Regenerative Medicine for Nerve and Neuropathic Pain

Dr. Matthew Cook is a former anesthesiologist who became a regenerative medicine specialist and founder of BioReset Medical¹ in Campbell, California. In this interview, we discuss several novel therapies offered there, which can be next to impossible to find elsewhere.

"I went to medical school and did an anesthesiology residency at University of California San Francisco (UCSF) … I was doing regional anesthesia, so I was basically doing nerve blocks all day, every day …

After that … I figured out how to do almost every surgery, from total knee replacement to shoulder surgery, without having to do general anesthesia. I sort of evolved into finding out that I could fix a lot of those problems either by treating nerves or treating ligaments, tendons, fascia and joints. I started the regenerative medicine practice.

As part of my journey of doing that, I found that NAD [nicotinamide adenine dinucleotide] was one of the most powerful tools in terms of resetting human biological systems. I started incorporating, putting it into different protocols," Cook says.

The Importance of NAD for Optimal Health

NAD+ is a vital coenzyme found in all living cells. It's essential for over 700 enzymatic reactions in your body, including ones occurring in your mitochondria. Without sufficient NAD, you're likely to age and die prematurely.

Nicotinamide adenine dinucleotide phosphate hydrogen (NADPH) is the reduced, phosphorylated form of NADP+. NADPH is a reducing agent necessary for anabolic reactions, including lipid and nucleic acid synthesis. 

For example, without sufficient amounts of NADPH, your body cannot recharge glutathione once it becomes oxidized. The reason I'm so intrigued with Cook's work is because very few clinicians understand the importance of NAD, let alone apply it clinically. One exception is in the treatment of alcohol addiction. Cook explains:

"People have been using NAD or its precursors, for example niacin, in addiction since the '60s … Early on in Alcoholics Anonymous, niacin was an important component of the protocol … Of the 700 enzymes that NAD catalyzes, one of them is alcohol dehydrogenase.

Every time an alcohol molecule is broken down, two NAD+ molecules are consumed … Daily continuous long-term exposure to [alcohol] ends up leading to a very extensive depletion in the NAD levels. Our NAD levels probably drop by 90% from age 1 to age 90.

We can do a lot to either prevent that or accelerate that in the case of addiction. I started my experience by treating people with addiction and had fairly profound results in terms of repleting people's total body source, by giving people a 10-day intravenous (IV) experience."

Aside from niacin, two other more commonly used precursors to NAD are nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN). While these will help, they're not excellent.

Cook, on the other hand, uses the actual NAD+ molecule, administered either through IV, subcutaneously, transdermally or submucosally — either sublingually or transrectally. This, I believe, is the leading edge and a strategy that can go a long way to restoring health, and not just for those struggling with alcohol addiction.

Clinical Uses of NAD

As noted by Cook, NAD is involved in some 700 enzymatic reactions, so listing them all is not possible here. Importantly, though, it can activate enzyme systems, DNA repair, and sirtuins (so-called "longevity proteins") that are crucial to multiple enzymatic pathways within the mitochondria, where your cellular energy is generated.

"As a simple example, there are mitochondria in nerves. One thing I found is that people who have nerve pain, people who have neuropathic pain, if I give them NAD — and I've used every single one of the routes just mentioned — nerve pain will go down," Cook says.

"It turns out if I give NAD surrounding a stem cell therapy or any regenerative medicine therapy, the therapy seems to work better … NAD seems to help turn the immune system on and get it functioning [properly]. It helps people start to detox and get their detox pathways going …  

I've noticed it improves cognitive function. It helps people recover from traumatic brain injury, from concussions. I think it's very, very profound in terms of what happens, in terms of the central and peripheral nervous system.

I've spent a lot of time treating patients with myriad conditions, from Parkinson's and dementia to peripheral neuropathy. I've seen improvements in all of those areas.

My approach to almost all of those problems is very multifactorial and multimodal. NAD is one of the tools that I use. I find it to be very helpful … In biological systems, there are messengers that turn on other components of a system that modulate that system.

Our goal is to do something that modulates either up or modulates down, depending on the situation we're facing. That modulation creates harmony and equilibrium, and then that resets us."

A common side effect of rapid NAD IV infusion is a flush-like experience similar to that of niacin. This flushing effect is likely an effect of methyl depletion, and can be circumvented by taking a methyl donor such as glycine or trimethylglycine.

Strategies That Increase NAD

Aside from using a precursor such as niacin, NR or NMN, other ways to increase NAD include exercise and fasting or time restricted eating.

It bears mentioning, however, that unless you're attending to the basics of health — optimizing your sleep, limiting EMF exposure, exercising, intermittently fasting and avoiding food for at least three hours before bed — then simply adding NAD or NAD precursors may be a waste of time. It's not a magic molecule that's going to cure all your ills if you are violating basic health tenets.

Benefits of Hyperbaric Oxygen Therapy

One crucial consumer of NAD is PARP, or poly-ADP ribose polymerase (its name was recently changes to ARDT). Whereas alcohol dehydrogenase takes out two NAD molecules, PARP takes about 150 each time it repairs a single- or double-stranded DNA break. Electromagnetic fields (EMFs) tend to overactivate PARP due to the DNA damage incurred.

Naturally there are many other sources of oxidative stress as well, and regardless of the cause, PARP will help repair it, but it needs NAD as a sirtuin protein.

Other nutrients you can use would be molecular hydrogen and hyperbaric oxygen. To me, hyperbaric oxygen and NAD are the two vital tools that can help optimize longevity, laid on the foundation of everything else we know about staying healthy.

Hyperbaric oxygen therapy or HBOT involves increasing the atmospheric pressure in the hyperbaric chamber while you're breathing a high concentration of oxygen. This increases the oxygen partial pressure in your body, beginning in your lungs, followed by your blood vessels and eventually your brain. In other words, you're increasing the amount of oxygen tension in your brain.

"One of the expressions a lot of hyperbaric people will say is, 'Oxygen heals.' I definitely think that's true," Cook says. "About once a week, I'll do a subcutaneous NAD. This morning, I took some vitamins, a subcutaneous NAD, and then I got in the hyperbaric chamber for 20 minutes. I can't imagine feeling better than I feel right now."

In the interview, Cook also shares a story about how hyperbaric oxygen therapy and NAD administration the week before a major surgery radically cut the patient's recovery time — and eliminated her need for pain medication altogether.

Hyperbaric oxygen therapy is approved for 17 clinical conditions (although insurance will only cover a few of them). Just imagine the benefits were more people given access to this before going under the knife for complicated surgeries. It could actually result in significant cost savings.

Hyperbaric oxygen also appears to have significant antiaging benefits, likely because it's a potent anti-inflammatory that removes senescent cells and increases stem cell activation.

It can also help improve cognitive function, and improves oxygen and nutrient supplies in your body. Oxygen is used in mitochondria. If you don't have enough oxygen, you can't optimize your energy production, so that's an important variable for health and longevity.

BioReset Training for Clinicians

While Cook's treatments are hard to come by elsewhere, he is training other clinicians, trying to spread this information. For more information, see BioResetNetwork.com. There, you will find a full video NAD certification course.

"I go over the science and a lot of what we're talking about [here]," Cook says. "I go over everything I found to make it work better with fewer side effects, which I think is important. I go over our protocols of how we give it in combination with other things. I often give [NAD] with ketamine."

On Ketamine

Ketamine is a drug that turns off one of the depression pathways in the brain and makes you feel safe. For that reason, it is sometimes used in the treatment of post-traumatic stress disorder (PTSD). Cook explains:

"One of the many things that our protocol for PTSD [includes] is an infusion of intravenous ketamine, which we would give after an NAD infusion … It's a mild psychedelic. It gives them an ability to see that they're going to be OK.

It's one of the most profound things that I do … The woman I saw this morning was a victim of terrible sexual abuse. For the last 40 years, she hasn't been able to lie down in bed on her back because she thinks, at all times, that someone's going to attack her.

She told me that for the last two months, she lies on her back and she feels totally safe and she hasn't thought about [the abuse]. She told me to mention it to you.

That's sort of emblematic of the type of things that we're seeing. That, along with … NAD is part of a reset that's temporary. We're resetting the biological system, and then supporting the natural function afterward."

Hydrodissection for Pain Relief

Another interesting treatment Cook offers is hydrodissection, a technical skill that his training as an anesthesiologist allows him to do well. During his residency as UCSF, he started using ultrasound to locate nerves, allowing for more precise delivery compared to simply looking at anatomy — an idea raised by his colleague, Dr. Andrew Gray.

Eventually, Cook realized he could inject other things besides a local anesthetic, such as 5% dextrose, placental matrix, stem cells, platelet-rich plasma and fat.

"Once I found that out, within about three months, I had a full-time practice and wasn't doing anesthesia anymore … It seems to fix peripheral nerve pain. Sometimes it fixes nerve pain from an inflammatory perspective. Sometimes it fixes nerve pain that's just from impingement.

For example, with carpal tunnel, we stick a needle in and we put fluid around the medial nerve. That's probably going to, depending on what you put around that nerve, be scientifically proven to be much more effective than carpal tunnel surgery.

We treat every nerve from head to toe, in multiple different locations with multiple different solutions, to turn inflammation off, to relieve entrapment and to reset that biological system."

Alternative Back Pain Treatments

One of the most common problems that people see their physician for is low back pain. In these cases, Cook will often do a caudal epidural, injecting a chosen substance into the epidural space to surround all the nerves. He explains:

"The spinal cord comes down and spreads into a whole bunch of nerves in the lumbar area. The anatomical name for it is cauda equina, because all of those nerves look like a horse's tail.

We're actually doing a hydrodissection in the epidural space. That seems to have a fairly profound effect of resetting the actual nerves coming off the end of a spinal cord. We also do hydrodissection of fascial planes in the back that can be quite profoundly helpful at resetting back pain …

I figure out which nerves are entrapped, which nerves are in pain, and then which muscle groups are involved. Then I either do hydrodissection or I use ultrasound- or fluoroscopy-guided approaches to put something regenerative there."

Addressing Herniations and Compressed Discs

In cases where a disc is herniated or the compressed disc is putting physical pressure on a nerve, Cook recommends first addressing the posterior ligamentous complex, which includes the iliolumbar ligaments, sacroiliac ligaments, SI joints and facets. About half the time, this will allow a frontal disc herniation to slide back into place.

"A lot of some of the top people who were doing intradiscal therapies will now do posterior approaches first, because it's very low-risk and very much easier to do," he says. "A lot of times, I'll do that to get started. However, if there is a disc herniation, we will use fluoroscopy, which is X-ray, and stick a needle into the disc.

I'll either put exosomes, PRP or bone marrow into the disc to try to stabilize it. In some cases, we'll actually put those products in the disc above and below, depending on what's happening. Often, I'll also try to treat the nerves around there.

There are nerves in front of the discs, actually, that control your fight or flight nervous system, called the sympathetic chain … We'll look at see if there are muscle groups that are not working well and start to turn them on by turning on the nerves that go to them.

And then, [we put] something good both around the facet joints and in the deep spinal muscles called the multifidus, which are responsible for most of your proprioception — which is where you are in space. Parallel to that, I'm trying to get a sense of, 'What else is going on? Can I give hyperbaric oxygen to make the treatment work better? Can I give NAD?' A lot of times that will help …

A lot of times, if people would have had bad chronic pain, we'll give ketamine. Ketamine will sort of reset pain and that will start to change the experience. A lot of times they're on high-dose pain meds, so we'll use NAD to get them off the pain meds …

I can't tell you how many people I have who were told they absolutely had to have a [spinal] fusion, and they're walking around with no pain … Now, this is experimental. It's new …

Probably the best teacher of this on the planet is my mentor for ultrasound, Dr. Tom Clark. He teaches physicians at a site called MSKUS.com. We teach there and we also teach in my office these approaches on how to do it, and then how to put it all together …

I like to say I spent the first half of my life putting people to sleep and having them undergo surgery. Now I'm spending the rest of my life waking them up and preventing surgery."

Sample Case History

Cook shares a particularly fascinating success story of a man who'd heard him speak about nerve hydrodissection on Ben Greenfield's podcast. He was a quadriplegic from a rollover motor vehicular accident. "He was in total spasticity all the time," Cook says.

Cook performed a hydrodissection, placing exosomes around all major nerves in the man's arms, legs and epidural space. Afterward, he was able to begin moving his legs — something he'd not been able to do since his accident, three years earlier.

"He started to get this control. Then he went from being able to stand in a locked-out position with the help of two strong people, to being able to do 20 or 30 squats. That was a pretty interesting experience. All of his neuropathic pain went away," Cook says.

"My next treatment that I'm going to do for him will be with placental matrix because the placental matrix actually is a scaffold that stays around the nerve within the sheath."

While results have been encouraging, Cook stresses they were not permanent, which indicates the need for further treatments.  

More Information

These really are exciting times. Case stories like that testify to the fact that your body has incredible ability to self-repair and regenerate, given the proper aid. Fortunately, we're now seeing more doctors like Cook who are operating well outside the conventional box and making new discoveries.

"[Health is about] getting your lifestyle right and then finding appropriate biological tweaks that allow you to heal the DNA breaks, activate the right enzymatic sequences and cascades, so that that system just functions naturally," Cook says, essentially summarizing what he does at BioReset Medical.

Again, if you're a clinician and would like to incorporate some of these techniques in your practice, sign up for Cook's educational courses on BioReset Network. "Soon, there's going to be an army of people out there, all over the world, doing this type of stuff. It's going to be a relatively normal standard of care type of approach," Cook says.

In the meantime, prospective patients can contact Cook via BioResetMedical.com. Simply scroll down the page and fill out the contact form to speak to a team specialist about your case, or call the phone number listed at the top.

If you're not on the West Coast and can't travel, contact Cook's office for a referral to a certified clinician in your local area. The website will eventually include a listing of trained physicians.

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