DO THIS To Prevent Alzheimer's & Protect Your BRAIN HEALTH! | Dale Bredesen & Mark Hyman

We've always been told there's absolutely nothing you can do to prevent, reverse or delay cognitive decline. In fact, the arsenal is huge.

It's really one of the most significant global threats we face. It's the most expensive disease in America, believe it or not, because of all this collateral damage that it causes. It affects so many people worldwide and the increase in the rates of Alzheimer's are staggering. I think there's gonna be 14 million people with Alzheimer's in this country by 2050, maybe more. and so many people have pre-Alzheimer's, which we should talk about that maybe in the tens and tens of millions. And we are taught by mainstream medicine that it really can't be prevented, that it's really untreatable, it's progressive, and that if you're lucky, you live three to 11 years, but it's pretty much hell. So, how is your work challenging this orthodoxy? And tell us about why you got into this and how it really has sort of Changing how we think about an approach to neurocognitive and degenerative disorders.

Yeah, that's a great point, Mark. And just for perspective, as you indicated, it's so common. So nearly 100 times as many as have died from COVID-19 in the United States, we have over 700,000 now, will die from Alzheimer's. Somewhere around of the currently living Americans, somewhere around 45 million Americans. So many, many times the pandemic, unfortunately, it is a huge problem. And I got into it for exactly the reason you mentioned, because there hasn't been any thing to do with these neurodegenerative diseases. They are the area of greatest biomedical therapeutic failure. And 30 years in the lab, we looked at all sorts of molecular species. We looked at networks. What is actually driving the loss of the synapses and the loss of the cells? And to make a 30-year story very short, what we found is that this is, when you get to the core of Alzheimer's, it is fundamentally a network insufficiency. In other words, just as you would have scurvy if you didn't have enough vitamin C, if you don't have enough support for this neuroplasticity network. And that includes dozens and dozens of different things from hormones to trophic factors to nutrients to oxygenation to mitochondrial function. As you know, it is kind of a perfect disease for functional medicine. Yeah. Because when you look at it, there are all these things that contribute. And so unfortunately, all the scientists had been going after Let's get that one molecular species. Let's get the misfolded protein. No, let's get the amyloid. Let's get the tau. Let's get the prions.

Let's get the herpes, whatever.

It's all reductionist. It's all reductionist. Exactly. And so you really have to look at this as a systems biology disorder and treat it with functional medicine. And when you go after all those things, you not only see people prevent the decline, but they also absolutely reverse the decline. Now, it's harder and harder the longer and longer you wait, of course. But we see tremendous reversals. As you know, we have a preprint on a trial where 84% of people actually improve their scores, which is unprecedented. And now we've just published another follow-up on 225 people who also improve their scores and improve their metabolic status as well. So we're very excited about this approach.

So I just don't want to just gloss over what you just said, because you said that 84% of people in this trial that you did, improve their cognitive scores.

Absolutely.

That's incredible because that just isn't possible given our current approach. And so, you know, to me, this is something they should have billions of dollars of NIH funding to look at, as opposed to all the ways we have been looking at it, which is looking at the reductionist approach of looking for the single drug to affect a single pathway. This is a multi-system disorder. And the beautiful part about your work deal is you've really gone into the details and all the things that affect the brain. So the brain is, we went to medical school, we learned that basically there's this blood-brain barrier and basically it's an isolated system above the neck, which is just nonsense. And we know that everything that affects the body affects the brain, everything that and vice versa, but also we have to really understand how do we leverage those things? And in your work you talked about three key major things that are causing problems that may need to be addressed. One is insulin resistance, one is inflammation, and one is lack of what we call trophic factors, which are things that help the brain grow and work. So, can you talk about from a big picture perspective, then we'll get into the details of actually what is causing these three things? Because these three things are driving all these other pathways. And there are many, many ways to get problems within some resistance or inflammation or lack of trophic factors. But, Can you just talk about these three things in general and how they affect the brain?

It's a great point. Really, we have to flip, completely flip, the way we think about this disease. As you know, it has been thought about as, why did you make this bad amyloid? The amyloid is bad for your brain. We just have to get rid of it. That's not the way this disease works. As I mentioned, it's an insufficiency. What's happening is your brain is under attack, just as you indicated. This is a systems problem. this is a whole body problem. And it is under attack, as you mentioned, inflammation. Any sorts of pathogens or leaky gut or chronic sinusitis or poor dentition, any of those things will give you this ongoing inflammatory process. And anything that does that will make your body respond by creating amyloid because the amyloid is actually an antimicrobial agent. So you are literally responding to these insults by making this stuff that is great for killing the bacteria, the spirochetes, the fungi, the viruses, but also is damaging your mitochondria, just as we hear from a number of antibiotics. So what's happening now is your brain literally switches to a downsizing protective mode. Your brain is going from a mode of functioning, making synapses, keeping synapses to, oh, I'm under attack. I'm gonna go into a protective downsizing mode. The world did with COVID-19. It went into a downsizing mode, protective mode, same idea. As you indicated, it's really four big areas. It's anything with inflammation, toxins. As you have talked about many times, these toxins, whether they be inorganics, organics, or biotoxins, are absolutely crucial for that downsizing. Your brain responds by downsizing once again. The third area is energetics, and that's oxygenation, blood flow, mitochondria, and ketones, the ability to have a substrate to burn. And then the fourth area, as you indicated, trophic factors, things like insulin resistance, critical. Loss of estradiol, loss of testosterone, loss of nutrients like vitamin D, loss of NGF or BDNF, brain-derived neurotrophic factor. These are all critical. for keeping your brain functioning optimally. And so you can literally write an equation and see where the brain is for each of these people when they are having cognitive decline.

Yeah, it's so important because the things that you looked at were so different than a traditional neurologist, right? I mean, in the study that you just preliminary published called Precision Medicine Approach to Alzheimer's Successful Proof of Concept Trials, this is a preprint publication, it should be published and peer reviewed. It's not yet, but it was very interesting to read about the design of the study, the things that you looked at, and how you address them, which is quite different than traditional medicine, right? And I'd love to sort of go through some of the details about how we start to look at these things, because there wasn't one thing. You look at genetics, you look at biochemical markers, you look at MRI and brain imaging, you look at infections, you look at all so many different things. So can you walk us through? Because I think what people need to understand is that if you just do one thing, it's not necessarily going to work. You have to look at all all the factors. And you always say, you know, if your roof has 36 holes in it, if you patch three of them, it's still going to rain inside your house. So you got to deal with all the holes. And essentially that's the approach. And it's, well, how do you know it work? How do you know it's working? Is it this or that? In a way, you, you need everything. If you want to grow a plant, you can't just have sunlight, but no soil or water. You can't just have water, but no sunlight and soil. Like, you need all. And so I think that's a, a disruptive idea. in traditional medicine, which is we have to use multi-system approaches for multiple factors that are being addressed at the same time. So can you kind of walk us through the kinds of things we look at on the diagnosis? Of course.

You have been pioneering this for many years. You and Jeffrey Bland and others have been pioneering this approach where you say, okay, we're literally, I mean, it's interesting to me, this is an inflection point in the history of medicine. Up until when you guys got going with functional medicine, Everything was about, okay, we're going to find that one thing. We're going to write a prescription. We're going to find that one thing and hopefully things will be a little better. That works great for pneumococcal pneumonia. Now for these complex chronic illnesses, neurodegenerative illnesses are probably the best example, but of course, cardiovascular disease, osteoporosis, so many others. Now instead of just finding that one thing, you have to go from the other direction. ask what are all the things that are failing in that network, in that system. And of course, what's interesting is this turns again completely backward the way we do these trials. All previous trials, you decide ahead of, I mean, isn't this crazy? You decide ahead of time what you're going to do to treat it. When someone comes in with cognitive decline, we're going to give them drug X. Well, we don't want to decide ahead of time. We want to look to see why did they have cognitive decline, and then we want to Go after those things. So, as you indicated, yes, we look at their genetics. We look, for example, are they APOE4 positive or negative? There's a whole other set. There are dozens and dozens of genes that play on this. But as you've indicated before, these are not your fate. They simply increase your risk. We look at that and then we look at their hormonal status, their nutritional status, their gut status. We look at their status of all the inflammagens. We look at their at their oral microbiome. We look to see whether they have chronic sinusitis. Do they have a leaky gut? What is their gut microbiome status? All of these different players. And then of course we look at, do they have mycotoxin exposure? Do they have organics?

That's from molds, right.

Molds and mold-related toxins. And of course, many people have been exposed to air pollution. That's another big one now that we currently has been shown to increase risk for cognitive decline. So we look at all of these different features the good news is we know from the research what is that set of things that tend to cause cognitive decline. It's not an infinite set. It's a set of dozens and dozens of things. And so we wanna look at all of those things and the diagnosis, if it's Alzheimer's or if it's Parkinson's or something else, tells you here are the things that are likely to be causing those. So for example, in Parkinson's, it's more likely to be organic toxins like TCE. But in Alzheimer's, it's more likely to be things like mycotoxins, or reduced vitamin D, or reduced hormonal support, or NGF, or BDNF, things like that. So then we addressed those things with a functional medicine sort of approach, and the results are unprecedented, as we indicated, probably most important in the paper, not only did their cognitive scores clearly improve, but their MRIs actually improved. And there's a long history of following MRIs in patients with cognitive decline. On average, if you have cognitive decline, your gray matter volume shrinks each year by about 4.5%. If you are a normal person and you're actually doing quite well, you still have a slight shrinkage, about 1.7%. These people, their gray matter volume actually went up. It actually went higher instead of going down. They did even better, even though they had Alzheimer's or pre-Alzheimer's, they actually did better than a normal person at that age.

Wait, wait. So what you're saying is in general, everybody's brain declines, Alzheimer's declines more, and the average person declines a little bit. What you're saying is people with already damaged brains not only didn't decline, but they got better, that they improved the.

Size and function of their brain. Absolutely.

That's exactly what we're trying to report to that paper. That's like discovering penicillin, right?

I mean, this is like a big deal. And yet, and you and I both know there's a long way to go still. We've had a few people with cognitive scores, MOCA of zero, improved, but the majority of the people at the end stage don't. So we need to understand, continue to develop this, to understand what do we do with the people who are farther along? How do we make it so that every single person gets better? Now, one other good thing that came out of this paper, 84% of the people improved, but the 16% who got worse, We actually looked at, okay, why? And you could see in some of these people. There was an example, one woman who had high mycotoxins in her home, in her urine. We said, okay, you've got to get out of there. You've got to remediate this. She said, I'm not leaving my house. I'm not remediating it. Of course, part of the problem was that part of this was carried out during the pandemic. When we started it, the pandemic hadn't started yet. As we were going through the trial, the pandemic hit, and people didn't want to go out and they didn't want to do some of the things that they would normally do. they unfortunately had increased exposure to mycotoxins. So, no surprise she did not get better.

Wow. So basically what you do with these patients is you do a personalized approach, which is looking at all the variables that we talked about. Just to kind of recap a little bit, you really look at specific genetics around the APOE4, which is really the Alzheimer's gene, but it doesn't make sure you're gonna get it, just predispose you to it. We look at factors around detoxification and how you get rid of toxins, you look at methylation, which is about B vitamins. And then you also look at the whole insulin resistance package, right? Because a lot of times doctors don't look at insulin, they just measure your cholesterol, your blood sugar, your A1C, but that's not enough. There's ways to really look deeply at what's going on there. We look at cardiovascular risk, inflammation, CRP, homocysteine, you look at all the other factors around infections like herpes and Epstein-Barr, tick infections, look at the gut, see what's going on in there, is there imbalances in the flora, all the hormones you mentioned, estrogen, progesterone, pregnenolone, DHA, testosterone, all these hormones are really important thyroid. You look at all your nutritional status, right? The B vitamins, vitamin D, vitamin E, magnesium, zinc, copper, CoQ10, lycopene, acid, omega-3s. You look at all the toxins, metals, organic pollutants like pesticides, biotoxins, mold toxins you mentioned, and all the autoimmune markers and immune function and sleep studies and all these things that look at how you actually see what's going on. So, you're basically taking a soil sample of everything going on in the body that may affect the brain. And then you see what's out of balance and then you tune it up. So, you're really not treating the Alzheimer's, you're just helping people get healthy and clearing out all the stuff that's bad.

For them and putting in the stuff that's good for them. Absolutely. We're looking at all the things that are driving this. And, Mark, I think it's really critical for people to understand doctors have been trying to treat Alzheimer's after it's been there for 20 years. So there are four stages. If we could get to everybody in the first two instead of the fourth one, and by the way, in this trial we did people in the third and early fourth stages. So they were still very far along. But the reality is you go through a period where you are asymptomatic, but you already have abnormal spinal fluid and abnormal PET scans. Then you go through what's called SCI, subjective cognitive impairment, which lasts about 10 years. So, we have a tremendous window. And those people, 100% of them, reverse and do beautifully. But rarely do people come in during that time because it's relative. They know there's something wrong, their spouses often notice, but they say, well, I'm not that bad yet. I'll wait.

Yeah, yeah, don't wait.

Then the third thing is called mild cognitive impairment. It should be called relatively advanced Alzheimer's disease. It's the third of four stages. If people would simply recognize that, not wait till then, everyone could do better. Then it's the fourth and final stage that we actually call Alzheimer's disease. Again, calling something mild cognitive impairment is like saying you have mildly metastatic cancer. It's a late stage of the problem and we'd like to get to people earlier and earlier. As you indicated, we look at all these different things. What we're saying really is that Yes, that's what Alzheimer's is. It is your brain's attempt to deal with these ongoing insults by producing a substance, amyloid, and the other downstream molecules like phosphotau that actually fights the insults. It fights the infections, things coming the oral microbiome, things like P. gingivalis, the neuropathologists find in the brains of patients with Alzheimer's disease. Various mold and fungal species they find in the brains of patients with Alzheimer's disease. Herpes simplex, of course, from the lip we find in the brains of patients with Alzheimer's disease. So this is a recurrent situation with these various pathogens and with the brains response to these pathogens. Yeah.

So, you're basically taking all this understanding of the things that do affect the brain, and then you create a therapeutic plan that addresses it on an individual level. And, I remember this article years ago called Shifting Thinking and Dementia in the Journal of the American Medical Association, and there was this great line in there where the author said, you know, there's basically categorical miscalcification and etiologic imprecision. And that means that we categorize people according to symptoms. You lost your memory, not according to the etiology or cause. This flips it upside down and is focused on medicine by cause, not by symptom. And that's what you're doing. So everybody doesn't get the same plan. If someone has mold, they get that treated. If someone has diabetes, they get that treated. If someone has a toxin, they get that treated. If someone's nutritionally deficient in this particular nutrient or that, that gets treated. So it's very individualized. So you're not just kind of throwing the same treatment at everybody. So tell us about high level. There's the foundational pieces and then there's the more therapeutic pieces. So there's diet, exercise, sleep and stress management and brain training, which are the sort of foundation. Talk about what are the specific kinds of dietary strategies, exercise strategies and the sleep strategies that you're using to help these patients because there's some really foundational research on how these things affect the brain and of course stress and then brain exercise or brainer size, which is brain training.

Yeah, it's a great point. And so as you know, when we were in the lab, this is way back in 2007, this guy named Mark Hyman wrote a book about, hey, you should be treating these brain diseases with these multifactorial approaches.

And the interesting thing to me- I.

Wouldn'T listen to anything that guy says, by the way. So the interesting thing to me is what we found in the test tube over 30 years Fits beautifully with what you published back in 2007. What we're seeing is very much the same thing. As you indicated, the great news here is, whereas we've always been told there's absolutely nothing you can do to prevent, reverse, or delay cognitive decline, and we hear this again and again and again, in fact, the arsenal is huge. We have a huge armamentarium. Yes, it's diet, exercise, sleep, stress, brain training, supplementation, and detoxification as the beginning. Then beyond that, there may be other things that are dependent on what we find. Those are the basics. As you indicated, you start with nutrition. Probably of all the things is the most important in terms of getting a good output. If you're getting a good outcome. If you look at, again, we're kind of coming from the biochemical side. If you look at what is the biochemistry that it takes to make you start making synapses again and reforming those and start making your synapses work again, there are several features to it. So number one, you have to get the appropriate energy delivery. And so what happens is, you know, you have both the ability to burn ketones, the ability to burn glucose. Well, when you have cognitive decline, you've lost both of those. So you are literally starving your brain. You've lost the glucose because you now have insulin resistance. You've lost the ketones because your insulin is high and it's preventing you from making the ketones. You need to get those both back. You need to become keto-adapted and you need to get into ketosis, but you need to become metabolically flexible and be able to go back and forth between burning. Getting people to do that is a critical piece of this. Then, it's a, plant rich, low carb, they have essentially zero simple carbs. No sugar in starch. Exactly. Mildly ketogenic diet. We encourage people to measure their ketones, whether you like to do it by finger stick or you can do it by breathalyzer to get in the appropriate ketone range. Have appropriate time for autophagy and for your glymphatics to act, in other words, appropriate time for sleep and appropriate time. Yeah.

So tell us about autophagy and the fasting because that's really important too, right? Yeah.

Critical. So autophagy, you're basically recycling components of your brain that are damaged, including things like mitochondria that aren't working so well. In fact, there was a beautiful experiment a few years ago in which just preventing the autophagy of mitochondria, that alone led to Parkinson's. And this is in animal models, of course, but it shows how critical it is to get rid of the old batteries and make the new batteries. This is a critical piece. Yes, we want to get people to have autophagy, which we do 12 to 16 hours of fasting at night. If you're APOE4 positive, we'd like to see it more 14 to 16. If you're APOE4 negative, 12 to 14 is probably good enough. Then you can again measure your ketones. Then it should be, as I say, plant-rich. You've got to have the phytonutrients. But you've also got to have it so that you have a high fiber diet. It turns out this is critical. This improves your glucose loads, as you know. It improves glycotoxicity. It improves your lipid status. It improves your gut microbiome. It helps with detox. Surprisingly, high fiber diets are important for a number of reasons and really critical. That's the combination. We call this KetoFlex 12-3, but you can do it any way you like as long as the bottom line is you improve those parameters. That gets you the best outcome in this in cognitive decline, restoring that insulin sensitivity, restoring the metabolic flexibility, getting the phytonutrients, helping with the detox, optimizing your gut microbiome. Lots of studies showing relationship between gut microbiome and brain function.

So important. And I think that the idea of the brain having type 3 diabetes is an interesting concept that scientists have sort of revealed from Brown University. And I think that is what we're seeing. So, you don't get fat in the brain, you get Alzheimer's. And that's what it looks like. And so cutting out the starch and the sugar, you get people off gluten, very often, and then get them on high quality protein, low toxin fish, pastured eggs, pastured meats, grass-fed meats, lots of organic produce, plant rich, very important diet. The diet is so important. And I remember I had a patient who I treated with Alzheimer's for a while. She did really quite well, and then she kind of relapsed because she had a stress event in her life. And I put her on a ketogenic diet, and she had a chef was able to afford it. And, it was amazing what happened. It was like rip, bam, wink, the lights went on. And, I was like, whoa, this stuff works. So, that's very important. The diet is so critical. So, talk about the kinds of exercise that are important.

It's a great point. And, as we do this, we're learning what works best, what works less. And, so, it's clear that by different mechanisms, aerobic, that part, and the strength training, they have different and complementary features. But there's also the coordination feature, so-called neuromotor, and now we're seeing there's also an issue with blood flow. So things like Katsuo bands are turning out to be helpful. And as you probably know, these have been used by a number of the Olympic athletes who are training. This is where when you're doing your training, you have bands that are somewhat restrictive. They don't cut off completely the blood flow, but they are somewhat restrictive. And they're basically telling your muscles You need to improve the flow. In fact, after you use these, people actually get improved flow not only to their muscles but to their brains. That's one way to go. Then, of course, E-WOT, exercise with oxygen therapy, where you're doing both. You're doing the exercise, but you're also delivering a higher oxygen to your brain. Again, this is a disease in which there is an insufficiency in support of this complex neuroplasticity network. As you indicated, getting the appropriate amount of insulin sensitivity, very important, but also getting the blood flow and the oxygenation. Of course, we've heard repeatedly with COVID-19, you've got all these same sorts of things are impacted. Now you've got less blood flow, you've got less oxygenation, you've got more inflammation. Unfortunately, people who've had this are at increased risk for cognitive decline and really should all be on prevention for cognitive decline.

And the exercise is key because that's one of the very powerful drivers of neuroplasticity and neurogenesis. So when you want to increase your brain's connectivity and function and cells, the best way to do it is exercise and the high intensity training, the strength training, the various kinds of oxygen supported exercise. It's actually precision exercise prescriptions too. It's not just, you know, just take a walk. It's more than that. And then sleep also is really important. A lot of people have sleep apnea. Many people are misfit, poor sleep quality, and sleep has a huge effect on the brain. So talk to me about how we.

Sort of evaluate and assess sleep. Yeah, and again, there are multiple things and multiple factors that will drive the sleep down and make it less helpful. Of course, starting with the amount of sleep. So many people waking up in the middle of the night ruminating about various things that can be addressed. As you mentioned, sleep apnea, but there are also people who have other reasons for nocturnal hypoxemia. Again, wearables are going to be very helpful here. Whether you like to use an Apple Watch or you like to use a stick an oximeter on your finger, borrow one from your physician, or you can get them online, very inexpensive. You can check to see where your oxygenation is at night. You should be sitting up in the 96 to 98%. We see people all the time that are down into the 80s and even into the 70s. These people are starving their brains for oxygen at night. and it could be from sleep apnea, but it can also be from upper airway resistance syndrome, another way, which, by the way, that also increases your adrenaline, which then wakes you up. So, and then, of course, people who have low hormones tend to sleep poorly, especially if your progesterone is low, you tend to sleep poorly. So all of these things can collude to give you a poor sleep. And that's a such a critical time. And, of course, So many of us, we have situations where we say, well, we just can't afford to sleep that much. We've got a lot of stuff going on at night. We've got a lot of stuff going on early in the morning. So we're just not going to get sleep. Well, that's a short-term solution.

That's not a long-term solution. Dr. No. Dr. And the brain training and stress management to meditation, these things do affect the brain. I remember listening to some scientists talk about the ways in which meditation actually improves connectivity in the brain, neuroplasticity, brain cells reduce inflammation. It's not just to relax. There's actually science around how it actually affects the brain in a positive way.

Dr. Pompa:You know, it's interesting. If you simply look at people's cortisol levels, as the cortisol levels go up, the brain size goes down. In fact, when we were developing drugs over the many years in the lab for Alzheimer's, one of the thing that came out that was very interesting is that there is a cortisol or it's a corticosteroid releasing factor, so CRF1 receptor. in the brain, in the hippocampus, and blocking this actually improved both the amyloid and the tau in the brain. So, in fact, the whole stress pathway is absolutely part of cognitive decline. Yes, fine to have some transient stress and then respond to it. That's great. That's what we're made to do. But this, as you know, this chronic stress for many, many years is damaging to your brain. It's damaging to your your vessels, you get the hypertension, on and on with all these problems, poor sleep, etc. Addressing that is very helpful. As you indicated, some form of meditation, whether it's TM, whether it's mindfulness, what have you, very helpful as well in this whole system. Getting that stress—when your brain feels that stress and threat and your amygdala is responding to this, part of the response is, okay, we can't deal with the The brain that we have, we're going to have to downsize a little bit. You want to get rid of that as well. Then, there's targeted supplementation and there's detoxification. Then, addressing the various things that you've identified, such as mycotoxins, which can take years to reduce these things, but it's well worth it because it keeps you out of a nursing home and keeps you sharp. The most common thing we hear from people is, oh my gosh, my spouse is so much more engaged. since he or she has been doing this.

Yeah, that's true. So you go through all these various modalities like diet, exercise, sleep, stress reduction, brain training, which essentially is using basically I think about, you know, crossword puzzles, Sudoku, those kinds of things, but there's actually software that allows you to really scientifically improve your brain. It's like brainer size, like brain HQ. So you include that and then what's really fascinating is you then start to go into how do we facilitate the brain to grow and to heal and repair? You call these trophic factors. Trophic means to grow. And so you use hormones, right? And you use estrogen, testosterone, progesterone, and then nutrients. So you replace all the missing nutrients and the key things like vitamin D, omega-3s, B vitamins, all these really help. And then you focus on the gut, right? You focus on fixing the gut if that's a problem. You start dealing with the infections and and the inflammation causes, you start addressing the toxins, the mold. So this is all part of a functional medicine approach. And I found this incredibly effective for so many patients. And what really I sort of want to sort of talk about is what you found in the study. Now, you did all these things with these patients, and you did a follow-up to look at brain size, to look at, you know, cognitive performance on standardized testing. You looked at all the biomarkers. What were the big findings and takeaways from the study?

Yeah, I think the big takeaway from the study is that for virtually everyone, Alzheimer's and pre-Alzheimer's can be reversed. That you can reverse this problem by addressing the things that are causing it. And we know now from people who've been on this since 2012, we had our first patients go on this in 2012. they are still better. This is something that was unheard of before because with a drug, you may get a little bump, but then you go right back to declining. Unfortunately, when you look out at five years, the people who went on these drugs typically are just as bad or worse than the ones who didn't go on them. With this, you improve and then you stay improved because you're actually addressing the root cause, just as you've mentioned. I think the big takeaway was the vast majority of these people could get better. And then secondly, the few who didn't, you could see why they didn't. You could see what wasn't addressed. You could see if they stopped doing the right things. And then thirdly, we've got, as I say, the sustaining of this. And then of course, the fourth takeaway would be that you've got to get the people to change their biochemistry. So you've got to get them into that mild ketosis. you've got to make them insulin sensitive. So as the metabolism goes, so goes the cognition. And of course, we now need to look at, okay, what do we need to do to make this even better, better, better? But this is a wonderful start. And we're seeing, we saw on average increasing in scores of 3.89 as opposed to, for example, the drug that was just considered a success at a canumab, no improvement, no stabilization, but in one trial at one dose only, the decline slowed by 22%. That was the exciting result.

So basically, none of these drug work and at best they'll slow you down a little bit. So maybe you won't end up in a nursing home for six months more than you. It's like we're not talking about any great breakthroughs here. Everybody gets so excited we're doing this drug and it's billions of dollars and so expensive and healthcare pays for it. But this kind of approach is not something that's really funded by health insurance. So it's pretty frustrating for people.

Absolutely. And then, of course, there's big discussions now, right now, about who is going to pay if atacanumab is now, since it's been approved back on June 7th, who will pay if you go in and get this drug that may slow the decline slightly. And of course, your Cleveland Clinic has come out saying that they're not going to pay pay for this, Medicare is still deciding. The VA has decided we will not pay for this, about $100,000 per year, $56,000 for the drug, and then additional for the infusions, for the PET scans, for the MRIs, for all the other things you need. So it's extremely expensive. And of course, the people who develop Alzheimer's spend on average $350,000 per person. by the time they pass away. Much of that, of course, is nursing homes. So it's, as you said, this is the most expensive disease. We're over $300 billion now in the United States per year because of all the lost wages, the people who are the caregivers, the medications, the nursing homes, all these sorts of things. It's truly heartbreaking. And so taking this sort of approach, whereas you indicated you you look at all these things and now you address all these things that have failed, get you back to a system that functions again, makes all the difference. And, it's amazing.

I mean, you did very rigorous science looking at all the standardized tests that a traditional neurologist would look at, like at CNS Vital Signs, they call the MOCA test, which is the Montreal Cognitive Assessment. You looked at brain training scores that are objective scores, looking at how people improve. You look at brain MRI, I mean, how do you even get something more objective than looking at someone's brain size and you saw changes in brain size and in volume of the hippocampus, which is the memory center, which is really staggering when you think about it. So, you know, even if you're only 10% right, it's still a major breakthrough, right? And I'm wondering why do you think you haven't been able to sort of get funding from the NIH or, you know, major Alzheimer's subgroups? What do you think that set of resistances? that's kind of behind this. 'Cause it just seems like this is so obvious to me. The results are there. You've got preliminary data. Why don't we just put our chips on that bet and double down and go for it?

Yeah, it's a great point. And I think that there's a system is in place. As you know, there is no place in the United States that is teaching, no medical school other than yours, that is teaching functional medicine to pardon. I actually talked to the vice chancellor of one of the greatest universities in the country in terms of medical school who said, you know, we'd like to teach this new medicine, but we can't do that until all doctors accept it. Well, of course, all doctors won't accept it until you teach it in medical school. So we're kind of stuck in this loop of, you know, let's do things the old fashioned way. And I think it will take continue, it'll take more trials to show that this is clearly superior. I do think in the long run it's going to be combining targeted drugs with an overall protocol, like a functional medicine protocol like this, that's going to get you the best outcomes because these targeted drugs are very good at what they do. It's just as you indicated earlier, they close one hole out of the 36 holes. So you've got a lot open. having them for targeted things is going to be very helpful. So I'm hoping at some point that the drug companies will understand that their drugs will work better on the backbone of these. I think when that happens, things will slowly start to improve. But you know, look what happened, Mark, with the opioid scandal. There was coercion because there were billions of dollars at stake. There was a whole infrastructure set up. There was coercion for doctors. Do this, make us lots of money. And to some extent, Alzheimer's currently is the new opioid scandal. There is coercion, there is an infrastructure. People are saying, well, you have to do this. You've got to do this drug. And there was a great piece a couple of days ago talking about this new drug. And they were interviewing a guy who said, oh, this is a breath of fresh air. I'm giving this drug to all my patients. Oh, who are you? Well, I'm a consultant for the company. Well, okay, yes. If you're a consultant for your company and you're being paid—and by the way, Biogen has paid the Alzheimer's Association. And the Alzheimer's Association in turn says, oh, we think it's a good drug. They've paid other foundations. This is just an unethical approach, unfortunately. And so it's going to take some time to break through that infrastructure that has been created by billions of dollars.

Well, the good news, Dale, is that you've really done the work and you've also written a number of books that I think for people listening, lay out the protocols and what to think about, what to test, how to work with your doctor, including the end of Alzheimer's, end of Alzheimer's program. And this new book, I sort of want to dip into a little bit, the first survivors of Alzheimer's, how patients recovered life and hope in their own words. Because, you know, we really, you know, we hear cancer survivors, we never hear of Alzheimer's. So tell us about some of the stories that you found striking and one of the takeaways that that you have from some of these patients.

Yeah, you know, this book was really a labor of love because it was so great when I started hearing these stories from the people and how it affects their families. And for example, Julie who talked about when she first told her son her diagnosis, she had been to a neurologist and she said, I'm APOE 4/4, so highest risk group. And unfortunately, I have cognitive decline. Can you just at least help me stay where I am? And the doctor looked at her said, Good luck with that. What a horrible thing to say to a patient. She told her son who started crying and said, Mom, I don't want you to die. She ended up doing these various same sorts of pieces and she ended up having a number of things. She had insulin resistance. She had inflammation initially. She's done so much better. Interestingly, she then had a little bit of a backslide and it turned out she ended up having babesia. she had had a tick bite and had gotten rid of the Lyme but didn't realize that she had a co-infection. Now it turns out she's also got some mycotoxicity, so that's being dealt with. With each of these things, she's getting better and better. She's gone from 35th percentile on her cognitive scoring to 98th percentile. Wow. She's almost normal. Yeah, so very, very high normal. She's doing great. In fact, she wrote a substantial part of the the second book, the End of Alzheimer's Program, based on what she has been doing for her own lifestyle and diet and things like that. She's one of the seven stories. We have seven wonderful stories. We have Frank, a guy who moved to Mexico because he knew he wouldn't have enough money as he got demented. His doctor said, oh, you've got mild cognitive impairment. He said, There's nothing mild about this. It's ruining my life. He's done very, very well. We have Sally who actually went on a drug trial. She had a positive amyloid PET scan. She was ApoE4 positive. She went on a drug trial, and as we've seen with a number of other patients, when she would get the drug, she would get much worse for a couple of weeks, and then slowly improve slightly, and then get almost back to where she was, and then get the next injection a month later. Because remember, this stuff is Antimicrobial. So, if you have an ongoing insult, getting rid of it is the last thing you want to do. And so, she would get worse. Now, fortunately for her, after her sixth injection, she said, this is making me worse, not better. She quit. She then went on the protocol, and she's now got a perfect MOCAT score of 30. She's done great.

What was it before?

She started at 24. So, she had significant MCI. And again, you don't start going down on your MOCAT until your fairly far along in the disease. She already had the positive amyloid scan. She already had well into MCI, the third of the four stages. She's done very, very well. Now five years into this, she's still scoring 30 and doing really, really well. She had gotten to the point where she would forget to pick up her granddaughters at school. She writes about this. Then when she found out, My God, I didn't pick them up. She would be just horrified. Oh, my God, I'm going to lose my granddaughters because of my cognitive problems. She ended up having a tremendous amount of mycotoxicity, actually had to get away from the source of that and go into a detox program. She's done very, very well. We have story after story after story of these people and how it affected their families and how much better they've done by doing the right things.

This is an extraordinary deal. And I think that people need to take home that one, that if you even start to have symptoms, there's something you can do. More importantly, there's a lot of people who are at risk. So we say there's 14 million people who have, are gonna have Alzheimer's in a few years. How many people actually have pre-Alzheimer's or are headed that direction? Because it's, it's tens and tens of millions, right? And this program This approach is not just for when you get it. It's actually an approach that you should do decades before you actually get any symptoms, if you're at risk, right?

Yeah, we recommend that everyone who's 45 years of age or older get a Cognoscopy, just like we know when you turn 50, you get a colonoscopy. When you hit 45, please get a Cognoscopy. That's a set of blood tests that we've been talking about. It's online cognitive assessment, very simple, takes about 30 minutes. and then if you have symptoms already or if you're scoring poorly on the tests, it includes an MRI with volumetrics. That's it. It's simple to do. I have to say it's much more pleasant than a colonoscopy. Get that checked out and then get on appropriate prevention because as you indicated, the numbers are staggering. So if you look across the spectrum, and there's a beautiful paper by Professor Christine Yaffe from UC San Francisco who showed that if you just follow serial autopsies, this is now the third leading cause of death. So about 15% of people, so about 45 million Americans will die from Alzheimer's disease if we don't do something, if we don't have active prevention and early reversal, we will end up with about 15% of the population dying from this. As you indicated, already about 6 million diagnosed, heading for 14 million, But then over 10 million that are on their way to get diagnosed. So we'll end up with all people from zero to the oldest ages, about 45 million of the currently living Americans will die from Alzheimer's if we don't get on appropriate prevention and treatment.

And what's striking, Dale, is that in the studies on brain imaging, you can see the changes that Alzheimer's is wreaking on people's brains. decades before, 20, 30 years before they ever get any symptoms. So that's really impressive. And it tells me that it's really important people understand if you have any Alzheimer's in your family, any risk factors that we need to fix those. And, I mean, obviously all these things people should fix anyway, from diet, exercise, stress and taking care of their brain. But how do you live a brain healthy lifestyle from the get-go and that's really important because if you if you let these things slide, it's harder and harder to deal with them. And what's even amazing is that even after you've gotten the symptoms, which is 20 or 30 years after you first start to get the process going in your brain, you can start to stop and reverse it, which is what your work is showing. And that's actually helpful, but I'd encourage people to think about how do they get a cognoscopy earlier in their life, 45, 50, whatever, 60, just get these things fixed. And this is what I do in functional medicine, but do you do, It's really, really so, so powerful. Tell us about the way in which you think that the current approach is so flawed. Because I think, you know, we're spending billions and billions of dollars on hundreds and hundreds of clinical trials for Alzheimer's and most of them have failed. So, you know, what is the sort of breakthrough moment for this approach because it seems like it's not getting the airtime it needs. It's not getting the scientific attention it needs. There's a lot of, you know, sort of push back against it. How do we break through that?

Yeah, it's a great point. And the problem has been that there's a fundamental flaw in the thinking. Everybody is saying, okay, we don't understand what Alzheimer's is, but we're going to try to treat it. I think a lot more needed to be put into what is this thing? It's not a virus. It's not like with SARS-CoV-2, with COVID-19, we know what it is. It's a viral illness. We have variants, we have sequence, we know how to deal with that sort of stuff. People develop vaccines, they develop antivirals, they develop improved immune systems, all that. With Alzheimer's, the problem has been people haven't understood what it is. They'll say, oh, it's you mentioned type 3 diabetes, and yeah, that's part of it, but it's not the whole thing, right? They'll say, oh, it's all about herpes, or, oh, it's all about amyloid, tau, prions, APP changes, all these on and on and on. And so if you look at what it actually is and then go after that, it is a network insufficiency. So you're fixing a network. And so I do think that when people start realizing you can't get away with a single prescription, Sure, hallelujah, if there's a prescription one day that does all the different things we need, great. But there's no evidence so far that that is the right way to go. So I think that it's simply going to be continuing to publish these studies and we're now just getting ready to start a larger randomized controlled trial that will begin in January, February of next year, depending on when the IRB approves it. So in that case, we're now also looking to see what needs to be added. So one of the things we've now added is cone beams because we're finding that some people have oral pathology that is not picked up by standard approaches, standard x-rays and just looking at the oral microbiome. So we're seeing what needs to be looked at further to get the best outcomes from these people. And I do think that when it is standard, when people realize they can get much better treatment by going to places that do this as opposed to simply these centers, that write prescriptions, I think that's when things are going to start to change.

So what is the next step in your work? Where do you see the next step of pushing this forward? You've talked about the study that's going to be published, you've got a study of hundreds of cases in the community, not that you've treated in a study, but they've been collected that show improvements. What is the next step in your work?

Yeah, great point. So three pieces to this. Number one, to now look at people who are in the later stages, can we do something about the people who come in with MOCAS scores of 0, 1, 2? We've seen people who get better, although they typically don't get all the way better. So they'll improve, they'll start to dress themselves again, they'll start to do this. So we do need to have something for the later stages, although I hope we will rarely see those later stages. This is what happened way back in the days when I was in medical school. The old timers had seen late-stage neurosyphilis. The new guys would not see late-stage neurosyphilis because you treat it early. And so we want to get to the same point where you don't ever see a late-stage Alzheimer's patient. But until then, we need to address that. Second piece is we need to continue to improve the overall approach, and this is why we got the randomized controlled trial starting up. And then the third piece is We need to now adapt this to the neurochemistry of each neurodegenerative disease. Each one affects a different subsystem of the nervous system. We need to be able to adapt the neurochemistry for each of those. We're actually starting with macular degeneration. We have the first few patients already who have early macular degeneration. They have a different chemistry. In fact, interestingly, ApoE4 protects you against macular degeneration, and ApoE2 is the one which protects you from Alzheimer's but increases your risk for macular degeneration. So, it's a slightly different strategy. You have to go after this.

I agree.

Okay, well, so make sure that I'm sure you're on top of your doing the right things, and you're not a smoker and you're not drinking alcohol, these things that will predispose you to macular degeneration. I think that's the third piece of this. We want to be able to do this to make it so that neurodegenerative diseases are things of the past.

This would work for Parkinson's, ALS, and other things, you think?

We've already seen some good results in people with Lewy body disease. Lewy body is, as you know, Parkinson's and Alzheimer's together. Those people typically turn out to have lots of toxins on board. and they can be metallo-toxins, they can be organics or mycotoxins. That's already looking pretty good. We need more, we need a whole trial on Lewy body, but yes, Parkinson's is another one, typically toxin related, and in some cases, pathogen related. The same thing, frontotemporal, ALS, right on down the line.

Dr. Yeah, it's quite amazing. I've seen so many patients—I had a patient with Lewy body recently who get up, but I have a chair, was motor impaired, severe cognitive impaired, unable to run her business. And, she was just, you know, had so many things going on. One of her doctors was giving her steroid shots for energy because she was older and tired. And, she had a blood sugar A1C was like eight or nine, which is really poorly controlled diabetes. She was a very small little woman, but she was, you know, a skinny fat woman. high carb diet, tons of yeast overgrowth in her gut, tons of B vitamin issues. And we just kind of worked on them. We just fixed her thyroid, we fixed her diabetes, we fixed her gut, we got rid of the yeast, we optimized her nutritional pathways. And it was amazing. She literally flipped right around and she was able to actually get back to work. She was, she wrote a book, she recorded an album. She was able to function and get up and walk, which she hadn't been able to do, it was really quite impressive. And I think it's just being methodical about looking at all these variables. I remember another patient, you know, and everybody's different. Like I had another patient with MCI and was basically kind of early dementia. And doctors told her, just, you know, get your affairs in order. There's not much we can do. Take some Aricept, which doesn't work anyway and causes side effects, which is the main Alzheimer's drug. It turned out she had low thyroid, she had renal issues, she had really severe mercury toxicity, She had all kinds of B vitamin issues, mitochondrial problems, gluten, dairy sensitivity, bacterial overgrowth in her gut, lots of inflammation, mold exposure, all the things you're talking about. We just exactly what you said. We just personalized it. We got her on the low glycemic, high fat, sort of keto light diet, lots of phytonutrients, replaced all the nutrients she was missing, got her thyroid sorted, got her metals detoxed, and optimized her mitochondria. And literally six months later, she was just totally normal. I mean, just totally normal. and all her markers were normal. CRP went from 4.7 to 0. Over time, her metals came down, took a little while, but over a couple of years, it came down from 100 to 13. And she really, really did great. And seven years later, was still doing great. So there's so much potential for, for people to actually get help. It's not easy, you know, it's not easy. We're saying this, it's like, so you go to the doctor, oh, you have high cholesterol, I'll take this statin, you take a pill. It's kind of easy. This is a very complex disease to treat, and it's part of the challenge because people are cognitively impaired, so it's hard for them to remember what to do. They need some help. And it's hard to do the diet, the exercise, the supplements, all of that.

And Mark, how do we get the doctors and the patients not to give up? Because as you indicated, it's methodical. You just go, you find the things, you address them one at a time. To me, one of the big breakthroughs is going to be when we can absolutely prioritize and say, okay, in your case, this is number one, this is number two, this is number three. It's not always obvious at the beginning what is number one, two, and three in priority. As long as you fix enough of them, people typically get better. But what will happen is the doctors will say, well, I work on these things, but I don't really do these other things. Or the patient will say, Look, I tried the first thing that really didn't help me that much. No, you're at the beginning. You've got multiple contributors, and so they give up. So if we could just get people to say, Look, don't give up. get a health coach working with you, make sure that you do the right things. There'll be so many people who do so much better.

I just want to point out the obvious here is you're a neurologist and you're treating people's guts and nutrition and their hormones and toxins. So, in a way, the way we're trained as super sub specialists, we don't.

Know what to do.

We don't know how to optimize someone's nutrition. If you're a specialist and whatever your specialist is, you don't know how to balance someone's hormones or treat these infections or fix someone's gut or help someone detoxify. And, this is what functional medicine does. This is what functional medicine doctors do. They look at the whole picture, not just their little slice. So, if you went to infectious disease doctor, all he'll do is focus on the Lyme or the viruses. Or, if you go to a GI doctor, all they do is focus on the SIBO or bacterial overgrowth. If you go to, you know, an endocrinologist, they'll just tweak your hormones. You need to do all of it. Like, that's the problem. And, I think, you know, the average physician is overwhelmed. So you've developed a program called Recode and you're building it as a platform where it's easier for people to get all this data in to kind of synthesize it and come up with an algorithmic set of solutions that helps people decide what to do. Can you talk a little bit about that? Because it's such a, it takes the, a lot of the, the painful work of learning all this away from the doctors, which, which They really don't have time to do, but they can implement this by getting the support of this program, right?

Exactly. And so what we realized, again, I'm treating dementia. That's what I mean. So it's whatever it takes to treat dementia and pre-dementia. And so what we realized years ago is we need larger data sets. When you go in today and say, My cognition is not so great. Can you help me? People check a couple of things. They'll check your TSH. They won't even check your free T3 and free T4. or your reverse T3, they'll check your TSH, they'll check your B12, they'll check your RPR, and then they might check your sed rate, and that's it. And then they'll do an MRI and say, yeah, you got Alzheimer's, we're going to put you on Aricept. And so we realized, no, we need to get these much larger data sets, exactly the things you've just been talking about. And so we developed this so-called re-code. And so this is a computer-based algorithm. So you look right now, we look at 150 different variables, but the reality is it should be 150 million, whole genomes, it should be many things. And this should be part of your office helper. Everyone should have access, just as if you do someone's genome, you don't read that yourself. You get a nice readout that says here are the genes that you have SNPs and here are the concerns you have. We need to have that for everything so that you can say, OK, one of the things it does, for example, is subtyping, so it says, aha, you have mostly inflammatory Alzheimer's, whereas this person has mostly glyco-toxic, and that person, the third person, may have mostly vascular. Different people have different subtypes of Alzheimer's disease or pre-Alzheimer's. And then it also gives you an optimal program, and as I mentioned earlier, we're working on, can we now tell people what is the highest priority to deal with? What is the second highest priority to deal with? Because again, it's different. If you deal with something that's not a rate-limiting step, then you're not going to see any improvement because that's already good enough. You want to identify what are the rate limiting steps for each person's improvement.

How do you figure out the priorities and the things that are the most important? They're going to have the biggest impact.

It's a great point and partly we do that by the subtyping. As an example, the people who have type 3, which is the toxic type, they often look somewhat different. They often have some depression. as part of their initial feature. They often will have a non-amnestic presentation. So they'll come in with executive dysfunction, problem with organizing things, or they'll come in with problems with word finding or problems with recognition of objects, things like that. And then we'll find high toxin levels. So in that case, you've got to, the toxins are the number one if they have that sort of presentation. Then the ones that are more inflammatory, as you know, It's the overweight, ruddy-faced guy in his 60s who's got hypertension and metabolic problems. They are the inflammatory ones. You need to go after that first. Then you've got the different people who have the sleep apnea or who have the oral microbiome changes. Then we have a different one where you have the 75-year-old woman who's got no hormones, no estradiol, no progesterone, low vitamin D, low everything, low pregnenolone, low thyroid, those are the atrophic subtypes. And those, you need to focus on that, get their BDNF up, get their NGF up. And there are ways, of course, as you indicated earlier, to do that. So to some extent, it's based on their presentation.

So it's very personalized and very specific. Do you want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks. where I share my favorite tips for health, longevity, well-being and lots more. Check it out and link below. I think this work is some of the most important work in science being done because it's one of the few areas where we're able to look at systems biology. I think autism is a very similar thing. I mean, they're at opposite ends of the age spectrum, but they're often the same diseases. And I think when I, when I treat, and you haven't treated a lot of autism patients because you're a neurologist, as an adult neurologist, but I have and I've also treated a lot of Alzheimer's patients. And when you look at the biology of what's going on, it's the same stuff. You can literally do the same approach and fix these kids, fix their gut, fix the toxins, fix the infections, deal with the inflammation, get their diet straight, put them on ketogenic diets. It's actually incredible how profoundly effective it is, but it's complicated and it's hard to do. And our system isn't set up to actually structured to do it for patients. It's structured for the to eight minute office visit with a prescription, take the pill, by the way, which most people don't do anyway. So, it's really this moment where we're beginning to rethink our whole approach to chronic illness based on systems, based on looking at all the variables, looking at everything. So, when people sort of criticize you, what do you say? How do you answer their skeptical remarks?

Yeah, so, you know, I just say to them, look, if you've got something better, Please publish it. Show me the patients who have better. We're getting better results and publishing better results than have ever been achieved before or published before. So, I hate to be that negative about it. Very interesting though, related to what you just mentioned. For the first time, so seven years after we published the first examples back in 2014 with the first 10 cases, the California Neurological Society has asked me to speak this year. I actually wrote back to the person who emailed me and said, Are you sure you want this? We've had a lot of pushback. There's been a lot of controversy. You may get some screaming and yelling from the classical neurologists. She said, no, we absolutely want to have some discussion and debate. I think that's a great first step. I have to say I give great credit to the physician, the neurologist who invited me and wants to have some dialogue. She's got all sorts of other speakers to talk about other features of neurology. So I think this is just the beginning and people are just starting to think about, okay, maybe we do this. And so what I want to encourage during the talk is let's address the specifics. Let's instead of focusing on politics, finance, and the usual sort of stuff, one of the things that was written negatively was, hey, you guys are saying that supplements are a cure for Alzheimer's. Nobody said, that's so silly. Nobody said that. That's a straw man argument. You put up something that's really worthless and then knock that down fine.

Yeah, yeah.

I want to get into, let's talk about the data from the people. Let's talk about their MRIs. Let's talk about their cognitive tests. No one criticizes those. The other thing they say is, oh, you published in a journal we don't like.

Oh, yeah.

Come on now. Read the data, read the stuff, and then talk about what we actually wrote If you want, go see some of the patients. We'll be happy to set you up, evaluate some of the patients, make sure that what we've published is accurate. That's all fine. I don't have the problem with that. But this idea of saying, wrong journal, wrong study, we don't like that, that's all political.

Well, I want to finish by giving a little bit of hope because you've not only done the scientific work, but you've actually gone to the trouble of helping build a system that can help patients prevent and also treat. You call it Pre-Code and Recode, and it's Apollo Health. Can you talk a little bit about Apollo Health, what it is, and how people can access it and what it offers?

Great point. Yeah. You can get a Cognoscopy, for example, at mycognoscopy.com, you can look at drbreseden.com, and so the idea is we needed to build this ability to get larger data sets, to manipulate them, to figure out subtyping, and then to help all doctors. This is like a doctor's helper, basically. So we work with a group from Silicon Valley led by Lance Kelly who used to work for Apple, and this is Apollo Health, as you mentioned. And so they now look and make it very simple. You get a set of blood tests. Everything is basically very simple to have a community of people. and there are over 5,000 people now that have gone through this. And we also trained over 2,000 physicians from 10 different countries and all over the United States. So this makes it much easier for people to get their testing, to get their analysis, to get what we call a recode report. So it gives you very much as you have a Cambridge Health so that you look at the cardiovascular report, it's the same idea. This is about a 50-page report that looks through all the different things that could potentially be either risk for you or actually causing your decline. And as you indicated, pre-code is for prevention of cognitive decline, re-code is for reversal of cognitive decline. So two related programs. Of course, if you're just trying to prevent, it's a little easier. You don't have to have quite as many tests. You don't have to do quite as many things. On the other hand, once you actually are suffering the decline itself, you really have to work harder to get things turned around, as you know.

That's what Benjamin Franklin said, an ounce of prevention is worth a pound of cure. So you want the ounce of prevention, not the ounce of cure. That's helpful. Well, this is such an incredibly hopeful conversation for so many millions of people suffering. And I spoke to a young woman today who said to me, Dr. Hyman, you know, my family has a really bad history of Alzheimer's and I'm really scared, what can I do? And I'm just so happy that I.

Have an answer for her.

If you love that last video, you're going to Love the next one. Check it out here. When you start to apply these concepts of personalized care around food, around exercise, around sleep, around stress, around supplements, around everything that you really begin to see dramatic changes in brain function.