Lactate Threshold is Misunderstood

Originally published on HVMN.org (https://hvmn.com/blog/training/lactate-threshold-is-misunderstood) and authored by Nate Martins on April 11, 2019

If you want to start a debate in a group of runners, mention lactic acid and lactate threshold. The topics are two of the most confused and misunderstood in the running world. For the last few decades, lactate was presumed to be all bad–causing only muscle soreness and dashing dreams of personal records.

But that’s only half the story.

Lactate threshold is the exercise level at which lactic acid builds up in the blood. This accumulation of lactic acid is associated with fatigue, and most people assume the burning sensation of hard exercise is caused by lactic acid.

Endurance athletes specifically focus on lactate threshold as a measure of efficiency and fitness. For many, the goal of training is to maintain increased power and speed without crossing over this threshold. Most athletes want to stave off blood lactate accumulation, training so they clear it faster and produce less.

That’s why lactate is generally considered a four-letter-word, thought to be a waste product linked to muscle fatigue.

Research on the issue makes muddy waters more clear: producing and burning lactate provide essential fuel for cells throughout the body when oxygen is depleted.1

Lactate & Lactate Threshold Basics

There’s a nuance to lactate responsible for its bad rap.

Lactate: More Protons, More Problems

Lactate can be produced throughout the body naturally.2 It’s a result of rapidly burning carbohydrate when the demand for energy is high, and oxygen availability is low, such as during sprinting or other high-intensity workouts.

Glucose is the body’s most readily available fuel, easily transported around the body and broken down to support short bursts of intense exercise. Glucose gets metabolized by a process called glycolysis, resulting in pyruvate. There are two possible uses for pyruvate: anaerobic or aerobic energy production.

When there is plenty of oxygen, pyruvate is turned into energy in the form of ATP through the aerobic pathway. Without enough oxygen present, pyruvate has another fate: anaerobic conversion to lactate. So all that huffing and puffing during intense exercise is used (among other things) to fuel the metabolic reactions that make our muscles work.

The majority of lactate released into the blood is mopped up in the liver where it can be converted back into glucose via a process called gluconeogenesis, and then released back into circulation.1 For example, the brain can directly use it as fuel (along with other parts of the body).

Lactate itself isn’t at all that bad for the body. The bad part is the acid associated with it.

Lactate caries a proton (an acid) when it’s released, and the build up of protons decreases the pH of the blood. When the body gets more acidic, function becomes compromised because the protons interfere with energy production and muscle contraction.

All this time, athletes have been blaming lactate like it’s a referee. But they should be blaming those protons.

Still, generally, lactate is pretty much always associated with protons, so there is a strong relationship between high lactate and fatigue.

Lactate Threshold: Recycling is the Name of the Game

Blood lactate levels rise gradually as one exercises. The harder the exercise, the higher it climbs; this is an indicator of a shift in our energy production from aerobic (lots of oxygen) to anaerobic (less oxygen).

Before reaching the lactate threshold, blood lactate concentrations increase gradually. But upon arriving at the lactate threshold, the blood concentration of lactate begins to exponentially increase. Usually that intensity hovers around 80% of an athlete’s maximum heart rate, or 75% of their maximum oxygen intake–but you can also link it to speed or power.

Recycling lactate is true north of endurance training, which aims to maintain an intensity below the lactate threshold. When the recycling process can’t keep up, lactate produced by the exercising muscles begins build up in the bloodstream.

Well-designed training programs target both sides of the lactate threshold; there should be some training sessions working at or above LT. These sessions are harder on the body, but this forces adaptations that ultimately increase speed on race day.

Why Does Lactate Build Up Happen During High Intensity Exercise?

Lactate buildup is a result of the rapid anaerobic breakdown of carbohydrate.

Cells break down carbs and fats from our food to produce a molecule called ATP (the body’s energy currency), which is then used as energy by exercising muscles. ATP is produced from carbs through a three-step process: Glycolysis, Krebs Cycle and Electron Transport Chain (ETC). Products from Glycolysis feed Krebs which feeds ETC.

ETC is what generates most of our ATP. Energy generated from ETC is effective enough to sustain moderately-intense exercise...but the process doesn’t happen fast enough to keep up with the energy demand of high-intensity exercise. This means rapid-release energy from glycolysis is required to keep going. Glycolysis increases to supplement the difference but, as we know, this leads to lactate production.

Oxygen delivery rate also becomes limited during high intensity exercise. The ETC absolutely relies on oxygen for its function. We can’t breathe enough, or pump blood fast enough to our muscles when they are in overdrive to keep the ETC going. This necessitates oxygen-free energy production via glycolysis and lactate production.

That extra lactate (along with its acidic proton) ends up in the blood and decreases our pH. Our brains aim to keep a steady state of pH, and sensing this imbalance in pH, cause us feel nauseous. This leads to a feeling of fatigue, then a decrease intensity, then decreasing ATP demand, then glycolysis slows, leading to a better match between oxygen demand and oxygen delivery. Ultimately, this match allows lactate clearance from the blood.

Exercise above the lactate threshold can only be sustained for a limited amount of time: the body runs out of glycogen (stored carbs) to convert into lactate, and the increasing acidity of the blood causes fatigue.

Better athletic performance comes from training with LT in mind, geared to a higher production of speed or power at the lactate threshold.

How to Figure Out Lactate Threshold

Testing protocols to determine lactate threshold are sport-specific. Many consider the running speed at lactate threshold (RSLT) to be the best indicator of running fitness and the most reliable barometer of endurance performance.

In cycling, step-tests (where power is increased at regular intervals until you are exhausted) are the gold standard for measuring physiological performance markers, such as lactate threshold.

Upon completing the test and finding a personal lactate threshold, one can begin incorporating lactate threshold training to target specific adaptations for the body to make.

There are a few different ways to test for a personal lactate threshold, and factors to consider when doing so. It’s important to remember everyone is different, and lactate threshold changes in response to training (or sadly, de-training).

Lab Testing: Accurate But Expensive

The most concrete way to determine lactate threshold is to take a series of blood samples as exercise is conducted at increasing intensities. This type of lactate testing occurs at an exercise physiology laboratory, and tends to be expensive (but worth it).

In a lactate threshold test, athletes exercise on a treadmill or stationary bike while increasing intensity every few minutes until exhaustion. A blood sample is taken during the each stage of the test–similar to testing for ketones, through the fingertip or earlobe–illustrating blood lactate readings at various running speeds or cycling power outputs. Results are then plotted on a curve to show the speed or power at which the lactate threshold occurs.

However, lactate threshold changes as more training is done to build your aerobic base. So in order to maintain an updated understanding of your lactate threshold, you’d have to visit the lab again after a block of training.

During her time on the Great Britian Rowing Team, H.V.M.N. Research lead, Dr Brianna Stubbs, did lactate threshold testing every 2-3 months. She recounts the collective effort to find lactate threshold.

"The gym even got gory on step-test days, with athletes dripping blood from the testing holes in their earlobes."Dr. Brianna Stubbs

"Seeing results change over time was interesting," she said. "I recorded my highest power at lactate threshold toward the end of the winter training block, which made sense because that’s when we did most of our endurance work."

Do-it-Yourself Field Test: You Have a Few Options

Many endurance athletes choose to estimate their lactate threshold by measuring heart rate and/or VO2 max at different training zones (there’s even a portable lactate blood analyzer some use to further cement results).

VDOT (or VO2 max) Chart

• A VDOT chart is an adjusted VO2 max chart (created by esteemed running coach Jack Daniels) that uses some of your most recent run times (at max effort) to identify training pace that will maintain your lactate threshold. There are two corresponding chats that work together to illustrate max effort and training paces for different distances (we've simplified it above)

• For example, running at a 7:49 mile pace at max effort corresponds to a VDOT number of 36. That VDOT number illustrates the pace at which training should be done to maintain lactate recycling: 8:55. For a more in-depth analysis of interval training and different distances, refer to these charts here

Conconi Method

• Using a heart rate monitor set to a five second recording interval

• Begin running and increase speed every 200 meters until exhaustion. The goal isn’t to maintain a steady state of exercise, instead increasing incrementally to test yourself

• Plot heart rate against speed; the deflection point in the graph (where your heart rate goes up much more than your speed) roughly corresponds to speed at lactate threshold

Time-Trial Method / 30-Minute Test

• Research has shown that doing a 30 minute flat out time trial is one of the most accurate ways to find your lactate threshold without using fancy equipment3

• Start by warming up

• Then, on a track or treadmill, run for 30 minutes at the fastest sustainable pace. 10 minutes into the run, obtain and note your heart rate. Then, after the final 20 minutes of the test, obtain and note your heart rate again

• Add your heart rate at the 10-minute mark to heart rate at the 30-minute mark–that's your lactate threshold heart rate. And your average pace for the entire 30-minute test (assuming it was steady) is your lactate threshold pace

Both elite athletes and weekend warriors can benefit from understanding personal lactate threshold to maximize results. However, lactate threshold is impacted by training and changes over time. So keeping regular on these types of tests will indicate an improving lactate threshold through focused training.

Optimizing Lactate Metabolism

Lactic acid gets blamed for muscle soreness, but the production of lactate is an important metabolic process. The idea that lactate is pure waste and leads to fatigue is somewhat outdated. Nevertheless, a higher speed or power at lactate threshold is still one of the key goals of aerobic training.1

Different strategies can help minimize lactate buildup during exercise.

Warming Up: As Important as Cooling Down

Warming up is important to reducing risk for injury and minimizing potential lactate buildup. During a warm-up, heart rate increases, and blood vessels dilate, meaning there is more blood flow and more oxygen reaching your muscles.

When exercise intensity picks up the pace, there’s less mismatch between oxygen needs of the muscles and blood. Therefore, you don’t need to do as much anaerobic respiration, and you don’t build lactate early in the run.

Equally, cooling down and stretching immediately after a workout is especially important. Gentle exercise (slow jogging or spinning on a bike) or using a foam roller can help clear lactic acid buildup from the muscle by stimulating blood flow and encouraging lymphatic drainage.

Nutrition and Supplements: Replenishment is Key

The key to dealing with high lactate production is dealing with the acid associated with it (that pesky little proton). Two “buffer supplements,” sodium bicarbonate and beta-alanine, work by mopping up that proton. This means lactate levels can go higher than before without triggering fatigue because the proton is taken care of.

Beta-alanine works inside the muscles to clean up protons before they affect muscle contraction. Compounding effects of beta-alanine powder (~5g per day) happen after several weeks, but studies show around a 2-3% performance boost.4

Sodium bicarbonate is better for short-term boosts in proton buffering. Bicarbonate is the main buffer usually binding protons to stop blood from becoming too acidic. About an hour before exercise, taking bicarb powder dissolved in water, at 0.3kg per body weight, has shown to improve performance.5 Be weary of stomach aches when first introducing bicarb. But there are bicarbonate gels that provide the same buffing effect without the side-effects.6

Lactate can only be produced by breaking down carbs. Sustaining an exercise intensity that is producing lactate means the depletion carbohydrate stores (glycogen). When the glycogen gas tank reads empty, we hit a wall.

Exogenous ketones can lower lactate production. By drinking pre-workout exogenous ketones, like H.V.M.N. Ketone, your body can use the ketones for energy instead of carbohydrates–glycolysis decreases and therefore, so does lactate production.

Having ketones as a whole new source of fuel means the body doesn’t need to dip into its existing carb and protein stores: athletes using H.V.M.N. Ketone show a decrease in the breakdown of intramuscular glycogen and protein during exercise, compared to carbohydrates alone.7

Exercise: Training Toward Adaptation

Regular training forces the body to adapt; what once felt like an unsustainable pace becomes easy. And adopting a training plan helps accelerate how that adaption will progress.

Looking at the whole body, the heart muscle gets stronger, building more small blood vessels. These small blood vessels mean more oxygen-rich blood can be transported to the muscles, requiring less demand for anaerobic respiration and lactate production.

On a muscular level, cells can produce more mitochondria, which are the site of aerobic respiration. This helps increase reliance on that energy system. Muscle cells also express more of the transport proteins for lactate, so lactate doesn’t build up inside the cells and compromise their function.8

Lactate threshold training switches up workout intensity, optimizing the body’s lactate response.

Peter Broomhall, who has been running ultramarathons for seven years, started incorporating lactate training into his regimen with his coach.

"I’ve trained with lactate threshold in mind this year more than any other year. It takes time to build up that threshold, but things like recovery become quicker. It compliments every aspect of training."Peter Broomhall

For runners, one way to work on lactate threshold is to breakdown a run into mile sections: the first mile or two should be run at a pace just below lactate threshold, while the proceeding mile section should be slower, thus allowing the body to process the lactate. Active recovery is more effective at clearing lactate than passive recovery.9 This allows a high volume of miles without going overboard.

Lactate, A Misunderstood Villain

Next time your running club gangs up on lactic acid, maybe you can remind everyone of its important role in helping our bodies produce energy quickly when oxygen is short.

We do know the combination of high lactate (and the associated increase in protons in the muscles and blood) can impact our ability to maintain peak athletic performance. But we now have a deeper understanding of blood lactate (and how to optimize it), thanks to monitoring tools outside the lab, structural training regimens and recovery techniques.

We’re altering how the body responds to lactate with nutrition supplements like H.V.M.N. Ketone and bicarb gels. And in the process, we’re rewriting the old story about lactic acid.

Scientific Citations

1.Patrizia Proia, Carlo Maria Di Liegro, Gabriella Schiera, Anna Fricano, and Italia Di Liegro. Lactate as a Metabolite and a Regulator in the Central Nervous System. Int J Mol Sci. 2016 Sep; 17(9): 1450. Published online 2016 Sep 1.

2.Matthew L. Goodwin, M.A., James E. Harris, M.Ed., Andrés Hernández, M.A., and L. Bruce Gladden, Ph.D. J. Blood Lactate Measurements and Analysis during Exercise: A Guide for Clinicians. Diabetes Sci Technol. 2007 Jul; 1(4): 558–569. Published online 2007 Jul.

3.McGehee JC, Tanner CJ, Houmard JA. A comparison of methods for estimating the lactate threshold. J Strength Cond Res. 2005 Aug;19(3):553-8

.4.Hobson RM, Saunders B, Ball G, Harris RC, Sale C. Effects of β-alanine supplementation on exercise performance: a meta-analysis. Amino Acids. 2012 Jul;43(1):25-37. Epub 2012 Jan 24.

5.Peart D1J Siegler JC, Vince RV. Practical recommendations for coaches and athletes: a meta-analysis of sodium bicarbonate use for athletic performance. J Strength Cond Res. 2012 Jul;26(7):1975-83.

6.Mark Kern; Lisa M. Misell; Andrew Ordille; Madeline Alm; Brookell Salewske. Double-blind, Placebo Controlled, Randomized Crossover Pilot Study Evaluating The Impacts Of Sodium Bicarbonate in a Transdermal Delivery System on Physiological Parameters and Exercise Performance: 2402 Board #238 June 1 11. Medicine & Science in Sports & Exercise. 50(5S):595, MAY 2018 Issn Print: 0195-9131. Publication Date: 2018/05/01

7.Cox, P.J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Murray, Andrew J., Stubbs, B., West, J., McLure, Stewart W., et al. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism 24, 1-13.

8.Holloszy JO, Coyle EF. Adaptations of skeletal muscle to endurance exercise and their metabolic consequences. J Appl Physiol Respir Environ Exerc Physiol. 1984 Apr;56(4):831-8.

9.Menzies P, Menzies C, McIntyre L, Paterson P, Wilson J, Kemi OJ. Blood lactate clearance during active recovery after an intense running bout depends on the intensity of the active recovery. J Sports Sci. 2010 Jul;28(9):975-82.

Triathlon Training Strategies to Conquer Your Race

Originally posted on HVMN and authored by Brady Holmer on May 16, 2019

A triathlon can be daunting. The three distance races of swim, bike, and run utilize different energy systems and muscle activation patterns. Each requires unique physical and mental skills to reach the finish line.

Triathlon training is also about tradeoffs.1

Table of Contents

Training for a Tri isn’t Negotiable

Triathlon 101: the Various Triathlon Distances

Which Distance is Right for You?

Dividing the Training Pie

Volume and Intensity

Cornerstone Workouts

Swim–Technique Sets

Other Swim Training Tips

Bike–Hill Sessions

Bike–Lactate Threshold Work

Other Bike Training Tips

Run–the Long Run

Run–Speed Work

The Brick: Your Best Friend and Worst Enemy

Sample Brick Workouts

When to Brick, and How Long to Go

Fuel for the Work Required: Triathlon Nutrition

Pre-Workout Nutrition

Training Low

Train Dual-Fueled

Have Sufficient Fuel for High Intensity Sessions

Jumping in

It would be nice if bike fitness easily translated into the water, or running ability made you a great bike rider. In some ways, fitness does translate. But each discipline requires dedication. A proper training schedule should be specific to triathlon demands.

A triathlon training plan focusing on specificity of the swim, bike, run, and all transition areas will optimize race day performance. And don’t forget about nutrition and sleep; these are considered the fourth triathlon disciplines. Both in and out of season, make sure you hit all of the basics.

Training for a Tri isn’t Negotiable

Finding new challenges and setting goals helps push performance limits. If you’re an athlete who has traditionally stuck to one sport, training for your first triathlon may be just what you need to spice up your training schedule. It may also light a new competitive flame.

Triathlon training can stimulate your body in new ways and work new energy systems. It’s like rigorous cross training. Triathlon-specific fitness can improve overall health, may translate to reduced injury in other sports and perhaps weight loss, if that’s a goal.

Triathlon 101: the Various Triathlon Distances

Before developing a training schedule, the first step is to decide which triathlon distance you’ll conquer for your next or first triathlon. This will influence your workouts and overall training time.

Sprint Distance Triathlon

Swim - 750 meters (¾ mile)

Bike - 20k (12.4 miles)

Run - 5k (3.1 miles)

Standard or Olympic Distance Triathlon

Swim - 1.5k (.93 miles)

Bike - 40k (24.8 miles)

Run - 10k (6.2 miles)

Half-Ironman

Swim - 1.9k (1.2 miles)

Bike - 90k (55.9 miles)

Run - 21.9k (13.6 miles)

Ironman Triathlon

Swim - 3.9k (2.4 miles)

Bike - 180k (112 miles)

Run - 42k (26.2 miles)

Which Distance is Right for You?

There are a few things to consider when choosing your race distance.

The first: time. How much of your schedule can you dedicate to training? Most programs include two workouts per day, several days per week. You’ll likely need to dedicate 10 - 12 hours or more to training each week. Naturally, a longer race (half-Ironman or full Ironman) will require more time in the pool, on your road bike, or laced into your running shoes pounding pavement. Most people don’t have the luxury of being a pro-athlete with unlimited training time. The average Joe isn’t training for the Ironman World Championships in Hawaii.

Training environment is another consideration. Will you be able to practice open water swims in a nearby lake, or is a pool your only option? Trails and roadways conducive to long runs and rides may dictate training quality and safety.

The most obvious consideration is experience.

Many new triathletes want to attack the biggest race their first time out, but this could spell disaster.

A long history of athletics or endurance sport may allow you to seamlessly finish your first race without much trouble, but it may not. It’s important to learn to enjoy the journey of the sport as much as the destination.

Dividing the Training Pie

You have three sports to train for, and only so many hours. How much should you dedicate to training for each discipline? Tradeoffs dictate that, by choosing to spend more time in one activity, you must lower the amount of time spent in another. Swimming, biking, and running can be thought of as three slices of the giant training pie.

The relationship between triathlon training and performance is specific.2Time spent training in a specific discipline directly predicts performance in that race leg. More swim training means a stronger swim portion. This makes sense physiologically because the same muscles, motions, and pace we train are the same muscles, motions, and pace with which we compete.

Generally, you should do the same number of swims, bike rides, and runs each week. In total, aim for two workouts per week for each discipline. An easy formula for this plan follows a single swim-bike-run-swim-bike-run each day. This also includes one day per week to be used for recovery.

While on the topic of rest, plan your training program so you never have back-to-back hard workouts (e.g. interval training on Monday and a hill workout on Tuesday).

If you’ve assessed your strengths and determined you may need a little more swim, run, or bike work, an additional third session of a specific discipline can be added per week. This might come in the form of a “brick workout” (discussed later) or a day where you complete two workouts (a double).

Volume and Intensity

Early research on elite endurance athletes found they gained the most fitness when completing approximately 80% or more of their training at low intensity (below lactate threshold) and the remaining 20% at moderate or high intensity.3 This pattern was remarkably consistent. A high-volume, low-intensity training program, sprinkled with high-intensity intervals sessions, can produce success in longer endurance events. Do what the elites do and you might snag an age group or podium finish.

Applying this rule to your training is simple. Create a schedule where 80% of your training volume (in time) is at a low intensity. What is a low intensity, exactly? Generally, low intensity is regarded as anywhere between 45% - 80% of your predicted heart rate max.

Plan your remaining training sessions at moderate or high intensity. These will be your interval workouts, tempo sessions, and hill work. One high-intensity swim, bike ride, and run per week is the general framework. High-intensity training occurs at a heart rate from 80% - 100% of your predicted heart rate max.

Cornerstone Workouts

Spending time logging miles in each discipline is crucial to develop proper endurance needed for the triathlon. Practice swimming, biking, and running at paces and tempos you’ll experience on race day.

It may be useful to research the race course to determine layout and elevation changes. Find out whether you’ll be racing an open water or ocean swim. This can help to guide specific training sessions.

Swim–Technique Sets

The swim portion is the most physically-technical part of the triathlon.

Good swimming should look almost effortless and relaxed. Swimming better isn’t just a matter of moving your arms harder or faster–efficiency is important.

You can build efficiency in two ways. The first involves swimming a set distance (say 25m) with a lower number of strokes in the same amount of time. Swim five sets of 25 meters each, and lower your stroke count by 1 - 2 for each repetition. This will improve the distance you can travel with each stroke.

To improve tempo, swim a set distance in the same amount of strokes, but decrease time on each repetition. This means you’ll be taking strokes more frequently.

Focus on long, clean strokes rather than choppy harsh ones.

Other Swim Training Tips

• If your race is open water, be sure that you practice a few open water swims before race day. Your local pool won’t mimic an ocean swim

• Practice sighting: swimming off course or getting lost during an open water swim can spell disaster for your race. Sighting is the ability to pick your head up enough while swimming to ensure you’re heading in a straight line to the buoy or other landmark. You can practice this in the pool

• Find a triathlon coach or join a team. Since swimming is so technical, learning from someone more experienced may have benefits

• Go the distance: it’s recommended to practice swimming the complete distance you’ll be racing

• Purchase and practice getting out of your bathing suit and swim cap. You don’t want to lose valuable race time struggling with this

Bike–Hill Sessions

The bike discipline of the triathlon is where you’ll spend the most amount of race time, and is also where you can potentially make up the most ground lost. Cycle training is crucial because many triathletes underperform on the run due to residual fatigue during the bike.

Power is the cyclist’s most crucial asset. More power on your road bike means you can ride faster over any race distance. Workouts to build power should be included in your cycling plan, and hill sessions are a great way to increase power. Hill workouts become extremely important if your race course contains significant elevation changes, long climbs, and steep inclines.

To hill train, start by finding a hill with about 1,000 feet of climbing. Each week, try to increase the distance climbed on this route while maintaining the same cadence and effort. If you have a power meter, trying to maintain power on climbs while increasing distance is a way to gauge fitness improvements.

Another variation of hill sessions are high-intensity uphill sprints. Sprint uphill for 60 - 90 seconds, followed by a ride back down for recovery. Repeat this 8 -12 times per workout.

Bike–Lactate Threshold Work

Your lactate threshold is the highest intensity you can sustain for around 60 minutes. At or above this intensity, the body starts to accumulate lactate, signaling a reliance on anaerobic energy production systems.

Exercise above this threshold can’t be sustained for long, so working to increase your threshold is crucial.

Lactate threshold is the best predictor of race performance for many cycling events.4

LT workouts are typically done as longer intervals. Find a long flat road where you won’t have to slow down or stop often. Try doing 3 - 4 ten-minute intervals at your lactate threshold pace. Increase time as you progressively get fitter or add more intervals.

Other Bike Training Tips

Unlike swimming and running, biking involves more technical equipment. Consider a few of training tips help optimize your time in the saddle.

• Learn to change a flat: nothing ruins a great bike ride like a flat tire. Even worse, this could happen during your big race. Invest in a patch kit and a spare tube just in case disaster strikes while out on the road

• Get fitted: a proper bike fit is critical to maximize comfort and efficiency in the saddle, and even boosts performance by increasing power and optimizing aerodynamics

• Consider indoor training: any bike can be hooked up to an indoor trainer. This will prevent days lost due to training if you can’t make it outdoors

Run–the Long Run

Endurance runs form the base of triathlon run training; they're key to developing a powerful heart, increasing muscle capillaries for oxygen delivery, building robust mitochondria, and strengthening running-specific muscles.5

Long runs build fatigue resistance and confidence, both crucial to perform well on race day. A general recommendation for triathletes: long runs should equate to about 35% of your total weekly running volume. If you train 4 - 6 hours per week, this would mean a long run of 1.5 - 2 hours or more.

Run–Speed Work

Speed (interval) training allows you become better at running faster, with goals of increasing lactate threshold and improving V02 max.

High-intensity speed work should occur at 80% - 100% of your maximal HR or V02 max.

Generally, a 2:1 or 1:1 work to rest ratio for intervals is recommended. This might take the form of two minutes at high intensity followed by one minute jog recovery, repeated eight times. Feel free to experiment with different types of intervals and mold them to your race distance.

The Brick: Your Best Friend and Worst Enemy

The triathlon is not three separate sports, but a single sport combining three interconnected events. The back-to-back-to-back nature of triathlons means you’ll need to practice the transitions and simulate the fatigue you’ll experience on race day. Brick workouts are race day dress rehearsals.

The brick is a specialized workout typically combining either a swim/bike or a bike/run into a single session.

In each, the first activity is followed immediately by the next with little to no recovery time.

Brick workouts allow the body to adapt to specifics of swim/bike and bike/run transitions. There are biomechanical and physiological differences among all events that will make transitioning uncomfortable if not practiced. Brick sessions allow you to practice making seamless transitions and minimize your performance drop from one event to the next.

Sample Brick Workouts

A simple brick workout might include a 500 meter swim in a pool, followed immediately by an easy bike ride of around 45 - 60 minutes. As you adapt to the transition, you can increase length and intensity of the swim and the bike ride.

For a bike/run brick workout, the same format can be applied. A 45 - 60-minute bike ride followed by a 30-minute run can get you into the rhythm of using different muscles and movements during this transition.

Outside of brick workouts, practice your swim-to-bike and bike-to-run transitions. Rehearse getting out of your wetsuit and swim cap, getting onto the bike and then, unclipping your cycling shoes and lacing up your running shoes. This will make sure things go as smooth as possible on race day.

When to Brick, and How Long to Go

Most triathletes should aim to complete one brick workout every 3 - 4 weeks. Keep the intensity of the swim, bike, and run the same as that of other workouts. If you had a moderate intensity swim or bike planned for a particular day, do a brick workout with both events at moderate intensity.

For duration, if you’re training for a sprint triathlon or Olympic distance triathlon, this workout should be 50% - 100% of race distance. For half-Ironman and full Ironman triathlons, 25% - 50% of race distance is recommended for a brick workout.

Fuel for the Work Required: Triathlon Nutrition

High-volume training means you’ll be tearing through energy stores. This requires you fuel properly and strategically.

Pre-Workout Nutrition

What you eat before a workout plays two roles. The first is ensuring that you’re able to maximize energy production needed for high-quality workouts and attain the greatest training adaptations. The second is the opportunity to practice race day nutrition strategies.

Training Low

The practice of training with reduced fuel availability, termed “training low,” is a recent strategy used by endurance athletes. It involves doing 30% - 50% of your training sessions with reduced carbohydrate availability.6 This could be accomplished by doing your ride, run, and swim in the morning after an overnight fast.

Manipulate carbohydrate availability on a session-by-session basis with intensity and duration in mind. Train low sessions should be planned around your lower-intensity workouts.

This is because low-intensity exercise relies more on fat oxidation versus carbohydrate oxidation for energy.

Training in a “fasted” state increases free fatty acid availability and lipid oxidation which can subsequently be used during the session.

There is evidence that training low stimulates post-exercise gene expression, oxidative enzymes, glycogen storage capacity, and other molecules related to positive metabolic adaptations compared to exercising with high carbohydrate availability.6 Multiple studies report exercise performance changes following exercise training with carbohydrate restriction, such as improved time trial and submaximal exercise performance.7,8,9

Train Dual-Fueled

When the body is low on carbohydrates, it burns more fat and even produces ketones for fuel. Ketones are the body’s natural back up, used in an energy crisis to replace carbohydrate–typically you either have enough carbs to get by but no ketones or no carbs and then elevated ketones. It's a trade off between fuels.

Not so with H.V.M.N. Ketone. After consuming H.V.M.N. Ketone, the body can use both carbohydrates and ketones for energy, essentially giving the body two fuel tanks to employ. The result? In a 30-minute time trial, elite cyclists rode 400m further (performing 2% - 3% better) after drinking H.V.M.N. Ketone.10

Have Sufficient Fuel for High Intensity Sessions

High-intensity sessions rely more heavily on carbohydrate oxidation than low-intensity work. For these workouts, having high availability of carbohydrate is recommended in order to maximize training output and adaptation. Pre-exercise carbohydrate intake (3 - 4 hours before a workout) enhances carbohydrate availability during exercise and has been shown to improve endurance capacity.11

Jumping in

A triathlon training plan doesn’t have to be complex. After you’ve found the right race, following some well known strategies in regards to your training and nutrition will set you up for success at any race distance.

Scientific Citations

1.Calsbeek R, Careau V. Survival of the Fastest: The Multivariate Optimization of Performance Phenotypes. Med Sci Sports Exerc. 20182.Hendy HM, Boyer BJ. Specificity in the relationship between training and performance in triathlons. Percept Mot Skills. 1995;81(3 Pt 2):1231-40.3.Seiler, S, & Tønnessen, E. Training Intervals, Thresholds, and Long Slow Distance: the Role of Intensity and Duration in Endurance Training. Sportscience 2009; (13) 32-53.4.Coyle EF, Coggan AR, Hopper MK, Walters TJ. Determinants of endurance in well-trained cyclists. J Appl Physiol. 1988;64(6):2622-30.5.Ingjer, F. Effects of endurance training on muscle fibre ATP-ase activity, capillary supply and mitochondrial content in man. J Physiol (1979); 294: 419–432.6.Impey SG, Hearris MA, Hammond KM, et al. Fuel for the Work Required: A Theoretical Framework for Carbohydrate Periodization and the Glycogen Threshold Hypothesis. Sports Med. 2018;48(5):1031-1048.7.Marquet LA, Brisswalter J, Louis J, et al. Enhanced Endurance Performance by Periodization of Carbohydrate Intake: "Sleep Low" Strategy. Med Sci Sports Exerc. 2016;48(4):663-72.8.Cochran AJ, Myslik F, Macinnis MJ, et al. Manipulating Carbohydrate Availability Between Twice-Daily Sessions of High-Intensity Interval Training Over 2 Weeks Improves Time-Trial Performance. Int J Sport Nutr Exerc Metab. 2015;25(5):463-70.9.Marquet LA, Hausswirth C, Molle O, et al. Periodization of Carbohydrate Intake: Short-Term Effect on Performance. Nutrients. 2016;8(12)10.Cox, P.J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., Murray, Andrew J., Stubbs, B., West, J., McLure, Stewart W., et al. (2016). Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes. Cell Metabolism 24, 1-13.11.Sherman WM, Brodowicz G, Wright DA, Allen WK, Simonsen J, Dernbach A. Effects of 4 h preexercise carbohydrate feedings on cycling performance. Med Sci Sports Exerc. 1989;21(5):598-604.

Bacopa Monnieri: Memory Boosting Herb For Anxiety

Originally published on HVMN by  Jamie Witherby

You’re in the waiting room of the dentist’s office, nervously tapping your foot on the patterned carpet and grinding your teeth until they finally call your name. You didn’t floss enough. You didn’t take care of that molar sensitivity when it first popped up three months ago. And you definitely didn’t schedule this cleaning a prompt six months after the last one. In short, you’re anxious.

Stress comes in many forms, and paths to relief are equally varied. Between the dizzying sound of the drill, you notice a fish tank: bubbles from the filter, fish floating through plastic pirate ships, swaying underwater plants. Interestingly, the simple sight of a fish tank can be a form of stress relief (maybe that’s why so many doctors’ and dentists’ offices have them). Hypnotic aquatic environments can lower your blood pressure and produce a state of relaxation.1 But if you really need extra tension relief, you may be better off reaching into the tank, pulling out the greenery, and feeding it through your chattering teeth.

Table of Contents

Bacopa Background

Bacopa: The Herb of Many Names

Bacopa Monnieri Mental Benefits

The Herb You Can’t Forget

Paying Attention

Anxiety and Stress

Depression

Bacopa Monnieri Physical Benefits

Radical Agent: Bacopa as an Antioxidant

Treat Yourself: Bacopa as Anti-inflammatory

Epilepsy: Bacopa Beginnings

Supplementing with Bacopa Monnieri

Testing Your Memory

Bacopa monnieri (buh-COH-puh moh-nee-AIR-ee) is an aquatic creeping perennial plant commonly sold to decorate fish tanks; but it can be used for much more than just underwater interior design. It can have a significant effect on cognitive function.

Let’s discuss how this powerful little plant can reduce anxiety and depression while enhancing memory and attention.

Bacopa Background

Before diving into the benefits, it’s best to know a bit more about why this herb has been used in medicine for centuries.

Bacopa: The Herb of Many Names

Native to the lush wetlands of South Asia, East Asia, and Australia, Bacopa monnieri has been an essential herb in Ayurvedic medicine for thousands of years. It joins a family of common medicines, Rasayanas, known for their youthful and rejuvenating enhancements, which is why they’ve primarily been prescribed to the elderly community.2

However, Bacopa monnieri is also part of the coveted Medhya Rasayana group along with another notorious nootropic, Ashwagandha. The prefix, “medha”, means “mind.” Thus, Medhya Rasayanas are prescribed to people of all age groups needing a mental boost. The list ranges from those recovering old memories to those recovering from brain injuries.2

Ayurvedic physicians in India have used Bacopa monnieri in combination with other herbs to treat conditions of the mind, such as anxiety, depression, ADHD, and dementia. The herb has also been used for inflammatory conditions, such as arthritis and ulcers.3,4,5

Bacopa monnieri goes by many names. If you’re buying it in a shop, you can ask for the classic carpeting varieties: moneywort or water hyssop. If you're researching its extracts, search for bacosides. If you’re talking to an Ayurvedic physician about it, try asking about Brahmi—a nickname based on the Hindu creator god, Brahma. Or if you're looking for the form of Bacopa monnieri extract, try changing a single letter: Bacopa monniera.

You won’t have to remember all those names to get through this article. But if you wanted to, you should consider taking a dose of Bacopa monnieri to help.

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Bacopa Monnieri Mental Benefits

From memory to anxiety, supplementing with Bacopa monnieri can be a powerful tool for the mind.

The Herb You Can’t Forget

It’ll take more than just a single dose to feel the full effects, but research has shown that regularly taking Bacopa monnieri for eight to twelve weeks can improve your memory.6,7,8,9,10

Human studies have found that supplementing with Bacopa monnieri can greatly increase your chances of acquiring and remembering new information.10,9 A 2001 double-blind study on healthy adults found that subjects increased their learning rates after Bacopa monnieri supplementation. While the results were evident in as little as five weeks, the most significant improvements were noted after the full twelve-week course.9

Not only was the information acquired more easily, but it was accessed from long-term memory more effortlessly.

A 2002 study echoed these findings after testing Brahmi’s memory capabilities in middle-aged adults.

Testing showed that Brahmi had significant effects on decreasing the rate of forgetting newly acquired information.10

Even after experiencing short delays to refocus the mind on other tasks, participants of all ages were able to recall new information more readily and fully after supplementing with Bacopa monnieri, including verbal processing.10 A 2012 meta-analyses of six memory intervention studies found that Bacopa monnieri can improve free memory recall.8 Imagine being able to actually remember the name of the road your maps app told you to take before your phone died. Or even just the name of that really cool plant you saw in a nature documentary last night. It could have been Bacopa monnieri.

Elderly participants even found Bacopa monnieri to be a very effective treatment for the unavoidable age-associated memory impairment (AAMI), enjoying increased memory procurement and retention.11,12 Grandma probably won’t stop confusing you with your sibling by taking Bacopa monnieri, but she will be more likely to remember the details of your life over time.

Commit this to memory: Bacopa monnieri can help the process of converting your short-term memories into long-term memories, known as memory consolidation.13

Every time you studied for a test, you engaged in this process. There’s a reason cramming the night before isn’t as efficient as studying over the period of a couple weeks. Your brain hasn’t had a chance to repeatedly fire this information on a pathway in your brain. The more frequently you study something, the stronger the pathways between the synapses in your brain become. That’s why mnemonic devices and other repetitive practices are suggested to help you rapidly store facts and figures. When it’s test time, strong pathways will allow you to more readily access information as needed.14

If you’re ready to spice up your daily routine a little, try testing your spatial memory in your current environment. Take a mental picture of your surroundings, close your eyes, and challenge yourself with questions: how many plants are on the window sill? What color is the book on the end table? Are the stripes on the area rug running vertically or horizontally? Then, open your eyes and see how you did. Supplementing with Bacopa monnieri could drastically improve your spotting skills because it boosts your spatial working memory. Working memory is about as straightforward as it sounds—it’s the part of your short term memory working to immediately process information. Add the spatial component, and you get an enhanced ability to remember things inhabiting space around you.6

Paying Attention

We can train many parts of our bodies, but Bacopa monnieri can help us focus on a soft spot: our eyeballs. Evidence supports that this herb can improve rapid visual information processing and speed of information processing.7 Translation? You can concentrate on what you’re seeing and comprehend it more quickly.

If faster processing didn’t get your attention, this will: elderly subjects also performed better on the infamous Stroop Test when taking the plant extract.7,15 You may have taken this tricky test yourself at some point. In it, participants are required to say the color of a word rather than reading the word itself. Easy, right? But all the words are colors…and the word does not match its hue. For instance, if the word "BLUE" is boldly scrawled in the color red, the subject should say ‘red.’ The test was developed to convey that embedded information about our environment strongly influences how we interact with it.

Doing well on the Stroop test assesses a few key things: cognitive processing speed, cognitive control, and attentional capacity, all of which were improved with Bacopa monnieri as an aide.15,7

These promising improvements are in line with the traditional Ayurvedic uses for the plant, further demonstrating why it’s been used as a memory aid for such a long time.

If you’ve been missing out on your memory’s potential, HVMN paired Bacopa monnieri with calming Ashwagandha and defensive Citicholine in Rise. Rise is a nootropic stack for long-term health benefits, including increased memory, adapting to chronic stress in order to reduce it, and building cognitive resiliency. The only thing you have to remember is to take two pills every day. In as little as two weeks of consistent supplementation, you could begin to see an increase in memory, stamina, and cognitive task efficiency.8,9,16

Anxiety and Stress

From the start, you were hooked with the promise of this plant being able to reduce anxiety. Like your hand in the fish tank, let’s dive right in.

In patients with anxiety, Bacopa monnieri had an anxiolytic effect, simply meaning an anti-anxiety effect. Participants in clinical trials experienced reduced heart rates and anxiety levels.15 These physiological effects point to the adaptogen potential of Bacopa monnieri.17Note the word “adapt” nestled inside. Adaptogens are classified by their abilities to help us adapt to stress by normalizing the body’s physiological responses to them.

But the criteria for being labeled an adaptogen are rather strict. The herb must not only be able to assist the body in coping with stress but also decrease stress-induced damage and produce beneficial effects over time.18 The kicker? Adaptogens must be devoid of significant negative side effects.

One of Bacopa monnieri’s adaptogenic effects is cortisol reduction.19 Although cortisol is the infamous “stress hormone,” it’s responsible for numerous processes—many of them beneficial. Cortisol is made in the adrenal glands and released into the bloodstream to transport it all over your body. Most of our cells contain cortisol receptors, which allows cortisol to have different effects depending on which cells it acts upon. The hormone can manage blood sugar levels, regulate metabolism, and influence blood pressure. Our cortisol levels are constantly fluctuating, but they generally cycle in a sensical way for a steroidal hormone, like being higher when we first wake up. Don’t worry if you’re not eager to jump out of bed every morning, though; cortisol doesn’t quite have the same vigor as caffeine.

When we feel stressed, we release cortisol to help us respond appropriately to the situation.

Fight-or-flight response, anyone? This reaction is very important for our survival. But we aren’t really supposed to engage this response over a long period of time, and elevated cortisol levels from chronic stress can negatively impact your body’s systems. On the minor side, you may suffer from digestive distress, such as diarrhea or constipation.20 Muscle tension could lead to daily soreness, headaches, or even migraines.21 On the major end, you could experience higher blood pressure, which is associated with an increased risk of heart attack and cardiovascular disease.22

In a 2013 study examining the anxiolytic effects of Bacopa monnieri supplementation, human subjects dosing with 640mg of the herb experienced a significant reduction in cortisol levels in as little as two hours after taking it.19

Depression

Bacopa monnieri’s calming effect may also be attributed to its modulation of serotonin levels, which Bacopa monnieri has been shown to regulate.9,15 Serotonin is the targeted neurotransmitter for the most successful antidepressive agents: the selective serotonin re-uptake inhibitors (or SSRIs).

Antidepressants also often increase the availability of dopamine in synapses, which is another neurotransmitter involved in regulating mood and motivation. Both dopamine and serotonin levels can decline with age, but Bacopa monnieri may be able to mitigate this decline by protecting dopaminergic neurons from death.23

In animal models, bacosides isolated from the Bacopa monnieri plant exhibited antidepressive effects.24 Better yet, human subjects reported a significant improvement in depression symptoms after supplementing with Bacopa monnieri for a twelve-week period.15

Bacopa Monnieri Physical Benefits

We can’t just let the brain have all the fun. Bacopa monnieri is a strong fighter for the body as well.

Radical Agent: Bacopa as an Antioxidant

Twelve weeks may seem like a long time, but Bacopa monnieri does its best work when given ample time to shine. Remember that in order for Bacopa monnieri to be classified as an adaptogen, it must be able to decrease stress-induced damage and produce beneficial effects over time. If you’re patient, it will react like an antioxidant in your system.25

Joining the ranks of other common antioxidants such as vitamins C and E, Bacopa monnieri can help remove free radicals such as nitric oxide from your system. Free radicals are unstable molecules missing an electron, which they attempt to take from our lipid membranes (known as lipid peroxidation). Over time, lipid peroxidation can cause tissue and muscle damage and contribute to a scary list of diseases: diabetes, heart disease, and cancer.25

Treat Yourself: Bacopa as Anti-inflammatory

If one disease-reducing quality wasn’t enough, here’s another.

In vivo studies on rats found that Bacopa extracts inhibit the release of cytokines and enzymes associated with inflammation in the brain, leading to an overall reduction in inflammation of the central nervous system (CNS).3,5

A 2016 study on the effects of Bacopa on signaling enzymes and inflammatory markers found that Bacopa monnieri targeted specific inflammatory mediators found in the central nervous system and the periphery that are linked to arthritis and neuroinflammation.3Similarly, a 2011 in vivo study found that the isolated bacosides prevented age-dependent elevation of pro-inflammatory markers in the aged cortex.4

While this doesn’t imply that Bacopa monnieri reduces aging, it does encourage further research into using the herb to reduce systemic inflammation.

This is especially promising because reducing inflammation can assist with the treatment of serious CNS disorders, such as Alzheimer’s disease, schizophrenia, and multiple sclerosis.3,5

Epilepsy: Bacopa Beginnings

While the research on Bacopa monnieri’s effects in individuals with epilepsy is in its infancy, the herb’s mechanisms are promising.

Epilepsy is a neuronal disorder often characterized by memory and learning impairments.26Frequent recurrent seizures can adversely affect cognition and contribute to brain injuries associated with cognitive degradation. For genetic epilepsies, the mechanisms of seizure activity are actually quite similar to the mechanisms of cognitive impairment.26 These mechanisms appear to occur as a result of abnormal signaling patterns, which result in modified synaptic function and hyperexcitability. Don’t get too excited—normal cognitive function requires a stable balance of excitatory and inhibitory drive.27

In epileptic animal models, Bacopa monnieri treatment significantly reversed the down-regulation of essential gene expression during seizure activity. In other words, neuronal cell receptors appeared to function normally again.28

Bacopa monnieri’s effects on epilepsy behavioral deficits were also researched in 2010. Because the herb has been tested for its antioxidant, anticonvulsant, and cognition improving properties, the authors posit that it may be a beneficial herbal medicine for ameliorating the neuronal deficits associated with frequent seizure activity.29

Supplementing with Bacopa Monnieri

Daily doses range from 200mg - 400mg of the standardized extract with no major adverse effects reported. Minor side effects include diarrhea, nausea, and an upset stomach. The extract is also not known for having the most pleasant flavor.

Bacopa monnieri is generally considered safe to pair with other medications and supplements.11

Remember: Bacopa monnieri is most effective after being used consistently for an eight to twelve week period. With its hefty list of benefits, this is one herb that’s worth the wait.

Testing Your Memory

Whether you need to train your brain to process new information more quickly or train your body to process new movements more gracefully, adding Bacopa monnieri to the mix can help you achieve your memory goals and boost cognitive function.

You may not have started supplementing yet, but try to see how many of Bacopa monnieri’s benefits you’re able to remember on your own:

• Increased memory acquisition and retention

• Defense against age-associated memory impairment

• Increased verbal processing

• Increased rapid visual information processing

• Increased spatial working memory

• Increased memory consolidation

• Defense against lipid peroxidation

• Reduced inflammation in the central nervous system

• Reduced heart rate

• Decreased anxiety

• Decreased depression

• Potential for those with epilepsy and seizure activity

Bacopa monnieri's cognitive enhancement and protective effects won’t get you out of going to the dentist. But it could help you remember to floss and keep you calm while the dental hygienist does it for you anyway.

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Nemetchek MD, Stierle AA, Stierle DB, Lurie DI. The Ayurvedic plant Bacopa monnieri inhibits inflammatory pathways in the brain. J Ethnopharmacol. 2017;197:92-100.

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Rastogi M, Ojha RP, Devi BP, Aggarwal A, Agrawal A, Dubey GP. Amelioration of age associated neuroinflammation on long term bacosides treatment. Neurochem Res. 2012;37(4):869-74.

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Viji V, Helen A. Inhibition of pro-inflammatory mediators: role of Bacopa monniera (L.) Wettst. Inflammopharmacology. 2011;19(5):283-91.

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Stough C, Downey LA, Lloyd J, et al. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008;22(12):1629-34.

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Neale C, Camfield D, Reay J, Stough C, Scholey A. Cognitive effects of two nutraceuticals Ginseng and Bacopa benchmarked against modafinil: a review and comparison of effect sizes. Br J Clin Pharmacol. 2013;75(3):728-37.

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Pase MP, Kean J, Sarris J, Neale C, Scholey AB, Stough C. The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med. 2012;18(7):647-52.

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Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001;156(4):481-4.

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Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker J. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology. 2002;27(2):279-81.

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Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med. 2010;16(7):753-9.

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Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006;48(4):238-42.

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Department of Biochemistry and Molecular Biophysics Thomas Jessell, Steven Siegelbaum, and A. J. Hudspeth. Principles of neural science. Eds. Eric R. Kandel, James H. Schwartz, and Thomas M. Jessell. Vol. 4. New York: McGraw-hill, 2000.

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Bellezza FS. Mnemonic Devices: Classification, Characteristics, and Criteria. JSTOR, 1981; 51 (2), 247-275.

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Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008;14(6):707-13.

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Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol. 2009;106(3):857-64.

17.

Rai D, Bhatia G, Palit G, Pal R, Singh S, Singh HK. Adaptogenic effect of Bacopa monniera (Brahmi). Pharmacol Biochem Behav. 2003;75(4):823-30.

18.

Tripathi S, Mahdi AA, Hasan M, Mitra K, Mahdi F. Protective potential of Bacopa monniera (Brahmi) extract on aluminum induced cerebellar toxicity and associated neuromuscular status in aged rats. Cell Mol Biol (Noisy-le-grand). 2011;57(1):3-15.

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Benson S, Downey LA, Stough C, Wetherell M, Zangara A, Scholey A. An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri (CDRI 08) on multitasking stress reactivity and mood. Phytother Res. 2014;28(4):551-9.

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Mayer EA. The neurobiology of stress and gastrointestinal disease Gut 2000;47:861-869.

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Leistad, R, Sand, T, Westgaard, R, Nilsen, K, Stovner, L. Stress-Induced Pain and Muscle Activity in Patients with Migraine and Tension-Type Headache. Cephalalgia 2006; 26(1), 64–73.

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Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol. 2008;51(13):1237-46.

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Aguiar S, Borowski T. Neuropharmacological review of the nootropic herb Bacopa monnieri. Rejuvenation Res. 2013;16(4):313-26.

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Zhou Y, Shen YH, Zhang C, Su J, Liu RH, Zhang WD. Triterpene saponins from Bacopa monnieri and their antidepressant effects in two mice models. J Nat Prod. 2007;70(4):652-5.

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Tripathi YB, Chaurasia S, Tripathi E, Upadhyay A, Dubey GP. Bacopa monniera Linn. as an antioxidant: mechanism of action. Indian J Exp Biol. 1996;34(6):523-6.

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Holmes GL. Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord. 2015;17(2):101-16.

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Yizhar O, Fenno LE, Prigge M, et al. Neocortical excitation/inhibition balance in information processing and social dysfunction. Nature. 2011;477(7363):171-8.

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Paulose CS, Chathu F, Khan SR, Krishnakumar A. Neuroprotective role of Bacopa monnieri extract in epilepsy and effect of glucose supplementation during hypoxia: glutamate receptor gene expression. Neurochem Res. 2008;33(9):1663-71.

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Mathew J, Paul J, Nandhu MS, Paulose CS. Bacopa monnieri and Bacoside-A for ameliorating epilepsy associated behavioral deficits. Fitoterapia. 2010;81(5):315-22.