Brain Stress, Trauma, and Recovery with Dr. Titus Chiu

Dr. Joel Rosen: All right. Hello, everyone and welcome back to another edition of the less stress life where we teach exhausted and burnt-out adults the truth about adrenal fatigue so that they can get their health back quickly.

And I’m really excited to be joined by a colleague, a mentor, educator, Dr. Titus Chiu. He’s the number one best selling author, award-winning international speaker, and a leader in the field of functional neurology, who help people struggling with post-concussive syndrome, get their brains and lives back. So Dr. Titus, thank you so much for being here today.


Dr. Titus Chiu: Yeah, thanks so much for having me. Appreciate it.


Dr. Joel Rosen: Yeah, so listen, I’ve, I’ve seen a lot of the work that you do. And ultimately, I want to delve into the post-concussive field and how that relates to stress, exhaustion, burnout, because the people that listen to this podcast are exhausted and burnt out and frustrated, because a lot of times they go see their doctor and Adrenal Fatigue is not real, and or their blood tests are normal.

And ultimately, they are not taken seriously. And they’re frustrated. And I always love to bring in experts about that around that field, but more specifically, things that can lead to fatigue, exhaustion, and burnout. And really, in terms of post-concussive injuries, that’s a huge area to discuss.

But before we get into that, Titus, can you tell us a little bit about yourself, your background, I know you have your own personal health story, maybe help the listeners understand a little bit about your own health challenges that you had had in the past?


Dr. Titus Chiu: Yeah, definitely. So over 20 years ago, I was in a really terrible car accident. And I ended up with broken ribs and a dislocated shoulder I was actually on a scooter on my way to work, and it was hit by a car and got thrown from that. And thank God, I survived. But I was left with chronic pain. And I didn’t know it at the time, I actually had suffered a concussion as well. And so through that whole process, I tried to find answers for the pain and the discomfort, and, you know, all the different symptoms I was experiencing.

And I was shocked, because, you know, I was raised in conventional medicine, a lot of my, you know, the family are medical doctors and nurses and, you know, speaking Better yet, against them. They’re great. But the whole model within conventional medicine of just focusing on symptoms, I was shocked, because I couldn’t find answers, you know, outside of painkillers or, you know, things like that, that just didn’t give me long term relief. So I decided to take it, you know, upon myself and I went outside the box, and I went back to school, I got a master’s in nutrition. I did a postdoc in clinical neurology.

I even studied chiropractic, and acupuncture, and all these everything I could get my hands on, to start getting answers to these symptoms I was experiencing, and also everything I could get my hands on, so I can share, you know, my breakthroughs with my patients in the world. And so fast forward those over 20 years ago, fast forward. And so here, I am really living that out. Because my mission is to really empower people, high achievers who have experienced concussion or trauma to get their lives back to go from surviving to thriving.


Dr. Joel Rosen: Awesome. Yeah. And you know, when you have that personal story, too, I have that story as well. I hurt my back. I had an exercise physiology degree. And I was watching those bodybuilding magazines, and I injured my back. And I’m from a traditional family of medical doctors as well. And I say I’m like the weird black sheep holistic guy wanted me to go for surgery.

And I was no way I was having surgery. Like, listen, I can rehab it on my own. And then it led to like, in your what you just described going down that rabbit hole. Yeah. And being yourself and then learning how to help other people. So I can resonate with a lot of that with what with and again, not that traditional approaches are bad. When there are major health acute based challenges.

There’s nowhere else you’d want to be to Yeah, and you know, going to lunch, right, exactly, yeah. Go ahead.


Dr. Titus Chiu: That’s, you know, that’s the thing when I got hit by that car, I was taken by ambulance to the emergency room. So I am so thankful for the doctors and nurses that attended me there because just like you said, when it comes to more life-threatening crises, you know, of, you know, health conditions, hands down conventional medicine all the way.

But I found that there was this huge gap and that was my experience at the time and the further I drove Especially around concussion, I found that there’s a massive gap in health care, right? being like discharged from the ER and then actually then getting follow up care for things such as post-concussion syndrome that can develop sometimes months or years after the event.

So yeah, I totally agree with you, you know, I’m on the same page when it comes to emergency health, especially conventional medicine hands down, but I find that things like well, we do the functional approaches really helps to fill in that gap for so many people are struggling more with more chronic health issues.


Dr. Joel Rosen: For sure, there are so many more shades of gray than black and white. And you know, in an optimal sort of looking at the glass half full, it is frustrating because I know when I was exhausted and burnt out, and I was searching for help, I didn’t get taken to the hospital in an ambulance. Right. I was exhausted and burnt out. And then I was told that it’s black or white, you know, you either have an Adrenal Exhaustion, it’s adrenal insufficiency. It’s Addison’s disease, or, you know, right.

And I think it’s similar to in the sense that with a concussive, like injury, Shades of Grey is not really in the, in the sort of the allopathic approach or curriculum, I would imagine. So that’s where we can sort of springboard into that. So the first question I would have for you Titus is when you were injured and hit and had that dreadful injury. What was it What were the symptoms and how did it get on your radar? That Okay, actually because unless it’s like a mike pipe, Tyson knockout punch, or out cold?

Yeah, I’m sure that many people don’t realize that there were concussive injuries and there was it fills the the the box in terms of all the characteristics that define that. So started to specifically ask you the question, what were the symptoms that you had? And then how did it get on your radar that you knew you had actually a concussion?


Dr. Titus Chiu: Yeah, that’s a great question. And through my whole experience, diving into this world and specializing in post-concussion syndrome, I find that it is a silent epidemic. Like when I had mentioned when I first was in a car accident, I dislocated my shoulder, I broke ribs. And so the main symptoms I was kind of struggling with was chronic neck and shoulder pain, you know, and so I wasn’t even thinking about a concussion. I was wearing a helmet when I look back on it now.

It’s like, Oh, yeah, I definitely did. I just, I was so focused on the pain, but I was actually wearing a helmet. And it was like, really, it was strapped in really tight Rigel. But when I hit the ground and kind of came to and caught my wind, again, I actually didn’t get knocked out, I got the wind knocked out of me. But when I came to my helmet, who had like, fallen off from the impact, even though it was buckled. So when I kind of look back at it, I kind of put the pieces together later on. So it’s really interesting because the most pressing symptoms at that time were chronic neck and shoulder pain. And who’s actually chiropractic, my brother who adjusted me, and within a few treatments completely changed my life.

I’m like, oh, my goodness, like, like this whole world opens up. So I went back to school. And as I went through the process, that was the thing, like I said, it’s a silent epidemic because I didn’t even realize I had a concussion or post-concussion syndrome. Number one, for those of you watching out there. One of the most common myths about concussions is you even need to hit your head, right you don’t even need to hit your head doesn’t have to be a physical trauma to your head. Because your brain is like it sits like in a fishbowl is sloshing around your skull and in bathe in the cerebral spinal fluid. And so even if I’ve had patients who I work with, even if they’re like skiing, and they land really hard, and then they develop all these symptoms, or if they fall off their bike and they kind of catch themselves with their hand.

Don’t even hit the head but the reverberation goes up, and then they develop symptoms. So that’s the number one biggest misconception with a concussion is that you need that be knocked out or see stars or even a hit your head. So that was my understanding at the time as well. And so, like it was really interesting because when I went back to school, I started experimenting with my health like changing my diet. Everything that I learned to like in workshops and conferences and in the school itself, I would actually apply to my own life and a lot of health issues I had before that car accident like brain fog and being sick all the time kind of stuff you described, right? Just kind of a more chronic, just not feeling well a lot of that stuff melted away. But what was really strange was, I would say, probably about five years after that car accident, I started to develop more cognitive and psychological symptoms. And when it got really bad, I developed, like vertigo, I’d have these vertiginous events where I’d literally be sitting, like at dinner, right, just sitting there eating my food, and all of a sudden, I feel the whole room move, or I thought was the room is actually the inner ear otolithic system out of balance, right. But it gave the illusion of that movement.

And so I, but that was like five years after that concussion, you know, it’s like, well, we kind of talked about before we got on this call here. You know, I see concussion as the silent epidemic, a very recognize root cause for these chronic stress conditions, right? I see a concussion, both as a physical, chemical, and emotional trauma, right? Because of the physical trauma, if they have the reverberation or you get hit in the head, that’s trauma. And that impacts the biomechanics, and it could lead to cooler counter-coup injuries.

Number two, it’s a chemical trauma because, after that, you trigger an immune excitotoxic response in both inflammation and excitotoxicity, where the brain cells become over-activated, they can’t handle it. And then people develop symptoms like brain fog or brain fatigue. And then finally, emotionally just, you know, having struggled with it for so long, and not finding answers. And I know work with a lot of people who have, you know, especially the messaging they get from a lot of the doctors they see or maybe even.

Well, meaning friends and families I go, you just have to get used to your new normal, right. And so I’m here to say that number one, you don’t have to get used to your new normal, because there are so many things that can be done to at least improve the situation. But yeah, so that was my whole experience as well, I, you know, it wasn’t this immediate, like, all of a sudden, I was losing my memory and I was having brain fog. It’s like it developed over many years. And when I think back on it, it was like that was like a massive stressor that was never attended to. And then other stressors I had to deal with, like with school and with starting a practice.

And you know, I wasn’t the healthiest. Even though I was making these changes, I was still didn’t have the healthiest lifestyle. So all these stressors compounded. And then I developed the post-concussion syndrome, you know, and but I really looked back and I see that that trauma from the car accident was massive, you know, pre predisposing event for sure. For sure,


Dr. Joel Rosen: I mean, it’s interesting because I don’t even think it’s a silent epidemic for those that get it. But for the providers like you and me or not so much you, but for a lot of complicated presentations, titles that come in the office that Yeah, you know, something’s missing. Why Why do you still have vertigo? or Why do you still have headaches, I mean, I’m looking at the neuro psycho immune component. And I think it really behooves the provider to really have an amazing history.

And sift that out during that history so that you can tailor your approach and consider that. So we’ll get into that. One of the things that I teach as well, and I’m sure you’re familiar with is that whole-cell danger, where when you have a cumulative effect of stressors, acute one-offs, plus an insidious continuation of stressors, that ultimately I tell people that you just don’t have enough supply to meet the demand. And as a result, the weak link in the broken chains break in different places for different people and manifest as fatigue, exhaustion, burnout, sexual function, all these things.

But the next thing that I would say, though, is in that second paper, by Dr. Navio, that talked about cell danger. He also talks about incomplete healing, so that you don’t really go through the healing cycle to the full extent. And it rings any more true than it would with a post-concussive type sin or diagnosis. Does that make sense?



Dr. Titus Chiu: Absolutely. Yeah, I see that all the time to you know, because for my experience, and what I see a lot of my patients and private clients is like, they have a concussion, or they have some type of trauma, may be mild or sometimes stronger. And they’re just like, you know, they just kind of went on with their life. And then whenever they get in touch with me, they’re like, Yeah, I don’t know what happened. But this time, I just knew something was different like I’ve had concussions in the past, but this time, I just, you know, it, it felt different, and then From there, they develop the further symptoms.

And so that’s absolutely in line with the latest research with a concussion and all, you know, the build-up of, you know what we call immune excitotoxicity, right, you get inflammatory processes turned on and activated in the nervous system by these immune cells we call microglia. Right? Normally, our immune cells, the microglia, should be just kind of surveying the area. But after a concussion, they become activated and they start to release inflammatory chemicals. Normally, if a person then like, is aware of that, and, you know, honors their need for rest and restoration, then in many cases, not always, though, that inflammatory process will go back to baseline, right. But number one, what I see is, people don’t allow give themselves that downtime, and then they end up just going back into life fully full-on stress, or maybe they get hit on the head again, and then that is, so if they don’t address that, you know, properly, then it builds up.

But a lot of times, it’s not their fault, because they weren’t educated about it by their doctors. But then number two, what I also see is a baseline, some type of issue is already going on, you know, you know, we talked about that, right, with stress, it’s just the build-up of the bucket, right? where, you know, maybe they had leaky gut at the time of the head injury. So if their inflammation levels were really not like, let’s say, green is normal, and red is in the high alert, let’s say their inflammation levels are about yellow-orange, to begin with, and then they got the head injury, then it immediately took them in the red, and it took them a really long time to get back to baseline. If ever, like a lot of people, I just that’s the thing, you know, things can be done.

And there’s so much everyday research and breakthroughs. You know, and I’ve spent, like, again, the past 20 years, both personally and professionally, kind of curating all that. But the point is, the sooner action is taken, like serious action to start decreasing inflammation, start healing the brain and retraining those areas and identifying first and foremost, what is the root cause preventing them from feeling better? Again, you know, without taking those steps, then it could be a really long arduous road. But it doesn’t have to be that’s the great news.


Dr. Joel Rosen: Yeah, no, that’s a great insight, Titus, and what you just shared, I think it relates to a lot of proactive preventative maintenance in terms of you have a female who’s pregnant, her delivery, and her recovery is going to be that much more accelerated when she goes into the pregnancy healthier. Same thing in today’s day and age with COVID. You know, the more proactive The more I guess the more vital the vitality of the person that gets the illness. And ultimately, this, you know, goes back to many, many decades ago about, you know, it’s the host, that is more succumbs to the illness than the actual cause. Right.

And the same thing with concussions like as well, when, like you mentioned that if your stress levels have already accumulated, which they are in today’s day and age because we’re just bombarded with EMF, and so many news and you know, the virus and everything else in between, it already has that bucket close to overflowing. Yeah, to the point where it doesn’t take, like you said, even a head trauma, but head trauma, it’s going to be potentially that much more deleterious to recover from so let’s kind of work through educating the listeners in terms of how you the expert would go about assessing.

Okay, you have the like for you five years later, you had these odd neurological findings that made you wonder because you were already being proactive, you were already changing your diet and doing things. So how can we help the listener understand, hey, yeah, like, I’ve been proactive as well? But I’ve also had my bucket kind of start to accumulate. And I don’t know if I had a concussion, but it sounds like you know, what you’re telling me right now is it should be on my radar. So how does the expert explain that to them? And then what do we do about all that?


Dr. Titus Chiu: Yeah, that’s a great question. And it’s really interesting, you know, my whole exploration and how I kind of stumbled upon this. It’s like as I was going through school, I was getting my hands on like I said, as much information as I could. That was good. I was a total seminar junkie conference, reading books and articles. And I wouldn’t get really good results with many of my patients.

But there is this one subset of patients that I work with. It’s just like I tried all the things, I tried the diet, I tried the supplements, I did like adjustments, and they wouldn’t get better. And so I just kind of stepped back and, you know, did what I do what I was born to do. So like, I went deeper and asked myself, why aren’t they getting better. And I was, I was shocked them, a huge percentage of them, like a vast majority of them had a history of a concussion, like, and that was a thing, it wasn’t like, they got knocked out, or they got, you know, whatever, like a massive trauma, who’s so I had to kind of explore them and ask them and, you know, go into their history more. But sure enough, many of them had a history of a concussion, either, it may be a car accident, like a whiplash, right? Or like I described before, maybe they just landed really hard when skiing or fault fall off their bike. And so once I discovered that I went deeper, I went to more conferences, and I started exploring the whole world, not just of the brain and neurology, but specifically of concussion.

And the fascinating thing was, again, I was, you know, the things that I learned the knowledge that I accumulated, I also want to experiment on myself. So I, you know, had all these technologies that I played around with, like brain healing technologies, and concussion protocols, and brain training, all these things that I was just adding to my tool belt, as a clinician, but then I would experiment on myself, and oh, my goodness, it was like the lights turned on again, Joel is like these symptoms that I started to develop, like, more brain fog, and cognitive symptoms, even more like emotional symptoms, like, anger issues. And when it got really bad, like paranoia, stuff that I never experience, you know, in my entire life, those things start to improve and like, oh, my goodness, it was like this light bulb came on. Years later, I’m like, I think I had a concussion.

And so it was almost like, it was like a process of, it wasn’t like, Okay, I know, I have a concussion, here’s what I’m gonna do. It was more like an experiment and learn as much as I can help these people. I apply that to my life, my brain finally got back online, then it was like, Oh, my goodness. And so you know, that’s just kind of the story of how I kind of stumbled upon it and became, you know, a specialize in post-concussion syndrome. And so that’s the thing. You know, the First things first, for people who are watching and wondering to themselves, Hmm, I wonder if my chronic fatigue or my chronic gut issues are due to concussion? Some things you can just think about is? Have you ever been in a car accident? Have you ever suffered whiplash, right? Have you ever fallen from your bike or fallen off a horse?

Or have you ever gone skiing? Like, do you play soccer? Right? One of the most common things I see with my patients is like, especially soccer players, they don’t even have a massive trauma. But those headers day in day out, they add up, right? And so those are things like number one, just kind of exploring your own history. Think about that. So people watching right now just kind of sit down and say, Hmm, have I ever like either hit my hand, have I been in a whiplash or even have I had like a strong jolt to my body, and then maybe a few days, weeks or months after that start to develop these symptoms. So that’s the first thing, right? That’s what I walk my patients through. I’ve been doing it for so long that I can kind of get right to it pretty quickly.

But those are for those of you who watch and just kind of sit down and maybe journal that like think about if you’re struggling with a health issue, think about like, okay, here’s when I started developing these things is either right immediately after something, or maybe it developed gradually over time, but try to trace it back, right. And you can think about the things I described, like actual head trauma or whiplash or, you know, a strong jolt to their body as a stressor, right. And you can kind of add, like one point, and depending on how big the stressor was, and maybe three points and you just add that up, it gives you a probability. That’s a good way to think about it. Number one, right? And then number two, it’s the interesting thing is, if I work with a lot of patients, and it sounds like you who’ve tried a lot of these foundational things, right?

And so, if you’ve tried a lot of the diet stuff, if you tried supplements, I work with awesome patients, amazing people who are really committed to their health. Maybe they’ve even run some advanced functional testing, and they’re still struggling with their symptoms. If you fall in that category, And upon kind of exploring your own story, you’re like, Oh, yeah, I actually had a pretty bad car accident I was in when I was 10 years old. If those two then add up the points even further, that that possible concussion could have been one of the massive triggers and stressors that hasn’t been addressed yet. And so that’s the thing.

Those of you watching right now, who might be like, Oh, my goodness, that does sound like me, you know, the brain is really unique, in that not only does it require nutrients not only require like rest and you know, healthy lifestyle, it also requires exercise and activation. And so that’s what I find for you know, people fall in those categories. Number one, yeah, they actually did have a history of some type of possible trauma. And then number two, they’re struggling with some chronic health issue that they haven’t figured out yet. You know, so if you fall in that category, one of the missing pieces could be that concussion, and no diet, no supplement can address the concussion completely. What does work though, in those situations, the missing ingredient, don’t get me wrong, diet, supplements, functional testing is all very important.

But it’s brain training. It’s using specific types of exercises to target the different regions of the nervous system. And that’s the really cool thing. I love this stuff. Because it’s so personalized, you know, just like you It’s like when you work with clients and patients, you want to test you want to take a history and you want to assess, to see what is the root cause for their fatigue and burnout, right? The same thing goes for the brain, but the fascinating thing is, like, all the different regions of the brain have different functions.

So there are clues. So as an example, very common symptoms I see people have after a concussion is light and sound sensitivity. Or maybe they become a lot more startled, like from noises or sounds right. So one area, the nervous system, that process is that and could be the root cause for that symptom is what we call the brainstem, specifically the top of the brainstem, which is the midbrain, right. And so by understanding that the cool thing is Joel, as you know, with your training, as well, in neurology, like there’s specific brain training, exercises, and therapies and advanced technology, sometimes as needed, that we can use to help balance out that brainstem number one, right, and we can activate what’s known as the Vegas nerve.

The second very common symptom I see in people with concussions that they might not even know is fatigue, but not just like physical fatigue, what we call neuro fatigue, where if they’re like trying to pay attention to this podcast, right, or they’re trying to read or use their cognitive resources and energy, then they feel fatigued. One of the root causes for that is this region we call the prefrontal cortex. And so why is that important to know because there are specific brain training exercises, we can do, like reaction time training, or even things like breathing exercises that can activate and strengthen and heal the prefrontal cortex.

So and I know that was kind of a long answer to your question, but those are the things you know, for people who are wondering, Hmm, I wonder if my chronic health issues are contributed by a concussion. Number one, just think back on your own story. And see if you fall in any of those categories. Number two, just if you’re watching this, most likely you have a health challenge that you still haven’t been able to figure out, you add those two up, there’s a huge chance for that. And then finally, number three, depending on the region of the brain that might have been injured, you’ll have your specific symptoms. Some of the most common symptoms I see are brain fog or brain fatigue.

Actually, chronic stress right, if the brainstem becomes overactive, the top part especially we call the midbrain. People can just experience chronic, just deep, unmitigated stress that you know, the normal approaches don’t help them with you know, so I find that to be a really unrecognized root cause for so many health issues and even, you know, you’ve probably seen the research, there’s actually been research looking at, and I see this a lot as well, some patients or clients I work with, after the head, they have a concussion, they might develop some of the brain symptoms I just described, right light and sound sensitivity, maybe headaches, vertigo or brain fog.

But in addition, they develop some type of hormonal imbalance, where they develop some type of gut issue or they develop in some cases, I’ve seen autoimmunity express itself. And there’s actually research very much looking at how an injury To the brain can create leaky gut. There’s, it’s in the research, it’s out there, it’s showing, they actually researched on, you know, these subjects, these animals who had a completely healthy gut, right? The villa, the micro Villa, the small intestine was like really juicy, really full, meaning they had a really healthy gut.

But then after the TBI, the traumatic brain injury that concussion, they immediately developed leaky gut. And as you know, and probably a lot of your audience knows, leaky gut or gut dysfunction is one of the biggest kind of like gateways so SFI gateway drugs into a chronic disease, you know, and so that’s the thing again, those are the three things I look at your own history, the current struggles with your health challenges and these brain symptoms combined, then you have a high likelihood that the concussion is contributing to your symptoms.


Dr. Joel Rosen: Yeah, awesome, awesome answer. I can understand that. You’re you do so much more than concussive-like symptoms based on the neurology based on the fuel based on the activation, autoimmunity chronic health issues. Yeah. In fact, it makes me feel that especially as it relates to fatigue, or HPA axis, or just stress in general, that cortisol bombardment of the frontal lobe and the prefrontal cortex is going to just with stress alone, exactly, which basically means everyone who’s listening to this, who’s dealing with fatigue, or stress needs some form of brain training if they’re not doing it already.

And I think just what we do like I think what’s most interesting for you, Titus, when you mentioned, I kind of reverse-engineered my limitations when I illuminated them, you know, in terms of I did, you know, these activities that activated my brain, and I had a way bigger response than I really thought I should have, probably, because a lot of the power source or the lights were sort of off in that area. And then you did the activation and they went on. So I don’t think anyone will ever lose from doing activation exercises to the brain. Because ultimately wear and tear bombardment of cortisol, I mean, all you know, I think any most people have, if they’ve been active have some form of acceleration, deceleration in the brain, where they have these things. So amazing information, I want to listen to it again.

And I want people to continue to listen to that, I was excited that you brought in the activation, because I was thinking, Okay, I’m going to bring up activation, and you brought up activation. And what’s really cool about funk neuro is like, you can do these cool things like you can activate the front part of the brain through smells. And, you know, think about just and maybe give us some insights in terms of how would someone do some specific activation to different areas in their brain and maybe correlate, hey, if it’s this part of the brain, this is what some of the things you may be dealing with.

And this is how we would activate it to layer on all the other great stuff they’re doing, but isn’t moving the chains as far as it could be? Because they’re not activating their brains?


Dr. Titus Chiu: Yeah, that’s a great question. And, you know, before I answer that, I love it because I keep hearing this common theme of yours that totally resonates. With the work I do. It’s about building resilience, right? What can we do to build resilience, and there are so many ways we can approach resilience. And when I talk about recovering from a concussion, or just brain health, there are these three pillars of brain health that I always explore. Number one is the physical structures, like the actual communication pathways, you can think about like kind of like telephone wires that allow your brain cells to communicate.

That’s the physical brain. The second is the chemistry of the chemical brain. And that deals with things like mitochondrial function with nutrients and the HPA axis, right. And so the chemistry is very important for brain health and recovery from a concussion. And finally, the third thing is the emotional brain. And that’s how our mindset, you know, that’s how we build stress resilience, the way we look at our health challenges or any challenges, and how we approach them. So I found in my journey to heal my brain and working with 1000s of amazing patients and clients like all three pillars need to be addressed.

And so the physical brain though, is when we talk about brain training, that’s where the physical brain, you know, comes in. And, you know, when I talk about the three pillars, it’s not just a semantic theoretical framework. It’s very helpful for me as a clinician to think through but it’s also very pragmatic and practical because, as I said, the physical brain responds to brain training and what we call experience-dependent neuroplasticity. Whereas the chemical brain responds to things like medications or supplements or diet, right? And then five, the emotional brain refers to or responds to things like, you know, therapy, or just mindset shifts in practices and stress management. So all three things are very important.

But yeah, you actually asked a great question. In terms of brain training, you know, the beautiful thing is, once you identify where in the nervous system, the root causes for, like a concussion symptom, or even for things like brain fatigue, or neuro fatigue, there’s a specific exercise you can use, right? Very low tech, the things I actually teach people how to do in the comfort of their own home, all the way to super high tech things that I have people fly in from all over the world to get treatments. Right. But you know, as a starting point, we could talk about some of the low tech things. So for people as an example, let’s just kind of continue the train that we were talking about earlier, Joe, like when I was saying, some people with concussion who developed like brain fatigue or brain fog, one of the areas could be this region known as the prefrontal cortex, that could be the root cause the prefrontal cortex is loaded, located right behind your forehead.

So it’s very susceptible to injury, right. But it’s also like you had mentioned before, it’s like a newer structure like embryologically. So it’s a lot more sensitive to things like cortisol, just like you mentioned, right? And just as a side note, it can become this vicious cycle, right? Where, because the prefrontal cortex is not only in charge of functions like focus, and concentration, and having energy like cognitive energy, but it’s also part of what I call the neurological stress response. Right? Whenever people talk about stress, they always talk about the HPA axis. But sitting at the top of that totem pole are two neurological structures, the hippocampus, and the prefrontal cortex. So that’s the reason why things like neurofeedback or meditation can actually change your autonomic function, meaning it can change your blood pressure, it could slow your pulse down, right? through doing things like neurofeedback, because the prefrontal cortex controls that whole, at least the neurological stress response, right? So I find people who have an injury to the prefrontal cortex, might develop symptoms like brain fatigue, or brain fog, they might have trouble organizing their thoughts.

I find a lot of patients and private clients who I work with, or people that I observe in my life, even if they don’t have a concussion, one tell of the prefrontal cortex is always running late to appointments No matter how much they plan, and don’t no foul because that was one of the areas that were impacted for me in my concussion. But no matter how much they plan for, they always managed to run late to their point. But again, it’s not your fault, is because the prefrontal cortex is a little bit sleepy. But another thing I see, and I know, this is, you know, probably very resonate with you and your work is this chronic stress, right? Is because it becomes this vicious cycle, the prefrontal cortex, which helps to put the brakes on the stress response, what we call the sympathetic nervous system, right?

It does that by way of a connection with the brainstem and the Vegas nerves, right? So for example, your prefrontal cortex can help you get perspective on a situation. And when you have perspective, it can literally change your stress response from one of like, sympathetic to what we call parasympathetic and calmer, just the shift in mindset, right. But the thing is a lot of people, especially with a concussion or chronic stress, like you’re saying, There’s cortisol, there’s adrenaline being released by your adrenal glands, that, you know, in the short term situation can help you, you know, survive something life-threatening, but over time, your prefrontal cortex and your hippocampus, both of which are these control circuits for your stress response, they become compromised, right? So it becomes this vicious cycle, you have stress, you have released cortisol which then damages your prefrontal cortex and hippocampus.

When those get damaged, then they can’t, you know, turn down the stress response as much. So then you have more cortisol, and on and on, it becomes this vicious vicious cycle. But again, the great news is, there are things we can do to retrain the prefrontal cortex. Number one, something as simple as breathing exercises right can help Help to not only mitigate you know the activity in your brainstem by activating what’s known as your vagus nerve, which will already put the brakes on the stress response. But when you bring your attention and awareness to anything, whether it’s a thought, whether it’s this conversation, whether it’s like a breathing exercise, when you bring your attention or focus to something, guess who else is being engaged your prefrontal cortex. So that’s one simple thing people can do is not only just do breathing exercises, but do breathing exercises, where they pay attention to either a count of, you know, counting for, you know, holding your breath for four, and then exhaling for four, right? Not even just the actual, like mechanics of the four-count is helpful for oxygen and carbon dioxide balance.

But the fact that you’re counting activates your prefrontal cortex, you can do the same thing by bringing your awareness to, you know when a big meditation that I do or breathwork that I do is what’s known as Vipassana, where you bring your awareness to air coming in and out of your nostril. Or you bring your awareness to the movement of your belly. Anytime you bring awareness to kind of your internal state, you activate the right prefrontal cortex, isn’t that amazing? And the reason why that’s important is not only done these things, activate an exercise and heal the brain, like the specific areas, we can do it right versus left, why is it important, just like in if you’re trying to, you know, if your left bicep is weak, you’re not going to go to the gym and do curls with your right bicep, right?

You want to be very specific. So that’s one example of something you can do to exercise this region called the prefrontal cortex. Other things, you know, things like ping pong, ping pong actually activate your prefrontal cortex and cerebellum. chiropractic adjustments have been shown to activate the prefrontal cortex, things like chess, or any type of memory game where you’re holding some information in your head for a little bit of time, or things like do your best to show up on time for your appointment, the more you plan, and actually follow through your growing brain cells in your prefrontal cortex. So that’s just one example. But the cool thing is just like, you know, Joel, you know, through your training in neurology, the prefrontal cortex is also involved with not only thought processes but movements. So you can do special movements, especially when it comes to fine motor control, the prefrontal cortex is very much involved with that, right.

And so sometimes I have my patients and private clients do like brush their teeth with their non-dominant hand exercises, their prefrontal cortex, or I have them learn how to use chopsticks or do things like origami, any type of fine motor control, is a great way of strengthening and healing your prefrontal cortex. And the amazing thing is when you do those movements and especial movements, and motor, you know, fine motor control, not only are you going to get better at those movements, but it’s because it’s the same area of your brain that deals with focus and concentration, guess what, I see this all the time, people’s ability to focus gets better their fatigue improves, by doing these specific fine motor exercises, why?

Why does it happen again, because it also strengthens the prefrontal cortex is Yeah, it’s really the sky’s the limit with this stuff, you know, once you can personalize, which are the areas of the nervous system, and then from there match the right exercise? It’s like personal training for the brain.


Dr. Joel Rosen: It’s awesome. It’s awesome information I tied us I used to do it like I’m probably 95% distant now I still have the hanger honors that come into the office and do some work. But I used to have the dots on the wall, the interactive metronome, which is really cool because you’re coordinating so many things that are activating so many different areas in your brain.

And I think that easy sort of take-home and in this is done the things that you’re not good at because obviously, those are the things that need work with. And it’s one of those things where it’s the motto is, you know, you use it or lose it or move it or lose it. And if you’re not good at specific things that you know you’re not good at, then that’s your homework assignment, in terms of those are the areas in the brain that need retraining. It also makes me feel that there’s a huge epidemic too, in terms of how like the analogy I always use is having so many browser windows open on your computer, and you’re spreading yourself too thin and you’re not going deep And you’re just how is that a problem for people just based on what you just talked about in terms of how that would potentially create brain chaos, or it wouldn’t actually be helpful in terms of brain retraining, because of how multitasking they are, are and the negative impact that would have with someone who had a concussion, or just, in general, that has brain challenges? What’s sorry, that’s a side curve, but I just, you know, have you the expert here. But what’s the problem with doing something like that for the brain?


Dr. Titus Chiu: Yeah, that’s a great question. You know, it’s really fascinating, because the way I look at, you know, I like how you put it is, like, do the things that are challenging for you, because that’s where the growth will be. That’s so true, right? Like, if you don’t have the ability to get assessed and figure out what those root causes are those weak links, that’s one great way to approach it.

And I just want to add to that, I also find too, that we have a tendency, whether we’re aware of it or not to self-medicate. So what I mean by that, as an example, I absolutely love music, right? It’s one of my favorite hobbies, just listening to music, playing music, the interesting thing actually has a book here, by Joe, this is your brain on music. But different, like music, actually activates in the different types of music will activate different regions of your brain. My point is, when I listen to music, especially certain songs, I feel it’s healing to me. But I know why is because it’s actually the healing to specific regions in my nervous system.

My point is, so in addition to doing things that are challenging, like, again, if you’re not able to get a full-on assessment, and figure out the fine details of what you need, another way to approach it to on top of the challenge is, what are you drawn to, right? Are you drawn to you just absolutely love ping pong?

There is a neurological reason for that. You know, do you absolutely love listening to music? Do you love learning? Do you love painting? Or do you love going on bike rides or horse rides? Like all those different activities? Again, they work or they go and our brains process that all the different activities I just described are processed by what we call a different neural network.

So I love the fact that you brought that up just like yeah, number one, do something to challenge yourself, right? Don’t overdo it, where you get frustrated, and like, don’t want to do it anymore. But push yourself. That’s where the growth happens. But if you do overdo it, make sure you get enough rest right to recoup time. But then number two, also just kind of listen to your own intuition. Like, what is the things that you’re drawn to? There is an energetic reason for that. But there’s also a neurological reason for it. So yeah, I’m really glad you brought that point up.


Dr. Joel Rosen: So sorry, go ahead. Well, you weren’t finished, I think I asked you in terms of the challenges with, I mean, I get that do the things that you’re not so good at and gravitate towards the things that you love to do.

But with the people that are exhausted and burnt out, I find that they are they exceed their metabolic capacity very quickly. Yeah. And so maybe explain what that means with doing too much multitasking, and, and really not having enough gas in the tank to handle that.


Dr. Titus Chiu: Yeah, that’s great. So, you know, again, it all comes down to personalization. And the interest, they think sometimes, depending on where a person’s at in their recovery healing process, I might give them stuff to multitask, right? Because I work with a lot of high achievers who, like we’re killing it at their work or whatever, or their job. And then after a concussion, they could barely do one thing at a time. It takes them like, three, five to 10 times longer just to do one thing, let alone a lot. So yeah, absolutely.

If you’re in a situation like that, and you feel overwhelmed pretty easily. Number one, yeah, the less stimulus you have the better, right. So you just have to think about it. You know, regardless if you’ve had a concussion or trauma, or you’ve just been chronically stressed, your brains kind of like in this healing phase, right? It needs to heal, and it needs the energy and the resources to heal. But it also needs the downtime to be able to do it. So that’s really great. So a lot of what I do, and that’s, that’s the thing.

So like I said, for those of you watching right now, you might be shocked. Yeah, I actually sometimes intentionally have people multitask. You know, I’ll have them do one thing. As an example. There’s a thing in neurology called dual tasking, where you might be walking and balancing or something and then you try saying the alphabet, skipping every other letter. So it’s multitasking and that’s challenging for a lot of people, especially if there are issues with the prefrontal cortex. So sometimes I’ll actually do that to train for that particular person. But almost always, especially at the start of the process.

You know, just like you said, the more you kind of focus on one area, whether it’s like, yeah, the fact that we’re finding ourselves so much more on screens, right, it’s so easy to get lost in like these wormholes. So it’s really good to like less than that amount of sensory stimuli, especially screens, and just take one of the best things I did in my recovery, and that I teach all my patients and clients is to take many breaks. And what that is, is like, our we all have a certain cognitive reserve in our brains, right? So it’s, it’s what’s known as the ultradian rhythm. So every, and this is for a healthy person.

So every 60 to 90 minutes, we go through this cycle of energy, where will every 69 minutes have energy, and around the end of that, we start to our energy reserves start to get used up. And so when it comes to the brain, what’s so important is to become aware of when that happens for you, like I said, for most people, it’s about 60 to 90 minutes. But I’ve worked with people who’ve had been on chronic stress, or have had a concussion, that that cycle becomes shortened by like 50%, or even 75%. So sometimes I’ve had people where they do something just for like, five or 10 minutes, and then they hit a wall, the last thing you want to do is try to push through that right, especially in the recovery phase. So so one of the things that I do is taking these mini-breaks. So I’ll set my alarm for like 15 minutes because I can get pretty focused, right? If I get in, engaged in a task or something like if I’m working or whatever writing, like, so I set my alarm for 15 minutes.

And whenever it goes off, I wrap up whatever I’m doing, and then I take a little mini-break. And what that could be is it could literally be like 30 seconds of breathing exercises, it could be I just do a little bit of stretching, right. And I find that throughout the day in the morning, I don’t need to take as long many breaks, maybe 30 seconds, as I go further on throughout the day, as we get towards the evening, I then give myself longer mini-breaks. Oh my goodness, Joe, like I’ll tell you this one thing if people do even if you don’t have a concussion, I guarantee you, especially if you find yourself engaging using your brain a lot, either on computers or on your work or even emotionally like you know, dealing with stuff in your life, like with relationships and stuff. Anything that requires cognitive energy, I guarantee if you practice these mini-breaks, it can literally change your life, right?

Because what you do is, if you don’t take many breaks, what ends up happening, you try to power through that, you then trigger the stress response, you can do it, but you’ll release adrenaline, you’ll release cortisol to help power you through that. And then as we talked about, that leads to all the damaging long-term effects on the brain, on the digestive system, the immune system, all of it, right.

So taking these mini-breaks. And what I found I learned this because I had to do that to my recovery process. But I still do that to this day. What I found though, is when I did that, and I gave myself those smaller resets, I wouldn’t need that big one-week hiatus from work or life. So the more you kind of build it in as a ritual like a mini habit, then you’re not gonna end up burning out or needing those big getaways for the weekend or a week or a month or whatever, a sabbatical, right. So it’s like building these things one at a time. But yeah, I encourage people watching out there just Next, you know, next time you’re gonna sit down to do anything that requires a lot of cognitive energy that isn’t kind of mindless, set your alarm starts at 50 minutes.

For some of you out there, you said it’d be like, wow, I can go even longer. I don’t you know, some signs that you’ve kind of reached that capacity is you start you know, your eyes glaze over. Or you start to yawn or you get more fidgety. Those are clues that you’ve reached that point. So then when that happens, and if you have the awareness, look at your timer, and it might be at like 6065 minutes. So then just set your alarm for like 60 minutes, and when it goes off, wrap stuff up, and then take a little break, right? And then whenever I do is I can’t tell you, man, you know the cool thing.

There are all these different actual activities you can do like to intentionally reset your nervous system. It’s a lot of them are Vegas nervous activation exercises, you know, and so there are all these different things you can do that can help speed up that recovery time, even when you take the mini-break. So that’s the one thing I really, you know, I’m glad you brought this up, Joel, because when it comes to your physical brain, and physical brain health, training, the brain is very important. It’s very underrecognized.

But just as important as having that downtime, to allow your brain to integrate. Because when you do that there’s a region of your nervous system that’s associated with the right hemisphere. It’s called the default mode network. When you do activities, like I just described, there, just kind of like in activities, actually, you activate your default mode network, which puts the brakes on your stress response, it allows for creativity for insight and the healing process.


Dr. Joel Rosen: That’s awesome. It’s awesome information, I got my mind spinning all over the place. Because I got away from when I got out of the physical brick and mortar from doing the rehab exercises, I still implement them.

But it makes it like, we need to write the next book of the, you know, the defragmentation of the human brain because of how we do so much multitasking. And they so studies show that you’re actually less effective at


Dr. Titus Chiu: Using this up so much glucose, when you’re multitasking, you just burn glucose in your basal ganglia, your prefrontal cortex. Yeah, you’re absolutely correct.


Dr. Joel Rosen: Right. And I think to like from the exercises you just described, you’ll be that much more productive. You know, not only will you save the brain and have strengthening of different areas, but you’ll actually be that much more productive. And then I love what you said, too, in terms of when I asked you about the activation, you clarify that there is emotional activation, and I’m really big on gratitude and celebration. And a lot of people will say, well, that’s just a PMA and let’s just, you know, mental attitude. And it’s like, no, it actually helps with plasticity. And with release favorable chemicals.

I used the example like when I was in undergrad, I use the example if I really went out of my way, Titus, I was on the soccer team. And I like okay, maybe I’ll go to class today, maybe I won’t, I’ll admit that I did that my first year. And I remember when I had to study for, you know, tests, I would have like notes missing. And I would just study the ones that I did study. And I do very well on those, but not on the whole test, because I missed half the test. And the thing I said was, I really had to go out of my way to do poorly, right, I really did. I mean, you either have to go out of your way to do poorly or go out of your way to do well. But either way, you got to go out of your way anyway. So why not just go out of your way, effectively, or put work into it effectively, that’s helping you, you know, not hurting you and everything you’ve shared, it’s been amazing information.

So I got a couple of things that I want to ask you as first and foremost, I know you wrote, you have a book and you also have some free tools. And I will love to go and read them and do them myself because just fascinated with the information. But where would the listener go to get you to know the book and take the free tool or get the free help with the Vegas? Tell us what the free help is with the Vegas nerf? And where they can get that?


Dr. Titus Chiu: Yeah, sure. So I have a whole guide a quick start guide to activating your Vegas stir. That’s what I was describing earlier, those specific exercises you can do to put the brakes on the stress response using these exercises, right. And so you go to brain save calm slash Vegas, and that’s spelled VAG us. So brains slash Vegas. And I have a whole guide.

There are 10 science-backed brain hacks to activate your vagus nerve. And for those of you who want to dive a little bit deeper and go into my whole process, I have his book brain save, you can find that on Amazon. So it’s brain save. And it has a whole six-week plan to the foundational steps to really start to pick your brain after a concussion.


Dr. Joel Rosen: That’s awesome. I got to get a signed version of those. That one over there that


Dr. Titus Chiu: Yeah, Absolutely!


Dr. Joel Rosen: But um, so Okay, listen, I always ask my guests on parting with the last question. I always ask him, Hey, knowing what you know. Now, given that you had your own health issues, you had a trauma.

What would you have told yourself back then to accelerate or change the course or have not suffered as much? What words of wisdom would you have told yourself that you know now what kinds of things would you tell yourself?


Dr. Titus Chiu: Yeah, so that’s that’s a great question. I would tell myself because of what I had done in terms of the healing process, I had to piece it all together myself. I don’t regret a minute of that, because I love learning. And I’m able to now share this information with others needing it right struggling with these health issues. But like, I had to piece it all together, I went back to school, and I studied this, and I did that.

So what I’d recommend is, if you’re struggling with any type of health challenge, find someone who knows what you’re going through, like probably both personally, but definitely professionally as well, if you can find that, and one person that gets it, you know, from a personal level, but also understands, like the actual ins and outs of your particular health challenge. Because again, it’s like, when you have that guidance, yeah, that mentorship, it can accelerate that whole process. It took me like, yeah, that car accident was 20 years ago. And I can rightfully say that I’m fully recovered now.

But it took me many, many years. And it doesn’t have to be the same for you guys out there, regardless of what you’re struggling with, right? As long as you can find that guide, the expert to walk you through, because there is a process, right? When it comes to brain health, it might seem like the most mysterious thing in the world, right. But there are steps, there is a framework, and there are principles that just cut across, you know, all kinds of different health challenges. So that’s probably the number one thing I’d recommend people do. If you want to accelerate the process, find someone, someone that’s been there and done that to guide you through it.


Dr. Joel Rosen: Yeah, I mean, as complicated as the brain is tightest, I mean, I do feel that that Functional Neurology is an exact science in the sense that we know specifically, that these pathways and these sensory inputs, and motor outputs go from here to there. And it’s, it’s fascinating. And you can actually really target the areas by assessing that it’s your, and by, you know, by activating it and all the ways that we’ve talked about, and like you said, having the prerequisite of reducing inflammation, supporting gut health, balancing blood sugar, getting your circadian rhythm, but the missing links and a lot of these for people that even haven’t had trauma to their brain, repetitively, metaphorically they do, whether it’s noticed or not.

And what you’re doing is amazing, amazing stuff. So thank you so much for your time. So I will have my listeners, make sure that we post the link to your, your hacks, brain for parasympathetic information, and also the link to the book. And I always say, Hey, listen, I hope we can keep the door open for all your amazing discoveries down the line so that I can interview again for the less stress life. So thank you so much for your time.


Dr. Titus Chiu: Thank you, Joe. Appreciate it.


Dr. Joel Rosen: Awesome. Thank you.

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