Fix Your Brain Fog—No Pills, Just This with Dr. Austin Perlmutter

Looking back at that time in my life, I drifted so far from the things that allowed me to feel connected and having purpose. I used to have this, like an addiction to hyper vigilance and being busy because I thought that meant productivity and success. And now the hypervigilance comes, the anticipatory stress that I have, I think there's.

A dynamic tension between a little bit of this feeling of anticipatory stress, knowing that there is more to be done, and the feeling of contentment that comes from saying, this is enough.

And I'm always fighting that there's no arriving, right? It's recognizing when those emotions or those feelings or the symptoms from the body come up and just owning in on, okay, this is a season of my life, a week of my life. Now I know that I need to then get back into nature instead of dismissing the symptoms like we maybe would have done previously.

There's this extreme irony here in that the more education and work you do to teach people the good stuff to do, the less your chances are of achieving that yourself. So I definitely experience that you.

Thank you for being with me today. Means a lot to me.

I'm excited to be here. You know, I've been following your content. I think what you're doing is meaningful and what a great opportunity to have a conversation about things that matter.

I feel the same about you and your mission and the education, the content that you put out for people, which I always say is so important when a doctor like you can make things so tangible and relatable, is where impact really happen. So before we dive in, we were sharing just before we started about the intention behind this podcast, but Rooted in Wellness ultimately is about ancient wisdom in our modern world and how we can become more rooted. This is not only rooted in our health, but the feeling of being ourselves and in our life and in our happiness and also our inner wisdom. I think that we all have to heal. So I'd love to start off by asking you what helps you feel really rooted in your health and in your life?

Well, you know, I know we could go on many segues around this topic, but I think this. This is the topic. Something that I've recognized is as much research as people like me can do and educate on lifestyle factors and food, exercise and good sleep, none of that stuff actually really matters unless you're connected to something more. You know, if you put a human in a cage and gave them the perfect diet and gave them the hamster wheel to run on, they even gave them access to fresh Air and sunlight, they would probably still be miserable because they're not connected to something more. And so I think that's really the core of this whole thing is as much as health and medicine seem like they matter, and they absolutely do that, as long as they stay siloed from this connection to something bigger, something that roots you to the bigger picture, it doesn't actually matter that much. So for me, I find that through a couple of things. One is nature, specifically just getting outside of nature. I have some sections with a couple of hobbies. One would be mushroom foraging, of all things, but just really anything that's outside in nature, getting to know the plants, getting to know the trees. The other thing that is an exceptionally grounding thing for me is just any time with my dog, which again, maybe sounds trivial, but he's a miniature dachshund. He's amazing. And just like literally just watching him while he's sleeping or doing thing, it is this purest emanation of just everything that is good in the world. You know, he doesn't. He's not trying to convince me of something. He doesn't have any ulterior motives. So spending time with him is something that any given day, I mean, it's kind of how I start my day with a coffee on the couch with my dog. And he's very excited first thing, and then he goes back to sleep, but I'm still with him and his energy and same at the end of the day, it's just time with him. Also my partner, my wife Rachel, you know, just having the time to connect and to debrief after the day, to be in each other's company, strong ground. But all the things that really work for me and I think, and getting back to the question itself, like, this is the stuff without which all the other stuff doesn't actually matter. You have to have some sort of a source that grounds you to something bigger than just the work that you're doing or the food that you're eating or the sleep you are not getting. So it's a great starting point.

I love that you answered that. And I think it's so important that I own in on that question, because every expert and doctor that's come on the show lists these beautiful practices and you can really feel into how it makes you feel during, you know, when I can see you outside with your mushrooms and with your dog and having your coffee. And they're all practices that are free. And after 15 years of being in this practice practice, I feel, and I think this is such a big topic. Maybe we should own on this in a little bit. But connection, I think what it does is it shifts the foundation, our terrain, right. If the terrain is optimized, then everything else can work. Otherwise, we're constantly seeking things outside of ourselves to feel better and to heal. And I think we need to end that, we need to stop that.

I think you're right on that. And let me just say so I definitely do mindfulness meditation. I think all these things are really important too. But there's different ways to come at this. And so one of the ways is to. Exactly, Lisa. Try to bring in more external factors, right? So eat more of the healthy food, spend more time exercising. All that stuff really matters a lot. But what you're actually trying to do is wire yourself and wire your brain to a state of relative satisfaction not towards pleasure, not towards dopamine boost, which is kind of the default now, but to a state where you're able to experience life not necessarily in a super happy way all the time, but in a way that excited and connected to the larger environment. And I actually think if you look at so many of the issues that surround us right now in the world and actually wrote a book about this with my dad called Brainwash, it is the disconnect from that, from the brain wiring that allows us to experience contentment and satisfaction that is such a problem. Because when we're chasing down the short term fix, the swipes, the food, the next episode of the TV show, it's actually at the very best, you know, it's just an opportunity cost, meaning we don't do the healthy stuff. And at the worst, it's actually taking our brains away from a state where we're best able to enjoy our lives. So I think again, we're getting at this point pretty early in the conversation, but you're absolutely right in terms of the way you're framing this.

That actually leads me to the next question you know, you talked about. We're sharing our shared story of heart palpitations and looking back at that time in my life, I had, I call it drifting. I drifted so far from the things that allowed me to feel connected and having purpose and just having these moments of connection or presence within my daily life. And I think that this is a phenomenon that's also happening right now with so many people because of the state of our world and the perpetual stress and busyness and overload and access to information and tragedy that's happening globally. So having gone through that journey yourself and your own healing and got the stress that you must have felt during medical school. Do you notice now when you have drifted? Because I think a lot of people in wellness we've really complicated things. People don't really recognize that they might have these practices every day that are actually uprooting them and causing them more physical, emotional or mental suffering. Do you notice when you drift?

Yeah, there's some real interesting kind of irony, specifically in the wellness world where I think there's a scenario people find themselves in where they associate themselves with a certain theme. So like now I'm going to be a happiness expert and the act of creating content or becoming an expert on happiness actually takes you away from happiness. I think it's extreme when it comes to mindfulness. You know, in order for me to feel like I'm able to do the best job I can in the world, it requires me to do a lot of travel, a lot of speaking, a lot of, you know, waking up early, a lot of research. And all that is, is great in service of this larger goal of educating people and how they can reclaim their brain health. But by virtue of these things that I do, it can actually completely pull me out of mindfulness and good mental health. If you're traveling a lot and you're staying in hotels, you're not spending time with family and you're not outside, I mean, these are the things that we know help people to live long, healthy, happy lives. It isn't incidental that you don't really have all these, you know, centenarians from the blue zones on social media talking about how to live a long and healthy life. They're actually out doing it, right?

Doing it.

There's this extreme irony here in that the more education and work you do to teach people the good stuff to do, the less your chances are of achieving that yourself. So I'm, I definitely experience that. I find, you know, I, I don't want to say I've always been a workaholic, but I've always been a little bit obsessed with work in certain ways. And so especially now when I feel like there's so much opportunity to create positive change, there are a lot of conversations happening, some of which I'm part of at large scale levels. And also there are so many people who are just looking for ways to their cognitive and mental health through lifestyle. So there's just, there's all this stuff on the table. And so I want to do more research, I want to do more education, I want to do more collaborations. And I also recognize that the more I do all those things, the more it takes me away from the basics of the things that are necessary for me to feel content. So I definitely feel it. I feel it every day. I think there's a dynamic tension between a little bit of this feeling of anticipatory stress, knowing that there is more to be done, and the feeling of contentment that comes from saying this is enough. And I'm always fighting that. And so I try to do things to bring myself back to that center. And I'll find sometimes, especially if I've done, you know, let's say a ton of back to back interviews or spoken at a conference, doing a lot of lectures or doing a lot of networking, I'll just come back to my hotel room and I'll just be so revved up. You know, it's almost caffeine, it's caffeine, but because of the connections, not because of actual caffeine. And so I try to make use of that energy, but also recognizing that that's not an energy that allows me to get restful sleep. That's not an energy that allows me to long term sustain my value in this community. And so finding ways to reground, to reconnect have been essential. But I've not always been the best person to make that happen. Sometimes I just want to play in that energy and, you know, do all of those things for longer periods of time.

I have to pause this episode to share something that's completely transformed how I feel every single day. And it all starts in my gut. I'm talking about Pendulum's Metabolic Daily and I'm genuinely obsessed. 88% of Americans are metabolically unhealthy. And so much of that comes down to our gut microbiome. If you're constantly battling afternoon energy crashes, sugar cravings, and that sleep sluggish feeling after meals, metabolic daily can change everything. This isn't your typical probiotic. It contains live Akkermansia municiphila. It's an incredible next generation strain that most of us are deficient in. It literally strengthens your gut lining and helps your body metabolize sugars and carbs so much more efficiently. What I love most is how it makes me feel. My energy is sustained throughout the day when I'm not constantly thinking about my next snack and I actually feel a little bit more full faster. It's like my body finally learned how to work with the food instead of against it. Plus my digestion has never been better. What sets Pendulum apart is the science. They were founded by PhD scientists and doctors with the Mayo Clinic as their first investor. They're the first company in the US to bring live Akkermansia to market using DNA sequencing in an oxygen free facility. I'm so selective about supplements that I recommend and Metabolic Daily has earned a permanent spot in my routine and recommendation to my clients. Go to pendulumlife.com and use code Mona M O N A for 20% off all Pendulum membership first orders. That's pendulumlife.com with code Mona. Your gut and your energy levels will thank you. What a beautiful journey though, to be able to recognize that state, but doing it in service, right? So I don't know about you, but I don't know. I used to have this. It was like an addiction to hyper vigilance and being busy because I thought that meant productivity and success. And now the hyper vigilance comes. As you said, that anticipatory stress that I have, it's all really positive. But what I really want listeners to hear is hearing from practitioners like us. There's no arriving, right? It's recognizing when those emotions or those feelings or the symptoms from the body come up and just owning in on, okay, this is a season of my life, a week of my life. Now I know that I need to then get back into nature instead of dismissing the symptoms like we maybe would have done previously. So thank you for that share.

One other thing I'll just add, which has been a persistent revelation. I mean, I know it's true, and then I remember it's true, is that by and large, the influences of other people in your life, with the exception of a few close people in my circle, are always pushing you towards productivity, towards externally validating stuff. And so the less you're aware of how you're being influenced, the more it just feels like, okay, of course I'm going to do that next thing. Because that's what everyone around me is validating me for. I mean, I have had a life in which I am persistently validated for doing more work, whether it's or otherwise. It's look at this accomplishment that you've had. And I think it takes a pretty big phase shift to say actually that is out of sync with what is best for me and what is best for my close relationships. And unless you're doing that repeatedly, if you're just out in the world allowing other people to direct you, you're going to find yourself burning out. And then you'll realize that all those other people who are directing you were just doing it kind of for what worked best for their paradigm of reality. So it's not as though when you benefited at the end of the day or even they care that you're not doing your best job. It's basically they're insecure in their own productivity or whatever and it just kind of has a ripple effect on going out into you. So I'm trying to be more aware of that, especially in the people I interact with, which is validating all these other ways of being that are equally important. Stuck in this. I mean, wellness has its own hamster wheel of productivity success, which you know, can be in some ways equally toxic to what happens outside wellness. So you just have to be careful because humans have this natural tendency to slip into this external validating scenario. And just because you're doing it for the right reasons doesn't necessarily mean that your mental health is going to be okay.

And isn't it wild? Do you notice with when you're speaking in larger groups, this concept of stress now as this new emotion and if we're not having conversations like this, it's almost like we're giving each other permission to just live there instead of setting boundaries. And I think that the concept of setting boundaries for people is overwhelming or they feel like they're not doing a good job. But I think that moving forward, especially with the way that AI is going, how fast we're able to do things now, if we're not being firm on setting boundaries to empower ourselves to feel better mentally and emotionally, we're the only ones that can take charge of that. And I don't think it's not going to be written on any doctor's pet soon.

What you bring up to is a really important point, which is nobody is going to care more about you than you. You may have, maybe lucky, you may have a parent, a spouse or somebody else in your life who just is so committed to your mental well being and phenomenal that's the case. But there is this myth that like somebody else is going to save us. And whether that's a doctor like me or somebody else that's going to provide you with that amazing wisdom that you read in a book or something, the reality is that nobody else is going to care as much about your health as you are. And so if you're not the strongest advocate for your mental health and cognitive health, you gotta expect that things are not going to go well because everyone else has an incentive. And I'm not saying that, but like wellness companies have their own incentives to sell their products and it's great if incidentally, you get better along the way. Doctors and clinics, they do care about your health, but they have other incentives too. So even though they're doing what they can, you have to be the one advocating for, actually, I care about my health, I care about my mental health. I'm going to do something each day because the other piece of this is as it relates to cognitive health and mental health, the two areas I spend the majority of my time focused on, the majority of the variables that are going to determine whether our cognitive health is good long term, and the majority of the variables, lifestyle variables linked to mental health, are things that we have to be in control of. They're not going to happen externally. It means we have to wake up and make these decisions for ourselves. And often in direct opposition to what we're being told, the signals we're being told. We're being told right now that unless you're reading the news for five hours a day, you're not informed that you should just put on the news and let it run in the background. That's what's necessarily required of us as citizens. And the reality is that news is one of the top sources of stress in America and that by the time you've seen the same news segment three times, you're not learning any additional information. So there's a huge disconnect here in what society would have us do, the degree to which our surrounding people care about our mental health and what's necessary for us to do if our goal is to preserve our mental health and cognitive health, which again, they're just, they tend to be different paths.

Oh my gosh. Yeah. Let's open this up to the impact of stress and that core root of inflammation. Right. I know that you're going to say that some stress, you know, cognitively can be really beneficial for us, but one of the first things we learn in school with nutrition is that this, you know, chronic, daily, persistent stress is the source of inflammation in any part of the body. And you said yourself that it's at the root of nearly every modern disease, including our cognitive decline and emotional disorders, that so many people, it feels like they're on the rise. We're now learning that neuroinflammation is linked to anxiety and linked to depression and also linked to Alzheimer's. But day to day life, I can't tell you the amount of people that I meet with who suffer from brain fog also. And they're not looking at the source of stress or maybe social media or the news or these external stresses being the source of what's causing them to feel inflamed. So can you expand on how this neural inflammation, brain inflammation, can manifest and why it's overlooked?

Yeah, and I'm going to rely on you to pull me back if we go too far into the weeds.

For sure.

One of my favorite.

I'm getting excited, so, yeah, I will.

So to take a quick step back, you know, a lot of things have changed in the last 10,000 plus years. And when you think about Paleo and what Paleo represented, certainly our ancestors were doing certain things better, like they were walking a lot more, but they were on average dying in Paleolithic era at around age 33. And so now the average lifespan is I think 73 or so years old, which is much, much better. Right. So this is a dramatic increase in the number of years on Earth. But what you see at that time span is even though we are living longer, we're not necessarily living better. And so, I mean, some of the rates here, I guess, would be that in America, 60% of Americans have, or American adults have one or more chronic diseases and 40% have two or more. And then if you look at these rates of diseases after age 65, about 29% of people have diabetes, 49% of people have pre diabetes. If you live over the age of 55, your rate of getting dementia is now 42%. And if you look at just overall trends in the American public, what you see is around 90% of people have at least some element of metabolic dysfunction. And as you alluded to before, you've got the majority of the top killers and contributors to disability on the planet, which are known to be inflammatory diseases. So putting all that together, what we're saying is we're living longer lives, but we're not necessarily optimizing the quality of our lives. And usually people will focus on whatever their most significant pain point is in terms of what brings them into the doctor's office or really any office. So if it's a 75 year old person, he might come in saying, my big issue is I have all this pain in my knee, right? This knee, I can't walk on it. And so we might get to the point of saying, oh, there's something going on in terms of your bones, there's some inflammation. And maybe this person gets prescribed an anti inflammatory medication, like a non steroidal anti inflammatory medicine like ibuprofen. Right. We'd say inflammation is causing a problem in your knee. That's why you're here, let's bring down inflammation and you're going to feel better. But what most people don't understand is what inflammation looks like in the brain and what metabolic like in the brain. These are kind of the twin epidemics that we're experiencing right now in America that are driving us to worse overall health. Metabolic dysfunction, we don't have to get into in too much detail as we can focus on inflammation, but just appreciating that metabolism is how your body takes energy from the outside world, converts it into fuel for your cells and allows you to function. Right, Allow cells to live. If you cut off metabolism, you die instantly because your cells require energy to function. And that energy has to come from somewhere. And the degree to which we're able to efficiently extract that energy correlates with a degree of conditions like diabetes and heart disease on the immune side or on the inflammatory side, which is where a lot of my research has been focused, is the understanding that when the immune system is put into a state of imbalance that we would call inflammation, kind of a low level background inflammation, that not only does that contribute to cardiovascular disease and diabetes and obesity and a shorter lifespan, but in the brain, that inflammation is now recognized to be a principal driver of mental health issues. I'd say depression is the best example. We also have data for schizophrenia, for PTSD and a host of other mental health issues, and then cognitive decline. So Alzheimer's disease, as well as a host of other neurodegenerative conditions. And as you mentioned, brain fog. So brain fog, super common thing. We're seeing a lot of people have brain fog in the context of what we're calling long Covid. And when research, what's happening in the brain, inflammation seems to be key to that. So all of this is to say if we think about what is keeping us from living long and healthy lives, not just long lives, we don't. At least I don't want to live to 120 if the quality of my life is terrible. We want to have long and healthy lives, what some people call health span. The goal to optimize metabolism, to optimize inflation, by basically not getting rid of inflammation. We absolutely need it, but not having this chronic inflammation in the body. And the best ways to do that are through nutrition, through exercise, through stress mitigation, through better sleep, all of these things that people are aware of. To kind of put a last point on this, because there's a lot to discuss in terms of mechanisms, what's activating inflammation in the brain, what Cells in the brain get inflamed is when we look at all of these major brain diseases, and here I'll just bring up depression and Alzheimer's. So Alzheimer's disease rates well, total number of people expected to triple in the next couple of decades to about 150 million people around the world. When you look at depression, it's already around 300 million people around the world. When we look at the explanations for these conditions, if you would go into a conventional medical doctor and say, what is causing depression? What is causing Alzheimer's, this maybe is updated in the last little bit. But historically what we would see is that depression, we'd say, well, from a mechanistic perspective, from a biological perspective, it seems to have something to do with serotonin. So what we do for depression is we prescribe selective serotonin reuptake inhibitors like Prozac, SSRIs, with the expectation that we're doing something to the serotonin system. And that's why people get better. We look at Alzheimer's disease, one of the pathological features is a buildup of an amyloid plaque. And so we'd say, well, amyloid is causing the Alzheimer's. We should go after the amyloid with an anti amyloid drug and that should make people better. What we've seen these conditions in the case of depression is this massive study that came out a couple years ago showing that serotonin doesn't explain depression. That when we look at all the data, it seems like serotonin is kind of a red hammer, that even the drugs that we use to treat depression don't seem to work by influencing serotonin signaling the way we thought. So when it comes to Alzheimer's disease, amyloid seems to be a downstream product of what goes wrong. And anti amyloid drugs, of which there have been many major expensive trials, don't seem to significantly work to reverse the disease or even to really slow the rate of decline without inducing a lot of side effects. So in both cases we'd say, well, it doesn't seem like it's this one molecule. And one of the themes that's emerged in the research is maybe it's actually more related to something like metabolic dysfunction, to inflammatory dysfunction within the brain. Why that's exciting is not only would it help us to develop new therapeutics. Right. It's one of the reasons, for example, why the keto diet is now being experimented with Alzheimer's disease, it's also one of the reasons why the Mediterranean pattern diet seems to be at the top of the list for treating and preventing depression. But it also helps us to understand where things went wrong. And so we can then look at the brain and say, hey, does inflammation play a role in depression? And if so, maybe instead of waiting until people get depressed and they're in the clinic and they're so depressed that we have to give them a drug, we should be talking about a preventive strategy to optimize the immune system such that it decreases the risk for a person developing depression. You know, I think mental health, cognitive health, anything brain related, there's been this, this really unhelpful scenario where we tend to like, associate the disease with the person. So if a person, perhaps we say, oh, well, I have depression, I don't want to tell anybody about it because it's something that's wrong with me. And as we look at what's actually going wrong, we could say, look, there's a biological change that underlies this, meaning something has changed in your brain that is making you feel depressed. And if that's the. The case, then we should be able to work backward and say, well, what can we do for both you and other people to decrease the chances of this happening at scale? And so a lot of my research is focused on that specific topic around inflammation in the brain, saying if inflammation we know is associated with all these mental health issues, with cognitive decline, with brain fog, with lower quality of life, with violent crime, with worse test taking, with lower iq, all these things we really want to not have happen, what can and should we doing, should we be doing right now to both decrease our chances of getting depression in the first place? Something that very few people ever talk about. It's like nothing until all of a sudden you have a mental health disorder. But also what lifestyle strategies could we be including in protocols for the management of depression? And so I've been, I've been in communication with several psychiatrists and we've been talking about what that looks like. Everything from understanding we need to do a genetic testing, epigenetic testing to see if certain people would benefit more from certain drugs, to understanding the microbiome of people with depression, if that influences inflammation, to appreciating that certain drugs, and in this category, I would use even psychedelics as a class, might be more beneficial to different people, depending on their inflammatory state before they start the treatment. And this has been shown that based on a person's levels of inflammation, they may be more or less sensitive to a standard antidepressant versus something like ketamine. So it's completely changing the game. What excites me is there's just so much new data coming out. But I think for many people it provides a degree of hope because you're no longer just saying there's this one thing, there's a drug forward where there isn't. And you're done saying this is, this is complicated stuff, but lifestyle really matters.

Right? I feel like it is such an exciting time and even with the awareness on metabolic health, on the rise of Alzheimer's, on the number of prescriptions that are being written for mental health issues and anxiety and depression, I feel like it's all happening so quickly now in the past few years. The unfortunate side to that is despite the rise of all these illnesses that you just painted such a picture, a terrifying picture of for the future, I don't think. No, but it's good. Like this is the awareness that people need to have. I think education is going to empower people to take charge of their own health and that's what we need to hear when people are going to the doctors, though. And prior, I just don't think that that prescription is coming with a protocol on. Let's talk about optimizing your sleep. Let's look at the stressors, your life right now. Let's look at the foods that you're eating or small sources of inflammation. So maybe for our listeners, can we just talk about what does low grade inflammation look like? I say that inflammation and I know you'll agree when it becomes systemic, it impacts the entire body, right? We tend to focus on the brain, the heart and the gut microbiome. But when we understand that everything is connected, can we all assume that to some degree, with all the kind of insult that we take in every day, do we all have some degree of brain inflammation?

It's a really good question. I want to come back to one thing you just mentioned, which is that when you go to the clinician, you know they're not going to have these protocols. From what I found, and it may be kind of a newer generation of doctors, they do have protocols around sleep and stress and all the other things. The problem is twofold. One is that by the time you get to the doctor, you've already lost your best chance of making those changes. You know, I'll say this again, if you're waiting until you have high blood pressure to see a doctor, it's going to be much harder to say, okay, look, change your diet and it's going to fix things. And also, people tend to have more difficulty with that not just because their biology has changed, but because the way that their brains are structured have changed. So, you know, I'll just make that caveat. The other thing is that the amount of time that people have available to interface with their primary care doctor is 15 minutes. And there is no scenario based on current building models where you're going to have the opportunity to sit down and actually get into all of that stuff. So that's why I think the point that I would bring up time and time again is your best chance at becoming healthier. Long term sustainable health is going to happen outside of the doctor's office. Don't wait until you get to the doctor to make these changes because they don't have the time to do what is necessary to fix all of these things. And more importantly, you need to be the person who is motivated to make these changes. Right. I have told people, here's what you need to do. And I cared a lot and they didn't care and it never works out because there's this massive gap. So anything a person can do to kind of develop this energy within themselves to say, I'm doing this for me and I care about this independent of what other people say, that's so powerful. So to go back to what you described though, in terms of the chronic low level inflammation, there's a couple of considerations. So one is what is actually causing the inflammation. I think that's really important because if we start to understand do I have risk factors or what causes it, that may be even more important in certain cases than actually measuring the inflammation. Usually we'll talk about low levels of inflammation. They're measuring things like crp. They're also measuring sometimes esr, which is a sedimentation rate and other inflammatory markers. There are some new labs that are being used. I'll just mention here in case anybody is a clinician that's interested, but something called the stomach Immune Inflammatory Index. So basically what you take is you take your platelets, multiply it by your neutrophils and you divide it by your lymphocyte count, things that you can get off of blood count. But these are all markers that can tell you if you have low level inflammation. Now these are lab based markers and not everybody wants to get labs and maybe not everybody has access to labs. So what are some of the things that might tell you that you have low levels of inflammation? One is BMI is not a great tool, but it does give a sense, specifically if you have a lot of kind of fat around your Belly. That can be a signal that you have low levels of inflammation if you've ever been diagnosed with any form of metabolic disease. So type 2 diabetes, as well as pre diabetes will translate into significantly higher rates of having low levels of inflammation. Same with hypertension and general cardiovascular disease. These are signals. Other things would be a person's experiencing brain fog. That's an interesting signal. So there's some really solid data around something called sickness behavior, which is a great way to connect inflammation in the body to inflammation in the brain. Sickness behavior is what happens when we come down with, let's say the flu or a cold, some sort of a viral illness, where anybody who's had this happen before, where they've been sick, they've been in bed, will recognize their thinking wasn't 100% right. So you're probably not going to be able to do your taxes. You may not even be motivated to do that kind of stuff. You probably won't be as sharp and able to listen to your friends talk on the phone and respond to all the things they're concerned about. You know, you may be having trouble just putting a basic sentence together. And the reason is because inflammation in your body is causing your brain to have trouble thinking. And a lot of this relates to the fact that inflammation is super costly. It takes the body a ton of energy, which kind of connects metabolism with immunity to power, inflammation. So you can look at it again two ways. One is to say you're going to get the labs done. You're going to get a CRP level tested. If it's above 3, then maybe that's a concern. If it's below, you'd say maybe not super concerned. You're going to get other labs that correlate with inflammation, like a hemoglobin A1C, that's a diabetes lab, but it also correlates with inflammatory levels. And then the other way is to say we're going to look at kind of these other signals. So again, overweight or over or obese, you know, these aren't perfect numbers because they come from bmi, but it's specifically a more kind of waist. If you have a higher waist to hip ratio, this is a signal they have inflammation. If you've been diagnosed with metabolic disease, sure. But the brain fog, I think, is an important signal too. All of this is to say, and the way that I structure this is everybody should be focused on strategies to help to decrease chronic inflammation. It may be different if a person has an autoimmune disease or they have an active infection, their inflammatory levels will be way, way, way higher. And so we're differentiating here between something where it's an active acute illness, like I need to go to the hospital because I'm very ill, versus saying in the background of our lives each day there's kind of grading force that is sapping our health. And that's what chronic inflammation is all about.

Such a good point. And what I'm really hearing from you, ultimately, despite whether or not you're able to get your labs done, don't ignore your symptoms. If you have any type of inflammatory symptom, it's your body telling you that it's time to really tune in before it turns into your body screaming. Do you recommend genetic testing for most people? I know genetics is a big factor for this. If I think about depression, depression runs in my family. And I think now we're also associating trauma with genetics and the ability to use epigenetics to turn off those biomarkers. Do you recommend them?

So in terms of testing, you know, being in the wellness space, I hear about lots of new tests, lots of advanced tests.

So many tests.

You get a full on emri. Should you get a finger stick for X, Y or Z? What I think would be, first thing is if you're not getting regular preventive care, get your basic labs done. Right. The cholesterol panel has some utility, you know, but I think it's really helpful to get the basic labs done. So get an A1C done. Get screened for type 2 diabetes and pre diabetes, super helpful. These are things that are covered under almost everybody's insurance. So there should not be much of an out of pocket expense. Beyond that, when we start to talk about what is the utility of additional labs, I think for metabolic dysfunction, there's definitely a good indication to get additional labs. You can get a fasting insulin level, you can get additional labs to look at whether there's metabolic inflexibility. So I think people who are at high risk of that, we talk about some of those risk factors. I do think that's helpful. And the reason I would say that is because when you look at the combined total of people with type 2 diabetes and prediabetes, we're getting close to about a half of the American population. What that, what's most concerning about it is that most of the people who have, for example, prediabetes don't know it. So this is something that at one point we could say, look, it's not a high utility to get that data because most people aren't going to benefit from it. I think at this point, most people really do need to know because there are so many people out there with metabolic dysfunction who would benefit from changing lifestyle before they develop full blown type 2 diabetes. And by that, a lot of people are out there with type 2 diabetes and don't know it too. So I think getting some of those metabolic labs is helpful. An A1C level, while not the perfect screen for diabetes or prediabetes. Like I said, there's a good screen for diabetes. It's a good starting spot because it's usually covered by your insurance. When it comes to more comprehensive labs, I think that genetics, epigenetics and so on is helpful if you're doing it the right way. One of the considerations I would bring up is getting a comprehensive set of labs, whether it's genetics or just standard labs, without a plan for how you're going to do anything with this can actually lead to a lot of problems. I know people who have had their labs come back. It shows, for example, an increased risk of X, Y or Z because of the 23andMe. Or it shows that some sort of an esoteric lab was high or low. And they say, I'm not a doctor, I have this, I'm really scared about it. What do I do? And then they go to their doctor and their doctor's like, oh, well, you probably just shouldn't have had this done in the first place. Doesn't mean anything, probably. And now you just have created this doubt and concern. So I think before you go, in order, like a comprehensive lab panel, have a plan for what you're going to do with that data. Specific though, to genetics and to epigenetics. I do think there is value in getting genetic testing specifically if you have a family history or specific concerns. I think methylation of various vitamins becomes more interesting. I know several cases of people who have had some rare mutations that actually explain a lot of their symptoms. And that has been helpful. But these are usually people who are a little bit more dialed in in terms of. Now I have this, I can go see the specialists. Where I spent most of my time recently is on epigenetic testing and just briefly on this. So you have, I guess each of Us have roughly 20,000 genes, but you can have all of these different mutations within these genes, single nucleotide polymorphisms, which is what genetic testing tells you about. So that's interesting. Epigenetics tells you about how those genes are being used. It tells you about whether that gene is turned on off somewhere in between. And what we've seen just in the last couple of years are several companies that have been capable of with as little as a finger stick of blood, which is great for people who don't like to do 12 tubes of blood with a phlebotomy sample can tell you about kind of your risk for tons of different issues, like hundreds of different labs. And from that epigenetic data, they can actually give you data related to what you would usually have to get from your blood. So it can tell you about your lipid levels, can tell you about your inflammatory markers. I'm a little biased here. We've been working with a group called True Diagnostic. They provide this test that gives you access to all of these markers using a finger stick. And while it's still early, I think this is going to be the next frontier of what lab testing looks like. So to kind of consolidate all this. I am a proponent of more advanced lab testing. I do think you should not do it on your own unless you have a plan for how you're going to interpret that data. And I do think it should be a little bit specific to a person's needs. So if you have a 20 year old who's getting comprehensive DNA testing, epigenetic testing, full body mri, I wouldn't necessarily recommend that unless, you know, there's a specific plan for what you're doing with that data.

Oh, my gosh. Thank you. Yeah. Because it is overwhelming. There's so many tests, there's so much marketing that's happening right now in that world. But I think that the lens that I really appreciate is ultimately the more information that you have to really, you know, customize a protocol that's for you and your blueprint. Use that as empowerment. Because what I see happening is a lot of people are doing these testings. I have some clients who've gone for full body MRIs. And oh, great, you don't have cancer now. We'll see you in a year. It's like, oh, shit, I've got to come back in a year. And it's fear based. It's this fear that's kind of instilled of prevention versus the empowerment that can come from knowledge. Oh, understanding my constitution and this vessel that I have and what it actually needs, according to my genetics and my current biomarkers, I think can be so empowering. And then we turn down the noise of looking for the protocol and the fix because we're so in tune with what our body actually needs. So thank you for that reframe.

I think my perspective at this point too is that there is 95% plus in value that comes from doing the basics well. And then that incremental 5% is from really narrowing in on a person's issues. Right. And so sometimes I get, people will push back on me and they'll say things like, you know, how can you recommend any sort of dietary intervention without knowing a person's labs like Mediterranean diet? Because some people, you know, may not be good metabolizers of X, Y or Z and. Right. I think this is actually the antithesis of what is helpful. Because the reality is, you know, you and I can have these conversations, people can ask specific questions. These are people who are informed, who have already heard some of this stuff before. So if I talk about different B vitamins and methylated B, they'll be like, oh yeah, I heard about this. My MTHFR is this. And now they can make some changes. Great. If you look at what the general public in the United States eats, right, where about a third of people eat fast food every day, what is coming out from some of this complexity is that people are just more and more confused. So am I supposed to do the Atkins diet or the south beach diet or the Mediterranean diet? I saw this guy on TV who said one is great, who told me plants are going to kill me. And the problem with that is that in the absence of consensus, we actually create more noise. So like, yes, it's really helpful to work with a qualified practitioner to do advanced lab testing if it's going to change what you do next. But it's not super helpful to tell a person like, don't make any lifestyle changes until you do this comprehensive set of labs that costs $4,000 a year because it just creates confusion, it creates fear. And the best data that we have right now for the things that they're going to let you live a long and healthy life are not supplements, are not advanced diagnostic tests. It is doing basic healthy stuff most of the time. And so I just don't want to lose that signal in the noise. That is this heavily marketed wellness industry where we create a lot of fear mongering or we create confusion around what the actual data says in terms of what's scientifically efficacious to promote health.

I couldn't agree more. A lot of the things that I'm hearing you've mentioned so far, they're things that are, they're just foundational truths, truths to human physiology. Things that we know that we need that have stood the test of time, so we're going to dive into those as a solution. But before we go there, let's just really kind of zone in on the insults that do come from modern living. So one of the most common complaints that I get from specifically women is brain fog. And they're not understanding how specific foods or lifestyle practices could be causing them inflammation. It's almost like this brain, body disconnect. So how are people, you know, what are some of the most common sources that you're seeing for this inflammation?

Yeah, I think you're, you're spot on. Which is, despite all the data to the contrary, many people still continue to look at the brain as separate from the body. They'll say, oh, I'm having issue with my, my gut, but it doesn't influence my thinking. Or, you know, they'll say, I feel a little bit off, I feel low energy. But, you know, what does that have to do with my brain? I just need to eat some more sugar and then I'll have enough energy and I'll be good to go. So the pathways by which what happens in the body influences the brain include sensory data. And I think that's the one that gets most often missed. So what we consume through our eyes and through our ears has a direct through our nose to, interestingly enough, smells, but has a direct conduit into our brains. So probably the single most significant source of inflammatory stress in the American life that is at least undervalued is the news and content that we consume. Whether you're watching MSNBC or Fox, chances are if you put in five to 10 minutes, you're going to feel your heart rate start to go up. You're going to feel stress. The reason is that's because what the news is designed to do, it knows, as do most people in the news and or on tv, that negativity sells. Right? So we have a negativity bias. We pay more attention to things that are scary because our brains say we don't want to die. So if it's scary, we'll make sure to take care of that first. So the content we consume through our eyes and through our ears is a major source of inflammatory stress. Because as you alluded to earlier, when we experience chronic stress in our brains, it actually promotes chronic inflammation. The pathways are a little bit nebulous, but it is the case that initially stress lowers inflammation, chronic stress increases inflammation. Because one thing to consider here is from the framework of what we're putting into our bodies, are we Giving our brains a danger signal. Stress is a danger signal. It says there's something scary out there in the world, we need to be on guard. We don't care so much about how, you know, the duration of our lives other than not dying right now. We don't care about happiness. We care about staying alive for the next 10 minutes, few hours. Anything that creates a danger signal tells our brains to optimize towards the present at the expense of our future brains. So what we consume through our eyes, through our ears, and that also includes, unfortunately, conversations we have with friends and family. If you're engaging in a conversation with your spouse or partner right before you go to sleep about whatever political thing you're talking about and that revs you up, that is a potentially inflammatory input. So bottom line here is to pay attention to what you consume through your eyes and through your ears, because that has a direct conduit into your brain. And I think it is a hugely underappreciated source of inflammatory stress. The next big thing would be to talk about kind of as we're moving down, what we take in through our nose and through our mouth. So the big one that most people pay attention to is the food that we eat. Absolutely. Food is vital to this conversation. Most people eat what we would call a western pattern diet or an ultra processed diet. There's tons of data showing that an ultra processed diet, which is rich in foods that have tons of ingredients on the back of the labels, high in sugar, high in salt, high in preservatives, correlates with every negative health thing you can think of, from dementia to depression, but also cardiovascular disease, shorter lifetime. So ultra processed foods are an inflammatory stress on our body. So what we eat, certainly huge part of the conversation then what we breathe. And this is something that similar to the news, most people are not nearly as aware as they should be because eat three times a day, but you breathe 20,000 times a day. And unfortunately, all these tiny particles that are in the air that we breathe, they get exposed to the two tennis courts or so of surface area within our lungs. And the very small particles can penetrate into our blood vessels where they cause local inflammation and systemic inflammation. And they've done studies where they looked at the inflammatory cells in the brain of dogs and children and adults in places with air pollution. And what you can see is that the higher the air, the more the brain inflammatory pathways rub up. So what.

Wow.

We'll shift over into some positive things just to kind of round this out here. So we've covered the Things you take in on the top, there's other stuff that influences inflammation. So exposure to certain infections for sure.

Right?

Skin infections, the things that we put on our skin. Absolutely. Other considerations. But really what you want to think about is anytime there is an opportunity for data to come in through the outside world and into your brain, that is an opportunity for either inflammation or for kind of the stabilization of the immune response. So in a perfect world, we're trying to do everything we can to optimize those variables. I'm very cautious because sometimes when you go down this conversation saying, oh, well, the world is toxic, the world is inflammatory, I'm just not going to leave my bubble. And that's not the goal. The goal is to just do a bit better. And then when you do that, you're targeting brain fog, the mental health, the cognitive health, and just general better quality of life.

I'm smiling for two reasons. One, the first thing that you said wasn't toxic food, it's consumption. One of the best lessons that I learned from the ashram and really from Ayurveda is questioning what are you digesting? And just knowing we digest with all of our senses what we watch, what we smell, what we eat, what we listen to and what we put on our skin. And in my healing journey, when I went back to the ashram, there was no, it was a time where there was no social media media. There's no more news, there's no more distraction. And when you have no external distraction, you're forced to tune in and you pay attention and all of a sudden you can kind of listen and tune into the symptoms, but also the quality of your thoughts and what you're saying makes sense. And I really hope our listeners ask themselves that question, what are you digesting? What are you consuming? Because I don't think I've been brought to my knees so many times in the past year from the news and social media than ever before. And I think that if we're really going to guard our health, this something that we've got to monitor.

You're totally right. And again, not to say that you don't participate. Right. I think that's, of course, I, I, I love sometimes where people do a lecture and basically what they're saying is move off the grid and, you know, farm with like, ignorance, two goats, a llama and, you know, some chickens, everything. I don't think that's feasible, but I.

Do think, I don't think so either.

Paying attention to the consumption, because anything that we consume changes us. You Know, physically, mentally, our brains, our mental health, it's a reflection of what we eat, what we consume, what we breathe. And so the amazing opportunity here is that there's so many chances to build a better brain. And by doing so, think clearer, feel better. And a lot of these things don't take some sort of, I mean, I don't have some crazy biohack, you know, it's more about the smaller things we do each day that can have such a compounding value to our long term health.

Yeah, I couldn't agree more. I think you nailed it. Also previously you said when you speak to somebody who lives in a blue zone, they're not, they don't have a checklist of biohacking, the supplements, the things that they're taking, grams of protein, they're actually just in practice of living a high quality life with things that actually make them feel good. Right. I think that's what we need to focus on. So thank you.

I mean, I'll be excited if 40 years from now it turns out the biohackers live to 120. But right now, the best day of the week is exactly what you just said, which is the people who do the best are the people for whom what we would call biohacking is just life. They're not going to, they're just moving because they need to for work or for pleasure. You know, they're, they're not trying to get a certain amount of sunlight through a sun lamp, they're just outside. Doesn't mean that we don't need the other stuff. But I think there's a, there's a real risk or liability when we try to extract individual perceived truths from something bigger. So, for example, food, there's been such a movement to say, well, this is the nutrient in this superfood and if we just take a big dose of that, it provides 10 times the value. Like not exactly. Right. There's value in doing the actual thing, you know, a two minute high intensity exercise. Or you could say, well, I'm gonna go on a 20 minute walk because that's actually enjoyable. And that's what people have done historically. So point here being the further you get from the real thing, the more risk there is, I think, to not actually getting the value.

Yeah, and I really hope for our listeners too, like I think you deserve a shout out to be able to turn down the noise on other people dictating what you should be doing and having the courage to just tune into what you know to be inherently true for your body. And how you feel. And maybe one day it is a really hard hit workout and another day it's simply a walk with a friend or a dog. And just understanding that the value can be equal on your body if it's what your body actually needs. I really hope that the future of medicine is about acknowledging that whether we're calling it nervous system regulation or optimizing the terrain of our body, or just bringing our body back into coherence. I think it's this coherence that state that we need to feel first in order for all the other modalities to eventually work. And food is very important. But I just think the way that we've built up our food system and the world of processed food and what we're calling healthy food is our ancestors wouldn't recognize that at all. It's not even real food. So it's not food.

We are. I'll just kind of shout out to the research team that I'm working with here because one of the things that we're doing at this company, Big Bold Health, that I'm a member of, is that we're trying to actually understand what is in our food. And why does it matter that we eat real food as opposed to just assuming like there's a nutrient in it that matters. We're doing, we're actually in the process right now and putting together what I think will be one of the largest kind of randomized trials ever done on a food. And we're looking at this plant called Himalayan tarbery Buckwheat.

Yeah, I was gonna say you're part of this. That's great.

Yeah, we've been, we've been studying it for about five years, but it's been, it's been basically eaten for like 3,000, 4,000 years. And the idea here being, you know, it's one thing to say food is medicine. A lot of people talk about that, hey, great, so certain foods are better than other foods. But then why. And so there's a lot of pushback, some of it quite valid, which is, you know, to not over index towards saying, oh, we just eat some blueberries and it cures everything healthy. But we need some science behind it. It can't just be. There's antioxidants, more antioxidants are better. Because that's actually not been the case. When they study high dose antioxidants, people have worse issues. So we're trying to do what I believe again will be one of the largest analyses ever done on a specific plant to better understand what does it do in real humans compared to a placebo? Looking at hundreds, thousands actually of different markers cross metabolism of the immune system. Because the reality of it is, you know, we live in these silos where one group of people would say, food is everything. You know, don't touch a pharmaceutical. It's all about food. And then the other group of people would say, it's all about drugs. If you want to change your diet, great, but it's not really going to make much of a difference. That's conventional medicine. All my doctor friends would say, yeah, you should eat less processed foods. But the reality is nobody's going to make the change, so we'll just give you the drug. And I think the bridge here is to say what's actually in a food. You know, how do we understand the specifics beyond just the macronutrients, the micronutrients of what is in a food and how it changes us? And as that kind of magic is allowed to percolate out into the world, I hope it will dissolve some of this artificial boundary with the idea that, like, it's only drugs or it's only nutrition. Because the reality is that a food is packed full of all these different molecules, this kind of dark matter of food that we're only just starting to understand. But that's why a single nutrient from a food is different from eating the food in its natural state. And I think it's so fundamental to this whole field of nutrition to actually get the data that we're not just saying, well, our ancestors ate the food, therefore it's good. We need to be able to test modern science.

Oh, yeah. Shout out to Big Bold Health that tartery buckwheat flour makes really yummy pancakes that my kids absolutely love.

Awesome.

I love that you're part of that. And I love, I want to stay tuned on that. And something that you just said, give me goosebumps. So the food that we're consuming is actually changing who we are. It's not just physically, but it's emotionally and cognitively too. Like, it becomes us. So with that consumption, can you share more about what the science is, is showing? Like, to your point, we keep hearing about ultra processed foods and we know that they're toxic. But for an everyday person, we see these foods being sold everywhere, globally. So there's already a sense of trust in what the government is putting out for us. Well, it can't be that bad. So for people, can you paint a picture of what happens physiologically for people who can't see what it does to our guts and to our brain.

Yeah, I think. I think this gets to a point that we already have talked about a little bit, which is this perceived disconnect between what happens in the body and what happens in the brain, where it's, you know, I've got my brain, I've got me, I've got my identity, and that's separate from the food that I eat or how I experience today, that the version of me that wakes up today is the same me that wakes up tomorrow. And that's just not how biology works. But the problem is because our perceived seed of ego and identity is in the head, in the. In the brain with what some people would call the mind. That we. We have this. That. That is a static thing, and everything else happens external to that, but clearly it changes, right? Like, if you wake up some days, you're feeling more optimistic or more excited about the day. Other days maybe you're feeling more sad or just more generally low energy. And so sometimes we have a sense as to why that might be the case. You know, goes out and drinks a ton of alcohol, and they wake up the next day and they feel hungover. They'll say, oh, it's because I drank the alcohol. So they'll make this connection, which was, I ingested a bunch of poison and now my brain, you're having to process it. Interestingly enough, levels of hangover, the subjective feeling of hangover correlates directly with levels of inflammation in the blood. So that's a great connection, which is I'm feeling off. I'm not feeling super great about the day. It's actually inflammation driving that. So we have these kind of specific examples where a person, let's say hungover or person's really hungry, where they feel like, oh, I'm hangry because I haven't eaten anything today, where we start to make those connections. But if you follow that thread all the way to the start, what you recognize is that your brain and everything it does is a function of what we consume. Meaning in our brain, which are mostly fat, if you were to strip out the water, that fat has to come from somewhere. And because our brain cells, one of the most common fats is actually an omega 3 fat called docosahexaenoic acid, or DHA. And that is something really can't synthesize in high amounts in our bodies, it has to kind of come from diet. We need at least the precursor epa, but also DHA from our diet. So we say, okay, well, structurally, our brains are made from our food. So is it true that different foods have different effects on how our brains are built? And therefore would that have an effect on how we think, act and feel? The answer is yeah, like if you were to deprive somebody of key nutrients, their brain health would drop off dramatically. There are deficiencies, for example, vitamin B1, where a person who is at prime with vitamin B1 will develop altered mental state. And these are scenarios basically in which we say clearly certain nutrients program and build our brains to where they're more or less functional. So to put this into context that I think people can understand, it's why am I thinking and feeling the way that I am? Just ask the question, right? What are the answers a person's going to give? Well, it's sunny out, so I'm happy or I just got a promotion at work, so I'm, I'm happy or I watched some sad news, so I'm sad. But really what you're experiencing is the biological output of your brain state overlaid with inputs. And we have agency over what inputs we're putting in. So there's a reason why people who consume a certain dietary pattern like a Mediterranean diet, are at a lower risk of developing depression and dementia because they're building and programming their brain towards a better state. What I find really interesting, and I wrote an article about it recently, is is it possible that our personality traits can be influenced by things that we consume? So thinking about, you know, open mindedness, conscientiousness, extroversion, agreeableness, neurotic, the big five personality traits, there's now some data suggesting that the microbiome and the food that we eat can change some of these traits. We already have data, for example, with ingestion of psilocybin showing more kind of open mindedness. And if that's what it means, is that what we eat is capable of fundamentally altering what we define as ourself. Right? So then it's maybe it does matter a little bit more not just about eating the right nutrients, but paying attention to where are these plants coming from? Where are these animals coming from? Because the next step, if you keep going down this rabbit hole, is to know that the quality of the food we eat is a reflection of the quality of what our food ate. Meaning if you eat an animal protein, how did that animal live? Do they live well? What nutrients were in the animal? If you eat a plant, what was the soil like that the plant lived in? Because the actual nutrient transfer from the soil to the plant to the animal, to the Human may actually have a lot more to do with our own health than just saying, I ate some kale or I ate a piece of steak. There's this data transfer between systems that's actually reprogramming us. And so this gets me to one last point, and then I'll stop this.

Kind of, yeah, no, this is great.

We are a reflection of what we consume, and we're not separate from nature. It's not like you can take a human and they can thrive in isolation. We talked earlier about, we need the connection. But also, if you're not eating plants that are healthy plants, you're not as healthy of a person. If you're not eating animals that are healthy animals, you're not as healthy as a person. It turns out that one of the reasons for this, because there are these tiny molecules within our food that program the immune system at a relative state of inflammation. And because that has an effect on mental health, on brain health, it becomes a whole lot more relevant to think about how the entire ecosystem is wrapped together. So, like, our health is planetary health. They aren't these separate themes. As much as people want to create an extract with exact levels of all of the vitamins, you know, the green drink, where you're going to get exactly what you need so you can be healthy, the real conversation is there's no human health without planetary health. So eventually, the scenario where everything is interconnected, what we define as our own identity, doesn't end where our skin ends, right? Because it also incorporates the microbiome, if incorporates the microbiome, some of which comes from our foods, microbiome that incorporates the soil health. So the bottom line here is it is all interconnected. Food is a major driver of what makes us who we are. And we change day to day depending.

On what we consume and what freedom is there in that understanding. We change day to day. Because I feel like often when we think about anything to do with the brain, it's about routine and structure and finding something that works and doing that habitually. And then we figure out what works with for us and we stick with it. But when we look at that connection, the beautiful connection to nature that you painted, nature's always changing and evolving. And when I'm working with my clients, I'm helping them understand the information that comes from food, even at different times of the year, that's designed to help our immune system thrive and communicate to our gut microbiome in a different way. Like if, if we could just paint that picture for people to understand. Like the Awe, that could come when you're choosing the foods to eat instead of distraction, of survival. And then you take on so much more ownership for what you're consuming. And I think that it's that connection that is everything. So I really love that you're owning in on that and I also love that you're. And this is exactly what I love. For this podcast, you're merging science with another concept in Ayurveda, which is about understanding the seasons and when we think about consumption and specific ingredients for our bodies and how personalized they should be and can be, and the fact that you can kind of validify it with science. There's a concept of eating sattvic food, so foods that are high in vibration and high in energy, that are grown in the sun, access to air and water, and the prana, the energy from that, the life force energy that then gets digested within our body. And you do feel the difference. And my hope is that for listeners, you go away and this could be on vacation, a healthy vacation, when there's no alcohol, but you're having these high pranic, high vibrational inputs for your body, and then you feel the difference. And the second you feel that difference, that's the driver for change.

I totally agree with that. You have to feel something. And I think that's where we've lost a lot of the drive in modern medicine. It's just this sterile thing, which is do this and it's going to fix your issues. I mean, we know, for example, that the placebo effect is huge, that if you get something that has no real reason to have a value for them in terms of the biology, that a huge percentage of people will still get better because they feel like they're consuming something that is of value to their health. They have this sense, and I think it can't be, you know, how important this whole thing is. We need to be tethered to something that connects us to this bigger picture and feel that what we're doing makes sense for our health. There's correlates to what you're describing that I'm a big fan of, which is the reasons why nature exposure time in nature matters for health. There's a lot of research around this, primarily out of Japan, where they've been studying forest bathing or Shinran yoku, but some of it in the States. And one of the things that's emerged from this is not only do people in hospitals get better if they have windows facing nature faster than people who don't have that exposure so there's something about nature there. But when you take people and put them outside, it changes the way their brains function. So it changes the way they think. It changes the activation of this default mode network. And one of the studies that I really love is how basically being exposed to awe inspiring nature instills in people pro social behavior. It connects them more with other people and with nature. And I think that's, that's what for me a lot of the science has brought up. I mean science is cool just because it's great to learn new things. But if you pick any field of modern science now, whether you go into the brain or the microbiome or the immune system, what you recognize is if you get deep enough into it, it's just this whole universe of complexity and amazing insights, many of which we still have to fully parse out. And then you start to say, well, I have my problems, things are wrong and all the other things are not necessarily going exactly the way I want to in life. But there is something bigger there, there's something that connects us all. And I think one of just, I guess this is more of a psychological concept. This isn't going, this isn't a medical degree piece of information. But one of the things that feels like it's really true now is the extent to which everyone senses that they're on their own trying to succeed on their own and at the expense of other people. So if one person succeeds, another person has to fail. And, and I think that this concept is actually so detrimental because what it does is it puts us all into our own little silos of defining what success is in life. And as I we've been talking about this a lot. The thing that provides value and the thing that provides context for all that we do is a sense of connection to scale. And you know, I'm not you're advocating for religion or spirituality necessarily, but one of the things that gives us is a sense of connection to something bigger than ourselves. And you can get this if you look outside at night and it's dark and you see the stars. It's hard not to kind of put all of our issues into perspective. But I think this is a huge issue that's come up where we over focus on the number of likes on a photo, the amount of money that we're making. Not to say that these things don't matter. I guess the likes on the photo doesn't, but the amount of money can matter. But the why of the whole thing, like why are we doing this at all? Right. Is it to get the new car? Is it to get the bigger house? And the connection piece, I think is something that is kind of progressively being lost, which is there's something more than just our own, you know, self achievement. Because that is literally the only thing that I ever see on LinkedIn or on Instagram or in forums or all these other publications. It's all look at what this person did. And they're so much better for doing it on their own without any help. It's like, that's not the goal. There's this proverb I'll just close this out with, which is, if you basket, go alone. If you want to go far, go together. And I feel like that's kind of the piece of this whole thing, which is we've got to find a way to reconnect some of this deeper stuff. Otherwise it's everyone just spiraling out of control and isolation.

That is so well said. These are such overlooked contributors to poor health, but also a sense of unhappiness and even the loneliness that you mentioned and the connection to mortality. And when we think back, when I think about the people that I've worked with, I can see there's a transition that happens from healing and what they need to do to heal. Every single day becomes. And it feels like this incredibly, you know, it's a place of solitude and this selfish journey where we're all on our own, we're all suffering, we're all trying to figure it out. It feels really, really hard. And we're just, we're void of that sense of what we used to do, which was the living outside in nature, nature being part of us, reliant on nature, but also in community where we did things to together. And I think, I love hearing this from you also because when we're showcasing that as a proponent for healing and optimal brain function also for future.

We'Re.

Keeping this truth alive, a sense of wisdom alive that needs to be part of the conversation with modern medicine. So thank you for doing that. And I think that this also ties into a point that you brought up with psilocybin and plant medicine, right, in terms of rejuvenation for the brain. But I think the reason why it's also catching on for so many people is when we experience, hopefully with, you know, with a practitioner, with guidance, with somebody who's working with you on coaching and integration afterwards. I, you know, I think a lot of people are jumping on this bandwagon without understanding the full truth. But what I think that's Happening in these moments, and whether it be with ketamine therapy or with psilocybin, and you can maybe put a scientific lens on this, but we pull out of our mind, we pull back from the limitations of our intellectual brain. And it's like the reminder of the awe and the wonder that exists beyond us. And I think that it feels so good to remember what that feels like. And even me talking about it right now, it's like, oh, it just turns down the noise of all the suffering and the congestion that I feel every single day and thinking about what I need to do and the stresses of. Of the world and anxiety and life and living. But do you think that plant medicine is going to be a big part of the future when we're thinking about brain health and rejuvenation also for the future when it comes to aging?

I hope so. And I mean, clearly it's been part of our past for thousands of years. It's been a central part of ceremonies across the world for rituals and for mental health. It's the irony of all of a sudden, we discovered these things in the last couple of decades. No, we did not been around for a long time. But I think based on the research that I'm aware of, and I'm actually involved with a group doing some work on ayahuasca right now, and looking at the influence on epigenetics, the microbiome, and the immune system, I think a couple. One is the current solutions to mental health are woefully inadequate. They just. They're nowhere near good enough. And part of this is because as much as there are people who benefit from a targeted medication like a tricyclic antidepressant or an SNRI or an ssri, that the issue isn't that the neurochemistry gets out of wonk or gets out of whack for most people, it's not like you were doing great and then randomly your serotonin levels got a little bit out of whack. And therefore the solution is to take this medication. There is something about our world that leads to hundreds of millions of people feeling depressed. And you could say, okay, that's just environmental. You know, people have. Have bad jobs. People are stressed about the news. And even that, we could say, well, then we should do something about the way that we interface with the world. But the thing about psychedelics that excites me most is that nothing else, no pharmaceutical provides perspective in the way that these molecules do. I think there is still some significant resistance because of concern for side effects. What I would say is, I mean, this isn't an exact admission that we should be using more psychedelics, but it is saying that based on the available research and the degree to which value could be created from more wide scale adoption of psychedelics versus side effect risk, I think it's a no here that we should be far more willing to take some of these risks because there is a huge opportunity cost to allowing hundreds of millions of people to continue to experience poor mental health without providing them with solutions. So what happens in the brain with psychedelics? It's a little bit different if you look at ketamine and associated anesthetic versus psilocybin, which is all kind of based around a DMT molecule, similar to what you would see in other kind of classic psychedelics. So partially in Ayahuasca but also in lsd, what you have with the psychedelics that are these classic psychedelics, these tryptamines, is in essence a major perspective shift that seems to occur in part by quieting the default mode network, which is the part of the brain that is responsible for remediation, just playing stuff over time and time again. And I think what is so valuable about psychedelics compared to almost everything else is that talk therapy, all these other modalities, you slowly get to a new state of understanding. Maybe there are breakthroughs, but it's more just, you know, the nudges towards a more homeostatic place where you're better able to deal with the world. With psychedelics you see in real time how distorted your view of the world is relative to what is true. And I think for people who have used psychedelics, maybe they can agree or not, but I think it is. There is, there are truths that are exposed that you don't doubt. It's just this is reality. And then you come back to a world in which, you know, you've convinced yourself that that doesn't matter and that what really matters is a social media post. Even though with the influence of psychedelics you would recognize how trivial all that is now beautiful the world is. And I think really what happens is in order for us to function in the modern world, we're not capable of handling the amount of data that psychedelics give us. Like we have to be super narrow and our brains in essence create a reality that works with the constraints of what this world requires. It creates a reality where it's normal to care to the extent that we care about, like what car do we drive? Or to, you know, it's normal to be stressed 247 about the news because obviously everybody else is, and so we should be too. And if you really question it at all, it's hard to move forward with anything. It's like, I don't want to spend my time concerned about these things. I want to just be out in nature. I want to be connected to the people I care about. So I think more of that would absolutely benefit society. The question is, how do you do it in a way that preserves safety and doesn't lead to a similar scenario as to what happened a couple of decades ago where psychedelics were criminalized because there was concern about something. Not exactly sure, but something.

I really hope it goes in that direction also. I think it's a modality that can be really powerful when done correctly. And I love the picture that you painted. And I can speak from experience, too. Whenever I've done psilocybin with guidance. Do you know what truth comes to me every time?

What's that?

It's like this memory of, oh, it's. You are your healer. It's like, oh, I can heal. I can heal myself. I just, I forgot. And I love it. And I'm laughing about it now because it's such a beautiful reminder. And when I remember that, it brings back a joy for life. And I think that in this world of wellness that's so full of doom and gloom, and I wanted to talk about the deep stuff and the symptoms and what you're seeing in research today, because I think the education, again, is what's going to drive people to change. But I think that you've done such a great job, and this is why I adore you as a doctor, for painting the beautiful lens that comes on the other side of all of that and tuning into the sense of connection and trust and intuition. So as we wind things down, you're so great at speaking to high yield investments for everyday living, for your brain health and for your mental health. So for people inspired by this conversation, if you were to think about these daily high yields, what are some of your favorites?

Yeah. And let me preface what I'm about to say by saying you don't have to do all these things. You don't have to do any of these things. You know, these are just things that research would suggest are really valuable. So if your goal is to improve your brain function, I think the most important thing you can do is prioritize your sleep. The reason I say that is because a lot of the things like diet and exercise are things that are going to be Maybe slightly unpleasant for certain people who are not used to it. It. So if you don't exercise, me telling you you should exercise for brain health. It's true that you will be healthier, your brain will function better, but it's not necessarily true that if you are not an exerciser, you're gonna, let's, let's say you're gonna love your routine, right? It takes some time to get into it. Similarly with food, I get the junk food tastes good. So me telling you you should eat a minimally processed diet, you should be using a lot of olive oil, you should be eating only whole grains. You know, you should be eating clean proteins. It's like, yeah, at some point you may get to the point where like if you're like me and you drink something with added sugar, you say, oh, I don't want that, that doesn't make me feel good. But it's not going to happen overnight. But with sleep, you're going to feel better the next day, you're going to think better, you're going to make better decisions. And so I would say of any of the things focusing on getting better sleep tonight, we could talk about some of the steps for that. But I think it's just a great starting point to get your brain on side so you're thinking better, making better choices and that way it'll be easier to do all the other things. Other things I would say here would be poor stress, social media, all these other things. The Test of time is a tool I developed with my dad. So it stands for time restricted, intentional, mindful and enriching. And that means that as you're going about your social media or your digital content exposure, use these principles. So instead of saying I'm going to watch TV for an indefined or undefined amount of time, saying I will give myself 30 minutes to watch the show. It's time restricted, just like you would do for food for I in general.

Beautiful.

It's you choosing the material that you're consuming as opposed to it choosing you, which everyone knows. The scenario where you go on social media and you don't even remember why you're there and you've scrolled for 10 minutes, that is non intentional. The other piece of this is the mindfulness piece. And as we've spoken about news, stressful social media, stressful. Being aware of how you're feeling as you're engaging with the content is what mindful digital consumption is about. And some people would benefit from just setting a timer for like five minutes, goes off Every five minutes. Oh, five minutes in, I'm actually getting really stressed, therefore no longer mindful. And I want to set this aside, but I think that's where the time restricted piece really comes in. And then E is the enriching. And it's basically meaning, am I getting more value from this or is it getting more value from me? We know that social media, that the news TV in general, it's all designed to capture our attention. Usually it's to sell us stuff that we don't want, but also the way it captures our attention is to stress us out. So if you think content was enriching, and let's be Honest, who spends 20 minutes on social media and walks away saying what a good use of time. I've really on the world in a positive way, then that's a indicator test of time is specific to the digital content. One other domain that I've spent a lot of time focused on recently is the air quality piece. Because as I alluded to before.

Next question.

It's missed. I mean, this has been really profound research in the top medical journals around the United States and around the world showing that what we breathe influences our health, it influences inflammation, it alters metabolism. People who breathe more polluted air, gain weight, have more infertility, live shorter lives, have more cardiovascular disease, have more lung issues. If your children, they have developmental issues, they have decreased iq, more violence in school, the list goes on and on. Then you say, well, what do you do about that? Most of us spend the majority of our time indoors. This is a double edged sword, right? So we should be spending more time outside usually. But since we're inside, we can do a lot to improve the quality of our air because that's where we spend the majority of our time. So some high yield tips, which I don't know your listeners, your viewers might not be thrilled with these. Don't use incense in the home.

That's my next question. You're talking to people in LA too. Or we are big fans of Palo Santo and white sage.

That's great, but just know that they're bad for your health. It's like smoking. You can be a fan of cigarettes, but just don't put it in the bucket of saying it's good for you. Here's the thing to be a little bit more specific. You can use incense, you can use Palo santo, you can use anything that smokes, but if you do that, you should just be aware that if you're breathing in the smoke, it's like breathing in a cigarette. Right. It's not good for your.

For sure.

So if you're going to use the incense, use it in a ventilated room, meaning open the windows, run an air purifier. And why is it total outside, not such a big deal. Same thing with like scented candles. Candles in general, I know they're very popular. I would say scented candles are worthy of avoiding completely if you.

Yeah, endocrine disruptors.

Yeah, sort of concern. But the other piece of this is the scents that you're smelling are by and large synthetic. They're not ripe. Most candles are made from paraffin wax, which comes from petroleum. So if you are going to use a candle, I would say the best is beeswax. Beeswax unscented, then soy and then a standard paraffin candle. But if the candle is smoking or sputtering, you'll see sometimes if the wick is too long, it'll be sputtering and it'll be throwing off smoke. These are other things to just consider. You want your wick about level at the top of the candle. So some basics there. And then the last kind of grouping of things I would say to avoid would be air fresheners and cleaning products. Air fresheners for sure. I think cleaning products, there's an actual utility. Most people want to clean their homes. That's great. But air fresheners are packed with synthetic chemicals. And even if you want to say, look, we don't know conclusively if they're bad for us. About a third of people have a significant sensitivity to fragrances. And there's a reason why that is happening. It's because our brains are incredibly sensitive to certain scents. It turns out these air fragrance molecules that are in the plugins and the wicks and all these other things.

Oh yeah, don't get me going part.

Of the aisle in there, you know, in your Safeway or grocery store for air fresheners, I would say there's really none of them that I'm convinced are a good idea. Whether it's the dangly tree that goes into your rearview mirror or the, I won't say the worst, the plug in ones. So definitely remove. And then the last piece of this is when you can optimize ventilation and purification in your home. The basics here would be if you have windows and you're not actively having like a wildfire outside, open your windows, especially while you're cooking. Then in terms of the purification and ventilation inside, if you have a H vac, make sure you're using it. Keeping the fan on circulate and if not, or in addition to that, air purifiers can do a great job of keeping the air clean.

Please mention your science backed air purifier.

Last week. The company is, it's called Lichen Air and I won't go into too many details, but I was just super frustrated because I was reading all of these publications talking about why air purification is so important and all of the purifiers I looked at were just with gimmicky like they didn't perform to the level that was necessary to give the health benefits. So we decided to design one that did all of that. So we built it from, from best specs for HEPA 14. So if you're familiar with HEPA 14 is the highest level and we built it so that it's like industrial levels for cleaning for a larger room, which, you know, we have, I don't know, like five other air purifiers and we've tested them all out. And it doesn't mean that the other ones don't work. It's just that there's this massive gap between what you actually need for purification to get the value and the way that they're mostly being sold. You know, you get like these tiny and they look nice, but they don't actually execute on the need.

So on Instagram I want people to check it out. It's breathe Lichen and your dad put a video up, moving closer to the device with incense. And I gasped because one of the first things I do is an audit of my clients houses going through personal care products and cleaning products and detergents and all of those things. So that was such great awareness. Do you use essential oils? Are you a fan of organic essential oils?

So this is a contentious question, right? There are some data suggesting that various essential oils can actually improve cognition. Lavender for relaxation, rosemary. I would say to be cautious. And the reason I would say that is twofold. One is certain essential oils, even if they're actually safe as an essential oil, can react with molecules in the atmosphere to create additional air pollutants. So like Lemon Descent, which is very popular in cleaning products. And light can actually react with ozone to create formaldehyde, which is a carcinogenic. So this is, this is one consideration. The other thing is again, essential oils, who knows, depending on the brand, how they're actually making it and what the vessel is the vehicle for the essential oils. When you aerosolize these products, you can actually create some significant pollution. So a couple of things I just say on that and one is, I think this is a quality thing. So certain essential oils are far less kind of modified than others. It's just the essential oil and the vehicle, as opposed to a synthetic set of oils. The other one would be, and this is kind of a deep cut, but using purified water. And the reason for that seems to be that when you aerosolize tap water, it actually increases particulate matter quite dramatically. And it hasn't really been studied to the extent that we know exactly what is in that particulate matter. But some of it does seem to be heavy metals and other things that you don't necessarily want in your air. So if you are going to use oils, if we're talking about something like a diffuser, I think going with purified water is important. And again, looking at better essential oils, I do think in the spectrum, while there are certain oils that have been studied and while breathing in some of those sense are good. For example, we know like seed roll, which is an oil that comes from cedar trees, may be calming. One of the reasons why we're outside breathing these molecules and people seem to do better. While that may be good, what does seem to be the case is that we get very quickly into an unregulated space where there's not a lot of insight into what's going into those products. And you are breathing them in. Kind of by definition, if you're smelling something, it means that you're being exposed to the volatile organic compounds in that aura. So I would say a caution here, which would be to be specific, to be working only with essential oils that you trust the brand. And also in the spectrum, I would say simmering herbs and spices on the.

So easy stovetop, probably a lot safer. So much safer. It'll infuse your entire house. And I'm going to add in, grow an herb garden inside your house. The aroma from that will smell amazing. Add some more green plants to your house if something is not safe to ingest. And look at all the cleaning products. My gosh. All the caution labels that are on that, chances are they're probably not safe to use. So I love that you. I think we've gone full spectrum on the consumption aspect and I'm so grateful for that because I think that we have to, instead of just owning in on one area, just understanding, just as you've spoken to today, everything is connected. So thank you so much for your time. I could talk to you for hours and hours. Can you tell me, tell people where to find you?

Yeah. Thank you so much. For the conversation. I'm glad we got to talk about so many things. The places to find me would be if you're interested in the research study would be bigboldhealth.com or@bigbold Health. On social media my website is austin perlmutter.com on social rustin Perlmutter. And then as you mentioned Lichen Air or Breathe Lichen on Social is the new company for air quality. So all places that I spend time and places that I'll be, I'm going to add in.

You have some phenomenal educational content on YouTube also in small bite sized pieces for people. So check them out there also. And in closing, two rapid fire questions. Tell me, what is your favorite ancient healing remedy?

Oh, my favorite ancient healing remedy. I think that's, that's, that's tricky. I mean I guess it's just meditation obviously been around for a couple thousand years. I have a meditation practice every morning. It's not super long, just mindful paying attention to my breath. But it's been definitely one of the most powerful things in terms of a daily practice that helps me to maintain my mental clarity.

Beautiful. And what's something about modern medicine that you're excited about?

A lot of things. A lot of things. I think that's we've covered some of them. I'm really optimistic about what epigenetics represents. Super excited about that. I'm really excited about applying modern medical techniques to understanding mental health conditions and starting to by people based on what type of depression do they have? Not just are you depressed but is this inflammatory, is this metabolic, is this neuroplastic? And then how does that change how we undergo treatment so that people get better outcomes? I think there is a lot of potential around the layering in of AI to that people's health outcomes. With the caveat here, there's a lot of potential downside to what that represents as well. But I think the concept of using large data sets and large language models to help people understand what's really going wrong is amazing. One of my former co residents at Oregon Health and Science University published a paper looking at a comparison between Harvard doctors and ChatGPT, finding that the AI model was better able to diagnose people's symptoms than either the doctors or the doctors plus the AI. And so while it's scary and while there's lots of concern around what AI represents, I think especially for people who have been struggling for a long time and haven't gotten a correct diagnosis, this is an amazing opportunity to leverage technology to create better. So those are a couple of things. I know you asked for one.

No, I love it. And this is where the excitement comes in. Like, I really am excited about the world of science in the future, but you've mentioned so many beautiful, kind of just traditional healing modalities that all of our ancestors practice. And thank you for being the doctor that has the courage to really bridge the science with the soul and translating data in a really comprehensible, tangible way. It's been so great to talk to you today, and I can't wait to have you back. I'm so excited for everything that you're growing and I'm excited to create some content on how to clean up our home. Thank you for that.

Fantastic. Thanks for having me.

Beautiful. Thank you, Dr. Austin.

Of course.

All right. I don't want to stop yet before I say goodbye. I will be in contact. I'm such a fan of your work. If there's anything I can do to support you. My team's going to follow up with all the details and stuff like that for posting and scheduling. So you've got all that, but you've got me as a supporter, so just say the word when there's something that you've got to promote and I'm here.

I so appreciate that it's a great conversation and I appreciate how thoughtful you are around all these topics, so I'm glad we had a chance to connect.