5 Steps To Reduce Brain Inflammation Today

Coming up on this episode of the Doctor's Pharmacy.

Being in a place where there's a high concentration of air pollution might actually be creating this inflammatory insult to the brain.

So it was like, wow, the gut.

Is connected to the brain.

Totally, totally connected to the brain. Literally there are viruses, yeast, bacteria in the brain that may be triggering this cascade of inflammation. And then the question is, where does this come from? Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me, helping patients heal using real food and functional medicine as your framework for getting to the root cause. What's critical to understanding what each individual person and body needs is testing, which is why I'm excited to tell you about Rupa Health. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to optimize health and reverse disease. But up till now, that meant you are usually ordering tests for one patient from multiple labs. And I'm sure many of you can relate how time consuming this process was and then it could all feel like a lot of work to keep track of. Now there's Rupa Health, a place for functional medicine practitioners to access more than 2000 specialty labs from over 20 labs like Dutch, Vibrant America, Genova, Great Plains and more. Rupa Health helped provide a significantly better patient experience and it's 90% faster. letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. This is really a much needed option in functional medicine space and I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at RupaHealth.com that's R-U-P-A-Health.com Now so many of my patients wait until they're sick to finally take care of their health. I've even had doctors as patients, well many actually, who just wait for their problems to get worse and worse and receive a diagnosis of disease before taking any kind of action. This is not the path to health. We can live longer, healthier, happier lives if we just prevent imbalances in our bodies in the first place. And nutrition is a key part of this. Many of us don't get the optimal amounts of key nutrients through diet alone, even with a whole foods diet. And then, when you add in all the stressors we're up against, like work demands, toxins, lack of sleep, or even more likely to have a nutrient deficiency. So one of the things I use every day to optimize my intake of vitamins, minerals, phytonutrients, pre and probiotics is AG1 from Athletic Greens. It's a comprehensive superfood powder with a special blend of high quality whole food ingredients that work together to fill the nutritional gaps in your diet. It's specifically designed to support energy and focus, aid with gut health and digestion, and support a healthy immune system, which we all need right now. I've made AG1 part of my daily ritual because I feel better knowing I have a little extra nutritional insurance to complement my healthy diet. It also gives me a nice energy boost without feeling overstimulated. I like to think of it as a huge leafy green salad shrunk down into a simple glass of water I can take anywhere. Right now, you can get 10 free travel pracs of AG1 when you make your first purchase. Just go to athleticgreens.com/hymen. That's A-T-H-L-E-T-I-C-G-R-E-E-N-S.com/hymen. Now let's get back to this week's episode of the Doctor's Pharmacy.

Hi, this is Lauren Fein, one of the producers of the Doctor's Pharmacy podcast. Almost every modern disease is caused or affected by inflammation. Inflammation can result from chronic stress, a gut imbalance, mold, or even a lingering untreated infection. And inflammation can affect the brain, just as it can any other part of the body. The most common symptom of neuroinflammation is brain fog, where you can't recall names or words or even think straight. On today's compilation episode, Dr. Hyman talks to Dr. Todd LePine and Max Lugavere about the causes of brain inflammation and how to treat it. They also discuss the importance of time and nature for a balanced mood, plus give suggestions for nutrients to support optimal brain health. Let's dive in.

Certain foods may trigger brain fog, and it is something that I think is intimately connected to the gut. I think the, and we'll talk about that at this particular case, is gut fermentation is oftentimes a cause for brain fog.

I mean, it's like bugs fermenting the food you're eating, creating all these nasty byproducts.

Yeah, and I don't know, Mark, if you've had patients who've had, this is a really interesting thing because I have patients come in and they say, I feel like my gut is just bloating and I'm fermenting and that's exactly what's happening. So, there is a condition. I just recently had a patient who had auto-brewery syndrome.

Yeah.

And I've seen it. So, you have your own beer factory. Exactly. So, when you want to make beer, what do you do? You take sugar and you add yeast to it and you can actually produce alcohol. And I've had a couple of cases where it was missed. And it's actually not just the recent findings is it's not just yeast in the gut that do this, but also Klebsiella bacteria. So, both bacteria and yeast can actually produce these compounds which are toxins. Alcohol is a toxin. That's why when you get drunk, you're intoxicated. And you'll actually produce alcohol and other toxins which affect your brain.

It's interesting. I never really had that insight before you said that word, intoxicated. you're toxic.

You're toxic. Exactly. That's what I was saying. Intoxicated. That's how I explain it to people.

It took me six years to figure that one out.

Exactly.

Exactly. But I think that what you're saying is very true. I mean, I've had two times in my life when I've had severe brain fog. One was when I had mercury poisoning 30, 25 years ago. And my gut was a mess then because the mercury poisoned my gut. I had terrible bloating, distension, diarrhea. And the second time was more recently when I had mold toxicity and I had C. diff and I also had colitis and gastritis and my whole gut was a mess and I had severe brain fog. And it was pretty debilitating. You could barely focus, answer an email, talk to somebody. Oh yeah, you can't concentrate. You can't concentrate at all. And people think, oh, that's just sort of in your head. It's not in your head, maybe in your stomach.

Well, it's manifesting in the head. That's the whole thing. And we have these artificial boundaries between the brain and the body and the mind and they're all interconnected. and brain fog is a real, it's a real phenomenon. And then you have to sort of figure out what's doing it. The other thing that is interesting that I see with some people with brain fog is just gluten and dairy. And I tell patients that, you know, one of the most addictive foods is pizza. And the reason for that is that pizza has gluten in it.

It's true, you can eat a whole pie, right?

Exactly, oh yeah, I tell you, it's one of the foods that I'll occasionally indulge in, but I don't have it.

That often, 'cause it's not the best food for you.

You have my cauliflower pizza with goat cheese. You can make a healthy pizza. Exactly, yeah. But the two foods which are interesting is that gluten and dairy both get broken down. The proteins in those get broken down into caseinomorphins and glutamorphins. And, caseinomorphins are the ones from dairy and glutamorphins are from gluten. And, those have morphine-like effects. So, you literally become high. You get a little high, you get a little foggy in the brain. and it also can cause cravings and it can sort of make you sleepy, you eat it and then you get a little sleepy from it also. That's when children drink breast milk, they go to sleep after, they conk out. That's because of the morphine-like action in milk.

Yeah, so that's true. I think it can be our diet, it can be food sensitivities like gluten and dairy which are really common and often people going on an elimination diet will have an immediate relief of brain fog, something that you don't know you have until you don't have it anymore sometimes. People just think this sort of slow decline of their cognitive function, they're not realizing that it's actually something that can be reversed and it can be reversed very quickly. So the second thing is the factors that are in the gut, bacterial overgrowth, yeast overgrowth, we call dysbiosis, that can also lead to a lot of cognitive issues because your gut's connected to your brain. and that causes this effect when the bugs are out of balance and it drives inflammation and then you get inflammation in the brain, essentially is what causes brain fog.

Absolutely. Well, the other important thing, and I think I talked about this last time, is that the blood flow from the gut has to go through the liver. And the reason for that is to filter all of the toxins that are there. So there's a lot of immune cells, the Kupffer cells in the liver and a lot of filtering processes and detoxification takes place in the liver. prior to the blood from the gut then going into the systemic circulation. So sometimes you'll have, in addition to leaky gut, you'll have problems with detoxification in the liver itself. And that's, you know, an example of that is the condition hepatic encephalopathy, which is brain fog. That's essentially-- well, talk about that.

What is that for people who don't know what that's so big word.

I learned, and I think I mentioned this before, and it was one of the things that really stuck with me is When I worked at the VA hospital, there was a lot of alcoholics and when you're an alcoholic, you basically turn your liver into a pickled liver. You trash your liver, yeah. You trash your liver and then you're not able to detoxify and I would typically see this over and over where patients had cirrhosis of the liver and their liver was not able to detoxify and then when they would eat foods, especially high protein type meals, they would get hepatic encephalopathy and literally go into a coma.

So, they would literally get delirium, confusion, brain fog.

Brain fog. That's when they did brain fog on steroids.

And the reason is it was coming from their gut. And what I found so striking when I started learning about functional medicine was that here was a condition in medicine that we knew how to treat by fixing the gut. We gave people antibiotics to sterilize their gut to kill the bacteria that caused all these byproducts that made people have, you know, basically delirium or encephalopathy and brain fog. So it was like, wow, the gut is connected to the brain.

Totally, totally connected to the brain, absolutely. And in some cases, you know, there have been cases of people actually having psychosis from gut dysfunction.

Yeah, you mentioned Auto-Brewery Syndrome. I remember reading a case of a woman who was arrested for driving under the influence and it turned out she wasn't drinking but she had a high blood alcohol level that was coming from her gut.

Yeah, it is. It's a very real phenomenon. You have to think about it and the way that you actually test for that is you can, it's actually quite simple, you just have somebody do what I call a pancake challenge. You basically some pancakes full of carbs, but throw some maple syrup on it, eat it and get a blood draw at 0.0, you know, eat the meal and then half an hour later check your alcohol level.

It sounds like a fun medical test.

Pancake challenge.

I don't know the pancake challenge. So we've talked about the gut, we've talked about gluten, dairy, food sensitivities. There are other reasons too.

Infections. Infections can do that. Another one that is- Tick infections. Oh, absolutely. Tick infections. Lyme. Yeah, those are- I would say that that's in addition to brain fog, you get a lot of cognitive dysfunction too.

Memory issues.

It's more severe. It's much more severe. The one thing that I see a lot is allergies. I call it the allergic brain. And you can have food allergies that can potentially do that or even environmental allergies or mold. And the high levels of histamine, because histamine actually acts as a neurotransmitter. And I've seen this in a number of patients. I've had some patients with another condition which we're seeing more and more of is mast cell activation syndrome. It's sort of a buzzword you know, but it's a very real phenomenon and is related to the mast cells, which are the types of immune cells in the body and the interstitial, the sort of the spaces between the cells where they reside and they release lots of histamine. And if anybody has ever had hay fever, you see that the typical picture of a person with hay fever, they're like this, like half asleep and like they're walking through a fog. Hay fever is an example of a brain fog. And antihistamines can actually have a benefit with that. Naturally, things like Quercetin and Nettles can also be very helpful. And you probably have used it. This is something that I've been using more is the drug Cromolyn Sodium, which is, I've had some amazing success with that in more difficult cases. I wouldn't necessarily go to that for my first choice.

What Todd's talking about is this drug that's used for asthma and allergies that is usually inhaled.

Yeah, usually inhale.

But there's a version you can take orally that before you eat inhibits your white blood cells from releasing histamine and creating an allergic response. And I often found it extremely effective for some patients. Exactly. So Todd, talk about this patient that you had that had really bad brain fog. This is a guy who'd come to see you who worked a lot, was a little bit stressed, and that could be easily dismissed as though you're just.

Stressed and tired, but you went deeper. What did you find? Well, he actually came into me and he had already seen a variety of different doctors. And the background is that the gentleman as a child had lots of allergies and asthma. So he had ear infections, bronchitis, also developed some sinusitis type symptoms. So he had multiple rounds of antibiotics. And I always emphasize to patients that when you have an immune dysfunction look for the gut because 60 to 70% of your immune system is in the gut. And just like, you know, with what's going on with the COVID virus or the COVID-19 syndrome that we're seeing by coronavirus is it's not the virus or the bacteria itself that causes the problem. It's our immune system's response to it. And in general, we want to have a, I call it a balanced immune system. So we want our immune system to be idling. Yeah, so basically just sort of sitting there and okay, we're enjoying planet Earth. We're going out for a walk.

We're not reacting to this.

Not under-reacting or over-reacting. Exactly, under-reacting or over-reacting. And when you overreact, we call that an autoimmune disease.

When you under-react, we call that AIDS. So AIDS or cancer?

AIDS or cancer. Or over-reactions, allergies or immune. And I think we talk about a weak immune system or a strong immune system. It's really, I think, an intelligent and a balanced immune system. that's how I like to think about it. And that's related to immunotolerance, which is what the gut does. So when we have a healthy gut, we have an immune system that is tolerant to lots of things. And you can eat certain things, you can go out in the environment, you're not going to react to dog dander and all these other things. There are some genetic, some people have genetic predispositions towards being more atopic or allergic, but having a healthy gut, especially early on, the priming of the gut is so critical. You know, having a vaginal birth, being breastfed, not introducing certain foods like gluten early on in the, in, in living on a farm. Living on a farm. Exactly. Being exposed. And crawling around in the dirt and literally putting dirt and, you know, I call it, you know, your, your body's immune system samples planet Earth. Planet Earth is a very dirty place. There's lots of bugs and all kinds of things and your body learns to be immunotolerant. And one of the things that is really, I also focus on is part of this immune system is called the T-reg cells. The T-reg cells are like the conductor in the Boston Symphony Orchestra. So, you've got the wind section over here and the horns over here and they keep everything in balance. And the T-reg cells are really, really critical. and what we're finding- They regulate, they regulate the whole balance of the immune system. And the T regs that we find out, the two things that are really simple that people can use to upregulate your T regs to keep things in balance are fibers. Fibers in the diet. Fibers are the key things that help with regulation of that. And then also, which I use quite a bit in the patients that I see, is vitamin A. Vitamin A helps to downregulate the immune system and helps to keep the T-reg cells in place.

So, this guy came in with brain fog and he had a lot of stress, but he also had other things. He had mold exposure.

Yeah, he was working in a building and they found out that he was in a water-damaged building unknown to him and he had mold exposure, which you've been experienced yourself.

Been lucky enough to have that.

Yeah, exactly. And we live in, you know, a lot of people are in older buildings. and you don't know, you might buy the building and there's water damage, you.

Don'T even know it's there. I mean, 50% of buildings have water damage in America.

That's a lot. Really? Yeah. Wow. Wow. That's a lot. Yeah, so he was actually, he came to me and he was, he had the diagnosis of mold toxins. In fact, he actually learned about this through one of your podcasts. I think it was, you were talking with David Asprey. Oh yeah, I was trying. Exactly. It was a moldy podcast. so that's how he sort of went down that road and he got treated with a variety of different therapies. He got some IV glutathione, he got some ozone therapies and other interventions and he got about 50% better and then within several months he sort of went back to where he was. He was also again not sleeping much because he was doing a lot of litigation, it was a lot of stress, he wasn't sleeping well. The big thing that I see with patients with conditions like immune dysregulation is stress and lack of sleep is a stressor, probably the number one stressor. So if people aren't getting a deep restorative sleep, that is a stress to the immune system. And I was trying to emphasize that you can do that for one or two days, but you can't do that on an ongoing basis. So really, really important, I always emphasize getting good deep restorative sleep with patients. So I emphasized that with him. So when he came in, he also had a lot of digestive symptoms. He was actually on a whole bunch of inhalers. He was on like Brio, Spirova, Ventolin, on Zolair injections, Flonase for his sinuses. He also had Zolair is a very.

Expensive, like $20,000 a year, intense immune suppressing medication. Yeah. And he still wasn't better.

He still wasn't better. No, exactly. And that actually worked by stabilizing mast cells, which you can actually naturally do. Quercetin actually can help high-dose quercetin can be very helpful for a mast cell.

Also great for COVID.

Exactly.

Yeah.

Yeah. So when he came in here, and I did a thorough workup on him, and I did retest him for mold, and he did have some mold, but I compared it to his previous labs, and it wasn't that bad. So I empirically treated him with some binders to sort of help. But he had already moved out of the moldy building that he was living in.

You get out of the moldy environment and then use these binders to help get the mold toxins out of your system.

Right, because the mycotoxins, they do tend to recirculate in the body, the enterohepatic recirculation, so they'll get reabsorbed by the body. And what are the kind of binders you use? In him, I actually use very natural things. I used clay, med clay, and I also used to activate charcoal. That was pretty much it.

These are things that don't get absorbed.

That suck all the bad stuff out. Oh yeah, exactly. And you worked in Murrieta, right? Somebody would overdose on drugs, we would give them charcoal.

Yeah, that's right.

We'd make them drink black charcoal. It was terrible. And every now and then they'd vomit up on you.

We've been there, done that. Yes, we. Right. Yeah, so this guy had also other stuff, right? gluten issues. Oh, yeah.

A lot of gut issues.

Yeah.

And unfortunately, when he went to the previous doctors who did help him out, they didn't go deep enough. They didn't sort of, you know, get all the pieces of the puzzle. So they did not check him for gluten sensitivity, which he would markedly was gluten sensitive. And also did the Cyrex testing on him for gluten and Cyrex for leaky gut and both of those were markedly positive.

So those are tests that we use at the Ultra Wellness Center that are a little bit different. than traditional food testing that looks at antibodies that aren't true allergy, but there are reactions that our immune system is having against foods and we can tell what you should and shouldn't eat based on this what's causing an immune response.

Exactly, exactly. And then also did stool testing on them. I did the, what I think is sort of the state of the art, the GI MAP test, which does quantitative PCR for the DNA of bacteria, yeast, viruses, parasites. and he had probably one of the worst cases of dysbiosis I've ever seen. That's imbalance. Yeah, imbalance. Yeah, a lot of imbalances. You know, I tell patients that everybody has, you know, hundreds of different kinds of bugs in their gut and they're a little bit like weeds in the garden. No garden does not have weeds. You just don't want too many weeds. And the interesting thing about the digestive tract and bacteria is that there is a phenomenon which is known as quorum sensing. Quorum sensing means that when certain bacterias reach a critical level, they start acting as bad actors. An example of that is like a cluster of diphthearia. So when patients get antibiotics and they wipe out the good guys, the bacteria, the C. diphthearia somehow or another sense that there's not enough cops around and they take over the place and they start producing toxins. Same thing happens in this particular case, he had one of the highest levels of pseudomonas bacteria that I've ever seen. and we typically see that in patients with cystic fibrosis. So he had bacterial dysbiosis, that organism plus other organisms.

And he had a lot of gut symptoms, right?

Yes, yes, exactly. Yep, exactly. A lot of mucus, and in my opinion, that mucus, that sticky mucus is a biofilm. That's where the bacteria live. They live in that biofilm layer, and antibiotics and such are very difficult to to penetrate that.

You're not having a smooth log that just comes out clean.

There may be some problems in there. Exactly.

Yeah.

And he also had yeast overgrowth, which was, you know, not unexpected.

Because of all the antibiotics he had.

Oh, yeah, absolutely. Absolutely.

And the acid blocker he was taking. He was on a proton pump inhibitor. That's one of my, you know, I hate. I hate them. I, they are, they are good and bad. They, they, I, they can say be helpful. But, I mean, I remember when I was in medical school, we talked about this in the podcast. We were told they just came out and they were like, these are very powerful drugs. You don't want to give them to any patient more than six weeks. It shuts down acid production. It's risky long term. And now everybody's on it. They're over the counter. They're over the counter. Over the counter and for life. And it causes all sorts of disruption in the gut. It causes you to not absorb your nutrients. It causes overgrowth of yeast.

It changes the pH.

Leaky gut. Leaky gut.

I mean, it causes irritable bowel.

Osteoporosis. Osteoporosis, pneumonia.

Small bowel deficiency. Yeah, there we go. We can keep going. It's a great way to keep the business going, isn't it?

Yeah, I wrote a textbook chapter on reflux and it was like, looking at.

All the data, I was like, holy cow, this is not good. Exactly. Yeah. And unfortunately, they're handed out like Pez candy. Yeah.

And patients stay on them long time. What's wrong with Pez candy? I used to eat that all the time. I had my little Pez dispenser. Those of you who are younger, you might not know what this is, but it's a little candy dispensing device with a little cute cartoon character on the top. Donald Duck.

You'd pull it open and then the.

Little candy would pop out, and it was so fun to eat. It was.

Yeah, right.

I quit when I was like eight.

No.

So this guy had all this stuff and he had gut issues, he had gluten issues, he had mold issues. And what I find really important to emphasize is that in functional medicine, it's about looking at the whole system and not just treating one thing. And often it's many things at the same time. Because when the system breaks down, lots of things break down. So this guy's gluten issues, well getting off the gluten would have fixed him. or just fixing the mold when to fix them, or just fixing his gut when to fix them. You've got to deal with all these various things. And you had, you know, another thing that you found on him as well, right? Oh, yeah, sinus issues.

Sinus issues. That was actually, he actually had sinus surgery for that. And it was really a big thing. And in fact, I actually just recently downloaded a paper from PubMed on the nasal microbiome. So, you know, we have bacteria on our skin, we have it in our mouth, we have it in our digestive tract, in the vagina, in the sinuses, they're everywhere.

Everywhere.

And so disruption of the nasal microbiome can also cause brain fog. Typically you see that a lot.

And all the steroids he was taking up his nose and everything was affecting him.

Absolutely. And it's also, it's a dark, moist environment. So a lot of patients who have chronic sinusitis, it's actually been shown not so much to be bacterial as it is to be fungal origin. So you got to really think about that. I typically will, you know, in his case, he actually had, he needed surgery, so he actually had sinus surgery. That helped a little bit, but it didn't clear up the problem, which is really a dysfunctional nasal microbiome. So I actually treated him with Neti-Pot nasal saline irrigation. You can also do, there are certain machines.

I like the Sinupulse machine.

Silicon. It's like a water pick for your nose.

Exactly.

You put a saline in there, it rinses it out. Rinses it out. Right. For people who do have chronic sinus issues, and then I, in his case, I actually used SilverSyllin, which is a, not a colloidal silver, but it's a SilverSoll. And silver is actually a great antimicrobial. And I use that in him with great success.

It was really very, very effective. So silver is also something that kills bugs. Kills bugs. And you put up your nose, it'll help deal with whatever latent infections are there.

Exactly. And then this particular paper that I was talking about, which is discussing the nasal microbiome, they were actually making a proponent to actually use probiotics like things like lactobacillus up into the nasal passages to recolonize the nose.

Incredible.

Yeah.

And the nasal pharynx.

Exactly. And Dale Bredesen, who's been a leader in looking at the various causes for Alzheimer's, talks about the nasal sinus passages as a problem when you have chronic inflammation in the sinuses being a risk factor for Alzheimer's. Because that is directly-- Chronic inflammation, right? Chronic inflammation, exactly, and goes right up into the brain.

So, you also did this nasal treatment. You also treated his gut.

So, what did you do for his gut? I treat, I mean, we did, obviously, we put him on an elimination diet. So, you got him off of gluten. You got him off of gluten, exactly. and fermented. Yeah, got him off a sort of a low yeast, low mold type diet. Got him on, I actually did not treat him with antibiotics. I treated him with antimicrobial botanicals. I also used oral silver, which I'll sometimes use in conjunction. And I also continued with binders, the activated charcoal and another product, GI detox. and it was pretty remarkable his success within a month. He said, like the light bulb went on in his brain.

So, you mentioned a product called GI Detox, which is something we use that actually has charcoal and clay in it, right? So, it actually helps to bind up all the nasty things that get produced by these bad bugs when they're fermenting the foods that you shouldn't be eating, right? So, it's really, it's fasting. So, you also so looked at this holistically from a functional medicine perspective, which is really quite different than most people. So the fact that this patient had gluten and mold and imbalanced gut flora and sinus issues was the reason for his brain fog. But if you take 10 people with brain fog, they might have 10 different reasons.

Absolutely, just like you have 10 different reasons for a cough.

Mine was mercury. That didn't show up in this guy. So really it's right, it's important. I think this is the thing that's so different about functional medicine is that we don't just stop thinking at the symptoms. We go, what's the cause of the symptoms? If you say, you know, you have rheumatoid arthritis or you have a headache or migraine, migraine isn't a diagnosis. It's a symptom.

It's a certain type of headache.

Absolutely. And so we really have to look at the different causes for each individual. So it's very personalized and absolutely.

It's totally personalized.

And it's often treating it not just one thing, it's treating multiple things in the right sequence to get people better.

Exactly.

And so he was building on getting rid of the mold and getting out of the environment and ozone and glutathione, which certainly helped, but then there were other things, right? He got to get off the acid blocker, he had to get all these nasal sprays that were suppressing his microbiome in his nose.

He had to- Get sleep.

He had to get sleep, right? He had to manage stress. He had to manage stress. He had to irrigate his sinuses. and use natural antimicrobials to kill the bad bugs in there. He had to reset his whole gut system and get rid of the pseudomonas and build all this together in a protocol, which it sounds complicated and sometimes it is, I guess, you know, but that's what we do in functional medicine. And it's a very unique approach that is the future of health care. It's not something that most Physicians are learning in school. It's something that is actually working far better than most traditional therapies for these kinds of things. If you have an acute problem, you go to the hospital. I had atrial fib, you gotta go to the hospital and I get my little electrical system fixed, it's fine. But I think if you have these weird symptoms that nobody can fix or that they're trying to medicate, it just doesn't work that well.

Yeah, and you really bring a very good point because regular mainstream medicine has its place. You break a bone, you have a a heart attack, you have a stroke, there's definitely places for acute care medicine. But when it comes to chronic care medicine, I would almost venture to say that the mainstream approach, which is either the scalpel or using expensive, potentially toxic medications, is actually doing more harm than good in most circumstances. It really is. It's unfortunate, but it really is.

Nature is medicine because we're so isolated from nature. both the light experience we have isn't based on natural light cycles. The temperature experiences we have aren't based on being exposed to the environment like we always have been. And it has really detrimental health effects. So you talk about, you know, nature and how that is really, the disconnection from nature is really a source of problems for us.

Major. Today we spend 93% of our time indoors, you know, in big cities, and there's a lot of this research now coming out of Japan on forest bathing. There's actually a Japanese word, I believe it's keroshi or keroshi or I could be butchering it, but essentially there's a very significant portion of the population that gets worked to death in Japan. And there, I mean, 90%, 93% of Japanese people live in cities, so they are far removed from nature. And so this nature bathing line of research has really become a major focus.

Wow.

Yeah.

And it's now being studied increasingly around the world, the relationship that we have with nature, especially as our cities become more and more dense and more and more polluted. But in the Genius Life, I talk all about how air pollution can affect cognitive function and put us at increased risk for Alzheimer's disease. 20% of Alzheimer's cases might be owed actually to heavily polluted air. And today, 52% of Americans live in in environments with heavily polluted air.

Isn't there like there's some like UV app on your phone where you can tell the air quality.

The air quality index. Yeah, you can, I believe you can actually, I think the weather app on an iPhone tells you the air quality.

But yeah, my niece lives in Houston, she says every day they get warnings not to go outside.

I mean, it's scary. And our indoor home air can be just as polluted, if not more polluted.

It can be.

Than outdoor air. But in regard to outdoor air, what I think is really the most pressing of concerns where brain health is concerned is what's called fine particulate matter. So airborne particles that are two and a half micrometers or smaller that are actually able to enter, we breathe it, we breathe these particles in, they enter circulation and they can pierce the blood-brain barrier and enter the brains. And they're doing studies now in very polluted parts of the world, like in Mexico City, where they'll take children and they'll actually see these particles, like magnetite, which is made of iron in the brains of children. And what's very interesting, Mark, you know Rudy Tanzi up at Harvard doing all this research on viruses in the brain and how it can-- the microbiome of the brain. Yeah, the microbiome of the brain and how amyloid might be a response to.

An inflammatory insult in the brain. Amyloid is like the gunk that clogs up your brain if you have Alzheimer's. And it's sort of a response to inflammation, sort of like a Band-Aid in a way. Yeah.

What they're seeing now is amyloid presence in brains of people who have inhabited very highly air polluted areas with very high level concentrations of air pollution.

Yeah.

So whether it's like magnetite or other fine particles or the herpes virus, amyloid is like this protein which may be actually coming to the rescue. But the point is that being in a place where there's a high concentration of air pollution might actually be creating this inflammatory insult to the brain, which is causing this very early presence of the pathologies that we associate with Alzheimer's disease.

So connect that back to nature, because you're saying we should all move out of cities and become farmers.

More connected to nature, yeah. That would be good. Yeah, I mean there are some things that you can do. So spending more time in nature, I think is super important, especially if you are at heightened genetic risk for Alzheimer's disease. So if you're an APOE4 allele carrier, making an effort to spend more time in nature.

That's a gene that increases your risk. If you have two of those genes, like getting Alzheimer's by 45.

14.4, yeah. So doing that, also getting out in nature is crucially important because of the exposure to the sun. So exposure to the sun, I think is very important. We were talking all about circadian biology. exposure to bright light, crucially important. Vitamin D deficiency is thought to be a risk factor for developing Alzheimer's disease. There's a review of environmental risk factors that I talk about in the book and vitamin D was one of the top.

Yeah, well, I mean, it's a big deal because, you know, depending on the data you look at, up to 80% of us are insufficient or deficient. And the way the reference range works is it's based on a population measure. You take a group of people, you measure the spectrum of the levels in a population, and then you look at what's the average, and you have two standard deviations from that, and you can determine what's normal. But normal isn't optimal. If you were a Martian and you landed in America today, 75% of Americans are overweight. It would be normal to be overweight. It does not mean it's optimal. so the levels we often see in the laboratory ranges are not really where we should be hitting. The levels can be 20 or 30, but you should really probably have 45, 50, 60 at least. And I think, you know, probably 80% of us are deficient or insufficient, and that leads to depression, it leads to increased risk for Parkinson's, Alzheimer's, cancer, so many different things. And I think, you know, there's been mixed data about where placing it, fixing it or not. I think It's complicated because when you're like, you know, people are eating, you know, garbage and they throw a vitamin D in there, it's not going to help. Yes, correct. You know, if they're not exercising, they're smoking, they're drinking a lot, they're not ex, they're, they're eating crap. You take a vitamin D, it's not going to do anything. But if in, in all things being equal, people who are low in vitamin.

D have higher risk of this. And if you clean up your lifestyle and you're still low vitamin D, it'll make a big difference. Yeah. I'm glad, I'm glad you brought up context, because one thing that, that very few people know, you could be spending as much time in the sun as you want, frolicking all day in the beautiful warming rays of the sun, or even supplementing with vitamin D, but if you're not getting adequate magnesium in your diet, which 50% of the population does not get adequate magnesium, the enzymes that convert the vitamin D that your skin creates into its active hormone form in the body, all are magnesium dependent. And magnesium, half of us don't consume adequate magnesium. It's found in dark leafy greens, pumpkin.

Seeds, dark chocolate almonds. Yeah. And a lot of things cause us to lose magnesium, stress, coffee, alcohol, sugar, all those things we love. Exactly, magnesium is like an anti-aging, you.

Know, it's a macro mineral, we don't consume enough of it and it's involved in all of the DNA repair enzymes, we're talking a little bit about DNA damage, they all require magnesium as a cofactor, it's involved in ATP synthesis, so energy production.

So true, I see so much of my practice in these patients come in with all these magnesium deficient symptoms and they think I'm a genius when I give them magnesium and they go away. Things like migraines or headaches, constipation, muscle cramps, twitching, palpitations, anxiety, insomnia, anything that's irritable, twitches or spasms in any way or cramps is usually magnesium deficiency. And it's so easy when people take it, they go, my God, I didn't know I was so low. And I think you're right, it's so prevalent. As you age also your skin doesn't really convert magnesium, I mean vitamin D as well either, right?

Yeah, I make specific recommendations in the book for people no matter where they are in their life, no matter what age they are, it's important, context is everything really, but you're right, people who are overweight, people who have darker skin complexions, people who are older, they probably are going to need to spend more time in the sun to create the same amount of vitamin D. Yes.

I once learned from Michael Holick who's a vitamin D expert. He said, if you really want to get adequate vitamin D without taking vitamin D, you have to basically be practically naked between 10 and 2 in the daytime for 20 minutes south of Atlanta.

Wow.

That probably isn't happening for 99% of people.

Yeah, it's tough. It's tough. I try to get into the sun as much as I can. Because the other thing about the sun, we as humans, I think that reductionist approach that we were talking about, I think we're hardwired to try to break everything down. And I forget who it was, maybe it was Michael Pollan, but in nutrition they call it nutritionism, where they like to break down foods into just the bare essentials to see if we can replicate it in a pill form, and that hasn't really... Or identify, or we.

Even do worse, we sort of identify the bad ingredients. like saturated fat or sugar or whatever. And so we focus on regulating those in food and then the food companies just kind of dial up or down different ingredients to sort of make it healthier, but it's not really, it's still junk food.

Yeah, exactly. And so I think we can apply the same thing to the benefits of getting sun exposure on our skin and in through our eyes. So, I mean, vitamin D is created when the UVB rays from the sun reach our skin. But, UVA rays might actually be useful in terms of creating nitric oxide and actually helping us lower our blood pressure. Yeah, that's pretty cool.

Yeah.

So, blood pressure is another topic that I talk about in the book because it's so related to brain health. If you want your brain to be performing well, if you want it to.

Age well, you really have to make.

Sure that your blood pressure is in a healthy range.

And, getting the right amount of sunlight can help. Can help. Yeah. Getting the right amount of sun. No, no. You know, mental health is such a big crisis in this country. One in four people experience major depression in their life. It's the biggest cause of the economic burden of chronic disease, not from direct health care costs, but things like disability, loss of quality of life, not being able to function very well in your life. And vitamin D is one of those things that seems to really impact depression. So you talk about a study in the book It has to do with vitamin D and depression. Can you talk more about that?

Well, vitamin D is important for the synthesis of serotonin, which is a neurotransmitter involved in mood.

It's a happy chemical. It's a happy chemical.

That's what Prozac does. It increases serotonin, right? Increases serotonin. SSRI's selective serotonin reuptake inhibitors can boost serotonin at the synapse, which is. But serotonin is also involved in focus and attention and executive function. But yeah, so vitamin D is important in the synthesis of serotonin from its raw materials, one of which is tryptophan, an amino acid. So making sure that your vitamin D levels are in a normal healthy range, important. And you can easily get your vitamin D levels tested from a doctor. It's a very cheap test. The recommendations that I make in the book are to make sure that your levels are somewhere between 40 and 60 nanograms per per milliliter, which seems to be a range where we see the lowest risk of all cause mortality.

Yeah, I mean, I remember reading a study, it was incredible that women who had vitamin D levels less than 45 had a 60% higher chance of having preterm labor. And when you think of the cost of neonatal intensive care, Taking care of preterm babies, it's staggering. And, you're talking about pennies for a vitamin. It can literally prevent preterm labor. So, it's really connected to almost everything. And, the difference is with vitamin D is that not everybody needs the same amount, right? So, what should we be taking?

Correct. Not everybody needs the same amount. You really, before you start taking vitamin D as a supplement, you ought to get your levels tested. You know, when we synthesize it from the sun, our skin basically makes what we need and it breaks down the rest. It's almost impossible to get too much vitamin D from the sun.

Although lifeguards can have levels of 150.

That's amazing.

Yeah.

And that's not toxic.

Right, I mean it could increase calcium, it increases calcium absorption. So, I always like to recommend vitamin K2 for people that are in, I mean especially at those levels. But with a vitamin D supplement, I think generally there was a research calculation that suggested that for the general population, 2,000 international units a day would be ideal to get the average person to an optimal level. But people again have different, you know, people who are older might need to supplement more.

Yeah.

People who are overweight might need to supplement more to get the same improvement. And also, again, yeah, people who are.

Overweight tend to be low in vitamin D because it's a fat-soluble vitamin. So, it all gets sucked into the.

Fat and it doesn't get into their system that we need. Yeah, it gets sequestered by fat tissue. The same also can occur with other.

Fat-Soluble vitamins like A, E, K. Yeah, I don't know if you read this morning, this morning, probably not because you probably don't read to jam a pediatrics journal every day, but not pediatrics, no, but I do. and I read this paper this morning that showed that women when they were pregnant took 2,800 units of vitamin D compared to 400, which is in the typical prenatal vitamin, that there was a dramatic reduction in the effects on bad effects on bone when their kids were born. In other words, their kids, their babies had much higher bone density and then their risk later in life of osteoporosis was dramatically reduced. so, and that, you know, that's almost 3000 units, which most doctors don't even think about recommending. And, and some people, you know, may need up to five or ten thousand if they're not good absorbers. And there's genes that affect that. So people might need only a thousand, but I, I think a thousand is minimum for most people. And it takes about a thousand units to raise your blood level, 10 nanograms per deciliter. So if you're 20, you need at least 3000 to get up to 50. Right. and then you can see how you do. But I think people need to measure it, they need to check it, and they need to make sure they're okay and if not, take the right supplement. And not the kind that you often get from your doctor, I hate to say, which is vitamin D2, which is not an active form of the vitamin, but vitamin D3. And you can get that over the counter now and you can get thousand units and others. But you want to make sure you measure it, right?

Yeah.

I mean, vitamin D2 is the plant-based form of vitamin D and vitamin D3 is the animal based form. It's bioidentical to what we create in our own skin. So you always want to make sure that you're taking vitamin D2. I mean, sorry, D3.

Okay, so there, that brings up a sticky question. So it's usually made from lanolin and other things that you can get it from sheep and stuff. And they're fat. So what if you're vegan? What do you do? Is it.

That's a good question. I've vegan sources of vitamin D3. That's hard to get. Yeah, right. It's just one more of those nutrients that you're just not really optimizing.

Yeah, and often people don't convert vitamin D2 to D3, and if you're a vegan, you wanna make sure you're checking vitamin D3. And, you can also check D2, so you can see you might have a really high D2 but a very low D3. So, it's important to make sure. I once took care of this Hasidic rabbi, and he had a really bad thyroid problem. And I said, you really need to take this combination thyroid, but I don't know if it's okay. Why? He said, well, it comes from, you know, pig. It's a whole thyroid extract from pig. And it's not kosher. It's fine as long as it's for your health and as long as you're not eating it and it's a medicine, it's fine. So I thought that was very interesting perspective. A sense from your experience, what are the, what are the things that show up? and how did you treat it and what happened?

Well, you know, I've had a whole variety of cases. In fact, a couple of cases that we've had at the clinic where we had some patients who presented to psychiatric hospitals. And when it came out, you know, you know, when somebody has psychosis or a breakdown, if you will, they call that, you know, a psychotic break or a manic break or whatever you want to call that. And we've had a couple of recent cases where the patient's underlying trigger was Lyme disease, which is a spirochetal condition. And always remember, this is something that I really like to emphasize to my patients is that way back when doctors used to treat syphilis, we don't have a lot of syphilis in a private practice today. It's just as a which was readily treated and it's pretty much gone, although there's still some recurrences of it. But syphilis was caused by a spiro or is caused by a spirochetal bacteria, and that's the same thing as Lyme disease. And Lyme disease is the great mimicker, and it also can cause dementia and psychosis. So that's one of the conditions that can trigger neural inflammation. And then also there was a recent case of Bartonella also causing neuropsychiatric conditions and a diagnosis of schizophrenia. So it's really a fascinating field. And the problem is that psychiatrists are not trained to think this way and neurologists are not trained to step over into psychiatry. So they're like they're two different fields, but they're really the same field. So it's neuropsychiatry. This is an area that is actually really quite fascinating to me. People always ask me, what kind of doctor are you? I have my own description.

Yeah, how do you answer that question?

I'm a psychoneuroimmunendo-gutologist and basically looking at the whole connection between the brain, the gut, the immune system, and all of the body when it's all sort of interconnected. It's really, really fascinating, and you can really help these people who are having significant conditions.

So what happened? You saw this patient with schizophrenia, right? And you found the tick infections. What happened then?

We're able to get their symptoms down by treating the underlying cause, which is the underlying spirochetal infection. I also had another patient who had mycoplasma infection. And it's actually known in the literature, mycoplasma is an atypical bacteria. and it's another infection which can cause the brain to be on fire. So it's a really fascinating thing. And one of the tests that you can do that can check for this, it's not a common test, I don't know if you've done this, Mark, is the NMDA receptor antibody testing. This is looking at the parts of the brain that are stimulatory, and this is something that any doctor who has a patient who has gone crazy or had a psychotic break, they should have an NMDA receptor antibody test because if you have this, it tells you that there is some type of neuroinflammation that's driving their symptoms.

Yeah, it's quite incredible. So, I've had patients who have schizophrenia before or bipolar disease, and you think these problems are just so intractable and so difficult to treat. And, they can be. But, in fact, the whole field of functional medicine came out of the field of psychiatry with Abraham Hoffer's discovery that you could treat schizophrenia using nutrients and helping to improve the biochemistry of the brain. And then Linus Pauling wrote his seminal paper, Orthomolecular Psychiatry in Science Magazine in 1969, which talked about the perspective of how do you straighten molecules? In other words, how do you correct the imbalances or dysfunctions in your biochemistry? It's called orthomolecular, which means to straighten. And, that has really led to the whole field of functional medicine. And, we then sort of expand on that with our understanding of the role of inflammation in the brain. And, you know, many schizophrenic patients have high levels of, for example, gluten antibodies. About 20% of Schizophrenics have anti-glide antibodies in their bloodstream. When you take the gluten away, they do better. That causes brain inflammation. And when you do autopsy studies on people with Alzheimer's or autism or schizophrenia or depression, you find that their brains are inflamed. So, you know, when you start to think about that, it's like, wait a minute, we are treating this completely incorrectly. And this is what was classical traditional medicine. You treat the symptoms, not the cause. And functional medicine is really about the cause and why. not just what disease you have, but why do you have it? And in the case of these brain disorders, it's often not obvious. And the problem may be far away from the brain. It might be in the gut, or it might be in your diet, or it might be a toxin, or it might be an infection, or it might be mold, and it might be all sorts of things that we are kind of missing the boat on. And so we have this potential to sort of rethink our whole approach to brain science. That's what's so exciting when we see the work of guys like Dale Bredesen or others and nutritional psychiatrists like those at Harvard and metabolic psychiatrists at Stanford. They're doing work in this field, understanding the connection between the brain and some.

Of these systemic processes. Yeah, absolutely. And, when you take a schizophrenic and you look at them with a PET scan, the positive emission tomography, what you'll see is their brain lights up and that's because their microglia, which is the immune cells in the brain, are literally on fire. and unless you actually treat that, a schizophrenic is at high risk for developing dementia down the road because their fire is not being put out. And this, Mark, is—I'm going to mention this because I actually have done some lectures for American Academy of Anti-Aging Medicine on neuroinflammation. And in the process of preparing for that, I came up against some really fascinating things. One is that when you look at the genetics of schizophrenia, there's, they did this whole genome wide Association studies of saying, well, what gene or what genes are associated with schizophrenia? And they did what's called a Manhattan plot. And on chromosome six, it sort of stood out like a, you know, the Empire State Building. And what they found out is that on chromosome six, chromosome six is highly involved with the immune system. So that tells us that A lot of patients who have schizophrenia have an issue on chromosome 6 related to the immune system. And what I'm going to tell you next is absolutely positively fascinating and this sort of blew me away. There are two case reports and remember case reports are just like a doctor observing, okay, this is interesting, look what happened, you know, why did this happen? And the two case reports were this and this tells you, you know, how the immune system is intimately involved in schizophrenia. One is a patient had refractory schizophrenia and developed some type of cancer and needed a bone marrow transplant. The refractory patient with schizophrenia got a bone marrow transplant. Well, bone marrow transplant is basically giving you a new immune system. After he got the bone marrow transplant, guess what happened to his refractory schizophrenia? It was gone.

What happened?

Gone.

Wow.

It completely cleared up because it changed his immune response to whatever it was responding to, I don't know. But his refractory schizophrenia went away. On the flip side, there was another gentleman who also needed a bone marrow transplant. He got his bone marrow from his brother who had schizophrenia. Guess what happened to him? He got schizophrenia. He got schizophrenia. Wow. It goes both ways.

Pretty amazing.

It is amazing. I was blown away by that and I think that, you know, people who are doing, I'm a clinician, I'm seeing patients, but those case reports are really, really seminal to change how we think about how we see these conditions and the fact that that can happen. I also found it fascinating that, you know, we talk about the gut microbiome and how that's so important related to the immune system. is that when you do stool transplants, you can literally transplant or infect a person and make them skinny or you can transplant stool and make them fat.

We're doing this with autism, Parkinson's, right? They're actually doing fecal transplants with autism and with Parkinson's and seeing real changes in the brain function. That blows my mind when you think about that.

It does blow my mind. And the thing about this is we are still in the nascent period of really understanding this because it's not like you take this one chemical or you take this one probiotic and everything's fixed. It's a very, very complex array. And, you know, we have hundreds of different microbes and bacteria and viruses in the gut. So it's going to take us a while to figure this all out. But, you know, I think we're also in a very good stage where, you know, we have, you know, massive computing power and we have artificial intelligence. And I think that we're going to probably approach these areas of understanding neuroinflammation and really difficult to treat conditions like ALS, like schizophrenia, like Parkinson's and such. And we're going to be able to biohack them and Alzheimer's. You're right, Alzheimer's.

That's another thing.

Now, this is, you're bringing up one of my favorite things. So for years, Mark, what did neurology focus on with Alzheimer's? It was what? It was amyloid plaque.

Right?

All you got to do is get rid of the amyloid and you get rid of part of Alzheimer's.

That's right.

I didn't work out.

You get rid of cholesterol and get rid of heart disease.

Right.

So guess what, the plaque, the beta amyloid plaque that was found in the brain, guess what that actually is? That's an antimicrobial peptide. The brain is producing beta amyloid in response to some type of organism, be it a virus, a bacteria, or a fungus. So when we see that, those are the footprints of a organism that the body is trying to attack.

Yeah, absolutely. And, I think, you know, we actually probably should have Rudy Tanzi on the podcast. He's a scientist at Harvard who specializes in Alzheimer's and he has discovered the microbiome of the brain. So, literally there are viruses, yeast, bacteria in the brain, which we thought was sterile, that may be triggering this cascade of inflammation. And, then the question is where does this come from? and it seems like a lot of it may come from the gut, which is crazy. How does it get from your gut to your brain? But it does, and it triggers this neuroinflammation that's driving things like Alzheimer's. You know, I think, I think we often get stuck on one thing, though, right? In, in medicine, we stick, it's stuck on. It's this or it's that. And, and I think the important thing people remember is whatever your diagnosis is, it doesn't immediately tell you what the cause is. So you could have 10 people with Alzheimer's. They could have 10 different causes. and in one person, you could have three or four or five different causes. Right. And I just remember one patient I had who was seven years old, really pretty significant. You know, Alzheimer's not, not bedridden at this point, but pretty non-functional also depression and was struggling really badly. He was former CEO of his company, a family-run business couldn't function anymore. Behavior was changing. His kids, grandkids, family didn't want to hang out with him anymore because he acting inappropriate. And it turned out he had so many things going on. I mean, the biggest thing he had was high mercury, which he lived in Pittsburgh and had exposed to all the steel plants. And they use coal ash for fertilizing land, and they put it on the streets in the winter instead of sort of salt for the icy roads. And he also had a mouthful of fillings. And he also had a terrible history of irritable bowel for 30 years. It was on stellazine, which is just like an anti-psychotic. So it's like a relaxant for your gut. which is terrible, but he had terrible gut issues and bacterial overgrowth and leaky gut and gluten sensitivity. And he also had insulin resistance. He had pre-diabetes. So essentially, essentially he had all these problems, heavy metals, microbiome issues, and he had insulin resistance or pre-diabetes which we know drives inflammation in the brain. They're calling Alzheimer's, you know, often type 3 diabetes. and he had all these other biochemical issues genetically like methylation problems, which are the B vitamins, we're also driving inflammation in his brain because he wasn't able to produce antioxidants and glutathione. And, when we started to address all these things, we got the mercury out, we fixed his gut, we cleaned up his diet, we got rid of the sugar and starch, we optimized his B vitamins, he literally came back from the dead, Rip Van Winkle, and was able to function, go back to work, be a functioning member of his family again. This is someone who would have just been said, okay, you have Alzheimer's and you are going to be in a nursing home and that's the end of that. And it was pretty miraculous to see that. It sort of woke me up to how by really being diligent with these patients, you can really help them either completely recover or dramatically recover. And I've seen, you know, the spectrum from, you know, the tough cases of autism, Alzheimer's, you know, depends how much they're, they've got going on, how far down the road they are, but you see amazing stuff with things like depression, bipolar disease, mood disorders, it's often remarkable how quickly the brain responds, ADD, and it's something that we just unfortunately are not thinking about that well in traditional medicine. That's really why we do what we do at the Ultra Wellness Center. We've treated nearly thousands and thousands of patients in this way, and we now do stuff virtually too, which is kind of fun, speaking to people from all over. We have a great team of physicians and nutritionists and practitioners who really help guide people through this space. Because, you know, what kills me, Todd, and I'm sure it kills you, is you hear story after story. And I'm sure you get this all the time. Hey, could you help this one? Could you help that one? My mom or my dad or my sister or my friend. And, and people are just struggling to find answers. And, you know, when you hear the story, you go, oh, God, I know what's wrong with this person. But it's because we have a certain set of filters or lenses that we look at, and it's so gratifying.

Can you think of any other cases that you want to share that sort of illustrate this? Yeah, I mean, I think I'd mentioned this, this is a fascinating case. I really can't 100% prove it, but I talked about it when we talked about the oral systemic health connection is the connection with the mouth. And there's some really good evidence of the particular bacterium, which is a bad actor, and it's called Porphyromonas gingivalis. And I have seen this in a number of patients who have had early Alzheimer type symptoms. You can also see this oral bacteria in patients with rheumatoid arthritis. So looking for this with DNA of the mouth organisms. And again, you know, this is to me is a really fascinating thing. You know, somebody says, well, Alzheimer's runs in our family. Well, Porphyromonas gingivalis may run in your family. You may be spreading the bacteria from person to person. And this bacteria, which is found in saliva, it stimulates the immune system and genetically susceptible individuals and can really lead to profound neuroinflammation. And in one patient in particular who I saw, he had Lewy body dementia, which is another form of inflammation. Lewy bodies because they are anatomical examination of the brain, they find these little things, they call them Lewy bodies.

Right?

It doesn't mean that they understand it. It's just Louie found it and that's because he named Louie body after Louie. And that's actually what, that I see is what Robin Williams had. Robin Williams had Louie body dementia with Parkinson's.

Yeah.

You know, so we call it Parkinson's. We put it in this neat little category and then we call it Alzheimer's or we call it dementia. We put it in this little category. And then we call it Louie body. And they're all sort of this interacting, overlapping kinds of things. Yeah, they can have different clinical presentations, but as you said, there can be many, many factors that go into the origin of this neuroinflammatory process. And diet plays a huge role. If you don't have the right nutrients, you don't have the right fatty acids, you're more going to be more prone to all of your cellular membranes have omega-3 fatty acids. If you're not able to make the compounds in the body, which are called pro-resolving mediators or SPMs, and actually have this as a supplement now. These are actually quite fascinating compounds. The SPMs are a selective pro-resolving mediator compounds. They're basically turbocharged fish oil. And certain people, some people can't take their omega-3 fatty acids and turn them into these compounds. And clinically, I have found them, they either work really well or they don't work. I don't know about you, Mark, but these are other things that you can use as a nutraceutical to help turn off inflammation in someone who's got some chronic inflammation. Not to say if you take it, it's going to help with Alzheimer's per se, but it's one of the other tools that we can use to modulate the inflammatory response in the body.

Yeah, so true. We often in traditional medicine don't know how to evaluate the brain properly because we're just looking at the brain, but we have to look systemically and that's really what we do in functional medicine. and, you know, Dale Bredesen coined the term a cognoscopy, like a colonoscopy, but for your brain. And it's looking at all the things we've been talking about, looking at diet, looking at nutrient levels, looking at hormones, looking at toxins, at the microbiome in the gut, looking at infections, looking at mold, looking at allergens, looking at the overall health of the person and seeing what of those things are driving adverse consequences for the brain and for brain function. And in any individual, the same cause might cause different things. So one person might cause schizophrenia, another person might cause Alzheimer's, another person might cause depression. So we really have the tools to look at a true cognoscopy. And then the question is, how do we help the brain repair? How do we set up the conditions for the brain repair? So let's talk about how, from a traditional functional medicine point of view, we actually treat these people. 'Cause it's a pretty systematic approach that addresses diet and lifestyle and also some of these underlying causes.

Yeah, I mean, so we, as you mentioned, Mark, we do a lot of the testing. So we'll do organic acid testing, which is checking for the nutrient metabolites that are found in the body. We'll also do gut microbiome testing, looking at all of the different bacteria, viruses, yeast, parasites potentially in the body. We'll look at markers for leaky gut. The other test that I do is a leaky brain. Just like you can have leaky gut, you can have a leaky brain. There's actually a test for that. Cyrex Laboratories does the blood-brain barrier test. You can check also for neuro-autoimmune markers with the Cyrex 7x test. Again, you can do gut microbiome testing. The one that I like to use is the GI MAP test because I think it's quantitative PCR. So, I find it to be very helpful. I think the whole GI realm area is an area that we're just learning. And there's gonna, I think as time goes on, these tests are gonna get better and better. But I find that to be very, very helpful to distinguish what's going on inside the person that I have. The other thing, which I think is also really, really critical, Mark, is sleep. And this is something that I really emphasize to people is that when our bodies sleep, our brains take out the garbage. Okay? And I'll guarantee you, when you have a patient who's got a neurodegenerative condition, one of the first things that you'll see is disruptions of their sleep. And what happens is during the day, you know, our brain only comprises 2% of our body weight, but it can, it uses 20% of our body's energy, which means that there's a lot of metabolic activity and what happens throughout the day is we get metabolic waste products that build up in the brain and our brain flushes them out during deep delta sleep. If we don't get that deep sleep, we can't flush the brain and take the garbage out in the brain and those toxins build up. Those things that metabolic byproducts, misfolded proteins, inflammatory molecules, amyloid, etc., build up in the brain and can affect how the, the person's cognition is, their memory, their mood, Etc.

It's amazing. Yeah. I think, you know, the, the diet is such a huge role, too, in the brain. I mean, we see that the, the diet we're eating is a highly inflammatory diet in this country of processed foods, inflammation that are driven by sugar and starch, excess refined oils, all the lack of things that are anti-inflammatory the whole foods with all the phytochemicals in them and the nutrient dense foods. So we're eating a diet that's super inflammatory. So this is the first thing. And often dairy and gluten are among the worst. And then, and then, and then we focus on how do we get the right nutrients? Because if you're low in certain nutrients, whether it's the antioxidant nutrients or the B vitamins, your body needs these nutrients to regulate your immune system, to function, whether it's zinc or vitamin A or selenium or vitamin D. Vitamin C, all these are really necessary for proper regulation of the immune function. So getting adequate levels of these is key. Also, we really get people on an elimination diet if we suspect or we test that they have sensitivity to certain foods. We treat the underlying infections if we find them directly with antibiotics if we need to, antivirals or sometimes we'll use herbal therapies or things like ozone and other approaches to deal with infections. We'll fix the gut often. That's a big issue. So we have a whole functional medicine approach to fixing the gut. We've talked about a lot on this podcast. and then we'll address whatever toxins that are there and help you eliminate the toxins through a really focused detoxification program. And so building on the framework of functional medicine, we can identify in each individual which of these things are the problem and then we can start to map the right treatments for that person. And it's so gratifying when you see this in people's lifelong depression gets better. I mean, there was a woman who was severely depressed who was in and out of psychiatric hospitals on lots of medications. Her marriage was falling apart. She wasn't able to really work at work anymore. It's about to get fired from her job. Very overweight diet, obviously high in sugar, starch and processed foods. And she did the Daniel plan, which is a, you know, faith-based Wellness program, but it's based on a Whole Foods anti-inflammatory Peganish diet, essentially. And she said at the six-week reunion. She's like, Dr. Hyman, after three days of changing my diet, my depression went away. And I've been on piles of medications, in and out of hospitals, admitted for severe depression, the hospitals many times in my life, and it's just gone. And I'm like, she goes, is that possible? I'm like, yeah, it's possible. If whatever you're eating was triggering the inflammation in your brain, you stopped it. Yes. So it's really is sort of untapped reservoir of tools and tests and therapies that traditional medicine, psychiatry, neurology, you're just.

Not using and is really where the money is. And, you bring up a really good point, Mark, because I often ask my patients who are seeing a psychiatrist and I'm not going to bash psychiatrists, but I think the profession of psychiatry is in the dark ages. I can't remember the last time a psychiatrist that I've seen has done a blood test or examine the patient. And, I think that a lot of psychiatrists would actually do a good job if they actually took a side course in neurology to really understand how the brain is working. So if you're a psychiatrist and you're seeing a patient and you are not utilizing a good nutritionist, preferably a functional medicine nutritionist, if you're not doing some blood testing and you're not actually examining your patient, you may be doing more harm than good. And it's not, and the other, the other, my other pet peeve about the psychiatric world is that we are now medicating young children in ways that are unexplored. We're doing polypharmacy in the young, polypharmacy in the old with these neuro psych drugs. They're advertised on television. And it is a complete, if you will, show. Excuse my French. It is awful. It's a terrible thing in this country. And I'll stand up here and I'll shout from the rooftops because this is a bad thing that we're doing to the brains of our people. the brains of our young kids. This is something that we should not be doing, period.

No, I mean, it's true. We really are relying on downstream treatments. So when the neurotransmitters go awry, whether it's depression or autism or Alzheimer's or ADD, we go, well, how do we fix the neurotransmitters? And the question is, how do we fix the neurotransmitters? The question is, why are the neurotransmitters so screwed up in the first place? and it's because of these phenomena. One of the great examples I'll see is that the basic driver of inflammation is diet, but there are other factors and anything that causes inflammation can interfere with our enzyme function in our, and throughout our bodies. And there's a key step in converting serotonin, I mean, tryptophan into 5-hydroxytryptophan into serotonin, which is the happy mood chemical. and when you get a high level of inflammation in the body, the, that enzyme is sort of blocked and you end up with this byproduct called kinurate or kinurate. I don't know if I'm pronouncing it right. I was reading. I don't remember pronouncing it.

Tyrosine acid, right?

Yeah.

Tyrosine acid. And, and that level goes up and you can actually measure it in these patients. And you see when they have high levels of these quinolinate or. Kyotorinic acid, it indicates inflammation. And, you know that the serotonin pathway is being screwed up and it's bypassing and producing these toxic molecules that cause inflammation in the brain. And so, one, by getting rid of the inflammation, two, by giving the helpers for these chemical reactions, you can often really help improve the cognitive function of the brain.

But it's really about the inflammation. And that's what's so different and striking about it. Now, did you know that most of you are inflamed and living and inflammatory lifestyle, that being inflamed makes you fat and sick, and that being fat and sick makes you inflamed, it's a vicious cycle. So what is inflammation anyway and why does it make us sick and fat? Well, inflammation can be a good thing, right? It's part of your body's own defense mechanisms. If you have a cold or an infection, you bang yourself, inflammation helps your body heal. But it's bad when it goes out of control. Now, what makes us inflamed and what makes the inflammation get out of control? It's mostly our diet. It's bad foods, sugar, trans fats, food allergens that are hidden, lack of exercise, stress, even hidden infections. All these things promote inflammation. So how do we deal with it? Well, we detox from inflammatory foods. We just get rid of them for a little while, one week, see what happens. Things like sugar, processed food, junk food, caffeine, alcohol. But what else is important? And I want to spend a little time talking about this other factor that mostly gets ignored. It's called hidden food sensitivities or hidden food allergens. And they're delayed. They're not like you eat a peanut and your tongue swells up and you have to go to the emergency room. I'm not talking about that. I'm not talking about shellfish allergy where you can nearly die from it. What I'm talking about are delayed subtle and often unrecognized symptoms that come from delayed reactions to the things we're eating. And these symptoms can include weight gain, fluid retention, fatigue, brain fog, irritable bowel syndrome, mood disorders, headaches, sinus problems, joint pains, acne, eczema, and much more. Now, why do we get it? Let me just say something first. This is an unrecognized epidemic. And most physicians, most practitioners ignore this type of allergy. It just hasn't hit the radar. And yet it's the biggest thing I do in my medical practice to help people feel better quickly and to lose weight quickly. So you have to recognize that it's not the same for everybody. That one man's medicine is another man's poison. And if you're eating something that doesn't agree with you, that you've developed a food sensitivity to or an allergy. You can develop a whole host of problems. In fact, in this country, we have an epidemic of inflammatory and allergic diseases. We have 24 million people with autoimmune disease. We have 50 million with allergic diseases. We have 30 million with asthma and over 60 million with irritable bowel syndrome. And all of these are connected by inflammation. So the question is, why have we become so sensitive? Why is our immune system acting this way? Obviously we weren't designed to have an immune system go awry and create tremendous amounts of inflammation all the time, make us sick and fat. So something's gone wrong. What has gone wrong? Well, it has to do with the idea that food is not just energy. I've talked about this before. Food is information. So it can be good information, right? Good information from phytonutrients, things that are found in plants, colorful antioxidants, detoxifying and anti-inflammatory molecules found in plant foods. So that's good information. But it can also be bad information. And that can include bad information from allergens and from toxins. So when does it become a problem? Well, it becomes a problem when we get something called a leaky gut. The medical term for this is increased intestinal permeability. But it basically means that the stuff on the inside of your gut, which should stay on the outside of your immune system, gets in and leaks into your body and is exposed to your immune system which then doesn't like it. And the cause of this leaky gut or damaged membrane in your intestinal tract is a bad diet, lack of fiber, too much sugar. It's drugs, antibiotics which kill all the healthy bacteria, hormones which promote yeast overgrowth, anti-inflammatories which damage the lining of the gut, acid blockers which change your whole digestive process, and even stress can cause a leaky gut. So when this all happens, the lining breaks down and all hell breaks loose. What happens is then that on the inside of your intestinal tract is basically a sewer, all the stool, food, junk, particles, things that should be protected from your immune system. It starts leaking in across this leaky membrane and is exposed to your immune system, 60% of which is right under that lining. When that happens, your immune system goes ah and starts attacking these quote foreign molecules, but it's really just food that you haven't properly digested or that should have been broken down, but is suddenly exposed to your immune system, and that's when you start getting sick and fat. So it's designed to give your body a vacation from toxins and allergens. All you have to do is this: get rid of the bad stuff and get the good stuff, and the body does the rest.

I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in.

Hey everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I wanna tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to DrHyman.com/picks to sign up. That's DrHyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health. and get healthier and better and live younger longer. Just a reminder that this podcast is.

For educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

Don't forget, there's a way to listen completely ad-free. With Hyman Plus on Apple Podcasts, you can enjoy every episode without any breaks. Just open Apple Podcasts and tap Try Free to start your seven-day free trial.