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5 Ways To Boost Brain Health By Optimizing The Glymphatic System

Ilene Ruhoy, M.D., Ph.D.
June 11, 2019
Ilene Ruhoy, M.D., Ph.D.
Integrative Neurologist
By Ilene Ruhoy, M.D., Ph.D.
Integrative Neurologist
Dr. Ruhoy is a board-certified neurologist practicing integrative pediatric and adult neurology in Seattle. She is the owner and founder of the Center for Healing Neurology, and received her M.D. from the University of Pittsburgh School of Medicine.
June 11, 2019
Worldwide, 50 million people are living with Alzheimer's and other forms of dementia, the mere thought of which is enough to elicit anxiety. The good news: Many experts believe we are largely in control of our cognitive destiny. So, in honor of Alzheimer's & Brain Awareness Month, we're bringing you content about the simple yet incredibly effective ways you can optimize brain health and curb your risk of chronic disease with simple diet and lifestyle shifts.

While the lymphatic system has been getting increasing attention in recent years, hardly anyone talks about the glymphatic system (aka the lymphatic system of the central nervous system). That's because we're only now beginning to understand what it is, what it does, and how optimizing it is crucial for maintaining good cognitive and mental health.

As an integrative neurologist who sees firsthand how devastating chronic conditions like Alzheimer's disease can be, I can say with certainty that the glymphatic system an area of health we can't afford to overlook.

Here, I offer some insight into how the glymphatic system works and how you can optimize it with simple dietary and lifestyle changes—boosting cognition and reducing your risk for neurodegenerative diseases in the process.

What is the glymphatic system?

The glymphatic system is made up of water channels, pores, and other clearance pathways in the brain and spinal cord that help us clear out by-products of cellular metabolism. The glymphatic system circulates cerebrospinal fluid (CSF) throughout these pathways, and, in addition to waste removal, the system is thought to be important for regulating intracranial fluid volume and central nervous system immune health.

But why exactly would the brain need a waste removal mechanism? The brain, as with our other organs, produces waste as part of a natural activation of biochemical pathways. All enzymatic reactions within the body can produce waste compounds (e.g., proteins, reactive oxygen species, excessive ions, and others) that are not necessarily needed for other functions and are therefore compounded and degraded. Indeed, neurodegenerative diseases are very commonly associated with a buildup of these by-products of cellular metabolism that are not appropriately packaged and excreted. 

What influences how well the glymphatic system works?

Effective function of the glymphatic system is dependent on a variety of factors, including heart health, immune health, and blood vessel health. Inflammation, disease, and poor dietary and lifestyle choices can impede the lymphatic drainage of the brain and adversely affect the health of both your body and brain.

Research has shown that the glymphatic system is more efficient and robust when our hearts are pumping, our blood is flowing, our bodies are moving, and our brains are getting regular restorative sleep. In fact, the glymphatic system is most active during reparative sleep stages, clearing out inflammatory mediators and allowing for necessary restoration and rejuvenation to take place.

5 ways to optimize the glymphatic system and boost brain health.

A healthy functioning glymphatic system can help keep us healthy for years to come, protect our cognition, and may even reduce the risk of neurodegenerative disease. After adopting these five simple strategies, I see patients experience fewer headaches, more mental clarity, increased energy, increased ability to focus, less anxiety and sadness, and decreased overall pain. Small changes can sometimes have exponential positive effects.


Stay hydrated, especially as temperatures rise.

The volume of fluid within our vessels helps to support cerebral blood flow. Blood has to pump from the heart to the brain against gravity. When we are dehydrated or have consumed too many not-hydrating beverages such as coffee or alcohol, we can have impaired cerebral blood flow. This can lead to fatigue, dizziness, and poor waste removal. The use of occasional electrolyte powders in your water can be useful to maintain intravascular volume.


Seriously prioritize your sleep.

Restorative sleep is critical for glymphatic drainage. One recent study found that the sleep-brain connection is so strong that people who suffer from sleep apnea have a 70 percent higher risk of contracting Alzheimer's.

My advice: Go to sleep at the same time each night and wake up at the same time each morning. This applies to weekdays and weekends! A few ways to make sure this actually happens: Get morning light before 10 a.m. to support your body's natural sleep-wake cycles, exercise every day, and eat your meals at regular times if possible. Our brains are circadian organs and thrive on rhythm (it's why babies and toddlers develop well with a regular routine), so the more we can simulate a circadian rhythm, the better chance we have of good sleep. Can't seem to get to sleep? Try amber or orange-hued glasses that block sleep-disrupting blue light, or consider one of these natural sleep aids.


Move your body every day.

Exercise gets our heart pumping and our blood moving. It delivers and exchanges nutrients, oxygen, and metabolic by-products so participates in both glymphatic and lymphatic drainage. Delivery of blood supports cellular metabolism so that intracellular debris can be packaged and released and aids efficient clearance.


Eat brain-supporting foods.

Foods that support brain health include the vast majority of fruits and vegetables, which contain multitudes of compounds important for combating reactive oxygen species (free radicals) and inflammatory mediators. Be sure to include magnesium-rich foods (nuts and seeds, cooked leafy greens, dark chocolate, and avocado, to name a few) as well since magnesium salts contribute to blood vessel wall health.


Make sure you're pooping regularly.

When the body has to divert much of its energy to digesting, absorbing, and cleansing and moving your sluggish bowels, there is less energy to support the bioenergetics of glymphatic drainage. Speak to your physician for help in addressing constipation and/or any underlying concern. Also, consider adding more fiber to your diet (or employing one of these strategies to make yourself poop), or try out intermittent fasting, which can be helpful in allowing the gastrointestinal tract to heal itself.

Additionally, I often recommend my patients consider additional modalities that can improve oxygenation and decrease inflammation throughout the body such as infrared saunas, hyperbaric oxygen, and cranial-sacral massage therapies.

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Ilene Ruhoy, M.D., Ph.D. author page.
Ilene Ruhoy, M.D., Ph.D.
Integrative Neurologist

Ilene Ruhoy, M.D., Ph.D., is a board-certified neurologist practicing integrative pediatric and adult neurology in Seattle. She is the owner and founder of the Center for Healing Neurology and is on the faculty of Seattle Children’s Hospital. Her holistic approach includes full neurological care with the addition of acupuncture, neurofeedback, and herbal and nutritional guidance. She received her M.D. from the University of Pittsburgh School of Medicine and completed her neurology training at the University of Washington in Seattle. In addition to becoming a certified medical acupuncturist, she has also completed the Integrative Medicine Fellowship at the University of Arizona. Her Ph.D. doctoral dissertation studied the effects of environmental toxins on our nation’s water systems.