Dementia Is Skyrocketing—Here’s How to Protect Your Brain NOW

Coming up on this episode of the Dr. Hyman Show.

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I came to this as a skeptic. I had heard, like most clinicians, I was trained that there was nothing you could do. And as you mentioned, to suggest there was something we could do for someone struggling with cognitive decline on their way towards Alzheimer's, it would be to give them false hope. The conventional model and the incentive structure of sort of the pharmaceutical industry, the insurance industry, the way that healthcare is set up is that what we want to find is a single molecule intervention, right? They can be patented. that is very simple to dispense from a pharmacy. There's simple instructions. Just take this one pill once a day and you'll feel better. And that works if you've got a UTI, right? And we can get a cure. And that can be in the past, take antibiotics for seven days, don't have to think about it again, hopefully. Now, when we're talking about Alzheimer's, this is very complex. And our friend Daniel Schmachtenberger, he really taught me to I feel very privileged to have spent a lot of time discussing, we would meet every Tuesday afternoon for four or five, six hours on these marathons, just kind of reprogramming my brain about how to think through diagnosis of complex disease. And put simply, when you think of any complex system, whether it's a house plant or a financial system or government systems or the brain, What you're looking for is balance, right? An imbalance is going to create dysfunction in that complex system. And so imbalance is going to be too much or too little or at the wrong time or in the wrong place. And when we think of the brain, this leads to disease when we have imbalance, especially over time. And so we can say, okay, imbalance, this is helpful, we'll simplify. And then we want to systematize imbalance of what? What are the causal level factors? And I would argue that there are six of them. It's toxins, so imbalances of toxins, in the wrong place at the wrong time, too much, too little. Nutrients, right? You mentioned insulin resistance and blood sugar becoming so high that it becomes toxic. That can be a problem. But also, you mentioned B12 and having too little B12 associated with genetics, and maybe for your neighbor, they need more B12 than you do. So we have these individualized needs and requirements. requirements where we're going to get that functional requirement met, not just the RDA, not just that recommended daily allowance. So we have toxins, nutrients, stressors. We can have too much or too little stress, right? Some people want to kick their feet up and just relax in retirement, but they're not getting that engagement. And then we also know on the flip side that caregivers, care partners for people with Alzheimer's are at higher risk of being diagnosed with Alzheimer's themselves later on because they have too much stress. Cortisol becomes literally toxic to the hippocampus, those memory centers of the brain. So toxins, nutrients, stressors, structure. You mentioned getting hit over the head and causing pain. Well, that can also cause inflammation in the brain and be a traumatic brain injury that can put us at risk. You mentioned APOE4. We can have molecular structure, genetic structure that puts us at risk for developing Alzheimer's later on. So again, toxins, nutrients, stressors, structure, infections. We know there are a handful of infections that are directly associated with the triggering of amyloid plaque production. So things like P gingivalis, so P gingivalis, which causes gingivitis in the mouth. Also, the Lyme spirochete has been found in amyloid plaques as well as H pylori is associated. And herpes, the herpes simplex 1 virus is another one. The gut-brain connection and infections on the gut can lead to imbalance and neurotransmitters, and there's many other, I mean, in fact, I have a reverence for how complex the gut-brain connection is and wouldn't pretend to understand it fully, but we know that there's a lot of back and forth communication between the gut and the brain and the microbes specifically in the gut have a lot to do with that. So again, toxins, nutrients, stressors, structure, infections can lead to dementia, and then signaling. Are we getting the signals? Dr. Bredesen has this phenomenal, I love this analogy, of Brain health, thinking of your brain like a country, my brain is done. If we are stuck in that fight and defend mode, if we're being invaded by infections, or if we're being, if we need to defend against toxins like heavy metals you mentioned, or mold toxicity, or chemical toxicity, then we're using our resource to take care of that attack and defend. We're not able to use that resource to build the infrastructure, right, to build new neurons and new connections between those neurons, the way a country might build roads and spools. We want to use those nutrients to fully resolve those issues that we're attacking and defending against. And it makes sense that if we're trying to do both, we're not going to be very good at doing either, right? We're not going to fully resolve the infections or fully resolve the toxic burden, and we're also not going to be that great at having functional neurons to help remember our neighbor's name or remember where we put our phone or our keys. So what we want to do is think really holistically about this. You mentioned There's multiple factors that go into brain health, and this is what I would think of as a comprehensive list, although I'm sure we will continue to know more. But it's a much more comprehensive way to approach each individual and what's causing them to go down this path towards this common diagnosis of Alzheimer's or memory loss associated with age.

Yeah, it's something I see a lot of. We get in this reductionist model. where we're looking for the single drug for the single disease like you've talked about. And it's why we spent billions and billions of dollars and hundreds and hundreds of studies with zero real benefit. And I think, you know, what you're speaking to is that this is a complex set of diseases, not just one disease, even if it's called Alzheimer's or other forms of dementia. They're really complex and have multiple causes. Not everybody who has that has the same causes. They might overlap, but it's really important to look at what's going on for that individual. Like that one patient I said, she had vitamin deficiencies. Another guy, he had a whole host of things like mercury. So you have to find out what the treatment is for that person, not a kind of one size fits all. And it's just the antithesis of how we do research. And I think what you're talking about also, there's insults that happen, you know, basically in the way I think about it is too much bad stuff, not a good stuff. And, and I think you're talking about we were missing the things that we need to make our brains work well, and we're having too much of the stuff, whether it's infections or microbiome or toxins or sugar or stress that actually cause damage to our body. So, when you start to think about someone like this, you're thinking about a lot of these factors that have modifiable solutions, right? It's not like, oh, well if you have a toxin, there's nothing you can do about it. Oh, if you have insulin resistance, there's nothing you can do about it. Oh, if you're nutritionally deficient, there's nothing you can do about it. They're all treatable, right? and so that's the beauty of this whole approach of functional medicine and this approach to dementia is that it really helps you to navigate a very complex set of variables and kind of understand how to start assessing them and actually treating them. So when you start to do assessment, one of the things I love that Dale talked about was this whole idea of dementogens, you know? And I wonder if you could kind of go through what you kind of did a little bit, But I think it's worth going through what the framework is of these dementogens that he talks about and how those can impact.

Us.

And what we call the exposome, which are the hidden things that tend to cause brain dysfunction.

Yeah. So when I work with a functional medicine patient, there are all these medical pieces that I almost think of as icing on the cake. So I definitely want to go in this direction and support people Knowing how to communicate with their doctor and knowing what to ask for and what kind of testing. And certainly there are a ton of modifiable things that we can address. And I also want to just take this step back to say, there are a ton of things that you can do without the help of a doctor, right? The foundations, like if that's the icing on the cake, it's all of the functional medicine intervention. The foundations are really come back to diet, exercise, sleep, stress management. And so I of course want to, because we're both functional medicine practitioners, I want to dive into that deeply. And I wish that the whole medical system was coming in that direction. But I also don't want to miss the opportunity to tell people, if you don't have access to that, if cost is an issue, there are many, many, many things that have an outsized impact that really come back to what are the things I put in my mouth every day? What do I eat? What do I consume? What is, what are the nature of my relationships and my stress levels? What time do I get to bed each night? How much movement do I get each day? Those are the things that really impact health over time. Now, these hidden causes, these hidden things, this exposome, these dementogens, toxins are a big part of that. And I think of three flavors. There's chemical toxicity, which is ubiquitous. None of us are going to be able to avoid it all, but there are great strategies for avoiding the things that we have control over. You talked about modifiable risk factors and not modifiable risk factors. And just to give people kind of a sense of what the difference is there, we can't change the year you were born. We can't change your chronological age. As that increases, our risk of dementia goes up. We can't change that you're born male or female. Females have higher risk of dementia. They're two-thirds of dementia or Alzheimer's patients. We also can't change your genetics, your APOE status. This is set. But what can we change? We can change our toxic exposures. We can increase our ability to detoxify, whether it's one of these three flavors, heavy metals, MycoToxins or mold associated toxins associated with water damaged buildings, which I see many elderly folks who have been in their houses for a long time.

Huge issue.

Really big kind of underrepresented issue. And my other mentor is Dr. Neil Nathan, who I'm sure you've come across.

Oh yeah, yeah.

I feel really grateful to have learned from him how to support very sensitive patients and also to just be hyper vigilant about that potential mold exposure. and then these chemical toxins that I mentioned. So metals, molds, and chemicals. And although we can't completely avoid all of them, what we can do is we can measure how much we're being exposed to and see if there is some detective work that can go into lowering our exposure to phthalates or petrochemicals or Roundup. Glyphosate is a big one that directly impacts the nervous system. I'm sure you're familiar with the work of Stephanie Seneff. She was at MIT and has done extensive research on how glyphosate impacts the nervous system.

And so, yeah, she's been on the podcast.

We'll link to that in the show notes, but yeah. Yeah, she's fantastic. And understanding what's coming into my system and then can my genetics tolerate those toxins? And how can I increase my ability to get rid of toxins through my liver, through my bowels, through my kidneys, through skin and lymph, maybe even through breath work through the lungs? so that we can optimize for cellular health.

Yeah, this toxin thing is big. There's other things we're going to point to that are modifiable like diet, like your microbiome, like infections. There's things that actually can be modifiable, but the toxin one is huge. And, I think like the case I mentioned, it's one of those things that if you look at the scientific literature, there's ample evidence that toxins are linked to dementia. But, on a clinical level, nobody's really looking at this from a traditional medicine perspective. When you go to see a neurologist, they don't measure toxin levels, they don't ask you about them, they don't ask you about exposures, they don't do any testing about it. And, you know, one of the challenges is that it's very hard to test for some of these compounds. Mold, you know, there was a great lab for mycotoxins that was run out of business because insurance companies didn't like it because they were getting actually, I think I was the cause of it, actually. I think it was like 20 years ago, but I had a patient who was in a house that was affected by mold. She had chronic fatigue. Her daughter had juvenile rheumatoid arthritis, and they lived in different bedrooms and had them go assess what was going on in their house and what was, what was growing in each room. And they were different molds. And then when we did lab work with Dr. Varani's lab, it was called immunoscience. That did these mold toxin lab assessments. It matched exactly, like the, the mycotoxin antibodies where the mycotoxins were in the room. And then she got a million dollar settlement. Then the insurance company in California came and shut down. to the government, shut down the lab. It's pretty bad. But anyway, that aside, it's sometimes hard to test for these things. Heavy metals are easier to test for. You can look at blood testing. That's helpful. There's challenge testing where you can take a key leader and collect your urine. But the other toxins, which are ubiquitous, like phthalates, BPA, glyphosate, PCBs, pesticides, plastics, microplastics, they're very hard to assess. And I recently learned about how to assess them in a different way. I want to tell you about it in a minute, but I'd love to hear how you think about those, rather than just your general, like, try to reduce your exposures and improve your own body's detoxification system, which is the sound advice. What are the other ways that you kind of assess these?

Yeah, so we do tests through Real Time Labs has an environmental pollutant panel. And so I do look at urine, at urine levels of excretion. And what I've seen is many of the sickest people, they actually don't collect much in their urine the first time. But then as we start using some binders, some glutathione, some support, some biochemical support, as we start getting them sweating and maybe get them on a detox breath work practice, we see that those numbers will go up. And so it's almost like, again, hidden, even with our testing, some of those exposures and that total toxic burden can, it takes a little bit to uncover. And three, six months later, we see those numbers go up even when there isn't an active exposure, but it's just that they're starting to actually mobilize more of it. Also, getting on a ketogenic diet, we start to mobilize fat soluble toxins as we are using the fats to create fuel. We can get that from adipocytes, and then we're releasing those toxins into the bloodstream, and then it's coming out in the urine a little bit more. So I think that many of these toxins, initial testing can also be deceptive, right? most of my patients are over 65. They've had a lifetime to accumulate these things. And this can be such a scary conversation, right? It can very quickly go to like overwhelm and anxiety about how much toxicity is in the environment. We can only control what we can control. So I think getting testing your water or getting spring water, findaspring.com, I think is a great source to find spring water near you that hopefully isn't contaminated. I'd love your opinion on RO water. Reverse osmosis is a great way to get a lot of toxins out, but it does require remineralization because it'll take the minerals out of the water. So getting away entirely from plastic, from drinking anything out of plastic, particularly because hot plastic will leach into the water. But even just the screw cap, it's like you've got plastic sawdust in there. And so I think plastic water bottles are just toxic for so many reasons. But yeah, we could talk for a weekend on all of the ways to think through toxicity.

I'm going to tell you something that might blow your mind and it's blown my mind actually. But before I do, I just want to kind of reinforce that the approach you're talking about fundamentally is lifestyle. It's what we eat, it's how much we exercise, it's sleep, it's how we manage stress, it's some basic nutritional support, and those have a profound impact. And there are some trials that have been done the finger trial and the pointer trial, which is underway, which are multimodal lifestyle interventions with risk factor management that have shown not just to slow dementia, but to actually reverse it, which is again something that all the drug studies never show. So even the best drugs that have been approved, there's not many of them, they don't show that. And I don't know why it's not something that's headline news because these studies are published. Your study should have been headline news. Again, it was published in the Journal of Alzheimer's. Because, you know, if something is incurable and you actually reverse it, then don't you think we should be actually spending the billions on that rather than more drug studies? Yeah, so I think we're going to get into all these factors that were studied finger trial and the pointer trial in your data as well. But I just kind of want to get back to the toxin conversation for a minute because, you know, I've personally had mercury poisoning and I know what it does to my brain. It was bad. I've also had mold toxicity, so I know what that does to my brain. It made me very demented. And, and I had terrible memory issues and cognition issues, and I, I figured out how to treat that, thank God. But I recently had been using a test out of Germany. It's a relatively new test that measures not just the stuff that comes out in your urine, that's in your blood, which is, by the way, these toxins that you're talking about are stored in fat. And so if you, if you look at what's in your blood or was cleared in your urine, they're not, they're not going to be there. Like, they're just, they're just not, that's not what they're like. It's like looking, I don't know, it's like looking in your urine for red blood cells. They're just, they're not supposed to be there, so they're just not going to be there. and, and this test that they do uses an analysis of cells, not, not blood, but your actual cells and cell membranes and using lymphocytes. And they, they find the load of toxins in there that we've never been able to see before. And it's kind of shocking to me how loaded people are and how loaded I was with everything from pesticides to. phthalates to glyphosate to metals. And, I've been treating myself and a bunch of others with a procedure called the PK protocol, which is designed to help replace the toxins in your cell membrane to improve cell membrane function and fluidity and cell communication and mitochondrial function, all of which are the things that go wrong when you have a neurological disease or dementia. and so I, I just talked to a patient, actually, a couple of days ago, who is a dementia patient. She's in her early 80s and very bright woman and was starting to go downhill and was diagnosed with MCI, mild cognitive impairment, and was getting worse and worse. And I, and I did this test on her, and I got the result, and I was sort of shocked. And, you know, it matched against what I would expect her, her history was. For example, she was a smoker. so there was a lot of cadmium in her cells. Cadmium is a metal that you get from smoking. She also had lindane, which is a pesticide that's been banned for years. She had glyphosate. She had all these Plastics, fungal toxins that were in her cells. And what we did is a protocol that basically flushes out all that stuff using high doses of intravenous phosphatidylcholine, which is basically the fatty substance that makes up your cell membranes. And then we for Porter with the glutathione and things to help detoxify and the B vitamins we talked about and a bunch of other minerals and support. And I talked to her on Sunday, and I was like, how's it going? She's like, I don't know. It's amazing. My memory's back. I have full short-term memory. A long-term memory is better. You know, I, someone can tell me something in the morning. I remember the next day. You know, that was, she couldn't remember five minutes from before when, when she had a conversation with her husband about something, and 10 minutes later, she wouldn't remember it. and it was so exciting to me because I'm like, wow, finally we have a way to actually assess and to monitor and to treat in a way that I don't think I've ever seen before in my practice. I'm curious if you have any experience with that, what you think about it, if you know what I'm talking about. The lab is a German lab.

It's called IGL.

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Your body will thank you. Oh, I'm writing that down. I'm not familiar with IGL, but I have been using the Patricia Kane, the phosphatidylcholine for a long time, for many years, the IVPC, and we do the exchange. by IV and then also oral PC, which we know helps with gallbladder, basically the discharge of bile, that toxic sludge that we build up. And so PC, I think, also very clear that that helps with the brain as does phosphatidylserine and choline is part of acetylcholine, a neurotransmitter, the most abundant neurotransmitter in the brain. But choline, we do know that choline has a big role to play in the brain. So not just the phosphatidylcholine, but choline found in eggs and in other food sources and also in many nootropics. formulas.

Right. That's the major neurotransmitter that goes down is acetylcholine in Alzheimer's. So, you know, I don't know what doses you're using, Heather, but we're using basically 20 grams, which is a lot. And we, over 10 weeks, we give two kilos, basically a fossil choline intravenously.

Are you doing the inessential vials?

Yeah, but we're doing 20 of 20 of them.

Wow. Yeah, we do five typically.

Yeah, I think there's way under dosing. Yeah, I think because I used to do five and I didn't see the same results. And, it's done over a period of time, but it's essentially 20 miles twice a week for 10 weeks. And, if people are wanting to know how to do this, we do this at our center, an Ultra Wellness Center in Lenox, Massachusetts.

I'll send Heather the protocol. I would love that.

Yeah, because are you dripping it in D5W? Yeah, it's dripped in, right? You're dripping it in and then you drip in a bag of glutathione and you have multi, I mean, methylfolate and, and leukovorin and, and other biotin and a bunch of other stuff. So it's, it's a pretty interesting thing, but I, I did my before and after testing, and it was completely different. I mean, I'll even share my, my, my results in the, in the, in the show notes because I think it's so compelling. And I think the before and after was just striking. And I personally felt different, dramatically different. So I think, like, we're learning about all these things that we didn't even know before. Medicine is advancing so fast and. you know, there's, unfortunately, there's not billions of dollars spent on researching IV phosphocholine in dementia, but we should because if what I'm finding is what I think is I'm finding, it's pretty exciting. And then, of course, you know, for the mold stuff and the metal stuff, there's other things to do. The phosphocholine actually also helps in the mold, but there's other things you could do for mold. But it's important to really assess whether you've got mold exposure because it's really one of those things that can be treated and so can heavy metals like I shared in my case study with the patient where we did chelation on him. And other things like infections, right? I mean, Chris Christopherson had Lyme disease that caused his dementia.

When he treated his Lyme disease, his dementia got better. Yeah, Rich Horowitz has also seen that the treatment of Lyme disease can help with dementia. The first patient I saw who really opened my eyes to this, Darlene was her name, and she came in soon after I was trained by Dr. Bredesen in 2017. and she and her husband came in, she was entirely dependent on him. She had a MOCA score of two. So the MOCA is the Montreal Cognitive Assessment, and we use this as a clinical tool to tell us where on the spectrum of cognitive decline someone is. And a perfect score is 30. It's a one-page worksheet that some of your listeners may be familiar with. You copy a cube and draw a clock, identify some zoo animals. And she had a MOCA score of two. So she was essentially answering, yeah, She was answering questions with like yes or no and not much more than that. Their life had been completely changed since she had gone down very quickly with dementia and diagnosed Alzheimer's. Now, her very dedicated, loving husband had read Dr. Bredesen's book and was all in. I mean, he had, thank goodness, enough confidence for both of us because I had never done this. And she was so severe that I was, I did not, I was not hopeful at all. But they asked, I mean, just to.

Give this perspective, it is out of 30. So, if your score is less than 25, it is a problem. Two is, you know, nobody is home.

Yeah, 26 and above is normal. Once you are down in the single digits, this is severe dementia. This is where you are dependent on others for activities of daily living. Your dignity is more or less gone, right? You are not able to do anything on your own. And so, she was in that state, but she had this bright smile and her eyes would track me. And she had on this beautiful floral dress and you could just see how much soul was in her. And they just shocked me. She came back six weeks later and her mocha had gone up to a seven. And of course my initial response was like disbelief. I was like, oh my gosh, we must have done the test wrong. Like this isn't possible. Like what is going on here? And her husband assured me, no, no, she's different. Listen to her. She's Speaking in complete sentences. They started bickering about something while they were in my office. And she was remembering things that he had said. And she wasn't going back to work. She wasn't a hundred percent better. But this was the moment. I mean, I remember it like exactly what I was wearing, the way the light was shining in the room. Cause it was so emotional for me to be like, what if this is possible for Darlene? What is possible for everybody else? Who's not so far down along this path, there is so much suffering that we could be avoiding by taking this approach. So what did they do? They moved out of a moldy bedroom and they didn't have to move out of their house entirely, but they moved into their living room. They started ballroom dancing three times a week, even though they weren't very good at it. They were going on walks every day. They got on a ketogenic diet. They ate only whole foods, got rid of all of the processed foods in their diet. She got on all the supplements that we put together based on Dr. Bradison's approach, she got on bioidentical hormone replacement. She went and got the mercury out of her teeth, her root canals out. She got all of her dental work taken care of very quickly. And lo and behold, she improved. And she, I really owe so much to, obviously, Dr. Bradison, but also to Darlene because, and her husband, because that was the moment, like, I could not deny how much better she had gotten.

Yeah. What was her score after you've done all that?

It was a seven then, and she continued to go up a bit. I've lost touch with them. They're doing things on their own, but we were together for a couple of years and probably like your patients, you hear from them years later and you think, oh, have they gone down? Or do they need extra help? And she'll probably be like, Nope, we're doing great. They were very motivated. It was really fun.

What you eat, I looked at through the lens of your microbes, does affect your behavior and your choices. And at the same time, those choices that you make affect the health and vitality of your gut microbes. So what you set up is what we call a vicious cycle, whereby eating the wrong foods changes the microbiome, it changes your brain, and makes you less able moving forward to make the right choices. So you make further bad choices, further damaging your gut bacteria, further changing your brain. And let me say that it's not just moment to moment changes in your brain that happens, that you make the wrong decisions, but ultimately as you continue to make these wrong decisions, you rewire your brain through a process called neuroplasticity. So you compromise your ability to tap into that part of your brain that lets you make good and appropriate decisions, and you connect more aggressively to the part of your brain that is much more impulsive and much more fear-based and much more narcissistic.

So basically we move from a place of love and connection to a place of fear and reactivity.

That's right. And you mentioned Alberto Villoldo. We wrote a book about this years ago called the Neuroscience of Enlightenment.

Power up your brain.

Power up your brain. And it dealt with what can we do first in terms of our lifestyle choices to enhance this process of neuroplasticity, to enhance the brain's ability to make stronger connections. Okay, once we've got that put to bed, in other words, higher levels of omega-3s, less inflammation, aerobic exercise being very important, then let's do the right things, let's make the best choices, and that will then set the stage for hardwiring the brain to those good parts.

It's pretty amazing how, you know, you've been the pioneer in saying this, but the brain is, is plastic. It can actually change and reverse some of the insults that happen. So not only is it about prevention, but it's about treatment or slowing down of these conditions like Parkinson's and Alzheimer's. And I had mercury poisoning years ago and early on I had a brain scan called a spec scan which looks at the blood flow in the brain. And I had all these areas of my brain that had no blood flow, they were dysfunctional. They looked like holes.

Not a good thing.

They looked like holes. like Swiss cheese in my brain. And as I used functional medicine, as I repaired my brain, as I repaired my body to fix my brain, essentially, my gut and also the mercury affected my gut in terrible ways, I actually repeated the scan, you know, more than a decade later. And all those holes had filled in. My brain had recovered. And it's not something that you learn as a typical neurologist, right?

Well, even gosh, when I was 19, I was doing research on micro, what's called micro neurosurgery. We had the operating room just got a microscope. And so neurosurgeons didn't have a roadmap to use the microscope because the anatomy of the brain had never been really teased apart microscopically. So our job was to create this roadmap for doing aneurysm surgery. So as part of what I did my research on, we were exploring how we can bring blood supply from outside the brain into the brain. So I became really kind of handy at tying small blood vessels together, and I was invited to go teach in Madrid, Spain at what's called the Centro Ramón y Cajal, and there, you know, this is an institution named after Ramón y Cajal, maybe the father of neurophysiology. And I walked into the lab and there was a statue of him with his statement saying, that the brain is immutable. It never changes, it never regenerates, that's it. And you know as well as I do that we were taught that in medical school. That the brain will never grow new brain cells.

That your brain cells in college, too bad.

Yeah, if you drank too much or whatever. But we know now that the brain A can regenerate itself and B can rewire or reroute pathways. How does a stroke patient recover? Well, he or she recovers Because they bring online different alternative pathways. They reroute the signal ultimately, and that's how they can improve. So we take advantage of that process called neuroplasticity and turn it on by turning on the body's production of a chemical growth factor for the brain called BDNF. But at the same time, we have to capitalize then on the brain wanting to rewire itself by behaving in ways.

You remove the insults and you provide the right inputs.

Changing our behavior. The Dalai Lama said that if you want to be happy, practice compassion. And if you want others to be happy, practice compassion. So it really, you know, it's you can be happier if you can wire into the happy part of your brain by doing things outwardly that are demonstrate empathy, that demonstrate planning for the future.

Okay, so let's get into some of the details here because you've written a lot about, for example, grains, grain brain. This is a new edition of grain brain. Everybody needs to get a copy. It's completely revised and updated.

It's pretty awesome.

And I think this guy has really nailed it. Now, a lot of people are not too happy with these ideas. You've been attacked on television, you've been attacked in the media, you've been attacked in medical journals. including indirect attacks against me and our colleague Dale Bredesen who's really pioneered the idea that we could actually stop or reverse Alzheimer's, which you actually were talking about decades ago. What are the things that are challenging? You're talking about changing your diet. So let's talk about the food part because there's such controversy. Should we eat saturated fat? Should we not? Is sugar really that bad or not? Because the Sugar Association says sugar is fine, so why wouldn't we believe them, right?

So, I would say to your viewers, Google Perlmutter and CBS and watch a recent interview.

And as this morning- yeah, but just.

Put CBS and Perlmutter, it'll come up. And as they show the book, Dr. Perlmutter has written a new book about carbohydrates in the brain. But before they cut to me, they said, But we reached out to the sugar industry and the sugar industry told us that we should eat sugar, decades of research, it's all good, have at it. what would you expect them to say? And why would you ask the sugar industry? And my response was, yeah, because it wasn't that long ago that the tobacco industry was telling us we should be smoking cigarettes. That's a good thing. But the reality is, the question that I was supposed to answer but I diverted because I wanted to really hit the sugar thing was, Dr. Perlmutter, what you're saying is that all grains are bad. And I've never said that. despite the name of the book, I believe that when we look at gluten-containing grains, we should avoid them. As you know, there's plenty of research in terms of what gluten, specifically a subpart of gluten, alpha gliadin, does in terms of threatening what we talked about earlier, and that is the gut lining.

Is that in everybody or just people who are sensitive to it?

It's difficult to say. I think we know that probably most people have some degree of increased gut permeability or leakiness of the gut when they consume gluten or specifically gliadin. That said, the non-gluten containing grains, grains meaning seeds of grass, things like rice and corn can be consumed in a quantity that doesn't present a lot of carbohydrate. So if you're watching your daily consumption of carbohydrate and you want to have a little bit of wild rice, have at it. some non-GMO corn, good luck trying to find that. But I think that if you're counting your carbs as you should be looking at net carbs, that I don't think that's necessarily the worst idea. Having said that, again- Because you know, there's just a back up on the carb thing.

Now there's been some recent studies published by Walter Willett and others at Harvard looking at thousands and thousands of people showing that people who eat very low carbohydrate diets don't do well, they die early or people eating very, very high carbohydrate. But somewhere in the middle, about 50%, which to you and I seems like a lot of carbohydrates, do better.

Can you kind of address that? Because it's- well, I think people should eat tons of carbohydrates.

Yes.

You should be eating carbohydrates. I just did a blog with somebody and it was said, why we need more carbs. David Perlmutter, MD, and people, I think the hashtag was why that's fantastic, WTF, right? Yeah. Yeah, we need lots of carbs because we need lots of fiber in our diets by definition. Broccoli is a carb.

You bet, it's a carbohydrate.

It's a low carb. So that's right. And there's something magic when you take you make a bagel or a croissant. I mean, it's no longer a carbohydrate or simple carbohydrate. It's a croissant or whatever it is.

Yeah.

But you're right. So broccoli, kale, I mean, these are good sources of dietary fiber, which is by definition, a carbohydrate, though it's non-digestible.

And polyphenols and antioxidants.

You bet, and fuel for the microbiome.

Fuel for your gut bacteria. So, I actually in my book, Ultra Metabolism, I wrote carbohydrates are the single.

Most important food for health and longevity. And what I was referring to was vegetables. But then people take it out of context. They say, yeah, he's not paleo, he's not keto. So I think that, you know, the biggest faults then with the, well, with that type of research is you've got qualify. The other area that needs great qualification is, you know, I'm often challenged by people saying, well, you know, the China study said that you eat meat, you're gonna die. And Dr. Dean Ornish says we need a very, very low fat diet. And people ask me, what do you think about that? And I would say, you know, I agree with both of them. Why do I agree with both of them? Well, I think by and large, the type of meat that people eat that goes into these studies where they come up with the relationships to colon cancer, for example, you bet those are very, very threatening forms of meat. I personally- But it's actually not even.

Meat, it's actually processed meat, which is.

Basically- It's processed meat and- Salami and- you- know, there is a sense of alchemy that somehow you can feed a cow or other animal that you're gonna eat garbage and it'll magically turn into gold. It's literally garbage.

Yeah. They feed them skittles and- you- bet. that are expired.

So I think there is a place on the table if you choose to eat meat for grass-fed, organically raised forms of animal product. And similarly, do I think that Dr. Ornish has some merit in his discussion of a low-fat diet? Yes, because the type of fat that is eaten in Western cultures is awful. It's highly processed omega-6 oils. soybean oil, canola oil, soybean, sunflower, that dramatically increase the production of inflammatory chemicals in the body and get back to where you and I start our conversation today. And what's really interesting to think about, you know, we've wondered the mechanism for that over the years. We've said, well, and it's a little technical for your viewers, but they'll love it. The omega-6s produce chemicals called prostaglandins and leukotrienes that can be pro-inflammatory we kind glammed onto that for many years.

And like the hormones of your immune system, they create inflammation.

Right. But now we know with all the interest in what's called the endocannabinoid system, which is what everyone's interested in now because of the availability of CBD and the use of medical marijuana, that the omega-6s help to increase the production of two important cannabinoid chemicals that are produced within the body. We call them endocannabinoids. because they're produced in the body, 2-AG and another one called anandamide, which bind to a receptor called the CB1 receptor that absolutely explodes the production of these inflammatory molecules. And interestingly, omega-3s.

I wrote that down when you said.

Was eating vegetable oil activates these receptors that creates inflammation.

Yeah, and this is yet another way to understand the beauty of the omega-3s. Because similarly, the omega-3s create cannabinoid-like chemicals in the body that block that activity. And that's another important pathway by which the omega-3s are so good for us. So when people like Dr. Ornish say we should be on a low-fat diet, pretty much based upon the type of fat that people consume in America, I'd say he's right. But you can get even more bang for the buck if you not only cut those oils out and fats out, but add to the equation the omega-3s. So we improved this ratio of omega-6s to omega-3s, which is so high now in America, down to a level of three to one or two to one, whereas typically in most people's diets it's about 20 to 1 in favor of the omega-6s.

These are new. I mean, we didn't have these oils a thousand years ago, a hundred years ago.

You're right.

We've increased our intake of soybean oil, which is now 10% 60% of our calories, 1000-fold since 1900. And canola oil that health advocates still.

Talk about, which was developed at the turn of the century as an industrial oil to lubricate machinery.

Yeah.

Rapeseed oil, yeah.

That's a good thing. And now it's highly GMO contaminated. Yeah, it's an issue. So you mentioned Omega-3s. The other issue people are concerned about is saturated fat. And particularly in the context of Alzheimer's, an APOE4 gene, which is a gene that may increase your risk of Alzheimer's. Well, it does depending on how many copies you have and so forth. Is this something we should be worried about? I mean, Bulletproof Coffee and everybody's- yeah, let's- let's cover Time Magazine.

It says eat butter. Like what's the deal here? Butter is back. And let's take that apart a little bit. Unpack that just for your viewers to be really clear that there are some genes that help increase a person's risk for Alzheimer's. and one of them is the so-called APOE4 allele. And you can learn about it by having an at-home genetic test that anybody can do, and 20% of Americans will carry the APOE4 allele.

One copy.

One copy, and some carry two copies, which is clearly associated with as much as a 12-fold increased risk for developing Alzheimer's disease. The APOE4 allele is genes are involved in the production of apolipoproteins. And that's a big term, but it has to do with proteins in the body that carry fat, deliver fat to where those fats might be needed. There is some indication that the benefits of saturated fat for the brain, we'll talk about that in just a moment, and even the benefits of a ketogenic diet, and we'll talk about that as well. I guess I'm putting a lot of things on the plate here.

Okay, we got it.

Okay. We might have to add another memory card. But those things are less beneficial in the APOE4 carriers, meaning that they're not going to gain as much benefit directly from ketogenic diet or a diet that's higher in saturated fat.

Is there harm?

Doesn't look like there's harm. And that said, I think that there are benefits that everybody gains that I believe if there is some sense of harm would offset those potential issues, which are very minimal to begin with. And that is what the benefits are from consuming saturated fat is the types that we recommend, MC2 oil, coconut oil, the saturated fat that's found in eggs, for example. The benefits are that we enhance our body's ability to produce these important chemicals that are called ketones. There's this huge interest these days all over the internet and certainly in various venues for lectures, etc., in what is called the ketogenic diet, the number one.

Diet books on Amazon.

You bet. And with good reason. And it's a brand new phenomenon for humans. It's only the type of diet we've been on for a couple million years. So, typically on and off of it.

Right.

But we've been in and out of.

Ketosis for a long, long time. So, it's got a heck of a track record. and we can talk about that, but basically it's a diet that counters inflammation, that enhances energy production, that activates this BDNF gene pathway to create more of that growth hormone to grow new brain cells, that helps reduce the production of free radicals, that helps get rid of damaged energy producers called mitochondria, that helps us with our ability to rid our bodies of cells, for example, that that are damaged. So in multiple arenas, being on a ketogenic diet is really a good thing. So I think that the ability of the coconut oil and the MCT oil to make that happen really is very, very powerful.

And there's data that's showing that those actually help improve outcomes in Alzheimer's patients.

There's actually a data that indicates interventionally that simply using MCT oil improves cognitive function in established Alzheimer's patients. And what did I just say? There's data that shows that a nutritional intervention is effective in turning dementia around.

Yeah.

There's also data from Iran that demonstrates that probiotic intervention demonstrates Improvement on the mini mental status test, which is a standardized test doctors use in the office to determine how well a person's brain is functioning.

It's impressive. I just, I just reviewed a book by the new head of the Lou Ruvo Center at Cleveland Clinic, which is the Alzheimer's Research Program there. And I was shocked to read he talked about using ketogenic diets in patients with Alzheimer's as a way of treating the problem, which is pretty radical. You've got the head of a major academic medical saying they're saying, yes, we can use food as medicine. We're seeing this trend.

Food as medicine.

Who knew?

And yet there's this incredible a couple backlash about this. We're going to get into that in a minute. There was an article in the Journal of the American Medical Association called the rise of pseudo medicine for dementia and brain health. And you and I would be considered in the pseudo medicine quack category. I think I, I, for me, it's a personal badge of honor that I'm.

On quack watch, me too, along with.

Most of our best friends. But the saturated fat thing, I just.

Want to come back to. And the, the, the Founder of Quackwatch commented on this article in JAMA. You need to see that.

I'm sure, I'm sure. I feel like I'm doing a good job when I get more people attacking me from certain categories of like Monsanto and the farming history. But the saturated fat thing is fascinating.

Because I want to be able to.

Hear that saturated fat is not necessarily bad, that it is something that can be helpful in many conditions. But that's with one big caution. is to avoid what I call sweet fat. And the reason that saturated fat, I believe, causes and I want to hear your opinion on this, causes problems in the research which can correlate saturated fat with disease like heart disease and other problems is that when those studies were done, they're done in the context of people eating saturated fat in a high starch sugar diet. I call that sweet fat. Think of donuts, french fries, ice cream, cookies. These are high fat, high sugar combos that are deadly. So the caution is if you're going to eat saturated fat, you can't eat a diet high in starch and sugar. Yes, high in carbohydrates, plant foods. I always say 75% of your diet should be plant foods in terms of starch, not in terms of starch, in terms of vegetables. In fact, most of your diet should be plant foods by volume, but they very little calories and most of your calories should be fat, but it's not much volume. Can you comment on that?

Yeah, sure. And I would say let's even take this unpracticed further. And it doesn't even have to be in relationship to eating carbohydrates, simple carbohydrates, because the data comes from these studies that look at calculating the amount of saturated fat in somebody's diet based upon the foods that they eat. Then they calculate, well, this person eats a bunch of beef, they eat a bunch of bacon, et cetera, they get a lot of saturated fat. As we talked about earlier, those are the wrong kinds of foods for many, many reasons. So this is a calculated determination of saturated fat. It's not a biochemical demonstration that saturated fat does something in the body. It's people who ate a diet higher in saturated fat, which delivers lots of toxins, because these are foods from animals that have been fed, as we said earlier, garbage. That's where those saturated fats, how they're delivered to the human body. So it's not a clean type of study. It doesn't relate to telling a person to take a tablespoon of organic coconut oil. No relationship whatsoever. Look, 50% of the fat in human breast milk is saturated fat. Saturated fat?

Wait a minute. So basically breast milk is almost as much saturated fat as Pure butter.

You bet. And why is it there? Because it helps for brain development, helps for immune system development.

It helps prime the- It was 25%.

50%. It's of the fat. It helps prime.

25% of the calories in breast milk is from saturated fat. Yeah, we're told to get less than 5% by the American Heart Association. So according to the American Heart Association.

We should ban breastfeeding. I think it needs a label. They need to go around and stamp, breasts all around the world saying, this is not hard out fat.

Avoid this.

I mean, you know, it wasn't long ago when we were told not to eat avocados or nuts because they had high levels of the dreaded fat. That was about the worst. And we know where that came from now. We know how medical literature in the late 1960s was tainted by industry, by sugar, who wanted, who influenced what was published in the New England Journal of Medicine, as recently revealed in the Journal of the American Medical Association and ended up on the front page of the New York Times. And doctors bought into that. We bought into what our journals were telling us and it was patently wrong. Now you bring up a journal article from the Journal of the American Medical Association that is castigating our approaches to dealing with brain health, calling it pseudoscience. We began our- Pseudomedicine. We began our conversation today with a discussion of the publication in the same journal, I'll have you know, in November of this year, wherein it was revealed that the so-called Alzheimer's drugs that this article is a proponent of don't work but actually make people worse. Which is the pseudomedicine.

Exactly. Well, I think, you know, Part of the problem is that our type of medicine has not had the funding to study these interventions. Nobody's funding dietary interventions because they're expensive, they take a long time. Nobody's looking at these complex systems approaches to treating dementia, which you and I have done for decades. It's not just treating one thing. Like our friend Dale talks about, now medicine, maybe there's 36 different problems or 54 or 12. And if you don't deal with all of them, you're not going to get better. And, our colleague and mentor, Sid Baker says, if you're standing on a tack, it takes a lot of aspirin to make it feel better. And, if you're standing on two, taking one tack out doesn't make you 50% better, right? So, if you have mercury poisoning and gluten sensitivity and you just deal with the gluten, the mercury still might be a problem and you don't get better. And, I think that's a really important lesson. I think this article is very disturbing to me because it didn't really analyze the data behind it. And, there's so much data behind the kinds of things we're doing, whether it's optimizing our diet or exercise or restoring sleep or meditation or using nutritional support, which is, you know, the B vitamins and methylation or getting rid of mercury or fixing the microbiome or balancing hormones. These are the things that we use in constellation to help optimize brain function. And, and what we know is that these things work. I mean, the only study that's ever been shown at a scale to reverse or slow Cognitive decline is called the finger study, which was basically using multiple interventions, diet, exercise, stress reduction, addressing risk factors for the heart, for example, insulin resistance.

And therein lies the criticism. But therein lies the criticism because the notion of leveraging multiple inputs into a system and looking for an outcome is absolutely at odds with the current model of how science as it relates to medicine is carried out. You mentioned Dr. Bredesen has a new book coming out where he actually reviews case studies of reversing Alzheimer's disease. And I had the opportunity to write the foreword for that book. And I talked about how this is unprecedented that he is not looking at what we call monotherapy to find the golden single drug that can be monetized. And yet he's looking at using multiple, but getting a great result. so why would we argue with that? But, you know, it is an inconvenient truth for people who want to believe otherwise that we need to create single approaches with monotherapy and that can be the home run, billion dollar product that makes the investors very happy.

Well, it's exciting to be excited to hear that I'm working with some of the top scientists at Cleveland Clinic talking about how do we study these systems approaches? How do we break the paradigm? How do we actually design a trial where we can test this theory? instead of calling it pseudo medicine, chronic, the future of medicine, which is really what it is.

So I have to say that as I get older, I'm less offended by these. And I really find it to be almost complimentary. It's sort of like complimentary medicine, because to be the outlier and to be disruptive, I think is really a good thing these days, because the status quo is not where we want it to be. And we need to challenge the status quo and it's why people call us out. It's why you appear on the various videos and so do I and some people put a thumbs down and comment, well, I read the China Study and it said we should all, we shouldn't, you know. It's great. People want to believe because it's an inconvenient truth to tell somebody, you need to stop drinking diet drinks. You need to stop eating as much sugar as you're eating because it's going to compromise your health. Most people don't want to hear that message. They'd rather, as I mentioned earlier, hope for the magic bullet. As it relates to Alzheimer's, it's interesting that in February of 2018, one of the world's largest pharmaceutical companies, Pfizer, gave up. Gave up, yeah. We're not gonna chase down the magic bullet for Alzheimer's anymore because it's not.

It doesn't have a good enough ROI. We've spent hundreds of studies, billions of dollars spent. going down this rabbit hole that is the wrong strategy for identifying the risks, the causes, and the treatments for cognitive decline or Alzheimer's. It's pretty stunning and everybody's failing and now people are starting to pay attention to what we're doing.

I have a slide that I'll show you at a conference you and I will be attending in a couple of days. And it's really quite interesting because it shows, it measures a group of people in terms of insulin resistance, whether they have insulin resistance, which is the consequence of diet, or not, over time who collects the most beta amyloid, this sticky protein in the brain that is associated with Alzheimer's risk, who collects more beta amyloid? And it's dramatic how much more amyloid is in the brains of people who are insulin resistant. The reason I mentioned in the context of our discussion right now is because the amyloid in the brain has really been the focus of the pharmaceutical industry trying to create an Alzheimer's drug, amyloid.

Does or doesn't play a role, whatever.

But- Sort of like sticky toffee that comes up. Right, but developing drugs to get rid of amyloid or to keep it from forming in the first place has been the focus of billions of dollars of research. 'Cause if you could get rid of that protein, that might cure Alzheimer's. It doesn't. But the point is that we can determine on the front end how to lower our risk for developing amyloid in the brain in the first place.

It's a reaction to something. It's a it's driving inflammation.

That's right. It's an overreaction. It's an overreaction to infection, for example, to herpes simplex virus, to chlamydia, to various organisms that do in fact colonize the brain. The microbiome of the brain. There is a microbiome of the brain. In fact, in a book we have coming out, there's a title, I mean, a chapter dedicated to that from Dr. Tansy's group at Harvard. Yes. So it is really quite incredible to realize another slide, series of slides looks at the degree of brain shrinkage if you carry the Alzheimer's gene in comparison to the degree of brain shrinkage in one year plotted against your hemoglobin A1C or your average blood sugar. And it turns out that the rate of shrinkage of your brain is greater with a higher A1C than it is carrying the Alzheimer's gene. And you can't change.

It's pretty frightening.

You can't change the Alzheimer's gene.

If you got it, you've got it.

You can change the expression of the gene. You can, but you can sure as heck lower your A1C by simply making some dietary changes. Yeah, low sugar. You bet. More carbohydrates in the form of fiber. And more good fiber. Nurturing your gut bacteria, reducing inflammation. But again, that is the inconvenient truth people don't want to embrace. The ball is very much on your side of the net. It's not up to me on the other side of the net, the doctor to fix this. It's up to you to hit that ball appropriately with some topspin so that I can return it. Give it a good shot. And here's how to do it.

How?

Lower your consumption of simple carbohydrates. Eat more healthful fat. Eat more dietary fiber. exercise. Make sure that your sleep is restorative. Really important, very much underrated. We spend a third of our lives sleeping or trying to sleep, and we recognize that so much is going on during that activity, which we used to think is simply passive, but that we understand that this is hugely involved in reducing inflammation, in enhancing the brain's ability to take the garbage out through the activity of the lymphatic to triage our.

Daily- the lymph system of the brain, David talked about the brain.

Exactly.

-Which has to work at night.

It works at night.

It's got the night shift garbage out of your brain.

So that you're ready to go the next day. And to triage our day-to-day experiences and put them where they will be meaningful for us to rely upon in terms of leveraging new information to make decisions. So underrated.

The good news is there's a lot.

Of things that we can do.

And we know, for example, in Alzheimer's that diet plays a huge role. The exercise plays a role. The nutritional status plays a role. B12 and vitamin D and methylation, we know the toxins play a role, that the gut microbiome plays a role, that insulin resistance and blood sugar play a role. So these are all modifiable risk factors.

People don't think of preventing Alzheimer's. They think of preventing heart disease. Well, I think what's interesting about that is that when I've been in the kind of Alzheimer's advocacy space for 20 years, because my dad was diagnosed in 2003. And lifestyle was not a part of the conversation when he was originally diagnosed. And then when, as I started researching it as a reporter and started been looking at women and trying to understand what was happening in women, I said, is there anything women, is it lifestyle connected? Is there anything we're doing, how we live, is it menopause, any of these things that everybody's like, no, no, lifestyle has nothing to do with any of this. Yeah. Jump to today, in the last five years, there's been a sea change around how we talk about Alzheimer's, about saying now you have people saying, well, maybe half of these cases could be preventable due to lifestyle choices made early on, right, what you're talking about. That was when I started, it was only plaques and tangles. Plaques and tangles, right? That's tau, plaques and tangles.

Amyloid, yes. It's basically the stuff that happens in the brain. Right.

But no one spoke about the importance of exercise. Nobody spoke about diet. Nobody spoke about nutrition in the brain. So I think this is a sea change in the Alzheimer's space. Nobody even talked about prevention of Alzheimer's. We opened the first women's Alzheimer's Prevention Center at the Cleveland Clinic. And everybody's like, you can't say that. And I was like, why not? You absolutely can.

Yeah, but now you can.

The data's there.

I mean, it's interesting, you know the data, but anybody, we've spent billions and billions of dollars on drug discovery for Alzheimer's, all of which have failed miserably in my opinion. Maybe we delay the admission to nursing home by a few months and that's a grand success. But, the only trials that I've seen that really have shown a difference in slowing or even reversing it have been aggressive lifestyle intervention trials like the Finger Trial where they use a multimodal intervention of lifestyle, diet, exercise, so forth, and then aggressively treating risk factors. And, they showed that they were able to slow or even reverse the cognitive decline. and then Richard Isaacson's work, you know, very well. He's done even a more personalized approach where he looks at their biomarkers and those nutritional levels and customizes and personalized approach to what's going on. And it's had tremendous success compared to like what we see in typical medicine. Dale Bredesen, who also has been doing this, I've treated many Alzheimer's patients. And by doing this, by taking a deep look at their biology and their biomarkers, their nutritional status, their metabolic status, their hormonal status, their toxin levels or gut health, all these things we can actually modify and change the trajectory of people's health. And that's really why we created Function Health was to help people identify things early on and not just kind of wait until something really serious happened.

When we talk about women and Alzheimer's, so it disproportionately, as I said, Alzheimer's disproportionately impacts women, but also disproportionately impacts black and brown women, right? And so so many people don't have access to really what you're talking about, you know, some of these more kind of concierge medicine, looking at biomarkers and looking at, so I'm really interested in how to democratize all of this to make it accessible to people who don't have money, who might be in maternal health deserts, who might be in just health deserts, period. So with the Prevention Center, I always looking at how do we bring this kind of home? How do we bring this, the education to people? How do we bring doctors who can talk about this in a way that people aren't scared? I think the conversation, I do a lot of work around how do you speak about this in a way that people can go, oh, I don't have to be so scared. Oh, maybe I could do this today. Maybe I could do this tomorrow. Bringing it kind of to Main Street is the challenge.

I think it's right. I mean, we need to democratize the information out there because it's not there's a lack of information or knowledge or scientific evidence. It's just that it hasn't been presented to the public in a way that they can access and use and they have to go through the firewall of the health care system and the doctor who is not to his or her detriment, has not been trained. My daughter's in medical school now and like, Rachel, have you learned about insulin resistance or microbiome or nutrition or toxins? Like, no, like the things that actually matter most.

Or women's health or menopause. But this is why I think, you know, when I talk about women's health, it starts by also changing the way medicine is taught in schools, right? It's by incorporating so many doctors said, well, I had an hour about menopause. I never even talked about perimenopause, much less postmenopausal women. You know, that was like not even in the textbook. So you're talking about a sea change, not only with doctors who are practicing, but for those coming into the space. And then also when we talk about women's health or when we talk about Alzheimer's, getting people interested in working in that space, in the geriatric space, right? Geriatric psychiatrist. Doctors, it's not young people are going into ortho, it's not sexy. They're going into orthopedics.

Like my daughter, that's what she wants to do.

Orthopedics, right? Because that's where the money is, right? And so this is a challenge on so many levels. It's a challenge on how do we talk about it? How do we bring it home to Main Street? How do we change medical schools? How do we bring doctors who are working up to date? How do we make it enticing to go into this space as we're an aging country?

Yeah.

You know, in California, I did a big report for Gavin Newsom about what does California, which is an aging state, you don't think of California that way. What do we need to do to be ready for the tsunami of baby boomers who are going to get Alzheimer's and dementia, right? We're not ready. We're not ready as a nation. We don't have caregivers, which also disproportionately falls on women. So I think it's a exciting space to be in. But it's an urgent space.

It is, yeah.

It's really kind of why we've created Function Health was to democratize access to people's own health data and make it very low cost. For $499 a year, you get over 110 biomarkers and testing twice a year to track your numbers and see what's going on. And in that data, you get empowered with not only just the information about what's going on, but you get empowered with insights and actionable steps to actually improve things.

That's the key.

And things that your doctor may not know. We're taking all the scientific evidence, all the expert knowledge extracted from all the world's top experts, both traditional and functional medicine, and helping create a personalized guide for how you can up level your health and what you need to do to explore if there's different issues going on. So I think 499 is still a fair bit of money, but it's certainly a lot less than people spend, for example, on coffee. You say every day is like a dollar.

I saw in there that you have, like, you could gift left it.

Right.

I was like, okay, well, that's actually something that's an interesting concept. By the time you finish buying somebody flowers or coffee, you could add no coffee for you for the next.

So it's really about empowering people with their health data and even people like you who are, you know, super active and powerful and doing stuff in the world and energetic. There's always little stuff that you find.

That you can fine tune. Yeah, absolutely.

Yeah.

That's what I'm curious about.

So when we did your test, we found some good news. Right.

You're, yeah, let's start with The good news. Good news is true.

I'm not gonna die right now.

You're not gonna die yet.

Yeah.

In this moment. And you're six year plus younger than your frontal lobe.

But I want that to be better.

Yeah. So you're an overachiever.

I got it.

Yes. So I wanna be, I have grandchildren.

Yeah.

I have, you know, adult children and I wanna be around for them. And I don't, I think that's the other thing, watching a parent or two parent, my mother ended up with lots of strokes too, later in life. And I think Being a caregiver for two parents is a lot.

Yeah, it's a lot.

Emotionally, financially, physically, spiritually in every way. And then I think once you've watched that up close, you think about yourself. And if you have children, you think about, okay, well, how do I keep myself? How do I keep myself so that my children- Don't have to do that. Don't have to do that. Maybe they're not capable of doing that, or maybe they don't have the money to do that, or maybe they're not in the same town. There's all these, So I think to myself, how can I be as independent for as long as I can be as strong as I can? So when I go to the gym now, actually, I say to the trainer, I said, Give me an exercise that can help me with my overhead compartment in the plane. I want to lift the bag in the overhead compartment. Give me an exercise. I have a granddaughter who weighs 30 some pounds.

You want to pick her up?

I want to pick her up. I want to walk around with her. I don't want to say when she says, Mama G, lift me up, lift me up. I don't want to go, oh, I can't. I want to be able to lift her up. And then the next one up and the next one. So when I go to the gym today, I'm looking for- To be functional. To be functional. Yeah. To be able to be strong for those things, to be independent for my kids so that they're not overwhelmed. Because I found it overwhelming to be a caregiver.

Yeah.

I mean, it's hard. And I think, you know, what you're talking about also is how do we prevent those things that actually are preventable. Like Alzheimer's is preventable, heart disease is preventable, diabetes is preventable. So many of the things we see, autoimmune disease is preventable, but people don't know what's going on under the hood until it's too late.

So we found that you're six years younger, which is great, and you can get younger. Oh yeah, we're going back to my test now, right? We're gonna go to the bad news now. My son said, you're not really gonna.

Talk about your own blood tests on the thing, are you? I was like, yeah, actually I think I am. well, it's empowering for other people to hear because people are walking around, think they're fine. So we didn't find anything really terrible. And you're 61 years old biologically, which is good.

That's okay.

And you could get younger. I just got a year younger in the last five months by doing a whole bunch of things based on my own function results. So I was able to sort of optimize my health.

Just learn.

How old were you on your results? 53.

53.

Yeah.

So.

Wow.

Now there's different biomarker tests for aging, but you want to look at all these things because they reflect really what's going on under the hood.

And we found- so you can get me to 50.

Yeah.

The other thing, you know, Maria, is that your family history is significant, right? You have a history of maybe celiac or autoimmune disease with your mom's stomach.

Yeah.

You know, certainly your uncle had that and your cousin has that. And we know it's in an Irish family. So right there, somebody should be looking at autoimmunity, at gluten and things that are not normally checked on a regular panel. And we did find some things. also, you know, your family history of Alzheimer's is concerning. And we want to make sure that the things that tend to promote Alzheimer's are not showing up in your blood test. Right. We want to look at your B vitamin levels. We want to look at something called homocysteine. We want to look at inflammation. We want to look at your metabolic health, like insulin resistance. And these are things that are not usually checked on your annual physical. So when you went to your doctor, they said, your tests are, quote, normal. Looking at 20 or 30 things. You know, we looked at over 110 things on your labs. Right. And a few things popped up. One was you low levels of inflammation. Inflammation is one of the things that drives Alzheimer's. We know that Alzheimer's is a disease of inflammation in the brain, just as.

Almost all chronic diseases, heart disease, diabetes, cancer. So why would I have low levels of inflammation?

Higher levels. I have higher levels than we've seen. Oh, I don't have low.

No.

So you want low. You want something called C-reactive protein. Again, a test not normally checked.

It should be under one.

Yours is 1.4. Not terrible. But it's like a trend, right?

I don't want you to have that.

I don't want to be on that trend. And we also saw this low level of autoimmunity. Now, why you have this autoimmune marker, it doesn't mean you have an autoimmune disease. It just means you have this low grade autoimmunity, which means your body is somehow attacking itself. And then we can figure out why, right? It may be something you're eating and maybe gluten and maybe heavy metals and maybe things that if left untreated could progress and lead to more serious inflammation in your body. But we don't know what it is. and we can find out, like we had, for example, you had high levels of mercury that were from probably eating fish. You know, people eat a lot of fish. Yeah. Because they think it's healthy, but all our oceans are polluted.

So mercury is a big, for example, factor. I had high levels of mercury. You did.

Oh, my gosh. I thought I had low levels. Well, your level range on the lab reference range, according to Quest, is zero to 10. But there's no biological requirement for mercury. There's no safe level of mercury. It's a neurotoxin.

Okay, so no more swordfish.

No more tuna. It's no more tuna.

I know I love this.

I don't like tuna, but I do love swordfish.

Swordfish is amazing. It is one of the worst.

Swordfish, shark, worst.

Oh, I'm not a big, I don't.

Like shark at all. So that's not an issue.

I know you'll help spend time at the Ivy.

Oh, yeah, swordfish is so high.

This hurts me.

This is going to be a hard truth. For giving up the risk of Alzheimer's, you might want to give up swordfish. Okay, swordfish, bye-bye. The high mercury, for example, yours was nine and 10 is the limit, but nine isn't good. The normal level is zero. And so we don't know what's stored in your body. We need to look at that. These are things that are not checked. Like for example, heavy metals are not checked in your general checkup, but they should be because they're risk factors for autoimmunity, for Alzheimer's, for fatigue. And some of these things you were just mentioning, low-grade fatigue. Well, yeah, you're busy running around, but maybe it's not normal. Like if your body was working properly, you should have energy to do whatever you want.

Right.

You know, and I think, you know, I'm turned 65 this year and I just last month I went to Patagonia and I climbed a mountain. It was 15 miles and it was a mile straight up and a mile straight down and took, you know, 13 hours and I was able to do it. Look at you. I know, but we should be able to do that. Our bodies can do that, but if we don't optimize them, they don't. We tend to decline. So we want to look at factors that may be triggering some of this low grade inflammation. And for me, it's a red flag.

If you have a family history of Alzheimer's. Gotcha. And you've already done your ApoE testing.

Which test did you have? Which?

Well, actually, Richard Isaacson did it, so I don't know which test he did. Did you have APOE4?

No, I don't. So you didn't have the Alzheimer's gene.

Which is really good.

But a lot of people who get Alzheimer's don't. Correct. So it may not be just that, but there may be other factors. So I really want to look at that.

You also said, you know, I'm a.

Little tired and maybe I don't have as much energy. And I saw, well, your iron levels were low. Right.

So I need to eat more meat.

So maybe you need to eat more meat. Or maybe we need to think about if you're losing blood somewhere and it, you know, could be a sign of.

You know, that you need a colonoscopy or. I just had a colonoscopy.

So that was clean. So that's great. So you if you're not having vaginal bleeding. So then I wonder, you know, maybe you're, you're not having proper absorption in your gut.

Maybe you do have a little bit of gluten sensitivity.

Maybe you do have. I definitely have some feeling of gluten sensitivity.

Yeah.

So this is, again, this is something that we need to dig deep in. And then if we find, oh, probably the reason for your iron deficiency and.

Your elevated inflammation and this low grade.

Autoimmunity with an ANA is maybe because you're gluten sensitive, not full celiac, but enough to test it for celiac. No. But enough that it creates a little bit of damage to your gut and you're not absorbing things. So these are the things that are super fixable. So I say, don't eat fish. Let's get your body to detox from mercury. Let's get you off gluten, see what happens. Let's retest your test and see how they're doing.

So there's really powerful things we found in your labs. Okay, so I'm going to come back. We're going to retest all of these things.

We're going to change it.

I'm going to come back and see.

How old I am and whether I-.

We're going to get you younger.

Actually, you're going to get you under-.

On my blood test.

Yeah, we're going to get you under 60.

Under 60. Under 60. Under 60.

I want to get to 50.

We'll get you to 50.

Yes. In my mind, I'm like 45.

Yeah.

Well, I did another test that's a different scale. We can do that for you, too. It grades it differently, but I'm 43 on that test. So I'm happy about that. That's the number I try to use. But 53 is this other calculus that is, is based on the one we do with function Health. But the other thing we found, Maria, is, you know, and this was a little surprising. Could you're traveling, dehydrated, maybe.

Yeah.

Could your kidney function was just slightly Right. And so this is something that is going on in our society that can be caused by many factors. It can be caused by inflammation, autoimmunity, heavy metals, obviously high blood pressure, diabetes, you don't have those. You have low blood pressure. Yes. And so those things often need to be addressed. And so we're finding things early so that we can do something about it and you're not going to end up having some problem with your kidneys later on.

Right.

So it's- and you didn't even know that. Right.

Right.

So these are the things we were finding on the function health panels that allow people to become empowered and then you get guidelines on exactly how to fix it and when to go to the doctor. So, for example, for the kidney function, I might say, gee, in the recommendations, you need to go see a kidney specialist to just double check what's going on.

Right.

So we really have learned all these things. Then I always wonder, like, you know, a lot of times you do these, and they're like, go to this doctor, go to this doctor. And I'm like, oh, you know, then it's like, it's a time issue, but.

I know that it's, I mean, I will do it. Well, there's certain things that are really important, but most of the things, I would say 80% of things we find people can take care of on their own, right?

Okay.

They might recommend, you know, do you need to do maybe a different kind of gluten sensitivity test? You maybe need to do a different heavy metal test. We need to look at why you're losing iron and if it's something that's losing or maybe it's just your diet. So we would fix these things. We saw your vitamin D was a little bit low. So it's just really tweaking things. And I think your energy level will come up, you'll feel better, you'll feel stronger, your brain will be clear.

And more importantly, you know, we're going.

To mitigate the risks of you ending up with the same issues that your dad had.

Yeah.

No, I don't want that. What's really interesting now is and soon we're gonna be offering this on the function health panel. There's even blood tests where you can detect in the blood biomarkers of Alzheimer's years and years before you ever have a symptom.

So people always talk about that, do you wanna know if you have the Alzheimer's gene? Do you wanna know if you can find it? Because then what? As long as we have no cure, is that actually gonna freak people out? Is that gonna be helpful in any way? And I think this is a debate going on with doctors, goes on, I hear it a lot that people are like, I don't wanna know. that's not gonna be helpful to me until we find a cure.

Yeah.

Which I totally also understand.

It's true, Maria, if you're operating from the traditional medical paradigm where drugs are the solution.

Right.

But if you actually look at the data around Alzheimer's or heart disease or diabetes or cancer, most of these conditions are lifestyle driven conditions. So there's really significant things you can do with your diet, with exercise, sleep, stress management, nutritional supplements, fixing your microbiome, dealing with heavy metals. There's so many things you can do to lower your risk, and it's all data driven. It's not like the data isn't out there, but it takes decades for scientific discoveries to actually be implemented into medical practice. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions, neither myself or the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at www.UltraWellnessCenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health.

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