Traumatic brain injuries are a leading cause of debilitating injury and death in the United States. According to the CDC, 1.7 million people annually get a traumatic brain injury (TBI), resulting in 275,000 hospitalizations and 52,000 deaths in the US.
A TBI is caused by a blow or jolt to the head that disrupts normal brain function. The most common causes of TBIs are car accidents, sports injuries, falls, and assaults.
Recently, Dr Leslie Matthews and colleagues published a case series of three coma patients with severe TBIs. The researchers aggressively treated the patients with combination vitamin D3, progesterone, omega-3 fatty acids, and glutamine.
The first patient was a 17 year old female in a “rollover” car crash who was ejected from the car. She had a grave prognosis with a Glasgow Coma Scale (GCS) of 5. GCS is a scale that is used to assess the consciousness of a patient following a head injury. A 3 on the GCS indicates deep coma or death, while a 15 means the patient is fully awake and responsive.
When the first patient was admitted, she was started on a regimen of 50,000 IU vitamin D3, 20 mg progesterone, 2 grams omega-3 fatty acids, and 20 grams glutamine per day. Within 3 days, she was able to respond to simple commands when not sedated. Within 9 days she was moved to inpatient rehab where her GCS improved to 15. Three months following the accident, she returned to school full time with no lasting injury.
Patient number two was brought to the emergency room when someone witnessed him having a seizure following an assault. His mental status deteriorated quickly during examination, so he was brought into surgery. The neurosurgeon described his prognosis as poor, with a GCS of 3. He was treated with the supplement protocol, along with other antibiotics and nutritional support. His GCS gradually improved and he was released to a long-term rehabilitation facility on day 18 with a GCS score of 11.
Patient number three was a 23 year old female involved in a car accident without a seat belt. She suffered multiple injuries and was taken into surgery. Once out of surgery, she was started on the protocol. She had a prolonged hospital stay due to increased pressure on the brain and pneumonia, among other problems. Her GCS improved from 3 to 8 and was transferred to a long term rehabilitation facility on day 109. She continued making improvements over the next 6 weeks and was released home with a GCS of 12 to 13.
“All three patients, who had a very poor prognosis, survived their severe TBI and had a return of recovery to a GCS of 15 out of 15. Six months follow up revealed that all three patients short-term memory lost had resolved,” the authors explain.
Dr Matthews and colleagues explain that vitamin D may improve prognosis of TBIs because of its anti-inflammatory and immunomodulation properties. Even more importantly, they explain that vitamin D receptors in the brain help produce heat shock proteins, which make cells more resistance to stress. The authors conclude:
“Our group is the first to report in literature the multicomponent therapeutic regimen of vitamin D3, progesterone, omega3 fatty acids, and glutamine as a combination therapy for moderate and severe TBI treatment… A large clinical study trial using these four supplements together is warranted. The potential for improving clinical outcomes and potentially decreasing healthcare costs associated with TBI patients is limitless.”
While the literature is limited, this series of case reports corroborates with a small randomized controlled trial from 2012, which found vitamin D and progesterone together improved TBI better than progesterone alone or placebo. We look forward to large scale, randomized controlled trials. While these trials would be warranted, would you wait? If your loved one had a severe TBI, would you have doctors administer the mentioned supplements?
Matthews LR, et al. Combination therapy with vitamin D3, progesterone, omega 3 fatty acids, and glutamine reverses coma and improves clinical outcomes in patients with severe traumatic brain injuries: A case series of three patients. International Journal of Case Reports and Images, 2013.