitis), and brain tumors.     While these disorders are all unique, they share fundamental pathological characteristics. Most involve an increase in oxidative stress, which involves excessive production of reactive oxygen species. The brain is especially vulnerable to oxidative stress because it has a high metabolic rate, and oxidative stress can occur both in chronic diseases (such as Alzheimer’s) and acute conditions (such as concussions). Alterations in brain metabolism are also common, which can precede and co-occur with oxidative stress. Brain metabolism accounts for around 20% of total metabolism, even though it only contributes 2% of total body weight. This makes the brain vulnerable to damage from metabolic effects such as those that occur with aging, poor diet, and trauma.  Neuroinflammation, which involves inflammation in the brain as a response to disease and injury, also occurs. Oxidative stress, impaired metabolism, and neuroinflammation overlap, involving many of the same molecules.  Brain disorders are notoriously difficult to treat. Because the blood brain barrier restricts entry of foreign substances into the brain, drug transport into the brain is limited. We are also limited by our lack of understanding these diseases. Experts admit that we actually know very little about how the brain works, for a variety of reasons. Given this complexity, using non-pharmacological interventions to treat the foundational pathologies of brain diseases (including oxidative stress, impaired metabolism, and neuroinflammation) is a great starting point. Light therapy, or photobiomodulation, is one such approach.               Light therapy Light therapy (also known as photobiomodulation) is the application of light with specific wavelengths to the body for the purposes of influencing biology. The most common form of light therapy uses red light (RL), which is visible as the color red, and/or near infrared light (NIRL), which is not visible but can be felt as heat. The RL used in light therapy usually ranges from 600 to 700 nanometres (nm), with the unit nm referring to distance the light wave travels in one cycle. The NIRL used in light therapy usually ranges from 800 to 900nm.   RL and NIRL are naturally produced by the sun, which gives off solar radiation. The term radiation describes energy that is transmitted in the form of waves or particles. The spectrum of light in our environment consists of both light we can see (visible light) and light that our eyes can’t perceive (invisible light). This is called the electromagnetic spectrum. The visible light spectrum is quite narrow, consisting of wavelengths that range from 400 to 700nm and span from violet to red in color. RL is part of this visible light spectrum, while NIRL is not. Red and near infrared light therapy is the application of artificially generated light in the red and near infrared spectral bands. The term “red light therapy” usually describes the use of both RL and NIRL, although only the red light produced by the device is visible to the naked eye. IRL can still be perceived by the body as heat when it contacts skin. How Does Red Light Therapy Affect Brain Health? Light therapy, specifically the application of red and near infrared light, positively impacts all three foundational pathologies of brain disorders: oxidative stress, impaired metabolism, and neuroinflammation. Oxidative Stress: Light is absorbed in cells by molecules called chromophores, many of which are found inside the mitochondria. Mitochondria are involved in regulating the production the reactive oxygen species that cause oxidative stress when present in high amounts. Light therapy has been shown to modulate oxidative stress and reactive oxygen species production. Impaired Metabolism: Through its impact on mitochondria, light also affects metabolism. In addition to regulating reactive oxygen species production, mitochondria also make the energy currency of the cell, called ATP. Specifically, RL and NIRL stimulates cytochrome c oxidase, a mitochondrial enzyme that produces ATP. This increases ATP synthesis which provides more energy to brain cells. Neuroinflammation: Red and NIRL have anti-inflammatory effects, and unlike anti-inflammatory medications (such as NSAID’s), do not cause side effects. Studies have found that light therapy affects levels of many molecules involved in inflammation, including reactive oxygen species, reactive nitrogen species, and prostaglandins. Red and NIRL therapy have specifically shown to reduce neuroinflammation.  Brain Disorders Treated by Red Light Therapy Since RL and NIRL therapy (hereafter referred to simply as “light therapy”) can positively impact the foundational pathology that characterizes so many brain disorders, it is not surprising that there is evidence to support its use in conditions ranging from Alzheimer’s Disease to traumatic brain injury. Here are the top 10 brain disorders that may benefit from RL and NIRL therapy, as supported by scientific research.    Alzheimer’s Disease & Dementia Alzheimer’s Disease (AD), a form of dementia, is a neurodegenerative disease that comprises 70% of dementia cases. AD affects 1 in 10 US adults over the age of 65, or 5.7 million Americans. AD is a progressive disease that is characterized by memory loss, disorientation, behavior changes, and an eventual loss of independent functioning. Research investigating the use of light therapy for AD is extensive, with dozens of studies published in the last decade. While many studies have used light therapy in animal models of AD, several clinical trials have been published which have shown positive results. Most studies have exclusively used NIRL, which has been found to penetrate more deeply into the brain.    A few studies have used unique research approaches to treating AD with light therapy. For example, a 2022 clinical trial combined light therapy to the brain with RL and NIRL therapy to the gut in patients with mild to moderate AD. The control group received sham, or placebo, light therapy. Patients receiving RL and NIRL showed improved cognitive function relative to the control group. The gut microbiome has been proven to play a role in maintaining brain health, and responds positively to light therapy. Another study combined light therapy with exercise in patients with AD. Patients in both the treatment and control groups participated in a moderate intensity exercise program 3 days per week, 45-60 minutes per session, for 3 months. Patients in the treatment group received NIRL through the nose and on wrist acupuncture points, while those in the control group received a sham light treatment. Both groups improved, but the group receiving NIRL showed more positive change.  Researchers state that there are many benefits of light therapy in AD that occur on a cellular level. These include improving mitochondrial function and increasing ATP production, decreasing neuroinflammation, and decreasing oxidative stress – which have a downstream effect of decreasing brain amyloid plaque accumulation.   While AD is the most common form of dementia, there is also non-Alzheimer’s dementia, which is similarly characterized by memory loss, disorientation, behavior changes, and an eventual loss of independent functioning. Although most research studies distinguish between types of dementia, some do not, and group all forms of dementia together. It’s not clear how important this distinction is, since the disorders share the same foundational pathologies, so light therapy is likely to have a similar impact regardless of the categorization of dementia. However, it’s still worth looking at some of this evidence. Mild cognitive impairment (MCI), which often progress to dementia, is also included here. A 2021 comprehensive review of dementia of all types assessed 10 studies of dementia patients treated with light therapy (either RL or NIRL). While not all studies were considered high quality, every one of them reported positive results. Included here was a study of a patient with mild dementia, as well as one of MCI. This analysis suggests that light therapy can benefit dementia starting from very early stages.  Another mechanism of how light therapy affects the brain of patients with dementia was revealed in a 2021 trial. In this study, cerebral blood flow was analyzed along with cognition. In addition to improvements in cognitive function, patients also had more blood flow in several areas of the brain. The authors suggest this may be due to changes in levels of nitric oxide.       Cognition In addition to improving brain health in people suffering from impaired cognitive function (such as AD, non-Alzheimer’s dementia, and MCI), light therapy has also been found to improve cognition in healthy people. This is quite remarkable, as it shows that the benefits of light therapy are quite universal.     Researchers have shown in a series of controlled clinical studies that light therapy using NIRL improves cognition in young and middle-aged healthy adults when applied to the prefrontal cortex of the brain. Cognitive improvements were accompanied by changes in brain function using tools such as EEG, fMRI, and brain blood flow.  In 2019, a meta-analysis of all the research looking at the effects of light therapy (including either NIRL or NIRL/RL combined) on cognition in healthy subjects was published. Seven studies included subjects aged 17 to 35 while two studies included subjects aged 49 and older. Despite some issues with study quality, the overall effect on cognition was found to be positive, leading the authors to conclude that light therapy is a “cognitive-enhancing intervention in healthy individuals”.       Parkinson's Disease Parkinson’s disease (PD) is a degenerative brain disease that involves damage to dopamine producing neurons in the brain. PD involves motor symptoms (such as balance and gait problems) and non-motor symptoms (such as depression, sleep disorders, and cognitive impairment). PD affects around one million people in the US, and over 10 million people globally.      Studies using light therapy to treat PD patients have shown that it is helpful. For example, one study of patients who used at-home NIRL therapy devices showed improvements in balance, fine motor skills, cognition, and mobility after 12 weeks of treatment. Patients applied the light to the head, neck, and abdomen. Research suggests that in PD, light therapy should be used 2-3 times per week for at least four weeks.  Animal models of PD have been used to try to determine precisely how light therapy is working. A 2020 analysis of 28 animal studies concluded that light therapy, including both RL and NIRL, is “an effective method to treat animal models of PD”. It is suggested that these benefits are due to effects on mitochondria, oxidative stress, and brain metabolism, which may be “helping the brain to repair itself”. The effects of light therapy on mitochondria may be especially important in PD, which involves significant mitochondrial dysfunction.        Stroke Stroke (Ischemic) – Ischemic stroke is a type of cardiovascular disease in which the blood flow to the brain is disrupted. Annually, close to 800 000 people have strokes in the US, with an economic cost of close to 57 billion dollars. Although some people recover fully from a stroke, it can cause permanent disability and death. The risk of stroke increases with age, but it can occur across all age groups.        Light therapy has shown small, but promising, effects in studies with stroke patients. Using NIRL laser light technology, it was found that treatment improved outcomes when used within 24 hours after a stroke. A larger follow up study showed smaller effects, but there was still a positive trend towards better outcomes.  Studies of animal models have shown many benefits when light therapy is used shortly after a stroke occurs. These include increasing the production of new neurons (neurogenesis), decreased inflammation, and improved mitochondrial function. The effects of light on mitochondria is very important in improving stroke outcomes, since mitochondria are responsible for protecting and maintain neurons. Light therapy may work synergistically with other non-invasive treatments for stroke, such as Coenzyme Q10.        Depression Depression – Depression is a highly prevalent mood disorder, affecting at least 21 million people in the US in 2021. Depression disproportionately affects young people, with considerably higher rates in people aged 18-25. While depression is associated with psychosocial factors such as trauma, there is also often an underlying brain pathology. In particular, depression has been associated with impaired functioning of brain mitochondria, neuroinflammation, and oxidative stress. Impaired mitochondrial functioning in depression is not just limited to the brain, but rather is found throughout the body and corresponds with symptom severity.   Given these associations, it is not surprising that light therapy can be used to treat depression. Several clinical trials of light therapy in depression have been conducted, all of which used NIRL applied directly to the head. A 2022 systematic review concluded that NIRL therapy “can be classified as strongly recommended for moderate grade of major depressive disorder”. Similarly, a 2023 meta-analysis concluded that there is a “promising role of in the treatment of depressive symptoms”. Multiple Sclerosis Multiple sclerosis (MS) is an autoimmune neurodegenerative disease that involves the brain and spinal cord. The prevalence of MS has recently been found to be higher than originally thought, affecting nearly 1 million people in the US. The symptoms of MS vary between affected individuals, and include fatigue, gait problems, numbness/tingling, weakness, spasticity, and vision problems. Interestingly, MS prevalence shows a north south gradient, in which people at northern latitudes have more disease. Low sun exposure is a known risk factor for MS, while greater exposure is associated with decreased disease severity. MS involves considerable neuroinflammation, as well as increased oxidative stress.     Since most research related to sun exposure and MS has focused on vitamin D – which is produced from UV light, rather than RL or NIRL – there are only a few studies looking at how RL and NIRL therapy (which does not stimulate vitamin D production) affects MS. However, the research that has been done has been very positive. Notably, only one study (using a mouse model of MS) applied light therapy to the brain, with mice showing improved motor function and decreased brain pathology following treatment. Other animal studies have applied light to the spinal cord, which was also the target of a study with human MS patients. A second study of human MS patients applied light to the inside of the mouth and the radial artery on the wrist. Since MS affects both the brain and the peripheral nervous system, it appears that light therapy can target the multiple areas and still be beneficial.     Autism Spectrum Disorder Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that manifests in childhood. ASD is characterized by difficulties with social interactions, abnormal language, and restricted/repetitive behaviors, interests, and activities. ASD is a term that includes a range of disorders, including both genetic and non-genetic conditions. Some people with ASD are high functioning, while others suffer from serious disability. ASD is highly prevalent, affecting 1 in 36 children in 2020.     Two studies have investigated whether light therapy can be used to improve symptoms of autism. In the first, adults with high functioning ASD received transcranial PBM for 8 weeks. Treatment caused a significant improvement in social responsiveness scores, social awareness, social communication, social motivation, and restricted/repetitive behaviors. In the second, Transcranial PBM with a RL & NIRL laser was used for the treatment of irritability associated with autistic spectrum disorder in children and adolescents aged 5-17 years. Light therapy significantly reduced irritability scores compared to the placebo group, as well as lethargy and social withdrawal, stereotypic behaviour, hyperactivity and non-compliance, and inappropriate speech. Benefits were maintained at both 6 and 12 month follow up. The long-lasting benefits seen in this study are striking, and suggest that brain structure and/or function has improved as a result of treatment with RL and NIRL.       Epilepsy Epilepsy is a brain disorder that causes seizures, which are discharges of electrical activity in the brain. Epilepsy affects 1.2% of the US population, or approximately 3.4 million people. Epilepsy is most commonly treated with drugs, but up to 1/3 of people do not improve with medication. Surgery is another treatment for epilepsy, but it carries some risk.      Although research on light therapy and epilepsy has so far been limited to animal models, the impact of light on seizures and brain health has been positive. A 2022 review article described that “ makes the neurons ‘healthier’ by restoring their function and making them more resistant to distress and disease”. Several animal studies using NIRL have observed positive outcomes, including reduced seizure activity and decreased mortality. This is consistent with research that shows a north south disease gradient with epilepsy, similar to that observed with MS.      Traumatic brain injury / concussion Traumatic brain injuries (TBI) occur when there is a violent blow to the head. Concussions are a common type of TBI. Symptoms include nausea, vomiting, vison and speech problems, and difficulty with memory and concentration. Around 1.7 million people in the US experience a TBI annually, with adolescents aged 15 to 19 and older adults over 65 years being affected more commonly.     Research using light therapy (both RL and NIRL) for TBI has looked at both immediate and chronic effects in animal and human models. Animal studies have shown a reduction in the size of the brain lesion when light therapy was used immediately following trauma, which correlated with the severity of neurological symptoms. Similarly, a case study of a hockey player with a history of six documented concussions using at-home intracranial and intranasal NIRL found improved markers of health using brain imaging. Other human studies looking at behavioral outcomes have observed benefits such as improved sleep, improved cognition, and reduced anxiety and depression.        Chronic Traumatic Encephalitis Chronic traumatic encephalitis (CTE) is a brain disorder caused by repeated head injuries. The injuries damage brain neurons and the condition worsens over time. CTE occurs most commonly in athletes that play contact sports, like football and boxing. CTE highlights the importance of healing traumatic brain injuries, as approximately 17% of people with repeated TBI progress to CTE.     As with TBI, light therapy has been found to benefit CTE. A study of four ex-football players with suspected CTE treated with RL and NIRL to the head found that three of the four players showed improvements in outcomes including depression, pain and sleep. More research is needed to confirm these preliminary findings.   Using Light Therapy for Brain Health There are an increasing number of devices on the market that directly target brain health. Most apply light therapy to the head (often as a hat or helmet), some deliver light to the brain through the nose (intranasally), some target specific areas only (such as the forehead or back of head), and some even shine light on distant areas on the body (such as the abdomen). With so many options available, how can you know which device is best for you? Here are five issues to consider. Style Preference: Your personal level of comfort with a device is important. If it isn’t easy to use, and if it doesn’t feel good on your body, you probably won’t use it consistently. Imagine yourself wearing the device – would you be comfortable wearing a hard helmet, or would you prefer a soft hat? Do you want a device that is wireless, or can you commit to being close to an electrical outlet so that you can plug it in? Do you want the flexibility of being able to lie down while wearing the device? Are you comfortable with having multiple contact points on the body, or would you prefer the device be on only one part? Think about your personal preferences and choose accordingly. Laser vs LED: Light therapy is administered using either laser or LED lights. While early light therapy research was done using lasers, LED lights have become much more popular over the last decade. The research described in this article includes both types of light sources. In 2018, Dr. Michael Hamblin – the world’s leading light therapy expert – concluded that LED lights using comparable parameters to lasers performed “equally well”, which is very important because LED powered light therapy devices can be made at a fraction of the cost of laser devices. Consumers can rest assured that using at home LED powered devices for the treatment of brain disorders is supported by research evidence. For at home use, look for a device that uses LED lights as safe and affordable option. Light Color/Wavelength: As described in this article, both RL and NIRL have been used in studies of light therapy to treat brain disorders. Although NIRL has been used most often, some studies have also found benefit from RL. Light with wavelengths between 600 and 1300nm, in the red and near infrared light spectrums, have been found to penetrate maximally into the brain. So, look for products that provide both RL and NIRL in combination, or NIRL only. Light Intensity: Light intensity refers to the amount of light being delivered by a device. It is also referred to as irradiance. The required intensity when using light therapy to impact brain disorders is unclear. The assumption is often made that for light to influence the brain, it must receive light photons, which must pass through the hair, skin, skull, and cerebrospinal fluid. Studies have found that the deepest penetration comes from higher intensity light sources using NIRL. However, studies have also shown that there are benefits to light therapy that can’t be explained by the depth of light penetration into the brain. For example, cognition and blood flow in the brain have been found to improve when light therapy is applied to the front and back of the neck. Similarly, depressive symptoms improve when light therapy is applied to either the periphery of the body, as well as directly to the brain. Although this isn’t well understand, there are several possible explanations, including effects on superficial blood and lymphatic vessels in the head and neck area as well as connections between the brain and other areas of the body, such as the gut. These “indirect” benefits to the brain from applying light therapy to somewhere on the body are increasingly being recognized as being neuroprotective. The penetration issue has led many companies to develop high intensity devices to support brain health. While these devices have been found to helpful, devices that are lower intensity have been also. Devices across a range of intensities may provide benefit, and consumers aren’t limited to a specific intensity range. Education: While light therapy education will not change the specific functionality of a device, it does have the potential to profoundly impact how someone uses the technology. When a company provides evidence-based education that teaches consumers why, how, and when to use a product, devices can be used to better support healing. Look for products with accompanying education and instructions for use, whether in printed and/or digital formats. You can also look for companies that provide support by phone or email to current or prospective customers.   Conclusion Light therapy with red and near infrared light has shown great promise in supporting brain health. Benefits of treatment have been observed across a wide range of populations, ranging from young healthy adults to elderly people with dementia. Light therapy affects the foundational pathologies that underlie virtually all brain disorders, including oxidative stress, impaired metabolism, and neuroinflammation. This occurs, at least in part, through stimulation of brain mitochondria, which produce energy.  Research using light therapy to support brain health has applied a range of technical specifications, including style of device, light source, light wavelength, and light intensity. Benefits have been observed in most studies, which suggests that consumers have options when it comes to choosing the device that is right for them. Factors such as comfort, cost, and ease of use can be considered. Therapy with RL and NIRL can be used to safely support brain health across the lifespan, making light therapy devices a wise investment for all.     shop red light therapy head wrap   For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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March 15, 2024

Top 10 Evidence-Based Uses for Red Light Therapy

Red Light Therapy, also known as photobiomodulation (PBM), may be used to support the health of cells and tissues throughout the body.  Defined as the use of red and/or near infrared (NIR) light to influence biology, most modern PBM devices emit both types of light, which have similar effects but penetrate the body to different depths. Red light is visible to the human eye, while infrared light is not, although it can be felt as heat. While early research on PBM used primarily lasers, more recent research has found that LED’s can also be used, which also have the advantage of applying light to a larger area of the body as well as an improved safety profile. The use of LED in red/NIR devices has also greatly reduced the cost of treatment, making it something that can be done in the comfort of one’s own home. There are many mechanisms by which PBM affects the body, with the most well-known being increasing the synthesis of ATP (the energy currency of the cell) through effects on the electron transport chain in the mitochondria. The link between PBM and improved mitochondrial function has been well established. This increased supply of energy can be used to do all kinds of cellular work, including healing, growth, maintenance, and repair. There are thousands of published studies showing the efficacy of PBM for a wide range of health applications, ranging from general support for healthy cells to improving brain function in Alzheimer’s Disease patients.  Here, we will review the top 10 evidence-based uses for PBM, as supported by scientific research: Reduce inflammation: Red and NIR light have anti-inflammatory effects, and unlike anti-inflammatory medications (such as NSAID’s), do not cause side effects. Studies have found that PBM affects levels of many molecules involved in inflammation, including reactive oxygen species, reactive nitrogen species, and prostaglandins. The ability of PBM to reduce inflammation suggests that it could have therapeutic potential in many chronic diseases that involve inflammation, including arthritis, Alzheimer’s Disease, and depression. Improve skin health: Red/NIR lights are being widely used in spas and dermatology clinics for their effects on skin health, in addition to at-home use. As already mentioned, PBM can improve the appearance and healing of scars, and it is also helpful in the treatment of wrinkles,  psoriasis, acne, rosacea, burns, and herpes. As well, PBM has been found to increase hair growth through stimulation of the hair follicle found in the dermis of the skin. Improvements in skin health are associated with increased collagen production in the dermis of the skin.  Decrease pain: Pain creates a huge burden of disability, both personal and economic. There is evidence that PBM decreases many types of pain, including knee, neck, low-back, temporomandibular joint, and post-surgical pain. PBM can also reduce pain associated with arthritis and fibromyalgia. There are several mechanisms of pain reduction by PBM, including decreasing inflammation, decreasing oxidative stress, reducing the sensitivity of neurons, and decreasing the transmission of pain related nerve impulses.  Improve athletic performance: PBM has been found to improve athletic performance in several ways, including decreasing muscle damage associated with exercise, decreasing muscle fatigue, improving muscle capacity, and speeding post-exercise recovery. PBM increases ATP production, which is needed for exercising muscles. PBM also helps muscles through increasing the synthesis of antioxidants, reducing inflammation, and decreasing synthesis of lactic acid (although not all studies have found this effect). Animal research has also shown that PBM can reduce muscle loss associated with trauma.    Reduce depression and anxiety: Depression and anxiety are highly prevalent mental disorders, and currently available pharmaceutical medications have limited efficacy and associated side effects. PBM has been shown to reduce depressive symptoms in both humans and animals, likely due to improvements in mitochondrial function, increased brain blood flow, and decreased neuroinflammation. A 2009 clinical trial found a reduction in symptoms of depression and anxiety in as little as a single session of PBM. The effects of PBM on mental health are so compelling that a recent systematic review of PBM concluded that it is “strongly recommended” as a treatment for moderate depressive disorder and is “recommended” for the treatment of anxiety disorder. Studies of PBM and depression often apply PBM directly to the skull, while some use an intranasal approach.  Improve cognitive function: PBM has been shown to improve cognitive function in both healthy and diseased patients. Clinical trials in healthy subjects have shown that PBM can improve outcomes including executive function, which consists of cognitive skills used for planning and performing tasks, as well as memory. People with traumatic brain injury (TBI) and stroke have also been shown to benefit from PBM, due to upregulation of brain repair mechanisms including the synthesis of new neurons. A recent systematic review similarly showed that PBM can help people with Alzheimer’s Disease by decreasing oxidative stress in the brain, reducing brain inflammation, and improving cognition. Speed healing from injury: It has already been mentioned that PBM has positive effects on muscle tissue, including speeding recovery from post-exercise damage, as well as on wound healing, such as from burn injuries. PBM can also speed healing from injuries to bone, including fractures and more complex bone injuries that require the use ceramic materials. Tendon injuries also benefit from PBM, with research showing that PBM increases the amount of collagen, which provides structural support during healing.  Promote fat loss: A somewhat surprising effect of PBM is to promote fat loss. This is particularly true when combined with exercise. A study of obese women found that PBM combined with exercise resulted in a higher percentage of fat loss than when exercise was combined with a placebo light. Another study found similar results, along with changes in levels of a marker associated with increasing brown adipose tissue, which improves metabolism. When combined with treadmill training, PBM decreases the appearance of cellulite and increases metabolism in the thighs. In addition to effects on metabolism, PBM may also cause fat cells to release their contents into the blood, where they can be metabolized or excreted. Improve immune function: Although an in-depth investigation of how PBM affects the immune system specifically has yet to be done, there is strong evidence that PBM improves immune function, as evidenced by its beneficial effects in many immune-related disorders. For example, in Hashimoto’s thyroiditis (an autoimmune disease affecting the thyroid gland), PBM improved levels of thyroid hormones and decreased the need for medication, probably due to a reduction in inflammation. Similarly, in multiple sclerosis (an autoimmune disease affecting the nervous system), PBM increased the regeneration of nerve cells and decreased markers of inflammation. PBM also improves immune function and inflammation in the oral autoimmune disease oral lichen planus. It has even been shown to improve outcomes of COVID-19 infections, likely by reducing inflammation and improving immune function. The process of inflammation is controlled by the immune system, and many disorders (such as autoimmune diseases), involve an impaired immune response.  Improve sleep: Light is a primary regulator of the body’s circadian rhythm, so it is not surprising that PBM has effects on sleep. Application of PBM during wakefulness improves sleep quality in people with cognitive decline, Guillain-Barré Syndrome, fibromyalgia and stroke. Interestingly, sleep duration decreased with full body PBM in elite athletes, while other parameters such as exercise recovery improved. When PBM is applied during sleep, there is an increased clearance of waste products from the brain and improved flow of cerebrospinal fluid, which are required for optimal brain health. So, PBM is beneficial when applied when either awake or sleeping, and the benefits relate more to improving sleep quality and physiology, rather than to increasing sleep duration.  This list of uses for PBM is not exhaustive. Research exploring the use of PBM is expanding into many areas of health, with exciting results being seen in areas including hypertension, polycystic ovarian syndrome, eye health, and fertility, to name but a few. Truly, the range of applications of PBM for improving health is incredibly vast and can be explained by the cellular and molecular changes induced by light exposure.  If you’re interested in buying a home PBM device, you have many options. When choosing a device, first look for a one that emits both red and NIR light. Second, look at the power of the device. While many high powered PBM units are available (usually at a higher price point), research shows that when it comes to light, more is not necessarily better. This is because PBM treatment to many tissues has a “biphasic” effect, where lower levels are beneficial while higher levels are not. But you don’t want to go too low, or you won’t get the treatment effect. Many of the cheaper devices on the market are underpowered and provide very little irradiation. At Fringe, our PBM devices were designed to mimic exposure to the sun, with consideration of the range of light exposure used in scientific research. Lastly, consider the type of device that is most appropriate for your condition. PBM devices come in panels and wearable forms such as wraps, with wearables providing more flexibility in terms of application and panels being better for general irradiation of larger surfaces.  For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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February 7, 2024

Red Light Therapy for Seasonal Affective Disorder

What is Seasonal Affective Disorder (SAD)? Seasonal Affective Disorder (SAD) is also known as the “winter blues” or “seasonal depression”. In the simplest terms, it is depression that follows a season pattern, usually occurring in the winter. SAD is considered a variant of Major Depressive Disorder or Bipolar Disorder, rather than a distinct condition. It is recognized in the Diagnostic Manual of Mental Disorders (DSM-5) and affects around 5% of US adults. January and February are the hardest months for people with SAD. The symptoms of SAD are similar to the symptoms of non-SAD depression, and include: feeling sad  fatigue and loss of energy loss in interest or pleasure in activities changes in appetite and sleep (especially overeating and oversleeping) feeling worthless or guilty difficulty thinking, concentrating, or making decisions physical aches and pains thoughts of death or suicide.  SAD occurs at a specific time of year and the diagnosis requires that it recurs at least two consecutive years in the same season. Symptoms last for around 4 to 5 months, and there is full remission of symptoms when the season ends. SAD usually occurs in the Fall or Winter. Risk factors for SAD include being female, living at a northern latitude, a family history of SAD, and being between 18 and 30 years of age. Both pharmacological and non-pharmacological treatments have been identified as first line therapies for SAD. Pharmacological treatments include antidepressant medications, such as selective serotonin reuptake inhibitors. Non-pharmacological treatments include cognitive behavioral therapy and light therapy. The goal of light therapy is to compensate for the loss of natural sunlight during the shorter and darker winter months, and most often involves exposure to bright white light.  What is the relationship between light and SAD? The seasonal nature of SAD and its high prevalence during the winter months, along with resolution during warmer, sunnier seasons, suggests a causal relationship with sun and light exposure. Human biology is clearly linked with the rhythm of the sun, with people naturally following a sleep/wake cycle that is associated with night and day. This sleep/wake cycle is also known as our circadian rhythm. Circadian rhythms are the “physical, mental, and behavioral changes an organism experiences over a 24-hr cycle.” In addition to light and dark, circadian rhythms are also influenced by temperature, diet, exercise, stress, and social environment. Light, however, is the primary regulator, and it exerts this influence through effects on the brain. The influence of light on the brain starts with the eyes. Light enters the retina and activates cells called intrinsically photosensitive retinal ganglion cells. Retinal ganglion cells are active even in people who are completely blind, who show similar sleep and wake cycles to sighted people because of the response of these cells to light. Retinal ganglion cells show their greatest response to the blue light spectrum. Sunlight contains blue light, in addition to many other wavelengths of color. From the eyes, a signal is sent to the suprachiasmatic nucleus in the brain. Known as the “master circadian clock”, the suprachiasmatic nucleus is the most important circadian regulator. The clock in turn sends out many signals that regulate a wide range of processes in the body, including controlling the expression of up to 10% of our genes. Light is the primary regulator of this internal clock, although there are other non-light influences on this rhythm too.   Melatonin and cortisol are the main hormonal mediators of the circadian rhythm, and the synthesis of both is regulated by light. Melatonin is secreted in response to the absence of light, triggering sleep. Cortisol is secreted in response to the presence of light, triggering wakefulness. The synthesis of both melatonin and cortisol is controlled by signals that come from the suprachiasmatic nucleus.  In the winter months, decreased exposure to light causes the circadian rhythm to shift later in the day, which results in a misalignment between the sleep-wake cycle and the circadian rhythms’ natural processes. Exposure to certain types of light on winter mornings pulls the circadian rhythm back into alignment.  Different types of light are known to have variable effects on the circadian rhythm. Both bright white and blue light suppress the release of melatonin, which promotes wakefulness. Blue light exposure can cause the circadian rhythm to shift even when applied later in the day, unlike bright white light which is more effective at causing a shift in the morning. Red light does not suppress melatonin levels or cause the circadian rhythm to shift. These variable effects of different wavelengths (colors) of light have important implications for light therapy, which is the application of external light sources to affect biology. Exposure to light has been clearly shown to be associated with mood. A study of over 400,000 people showed that increasing exposure to daylight associated with reduced risk of major depression and greater happiness. This may be mediated by serotonin, which is known as a “natural mood booster”. Serotonin is a critical link and regulator of both the circadian rhythm and mood, and levels increase with sun exposure. In contrast to the positive mood effects of sunlight exposure, exposure to artificial light later in the day can have adverse effects. In simple terms, the naturally stimulating effect of white and blue light on wakefulness is helpful in the early part of the day but is harmful in the evening and at night.  The associations between light and levels of melatonin, cortisol, and serotonin provide clues as to how the dark, short days of winter can negatively impact mood. And while more research is needed to clearly understand the pathology of SAD, its positive response to light therapy suggest that light is one of the most important mediators.  How is red light therapy for Seasonal Affective Disorder used? Light therapy is widely accepted as a first line non-pharmacological treatment for SAD. Usually, this involves treatment with bright light (called Bright Light Therapy, BLT), but dawn simulation is also used. Dawn simulation delivers light that gradually increases during the last half hour of sleep, while BLT delivers very bright light (most often white, but sometimes blue) shortly after waking. Bright light therapy has been shown to be more effective for people with more severe depression, but both are beneficial. As already described, retinal ganglion cells in the eye respond to light, particularly in the blue spectrum. White light contains all visible light frequencies, including blue, and both white and blue light promote wakefulness, in part through suppression of melatonin. This is why white and blue light are the main sources of light used in SAD light therapy. Light intensity is measured in Lux, and bright light is typically considered to be at least 10,000 Lux. Light intensity varies greatly, sometimes in surprising ways. Here are some light intensities under different conditions: Bright sunlight = 120,000 Lux Bright sunlight = 110,000 Lux Shaded area on a sunny day = 20,000 Lux Overcast day, midday = 1,000 – 2,000 Lux Sunrise/Sunset (clear day) = 400 Lux Sunrise/Sunset (overcast) = 40 Lux Moonlight (clear night) = 1 Lux Office lighting = 200 – 400 Lux Home lighting = 50 – 200 Lux In BLT, an external light source (usually called a “light box”) is used that delivers light at around 10,000 Lux. It is recommended to use BLT in the early morning shortly after waking for approximately 30 minutes. The person should position themself 60-80cm from the light box, with the light at eye level. Lower intensity light can be used (2,500 - 5,000 Lux) but with lower intensity light the treatment duration is extended to 1 to 2 hours. Treatment should be done until the season ends. Light used in BLT will be delivered by either fluorescent or LED lights. Fluorescent lights deliver white light, either warm or cool, while LED lights can deliver both white and blue light. White light is referred to as “colorless daylight” and is made up of all the frequencies in the visible light spectrum (including red, yellow, green, blue, etc.). White fluorescent bulbs and LED lights will also contain all of the visible light frequencies but they can vary in their spectral characteristics, such as the particular wavelength distribution and intensity.  When the spectrum of light from bright light devices is analyzed, it varies depending on the light source. Fluorescent lights, both warm and cool, emit light that shows several peaks that correspond to different colors, including red. White LED diodes usually have a sharp blue peak, but they also contain wavelengths of different colors. The main difference between white and blue BLT devices is that white light contains multiple colors (called polychromatic), even though it appears white or colorless, while blue light is a singular color (called monochromatic).  It is sometimes claimed that SAD light boxes provide a “hefty dose” of blue light. This is not entirely true. The spectral analysis of devices that use both warm and cool fluorescent lights reveals a mixture of wavelengths (yes, including blue), but their calculated “blue light hazard” level is actually quite low. Warm fluorescent light is a bit better than cool fluorescent light, which showed around the same blue light hazard as white LED light. It’s also important to note that blue light is “disruptive” to the circadian rhythm precisely because our bodies are naturally designed to respond to the blue wavelengths of light from the sun. When used in the morning, exposure to blue light (even artificial) provides a cue for the system to wake up. It should go without saying that bright light therapy devices should not be used in the evening. BLT has been found to effectively reduce the symptoms of SAD, although white light shows more effectiveness than blue light. A meta-analysis published in 2015 found that bright white light therapy was effective, although the effects were weaker at some time points. A meta-analysis of bright blue light therapy for SAD did not find it to be beneficial.  How Does Seasonal Affective Disorder Relate to Different Wavelengths of Light? SAD is related to the lack of daylight, or sunlight, during winter months. Sunlight consists of solar radiation, which is energy that is transmitted in the form of waves or particles. The spectrum of light in our environment consists of both light we can see (visible light) and light that our eyes can’t perceive (invisible light). This is called the electromagnetic spectrum. The visible light spectrum is quite narrow, consisting of wavelengths that range from 400 to 700nm and span from violet to red in color. Although the amount of solar radiation is not constant, approximately 40% percent of the light from the sun is visible light, which can be divided by color and wavelength. Near infrared light waves lie just beyond the “red” end of the visible light spectrum, so we don’t see them. Near infrared light is part of the “infrared” spectrum, which consists of both near infrared and far infrared light. Infrared light makes up 50% of the solar radiation that reaches the earth. The remaining 10% of the light from the sun is also invisible, falling just beyond the opposite “violet” end of the visible spectrum to IR. This is called ultraviolet light (UVL).  What this means is that BLT only partly mimics the natural effects of sunlight, since it delivers only visible light. Bright white light does not include light in the UV spectrum of the sun. This is done intentionally, since UV rays are the component of solar radiation that are the main culprits in causing skin cancer. Bright white light also does not include light in the infrared spectrum of the sun. This omission is less justified, since infrared light does not have harmful effects on the skin (quite the opposite, in fact), and infrared light makes up a significant amount of natural sunlight. BLT that uses blue light excludes not only UV and infrared light but also the non-blue wavelengths of light, including red, orange, yellow, green and violet.  Does Red Light Therapy Improve Seasonal Affective Disorder? Red and near infrared light therapy is the application of artificially generated light in the red and near infrared spectral bands. The term “red light therapy” usually describes the use of both red and near infrared light, although only the red light produced by the device is visible to the naked eye. Infrared light can still be perceived by the body as heat when it contacts skin. Like BLT, red and near infrared light therapy does not involve the use of UV rays. The red light used in light therapy usually ranges from 600 to 700 nanometres (nm), with the unit nm referring to distance the light wave travels in one cycle. The near infrared light used in light therapy usually ranges from 800 to 1100nm.  Interestingly, there are no clinical trials of red light therapy to treat SAD, but there are many that have been done looking at the effects of red light on non-SAD depression. All of the non-SAD clinical trials of red light therapy used near infrared light applied directly to the head. A 2022 systematic review concluded that near infrared light therapy “can be classified as strongly recommended for moderate grade of major depressive disorder”. Similarly, a 2023 meta-analysis concluded that there is a “promising role of in the treatment of depressive symptoms”. These results demonstrate that red light therapy has positive effects on mood. Another challenging symptom of SAD is sleep disturbance, which is another issue that red light therapy has been found to help. Application of red light therapy during wakefulness improves sleep quality in people with cognitive decline, Guillain-Barré Syndrome, fibromyalgia and stroke. Interestingly, sleep duration decreased with full body red light therapy in elite athletes, while other parameters such as exercise recovery improved. When red light therapy is applied during sleep, there is an increased clearance of waste products from the brain and improved flow of cerebrospinal fluid, which are required for optimal brain health. So, red light therapy is beneficial when applied when either awake or sleeping, and the benefits relate more to improving sleep quality and physiology, rather than to increasing sleep duration.  As already described, increased exposure to outdoor light is associated with reduced risk of major depression and greater happiness. Since outdoor light is a combination of visible light (including blue and red), infrared, and UV light, this contrasts with the light used in BLT, which includes only white visible light or blue monochromatic light. With so many studies showing a benefit to using red light therapy (especially infrared light), it is possible that the addition of red light in the treatment of SAD could be beneficial.  Combining Bright and Red Light Therapy to Improve Seasonal Affective Disorder Red light therapy can easily be combined with BLT in the treatment of Seasonal Affective Disorder. Since the rising sun appears red when first coming up over the horizon, exposure to red light followed by exposure to BLT is recommended. This is a practice that I’ve been doing for several years, following decades of winter seasons in which I suffered from some degree of seasonal depression. Initially, my doctor recommended that I purchase a fluorescent light box, which I used successfully for a few years. After gaining knowledge of red light therapy, I combined the two and now use them in tandem.  My recommended practice is as follows:  Shortly after waking, use a red light therapy panel (that delivers both red and near infrared light) for 10 minutes, sitting comfortably 6 to 12 inches away. If you prefer, or if it’s uncomfortable to keep your eyes open in front of the red light panel, you can close them – light still penetrates through to the retinal ganglion cells. However, it is safe to open your eyes as long as your red light panel is low to moderate intensity. The 10 minutes spent in front of the red light panel provides a great opportunity to work on breathwork or mindfulness, which have positive effects on mood. After 10 minutes of red light therapy, use a light box that delivers white light (preferably using warm fluorescent bulbs, which have a lower blue light hazard ratio) for 20 minutes. It is possible to do normal activities while in front of the light box, so people usually set them up in an office (so that they can work on a computer or read) or on a kitchen island. I recommend setting it up in an office space and spending that 20 minutes engaged in an activity that generates a positive mood. For most people, this means avoiding reading the news, but you can do things like sending emails to friends or reading something uplifting. Taking time to be calm and to orient your attention in a positive direction uplifts mood. Avoid bright light, especially blue light, at night. Exposure to blue light (especially bright blue light) is disruptive to sleep, which is why it is not recommended to use electronic devices (like iPads or e-readers) that emit blue light at night. Keep household lighting dim in the evening and at night. Red light therapy may also be used at night, although you should position yourself farther from the panel so that the light is less intense. Red light panels can even be used as a source of evening/nighttime illumination. Red LED light bulbs may also be used as a source of illumination at night.  Conclusion We often hear the recommendation by health experts these days to “view morning sun” as a way to optimize health, including mental health. While it is no doubt ideal to have exposure to natural light in the morning, for people that live in cold winter climates this can be very difficult. Under these circumstances, light devices – both bright and red light - can be used to mimic sunrise and sun exposure. Although the combination of bright and red/near infrared light has yet to be subject to intensive research, there is strong evidence that both exert a positive influence on mood. Since daylight consists of a combination of light wavelengths, including near infrared light, there is good reason to believe that these two may work in tandem as a powerful tool in the prevention and treatment of Seasonal Affective Disorder. For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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January 31, 2024

Red Light Therapy for Alzheimer’s

Red Light Therapy for Alzheimer’s and Dementia Alzheimer’s Disease (AD) and other forms of dementia affect more than 1 in 10 US adults over the age of 65. These diseases are devastating, causing memory loss, disorientation, behavior changes, and an eventual loss of independent functioning. Effective treatments are limited but are desperately needed, especially ones that are safe and have minimal side effects. In recent years one treatment that has shown success in reducing the symptoms of AD and dementia is therapy with red and near infrared light (often referred to as “red light therapy”). In 2021, a comprehensive review of 10 studies of dementia patients treated with red light therapy found that every one of them reported positive results.  Red light therapy for AD is usually applied to the brain, but it can also be applied to the gut. This is because light therapy to the gut affects the gut microbiome. The gut microbiome is known to communicate extensively with the brain (called the gut-brain axis) and to influence functions like mood and patterns of brain communication. A 2022 clinical trial combined red light therapy to the brain and gut in patients with mild to moderate AD. Patients receiving red light therapy showed improved cognitive function relative to the control group. Research has also shown that red light therapy benefits patients with AD when combined with exercise. There are many benefits of light therapy in AD and dementia that occur on a cellular level. These include improving the production of cellular energy, decreasing brain inflammation, and reducing cellular stress – which may ultimately decrease the production of amyloid plaques, which buildup in the brain of AD patients. Red light therapy has also been shown to improve blood flow to the brain. Benefits are from direct absorption of light into the brain as well as by superficial blood and lymphatic vessels in the head. The brain may also benefit when light therapy is applied to other locations on the body, such as the gut and various acupuncture points. As a comfortable tool for targeted cellular healing, cognitive function, and brain health, the Fringe red light therapy head wrap contains 450 LED light chips to provide light therapy and light coverage over the forehead, top, sides and back of the head. With wavelengths of red (650nm), near infrared (810nm), and deep penetrating near infrared light (1050nm), it delivers light to the front, back, and sides of the head. Unlike most devices on the market, the Fringe red light therapy head wrap is wireless and flexible, making it both comfortable and portable.  For more information about Fringe light products, go to: https://fringeheals.com/shop-all-products/

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