Your 2 Brains And The Link To ADHD, Autism, Anxiety, And Autoimmunity with Dr. Mel Hopper Koppelman

Ari: Make this really practical for everyone listening in the sense of what specific kinds of imbalances might you see or problems that arose from improper development of, let’s say, primitive reflexes or brain development more broadly in childhood? What specific health problems might that be linked to?

Mel: Great questions. If someone has, let’s say the left hemisphere of their brain has developed chronologically faster than you’d expect, and the right hemisphere is underdeveloped, and again, these things tend to go together because they’re meant to be mutually regulating each other, this pattern is strongly associated with autism and ADHD, and it goes along with all the comorbidities you get with those, like these inflammatory issues. In either sides, you’ll get gut dysfunction.

One thing I learned, again, shockingly recently, I can’t believe how long I thought I knew a lot about things and then learned these new things, but many people are aware of this issue with leaky gut, where your gut is too permeable. We all start off our life with a permeable gut, and that’s part of the reason why we’re not eating solid foods. For some people, their gut never became unleaky in the first place, which is a totally different frame.

Probiotics isn’t going to solve that problem. With the left hemisphere developing faster than the right, then depending on the parts affected, you get either the little professor who just is super smart, or two-year-olds who are reading, or these hyper-analytical skills, hyper-math skills, these savant skills, but without the social regulation, without the ability to fill their own body and space, and you get these inflammatory conditions. Certain types of autoimmunity can go along with this pattern.

On the other side, when we have a right hemisphere that has developed faster and more than we expect, and the left hemisphere hasn’t come on as well, then this is more associated with patterns that we see with dyslexia. This is more associated with things like major depression can go along with this because the left hemisphere is like the torrid behavior, the right hemisphere is the break. We can get certain types of anxiety that are associated more with the right hemisphere dominance. There’s also other flavors of anxiety that are associated more with the left.

With the right hemisphere, because of the immune relationship, you tend to get stuck with these lingering chronic infections. Again, I said this before, but at first when I was hearing these ideas, I’m like, “This can’t be right.” There is nuance to it, but starting off looking at hemispheres is a good place to start. Then, of course, there are sub-patterns within this, and there’s individuality within this. Even looking at certain things like people who have a relatively overdeveloped right hemisphere, they have a lower or can have a lower white blood cell count.

I have a number of patients who have chronically low white blood cell counts to the point where their doctors are like, “Oh my God, you’re going to die.” It’s been like that for years. They go on year to year, and they don’t die, and it’s fine. It always bothered me because I was like, “Why is this happening? What do we do about it?” I’ve been always thinking that. Then I looked at it and I was like, “Could it be that this is hemispheric?”

The research really supports that, that if you damage certain parts of the left hemisphere, you will get a low white blood cell count. If you have more activity in the right hemisphere, you will get a low white blood cell count. That issue was not going to be solved by immunoadaptogen supplement, blah, blah, blah. You really need to address the underlying cause there. Yes, it affects our personality, our strengths, our body. Actually a really important aspect as well is that our interoception, so our ability to sense our own body map, and plan, and levels of inflammation hormones lives in the right insula. The insula is a part of the brain that is under the tempo. I think it’s really specific to humans actually. It’s underneath the layer of the brain and really for us to be able to feel our body in space and to know what our digestion is doing and know what our emotions are doing is there.

If you are left hemisphere dominant and the right hemisphere is underdeveloped, you might not be able to feel your own body very well. We see this that in people with the most common patterns of let’s say ADHD or autism, they might not feel temperature as much. They’ll go out into the cold wearing shorts. They might not feel pain as directly and things like that. Understanding how the brain is specialized makes it understandable.

Ari: I’ve been writing a lot lately about willpower and impulse control. There’s a term, it’s somewhat nebulous term that is often defined slightly differently by different people, but it’s called conscientiousness. It is inclusive of willpower, and impulse control, and doing one’s duty, and self-discipline, and things of that nature. It’s highly linked to longevity of personality dimensions. Conscientiousness is the one that is the most strongly linked with longevity. There is a willpower longevity link. As I’ve been looking into this, and writing about it, and reading a lot of the research on it, it’s very interesting to see just how malleable and dynamic that system is.

Where in people who are exercisers, habitual exercisers for long periods of time, this area of the brain, the anterior cingulate cortex is highly, highly developed. It’s physically larger, and more robust, and more active. In people who are non-exercisers and people who are overweight or drug addicts and things like that, it’s much smaller and less active. This is not something that just occurs over years and decades. It’s something that you can literally measure changes in this system, like from a single session of exercise, for example, or a single instance of having strong impulse control, you have a strong desire to do something and you restrain yourself.

The famous studies in this field come from these, I think, they’re marshmallow studies or candy studies in little kids where they took little kids and they offered them one candy now, or if they waited 30 minutes, they could get two candies. They tracked these kids over decades and they found that this dimension, which again relates to conscientiousness, and willpower, and impulse control, was strongly predictive of so much of their later life success, financial success, healthy relationships, how likely they were to be obese or lean, how physically active they were, and ultimately longevity and risk of many diseases.

Anyway, I bring this up only to say it’s so interesting to see how malleable these different systems of the brain actually are. In the context of primitive reflexes and these different hemispheres of the brain, can you give a map of how one might begin, people listening, how one might begin to understand some of their specific symptoms or health problems as being a problem of one part of the brain or the other? Then I want to segue into maybe what we can do practically about that. I know that’s a very broad thing, but maybe you can piece it out.

Mel: Absolutely. With how to approach these things, there’s a spectrum from DIY, like reading a self-help book and suddenly everything becomes clear or doing a personality test to going to see a center of excellence where you get assessed and that sort of thing. I want to provide a framework to say that that spectrum exists, and that if you can find someone to assess you, then that’s always helpful. You can start to tease out these tendencies. First of all, your looking at your own history, did you have any– Actually, one thing I want to point out or going to make sure I say it is that, when we have these imbalances, it often goes part and parcel with having these extraordinary gifts or inabilities coupled with these deficits. Actually, understanding this about myself is one of the things that made my own life make much more sense than anything else. If you’re particularly good at certain things and terrible at other things, it’s really hard to make sense of that. Like, “Am I good? Am I bad? Do I suck? Am I awesome?” What’s going on with that anyways? I grew up in a worldview where you were just good at things, or you weren’t, which is obviously limited and not accurate.

We get these mixes, but if you look at your own life history, and if you’re an adult watching, looking at childhood, were there things that you were particularly great at? Were there things that you particularly found challenging? Also, your own health throughout your lifespan, so were you pretty healthy, happy, well-adjusted, happy healthy family of origin until you were in your 40s? Then the developmental lens is probably not predominant for you as a rough guide.

Versus someone who’s like, “Oh my God, I was getting all these ear infections, then they took my tonsils out, and I was on all these antibiotics. I had this really unstable household where either there was food insecurity or bad emotional relationships, and there wasn’t emotional nurturing,” or different things like that. The history starts there. Then looking at your current health issues through a developmental lens is probably going to be really useful, especially if you’ve never done it before. That would be one way to parse it out.

Then doing a combination of looking at health and cognitive skills, and even personality skills to a certain extent that’s organized this way can give a rough overview, and then having a primitive reflex exam. Dr. Melillo has written a book where he teaches parents how to administer this on their kids. I include this in my program because I realized I was specializing in autoimmunity, chronic fatigue, and fibromyalgia, and this was a really big missing piece for most of my patients, so I teach patients.

I had a patient in Australia, and her engineer husband did this exam on her. They recorded it and we got really actionable data from it. You just wouldn’t get this information any other way. Or you go to someone who’s trained to give the exam. That’s always the best thing if you can access it to do that. Then you just have your starting point there and you can start to see it. What I’ve found is that when I start to have these conversations– again, if you’re tapping on something that’s truthy, people have already started to sense this, and then it just starts to make sense to them.

Ari: Can you give some specific examples? It doesn’t have to be from the one you just mentioned of the person in Australia, but maybe some stories of what specifically was found upon the examination and how that led to approaching resolution of those symptoms or health problems through this–

Mel: Sure. I’m very transparent. I’m always happy to share my own health story because that also informs a lot of my work. For me, I was first diagnosed with an autoimmune condition in my early 20s, I was doing my own lab testing, and I found additional autoimmune conditions later on. I had antibodies to my own collagen. I had digestive issues from early childhood. I had all sorts of things like this, and I had done so much over the years and I’ve done a lot of training and I’ve been honing my diet. I’ve been doing this lab testing, all of these sorts of things, and I had made a lot of progress by the way. It wasn’t that nothing had done anything.

I’d made a lot of progress, but by the time I then realized that this was a really important lens, I also found the history of– both my parents are really, really nerdy, so it’s very clear that there’s a left hemisphere dominant trait that runs very strongly in my family. In the offspring, that can just create a bit of susceptibility to certain issues. I went, and I was actually a patient or am a patient of Dr. Melillo. When he tested my primitive reflexes, almost all of them were there strongly.

Again, as I said, that’s just never a normal finding. Whether or not someone has their own ideas about the significance or how truthy these models are or whatever that is, it’s just never for a 41-year-old middle-aged woman to have this rolling reflex. It’s just not supposed to be there. It’s so much of the advice out there.

I was functioning reasonably well, but I was having a lot of attention issues, which I’d had from childhood, a lot of memory issues, and a lot of just different cognitive issues. A lot of the advice out there is really top-down. It’s about teaching you strategies for organizing better, or how to lay out your books, or how to use certain software. Now, to contrast that with the fact that I had retained primitive reflexes, it’s not going to work, right?

Doing a targeted approach to integrate those reflexes by stimulating them, and stimulating my brain, my memory has vastly improved. That’s based on testing as well, so doing a cognitive testing. My posture’s improved, my pain levels have reduced, all of those things. I definitely, just through my own experience, can see how important this is because I know all the things I did before. A lot of them are really good, and a lot of them are really helpful, but again, if you have brainstem immaturity, none of these other techniques and tools which have validity in the right context and may have some use to them are going to solve that problem.

Ari: Tell me again, what it was that you did in terms of this. You stimulated the primitive reflexes?

Mel: Yes. The way we’re meant to develop in the first place, the way we were meant to integrate in the first place is that they become integrated through stimulation. Doing the trigger that makes this reflex fire is what drives the development of the brain higher up to come down and inhibit them. Even if you’re middle-aged or older, if you do exercises that stimulate those reflexes, and you need to do it often, you need to repeat it, then that ends up driving the development of the brain that will help it to catch up.

Ari: That’s really interesting. You’re stimulating these primitive reflexes, and that leads to them being integrated into the higher centers of the brain.

Mel: Yes. It physically grows the higher centers of the brain to come down and integrate them.

Ari: Wow. Very interesting. What is an example of the other side of it? Presumably, if you had autoimmunity issues that would imply left hemisphere dominance, how would right hemisphere dominance present? Take me through that sequence of the symptoms that might present, what you might find based on primitive reflex testing, and then what you do about it.

Mel: Yes, sure. I want to clarify, if I haven’t already, that we’re going to see more than two patterns. Once we dial in, we’re not going to see a left hemisphere pattern and a right hemisphere pattern. I want to anticipate people’s reservations because that would be a fair reservation, right? Within that, we do have some diversity. If someone has more of a right hemisphere dominance, and what you’ve just said is correct, but I am actually also seeing some autoimmunity in the right hemisphere dominant folks, I think that’s more because they’ve allowed these infections to simmer for so long, so it might be later.

Because with the right hemisphere dominance, we get a less active or inhibited immune system, I think it can metabolically predispose people towards cancer because they have less immune surveillance, and also predispose them to more chronic viral infection because they’re not able to ramp up the response, whether that’s creating the right cells or increasing their body temperature to get rid of them, so we get chronic infections.

I think that this is fair to say, and this is supported in literature, but it’s also just observational, folks who are more right-hemisphere dominant are going to be the ones who will end up super-duper sensitive when they’re sick. These are the folks who can feel electricity, they can feel the 5G, if they get one single mold spore part per billion, they are done. They are definitely not making this up, and that’s going to be more of a right hemisphere dominance where the left hemisphere is separating us off from our environment for more right hemisphere, and we’re also sick on top of it, then there’s just going to be no way for us to defend ourselves from what’s going on.

Now, what I’ve seen with left hemisphere, not to jump around too much, is that because folks in this category can have a lower sense of interoception, they might not report any symptoms, and the first problems they have might be serious. For example, I had a patient who was a husband of a patient. When he came to see me, he had been completely healthy, normal weight, active, reasonable diet, no lifestyle factors, and feeling good. His first symptom of a problem was a heart attack.

His doctors could not figure this out, and when I ran his labs, to me, it was actually quite clear what had happened, which is that he did have a very permeable gut, he had very high levels of antibodies to something called lipopolysaccharides, which just means that the bacteria that are meant to stay in the gut, when they get out into the bloodstream, the immune system tags that as an infection. He had off-the-charts levels of that.

I tested his primitive reflexes, they were very much there, but also taking a history, talking to him, he said, “If I’d been born later, I definitely would have been diagnosed with ADHD. I wasn’t diagnosed at the time. My handwriting was so bad, my grandparents send me to have handwriting lessons.” That’s neurological. That’s looking after your brain, fine motor control, and all of these things. It was that kind of persistent endotoxemia that led him to have this heart attack, but he didn’t have any warning of any problem. He was very inflamed, but he was not aware of it because, presumably, his right insula and anterior cingulate cortex on the right side were dialed down, so he wasn’t getting that message.

In terms of left and right, when you do a primitive reflex exam, those can look similar. When we have these developmental imbalances, whether it’s more of a right brain dominance or a left brain dominance, a primitive reflex exam is going to look similar, depending on what your findings are, but then once we dive into your signs and symptoms and also we do other testing, there’s a more in-depth neurological exam and then we can start to see really, is it more of a right brain dominance or left brain dominance.

Ari: The right brain versus left brain dominance is determined less by the primitive reflex testing and more by signs and symptoms?

Mel: By signs and symptoms and the other neurological exam, that’s right. The primitive reflex exam itself isn’t going to tell you if it’s left or right, it just tends to be there because of this difference in maturity, one way or another, but then a more in-depth neurological exam and also history questionnaire would help to give a pattern of if it was more of a left or right delay.