At The Neuro Well, we encounter many patients who have tried it all. Several medications, treatments, and dietary interventions. Things sometimes go well, sometimes they go wrong.
And often, no one’s looked at what’s happening underneath.
That’s where blood work comes in. We’re talking about specific biomarkers that tell us whether your body is actually giving your brain what it needs to function.
Where we discover deficiencies or disproportions here, fixing them can change things that medication alone could not accomplish.
Not every time, but frequently enough that these tests are worth running.
Your Body Feeds Your Brain
This is so self-evident, yet it can be overlooked. All of the neurotransmitters, all of the neural connections, all of your thoughts rely on raw materials that your body provides.
When such materials are scarce, your brain cannot perform its task well.
Standard blood panels miss most of this. They are set to prevent large-scale disease, rather than minor deficiencies that impact mood, attention, and thinking ability.
Here are ten biomarkers that actually matter for brain health.
The Nutrition Markers
1. Vitamin B12
B12 is needed to produce dopamine, serotonin and norepinephrine. When you lack sufficient amounts, your brain will be unable to generate sufficient quantities of the neurotransmitters that control mood and energy.
The issue is that normal levels of B12 (anything more than 200 ng/mL) were set to avoid anemia, rather than by supporting the functioning of the brain.
To be healthy neurologically, you want quantities of more than 400 ng/mL.
Who’s usually low: vegans, people on acid reflux medications long-term, and adults over 50.
The animal products are the source of B12. Unless you eat those or you have problems with absorption, you have to supplement.
Some people have a genetic variation (MTHFR, which we’ll get to) that means they need methylated B12 specifically.
2. Red Blood Cell Magnesium
Not serum magnesium. RBC magnesium measures what’s inside your cells, where it actually works.
There are hundreds of processes in your brain and body which involve magnesium. Once it is low, you may tend to experience headaches, anxiety, muscle tightness, and insomnia.
(Also see: Migraines Without Headache? Understanding Psychiatric Migraine Variants)
Nearly half the population no longer gets enough out from food due to agricultural soils having lower magnesium than they previously did.
Target: at least 4.3 mg/dL
It is found in nuts, seeds, and greens.
Magnesium glycinate or citrate supplements seem to be effective in the vast majority of individuals. Particularly when you are struggling with chronic headaches or lack of concentration.
3. Omega-3 Index
This measures EPA and DHA levels in your red blood cells. These fatty acids literally become part of your brain structure. Your neural tissue is mostly fat.
A great level of omega-3 means fewer inflammations, enhanced membrane functioning, and improved neuron-neuron communication.
The majority of Americans are way below the optimum levels.
Target: above 8%
Salmon, sardines, and mackerel are the best sources of fatty fish. ALA is found in plant foods such as walnuts and flax, and your body must be able to turn it into DHA.
Most people do not convert it efficiently, hence fish or fish oil supplements tend to be more effective.
The Circulation Markers
4. ApoB:ApoA Ratio
This measures inflammatory versus anti-inflammatory cholesterol particles. Standard cholesterol tests don’t give you this information.
Your brain uses 20% of your blood flow. If your arteries are inflamed, that affects how well your brain gets what it needs.
This ratio tells you more about cardiovascular health, and therefore brain health, than LDL and HDL alone
Target: below 0.6
Physical activity helps. So does fiber, fatty fish, and reducing processed food intake. The goal is to keep your blood vessels healthy.
5. Homocysteine
An accumulation of this amino acid causes blood vessels to be damaged and inflamed. Elevated homocysteine levels are a major risk factor for stroke and rapid cognitive decline.
Who’s at risk: people low in B12 or folate, those with migraines, family history of stroke or dementia, smokers, and people with MTHFR variations.
Target: 10 mmol/L or below
The dark leafy vegetables contain folate. Adequate B12 matters too. Both are used in the breakdown of homocysteine in your body.
In case the levels remain high even with supplementation, then the MTHFR gene may be responsible.
6. MTHFR Gene
MTHFR encodes an enzyme which transforms homocysteine into neurotransmitters with the help of B12 and folate. There are individuals whose gene variations render this enzyme inefficient.
This is worth checking out in case you have high homocysteine despite normal B12 and folate, or in case you have a treatment-resistant depression or chronic fatigue.
Individuals who have variations in MTHFR require methylated versions of B12 and folate since their body systems cannot efficiently work with the normal versions.
The Metabolism Markers
7. HOMA-IR
This calculates insulin resistance by looking at fasting glucose and insulin together. It tells you how efficiently your metabolism works.
Your brain runs on glucose. If your metabolism is inefficient, that affects cognitive function. There’s growing evidence that Alzheimer’s has a metabolic component; some researchers call it type 3 diabetes.
About a third of American adults have metabolic issues. Family history matters, but so do muscle mass, diet, and activity level.
Target: below 1.9
Building muscle is the most effective intervention. Colorful plant foods help. So do spices like cinnamon and turmeric. But really, it comes down to movement and muscle.
8. Adiponectin
Fat cells make this hormone. Healthy fat cells make more of it. When you have too much body fat or unhealthy fat distribution, production drops.
Adiponectin regulates how your body converts food into energy. Higher levels correlate with better cognitive function and lower dementia risk.
Target: at least 14 ug/mL
Again, building muscle helps. So does reducing body fat percentage. Some evidence suggests curcumin supplementation may help, but strength training is what really moves the needle.
The Gut Markers
9. Celiac Antibodies
Celiac disease makes your immune system attack your intestinal lining when you eat gluten. This may inhibit nutrient absorption even in the absence of obvious gut symptoms and result in neurological problems.
Tests can measure anti-gliadin and tissue transglutaminase antibodies. In the event of a positive and full gluten avoidance leaves your gut to heal and reabsorb.
You can still eat gluten-free whole grains like quinoa, buckwheat, and rice.
10. Food Allergy Antibodies
IgE testing identifies immune reactions to specific foods. Common triggers include dairy, eggs, nuts, shellfish, wheat, and soy.
Chronic inflammation anywhere affects your brain. Finding and eliminating trigger foods reduces that burden.
If tests come back negative but you still have digestive issues. It might be IBS, a stress-related gut disorder that often responds to magnesium and stress management.
How We Use This Information
These biomarkers are not isolated. Low B12 in combination with high levels of homocysteine and a poor omega-3 level speaks volumes.
It may be one of the causes as to why a person is not responding to traditional depression treatment, or why the brain fog cannot be removed, even with all the efforts that they have undertaken.
By this we do not mean that nutrients will replace psychiatric or neurological therapy.
Nevertheless, with the ability to address these underlying issues and treatment, a considerable difference is normally obtained.
Clarity of thinking, enhanced mood stability, increased energy, and enhanced sleep.
Checking these labs early in life can reduce risk for stroke and heart attack, and dementia in older age.
Not all ten tests are necessary for everybody. But when you have been treating a set of symptoms that have not entirely cleared with conventional treatment, like mood problems, cognitive problems, chronic fatigue, and inexplicable neurological symptoms, it is worth considering what is going on at this level.
The brain is only able to work to the extent that your body provides.
Sometimes the answer isn’t a different medication. Sometimes it’s getting your biochemistry right first.
If you want to explore this as part of your care, we include biomarker evaluation in our comprehensive assessments at The Neuro Well. Contact us to schedule an appointment.
