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For those seeking non-invasive BDNF enhancement, the evidence supports high-intensity interval training (HIIT)—12 weeks of HIIT produced 20% increases in hippocampal BDNF and improved cognitive flexibility in older adults—and flavonoid-rich diets containing polyphenols from sources like green tea and dark chocolate

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Frank deficiency (below 145 pmol/L): I start aggressive supplementation, often intramuscular for post-RYGB patients, and I will want repletion confirmed on a follow-up blood test before I am comfortable proceeding with surgery