Brain on Fire: Making Neuroinflammation Clinically Actionable
The third episode of the Precision Protocol Series from Biocanic, hosted by Jeremy Malecha with co-host Brendan Vermeire of Metabolic Solutions, turned the spotlight to a topic reshaping how we think about mental health, neurodevelopment, and neurodegeneration. Neuroinflammation is no longer a fringe idea. It sits at the center of a growing body of research that connects immune activity in the brain to symptoms across mood, cognition, and behavior.
This conversation moved past buzzwords and explored how practitioners can define, detect, and address neuroinflammation with both clinical rigor and practical workflows.
RSVP for upcoming episodes and catch the replays on YouTube.
Understanding Neuroinflammation
Inflammation is not inherently bad. In an acute infection or injury, inflammatory activity helps clear threats and remodel tissue. Problems arise when that fire does not resolve. Chronic inflammation is implicated in nearly every chronic disease, including those that affect the brain.
In the central nervous system, neuroinflammation is largely moderated by glial cells. Brendan outlined four key players. Neurons carry electrical signals and are the classic focus of neurochemistry. Microglia function as innate immune cells in the brain, acting as both guardians and architects in development and repair. Astrocytes support the blood brain barrier and bioenergetics. Oligodendrocytes myelinate neurons to enable efficient electrical conductivity. Glial activation is now observed across neurodevelopmental, neuropsychiatric, and neurodegenerative conditions. It is not the only mechanism, but it is a major one.
From Theory to Measurement
Practitioners often ask how to move from theory to measurement. Brendan’s answer is simple. Test, do not guess. Start with a shared language and objective markers that can anchor care plans.
Neuroinflammation requires two lenses. A brain lens that looks at glial activity and neuronal injury. A body lens that evaluates systemic inflammation and metabolic context. This is where blood biomarkers have become indispensable. C reactive protein and GlycA are widely used inflammatory markers. Homocysteine is a gold standard for methylation status. Basic CBC and CMP patterns add helpful clues about immune activity and metabolic stress.
On the brain side, next generation markers such as neurofilament light chain, glial fibrillary acidic protein, and S100B give visibility into neuronal damage and astrocyte activation. These are accessible through major reference labs and correlate with research in multiple sclerosis, neurodegeneration, concussion recovery, and broader neuropsychiatric states.
A Layered Testing Strategy
Brendan outlined a layered strategy that he teaches through his Mental Map approach.
-
Begin with foundational blood work
Use a basic wellness panel to identify inflammation, methylation status, glucose and insulin dynamics, liver burden, and other systemic drivers. If measurable inflammation is present, that becomes the priority. Put out the fire so recovery is possible. -
Add brain specific biomarkers when indicated
If history and symptoms suggest neuro involvement, layer in neurofilament light chain, GFAP, and related markers to assess neuronal injury and glial activation. These are the anchors for monitoring resolution over time. -
Correlate findings across domains
Gut, hormones, nutrients, and toxins matter, but context is critical. Urine mycotoxin levels or microbiome panels are informative only when connected to physiology. Look for patterns that link exposure to measurable immune or oxidative activity. This is where practice wide data and tools like Nexus can help reveal relationships across labs, symptoms, and timelines. -
Use structured assessments and symptom maps
Standard tools like PHQ 9, GAD 7, and condition specific questionnaires organize the subjective story in parallel with objective labs. Both are needed to tailor the intervention and track progress.
Practical Application in the Clinic
The goal is not to chase every possible root cause. The goal is to sequence care so it works. Brendan shared several practical notes from the field.
-
If inflammation is measurable, address it first. Calming systemic immune activity often reduces brain symptoms faster than any single supplement or protocol.
-
Hormones are common amplifiers. Low progesterone, altered thyroid function, or androgen imbalances can intensify anxiety, rumination, and low mood. Optimizing these inputs can significantly reduce symptom load while deeper work continues.
-
OCD is a prime example of both and. A gold standard psychotherapy approach like exposure and response prevention is essential. At the same time, correcting physiology such as low progesterone or thyroid issues can reduce triggers that make intrusive thoughts harder to manage.
-
Retesting is not optional. Symptom tracking is helpful, but it is not enough. Biomarkers show whether the physiology is moving in the right direction. For neurodegeneration risk, neurofilament light chain can be checked annually and becomes a navigational beacon for peace of mind.
Common Pitfalls to Avoid
-
Over indexing on single tests
Functional tests that detect the presence of exposures are not the same as physiological markers that measure impact. Use both wisely and correlate. -
Fear based interpretations
Overstating risk can unintentionally produce a nocebo response. Let the biomarkers guide the narrative and empower clients with clarity. -
One size fits all protocols
Keto can be powerful, especially for certain neuropsychiatric states, but it is not universally superior and may not support microbiome diversity the way higher fiber patterns do. Choose dietary approaches based on the individual and the markers.
The Future of Brain Health Testing
The most exciting shift is the convergence of clinical biomarkers with multimodal data. As platforms like Nexus unify lab results, assessment scores, and health trackers across an entire practice, practitioners can see which inputs change which outcomes. This enables research grade insight inside everyday clinical work.
Looking forward, Brendan pointed to promising areas that deserve continued exploration. Photobiomodulation, breath work, and targeted nervous system training. Psychedelic assisted therapies and their potential anti inflammatory and pro neurotrophic effects. Community, purpose, and lifestyle routines that rebuild human inputs modern life has stripped away.
The destination is not another stack of tests. It is an integrated model of care where objective markers validate progress, refine protocols, and restore confidence for both practitioner and client.
Key Takeaways
-
Neuroinflammation is central to mental health, neurodevelopment, and neurodegeneration
-
Start with foundational blood work and add brain specific markers when indicated
-
Correlate exposures to physiology before you build protocols
-
Treat inflammation as a first order priority and retest to verify change
-
Pair psychotherapy with physiology for complex presentations like OCD
-
Personalize diet and tools, do not prescribe by trend
-
Use practice wide data to connect inputs to outcomes
This was only a fraction of the insight shared in the Precision Protocol Series episode with Brendan Vermeire. In the full conversation, we dive deeper into stool testing, which tests are worth your time with clients, the truth behind the results and have to use these tests effectively within your practice.