In this video Dr. David Perlmutter explains the gut‑brain connection he described in his book Brain Maker, proposing that Alzheimer’s disease may be driven by systemic inflammation that originates in the gut. He reviews a November 2016 randomized, double‑blind, placebo‑controlled trial published in Frontiers in Aging Neuroscience that enrolled 60 adults (ages 60‑95) with confirmed Alzheimer’s disease. Participants received either a probiotic cocktail (Lactobacillus acidophilus, Lactobacillus fermentum, Bifidobacterium bifidum) or a placebo for 12 weeks. The study measured Mini‑Mental State Examination (MMSE) scores, high‑sensitivity C‑reactive protein (hs‑CRP) as an inflammation marker, total glutathione (antioxidant capacity), and pancreatic beta‑cell function (insulin secretion). Results showed the probiotic group experienced a marked reduction in hs‑CRP, a significant increase in glutathione, and improved beta‑cell function, whereas the placebo group showed worsening or no change. Cognitively, the placebo group’s MMSE scores declined as expected, while the probiotic group demonstrated a notable improvement. Dr. Perlmutter interprets these findings as evidence that modulating gut microbiota can positively affect brain health and metabolic status in Alzheimer’s patients. He concludes with practical lifestyle advice: consume probiotic and prebiotic foods, lower carbohydrate intake, increase healthy fats (olive oil, coconut oil, grass‑fed beef, pasture‑raised eggs), ensure adequate magnesium, engage in aerobic exercise, and supplement with omega‑3 DHA. He emphasizes that while the research is promising, further studies are needed.
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Hello everyone, I'm Dr. David Perlmutter. You know, in the book Brain Maker, I drew conclusions based upon relationships that have been established now between things going on in the gut and their effects upon the brain, really indicating that, for example, Alzheimer's being an inflammatory disorder might well be related to where Inflammation begins in the human body, and that is in the gut. So you might then wonder, well, gee, why can't we rearrange the gut bacteria in hopes of having an effect on the brain? And specifically, might that be an avenue that could be explored in terms of actually treating a disease like Alzheimer's disease? Well, that's what just happened. Let's take a look at this really interesting report. This is actually a very, very fascinating study, the effect of probiotic supplementation on cognitive function and metabolic status in Alzheimer's disease, a randomized double-blind and controlled trial. This was just published in Frontiers in Aging Neuroscience in November of 2016, and here's what the researchers did. They took 60 adults who had confirmed Alzheimer's disease. These folks are between the ages of 60 and 95. They either were given a placebo or a probiotic. The study went on for 12 weeks, and they did what was called a mini mental status exam, a kind of standard examination that's done in patients who are suspected of having dementia or may already have dementia to assess their progress or lack thereof, used in neurologists' office. And the intervention was giving a group of fairly common probiotics, Lactobacillus acidophilus, KCI, Fermentum, and Bifidobacterium bifidum, fairly standard probiotics. And they measured not only the Mini Mental Status Test on these people before and after, but they also measured what's called highly sensitive C-reactive protein. a marker of inflammation, total glutathione, which is a marker of— well, which participates in antioxidant function and also detoxification, and also the function of the beta cells, which are the cells in the pancreas that make insulin. And here's what they found. In looking at the placebo group over 12 weeks, their level of C-reactive protein, in other words, their marker of inflammation, got worse during the 3-month period of time. In comparison, the group taking the probiotics watched their C-reactive proteins— again, their inflammation level— dramatically decline. As we look at the total glutathione level, the placebo group had a slight decline in their total glutathione. Let me tell you, you want to have a lot of glutathione. It's an important antioxidant. And then when we look at the intervention group taking the probiotic, we see a significant increase in glutathione just by taking the probiotic. And then when we look at the beta cell function, we see that the placebo group had really no change in beta cell function, but a dramatic improvement increase in the way the pancreas secretes insulin. In the group taking the probiotic, and this is really quite remarkable when we look at it, a pretty dramatic increase in the way that their pancreas works. Now, where the rubber meets the road here is in the Mini Mental Status Test. What we found is pretty much as expected that the placebo group would decline. with no intervention having Alzheimer's as a diagnosis over the 3-month period of time. But there was actually a fairly dramatic improvement in the way the brain works, in the cognitive function, in Alzheimer's patients who took the probiotic cocktail that I just described. So we have to look at things like probiotic foods and supplements and even prebiotic foods and supplements, prebiotic being the fiber that nurtures the gut bacteria, fundamental players in cultivating a healthy gut and reducing inflammation, increasing glutathione, decreasing markers like C-reactive protein. Also very important to lower your carbohydrates, increase your consumption of good healthful fats— olive oil, coconut oil, grass-fed beef, pasture-raised eggs. I cannot overemphasize the critical importance of magnesium as well as aerobic exercise. Aerobic exercise actually leading to increased growth of new brain cells, as does the omega-3 DHA that you can get as a nutritional supplement or that you will get by eating fish or even grass-fed beef. You know, primarily the critical player here is, of course, Of course, our food choices are very, very fundamental in terms of health of the brain. Well, I think you'll agree this is fascinating research. Interventional trial with a probiotic which actually significantly improved not only cognitive function, in other words, as measured on the Mini Mental Status Examination, but also some other very important biometrics. Things like C-reactive protein and glutathione, which are really kind of markers of the action of free radicals and the ability of the body to handle inflammation, all demonstrating improvement with a simple probiotic intervention. We don't know where this is going to lead, but it's really very encouraging at least that this research is taking place. So I'll do my best to keep you on top of this stuff as it evolves. Very, very fascinating information. Thanks for joining me today. I'm Dr. David Perlmutter.
