Dhru Purohit Show - Simple and Safe Evidence-Based Ways to Reduce Autism Risk From a Physician and a Father On a Mission

Episode Date: September 10, 2025

This episode is brought to you by BiOptimizers, Birch Living, and Our Place. Autism rates have increased fivefold over the past twenty years. While much remains unknown about how children develop autism, research suggests that the rise in cases may not be explained by increased diagnoses alone. Today’s guest takes us on a deep dive into autism and shares his proposals for reducing these rates. Today on The Dhru Purohit Show, Dhru sits down with Dr. Jeff Zadeh for a deep dive into autism and the research he’s uncovered on key strategies that may reduce the likelihood of a child being diagnosed with autism. While Dr. Jeff acknowledges that much remains unknown about why some children are on the autism spectrum, he highlights the top nutrients and vitamins women should focus on before pregnancy to help lower the risk. From dosages to deficiencies, Dr. Jeff breaks down what the research shows so far. He also shares his personal journey with his son’s diagnosis and what inspired him to begin exploring this topic in depth. Dr. Jeff Zadeh, a board-certified internist with nearly 30 years of experience, founded Dallas Medical Specialists in 2005 and later moved his practice to rural North Texas, where he serves as a hospitalist, trauma director, and emergency physician. After his oldest son was diagnosed with autism, he discovered research suggesting many cases may be preventable through prenatal counseling, yet most physicians were unaware of it. Inspired by this and the work of Dr. David Berger, he wrote Autism Prevention 5 Days a Week to share simple, evidence-based prevention strategies in accessible language. In this episode, Dhru and Dr. Zadeh dive into: Dr. Zadeh’s personal journey with his son’s autism diagnosis (00:55) Dr. Zadeh’s medical background and the challenges of obtaining a diagnosis (8:50) The importance of supplementation before conception (27:32) What to look for in prenatal vitamins (45:27) The 5-day-a-week proposal and the studies behind it (49:55) Maintaining sufficient iron levels in women (1:06:33) Why checking thyroid levels before pregnancy is essential (1:15:21) Environmental toxin exposures affecting pregnancy (1:15:26) The risks of taking Tylenol during pregnancy (1:27:23) The connection between celiac disease and autism (1:31:35) How increasing DHA omega-3 and vitamin D intake may lower the risk of autism (1:35:32) The role of choline in autism prevention (1:51:12) Key factors we should pay attention to (1:54:47) Dr. Zadeh’s reflections as a parent of a child on the autism spectrum (2:00:20) Final thoughts and takeaways (2:07:30) Also mentioned in this episode: Dr. Jeff Zadeh’s Slides Autism Prevention 5 Days a Week Dr. Rhonda Patrick BPA Instagram Post  For more on Dr. Zadeh, follow him on X/Twitter and visit his Website. This episode is brought to you by BiOptimizers, Birch Living, and Our Place. Upgrade your digestion with enzymes! Go to bioptimizers.com/dhru now and enter promo code DHRU to get 15% off any order and free gifts for a limited time. Get 25% off your Birch Living mattress during their Labor Day Extended Sale—just head to birchliving.com/dhru today!  Reduce your toxic load by upgrading your cookware! Go to fromourplace.com today and use promo code DHRU at checkout to receive 10% off any order. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Jeff, welcome to the podcast. Happy to have you here, brother. Thank you for having me here, Drew. I really appreciate it. Today we're having an in-depth and nuanced conversation about the topic of autism, which is probably one of the more polarizing topics to talk about. But as a physician, you've written a book

and you're on the podcast today to talk about things that you've learned from not only having a child, a son, Luke, on the autism spectrum, but also digging into the literature about what parents, especially those that would want to have a kid in the future, should know about things that could be increasing their risk of having a child on the autism spectrum. Along with that, we're going to go into a bunch of other topics and nuances around this subject. But before we get started, is there anything that you want to say about your story and your journey?

Well, yeah, so, you know, my oldest son, Luke, has autism. And I was looking for ways, and he's wonderful. I mean, I love him so much. And so he's just. Yes, yes, yes. I mean, his little brother jumps on his back. Give me a piggyback ride and he does it. He just gets up.

And he's just such, I mean, he'll give you this shirt off his back. I mean, he'll have little treats and he'll just give him to his little brother and sister. If they start crying and they want him, he'll just give him to him. He's such a cool kid. Super heartfelt. Yeah, but I started doing research to see, well, what if we wanted our next kid to have a less, to be, you know, less like that our next kid has autism. And I started doing research on it. And even as a physician, it was really hard to find anything.

And so I finally kind of stumbled across it. My brother helped me actually find a doctor who was doing preconception counseling. And he had written an article back like in 2012. And so that gave me the idea that, well, maybe there is something we could do. He claims the rate of autism in his clinic had gone all the way down to 1 and 400. This is your brother? This is Dr. Brian Berger. Okay.

And my brother had done a little mini internship with him. And so my brother was one who told me about him and said, you know, you should look into this. You know, mostly to help with Luke. But then I went to his website and it was right there. And then watched his videos. And he said, you know, look, I've got it down to 1 in 400, which I was just like, this is amazing. why doesn't everybody know about this? Compared to the national stats, which are a reminder audience again, what are those?

The latest is 1 in 31. So 1 in 31. And I think like in 2012, it was like 1 in 60 and something like that. Yeah, it was 1 in 150 more or less. 2000, it was 1 in 150. Yeah. So every year, every decade or so, it's increasing the rates of autism. It's gone up about fivefold in the last 20 years.

And so this doctor, you were on his website and he was talking about how he primarily works with couples who are in the preconception conception phase. He's actually a pediatrician. Okay. And so he's dealing with kids with autism. And so the parents are coming to him and saying, is there anything you can do for us for our next kid? And so what he told me was he kind of had this idea of like, why don't I do what I'm doing for these kids? Why don't I do the same thing for the mom when she's getting right? ready for pregnancy. And so he wrote an article about what he was doing. He published it in 2012.

It was all references from 2010 and before. And so I read that article. I was like, well, that's interesting. And I started looking more into what he was doing. And I found, wow, there's this huge research base that it started to support what this guy's been doing already for decades. And so I said, this might be real. This, you know, it's not just research. There's a guy actually doing it and getting results. But his last article he had written was back, you know, with 2010 references. I said, well, I think I want to write a book about this and kind of provide the latest research. And, you know, I hadn't seen anything out there. I mean, if you go on the internet even or podcast, there's nothing out there like this. Well, what can we do before we get pregnant to reduce the risk of

having a kid with autism? And the research is just incredible and people just don't know about it. I talked to my friends who are doctors, never heard of it. Yeah. It's just incredible. Yeah. I've even done some episodes on this topic with different experts. I know you've listened to a few of them. Yeah.

And even some of the things that I read about in your book that we're going to be talking about today, I hadn't heard about some of those. Yeah. Now, you know, we'll get into some of those things that are there. And we have a bunch of slides for those that are watching on YouTube. And also on Spotify, we have video as well, too. And we'll link to some of the slides and the studies that you'll be chatting about. but I want to zoom back a little bit.

Remind me again this doctor's name that you went on his website. It's Dr. David Berger. I'm just said Brian Berger. Sorry, that was my lab named in college in med school. So it's Dr. David Berger. And fascinating that you have parents primarily that he's taking care of that already have a child on the spectrum. Yeah.

Who are coming back and want another child. Yeah. And are wanting to know what can we do? Is there anything out there in the evidence space that could decrease the likelihood that our child is on the spectrum? And this is a great opportunity for us to just mention something, which is that all kids are God's kids. All kids are perfect the way they are. And this is not here to say that any child out there is broken. And you said also something very important that as a parent and on top of that being a physician,

your oldest Luke had autism, but you are curious yourself too that you know the stats around autism and it is a spectrum. There are some kids that are super high functional and live largely a normal life. But for the ones that are on the most severe side of the spectrum, middle to severe,

they have shorter lifespans and their lives are tougher as well too. So you wouldn't want that burden to be placed on a kid if there was something that could be potentially done about that. Can you talk about that? as a parent and as a physician? Well, you know, if my mom had done something to give me an extra 10 IQ points, I wouldn't

complain. Is that the difference between a child? I'm just throwing that out. I can't tell you exactly. But if that had happened, I wouldn't have been upset about it. You know, like, sure, that's great. Give me an extra. I got to use those in med school.

And this is very relevant to me because, you know, my wife and I want to start a family one day and hopefully soon. And I want to be paying attention to these. these components. Yeah, and that is something that isn't, I think, widely known, is that there may be things that we can do even before the pregnancy or during the pregnancy that can dramatically lower the rate of autism. And that's something I think people just have never heard about before. Before we get into the first big one that you'll cover here in a second, and we'll jump around a little bit. Just give us a little bit of your occupation. I mentioned.

your physician. What's your background in that space? Yeah. So I'm a internal medicine physician and I did my med school at UT Southwestern in Dallas. I do ER as well and I do hospital work as well and I've done office work. I've done it all. Now mostly ERs are covered by ER doctors, but when I was back in my training, internal medicine where I was in my residency, we did the ER. And so I did a lot of moonlining. I did all my electives in ER so I can do, especially like in a small little town. And so I've kind of gradually moved further and further north from Dallas. And now for the last 10 years, I've been in a small little town north of Dallas, practicing like small town medicine where we see all comers. So I take care of the hospital. I take care of the

ER. So it's just a wonderful little hospital, little town. It's great. Really enjoy it. Every parent's so excited. Yeah. To have their first child. Oh, yeah. Right? Yeah. Oh, yeah. And take us through that process of when did you get a diagnosis or start to notice that maybe some of his behavior or other components that might be related to development were a little bit different. You know, it was our first kid, so we didn't really know what to look for. But even like when he could crawl, he would crawl over to little doorstops that you can unscrew and he would unscrew all the doorstops.

So like in our house, like there's little dents, you know, where the door handle goes. so we didn't get our deposit back on that rental, you know, I didn't even try. But, you know, so even things like that that he was doing at a younger age, maybe we're little signs. He wouldn't really answer to his name as much. But he would look us in the eye. He would smile. But it was finally when we were trying to get him into a preschool,

and they did like a little test before that. The person doing that test said, you know, you might want to get a test for autism. Do you know what they saw or what they felt that they saw? Actually, they didn't even say autism. They said speech. You want to probably get him checked out for his speech. And so then we went to a speech pathologist, and they looked at him and said, hey, he might have autism. And then at that point, we got referred to somebody and they made the diagnosis.

Were you guys noticing anything? Like, did you notice anything with this speech? I mean, not really. Not really. I mean, but it was our first kid. And he, I mean, Luke's different. really social. So, you know, autism spectrum, they say it's a spectrum. Right. Because the kids are so different. The saying is when you've seen one kid with autism, you've seen one kid with autism. Yeah.

Because they're so different. You know, there are kids who are, you know, super smart. You know, Elon Musk, you know, famously has autism, admits he has autism. And then there are kids who are nonverbal. And so it's this huge spectrum. And so Luke is, you know, social and good eye contact and smiles and laugh, so it was kind of hard to pick it up earlier. What do you typically go to like a speech pathologist? It's a child psychologist. Okay. And they do a test called an ADOS, and it's a fairly long test.

And then they'll get reports from the parents and other specialists treating the child. And it's a really long process to do it. And we might get to this a little later. But because of that, it's actually really hard to get your kid diagnosed with autism. even just getting to that point is so hard. Meaning that there's a lot of the long weight? Oh, just the weight. I mean, so just, I can tell you about, you know,

the Dallas-Fort Worth area and Oklahoma City area, I called the university clinics, and they don't even let you leave a message. They said, look, we're so hopelessly backed up. Just forget it. Like, don't, it's not, don't call us, we'll call you. It's just don't call us. We're so busy.

We're so backed up. So we just happened to know somebody who is, a solo practitioner the first time, and then the second time we had to get him, you know, re-diagnosed to, you know, keep his coverage going, it was insurance coverage for all the therapy. And that was really hard again. And it's like you have to like a Noah guy to get your kid in to get him diagnosed. The weights can be like a year or longer, which is tough because the earlier you can have them diagnosed, they've shown the better they'll do. So ideally, you want your kid diagnosed at two and a half years old and get them in with you. And get them in

therapy speech, maybe ABA, occupational therapy, and they've shown they'll actually do better longer term. But you can imagine it takes a year to even get your kid in to get diagnosed. You can imagine how hard it is to try to rapidly developing during that time. Yeah. And so this comes into play, you know, when we talk about the rate of autism being one in 31, I think it's actually much higher. I mean, that's in a world where we can't, you can't even get, I talked to my friend who works in the Dallas County system, he's a pediatrician. And he said, we can't get our kids in. It's in our system.

We're trying to get our kids in to get them diagnosed. We can't even get them in. It's kind of like, imagine trying to get into like a really nice restaurant in Los Angeles that's booked out for a month. You have to know a guy to get in, you know? It's like that. And he's like, I know the guy. And I can't get my patients in. And so they had to develop like a new system where they do like a 15-minute screening first.

And then the kid comes back. If that's positive for like a 30-minute screening and if that's positive, then they go for the bigger test. But a lot of, you know, he takes care of a lot of kind of working class families and they have a hard time coming back three times. So a lot of times the diagnosis gets really delayed, especially in the markets I'm in. That's so tough for parents who are just trying to get their kids help. Oh, yeah. So here in California, so they've got this network called ADDM, the monitoring network, the government does. And there's 16 sites around the country. And that's how we get this one in 31 number. So they have kind of relationships with their local providers and schools, and they can figure out what percentage of kids have autism that way.

And so there's one here in San Diego. There's two in Texas. So the one in San Diego, it's one in 19 kids have autism. It's one in 12.5 boys. But in Laredo, Texas, it's one in 103 kids have autism. The average age of diagnosis in San Diego is three, whereas in Laredo, it's about six. six years old. So what I think is going on is it's not that there's five times more autism in San Diego than the radio. It's just you can't get your kid in, get them diagnosed. This is actually, yeah, this is really interesting because part of the landscape of the conversation around autism

and there's so many things that are there, right? You have people arguing over vaccines. Yes. And at their role in autism, you have people talking about environmental toxins and other things that are out there. And then you also have this sort of, this debate around diagnosis. And like a lot of things, what I'm hearing from you is that it's a little bit in between. And so the debate for the people that are not familiar, there's one group, let's call it sort of like the classic group that feels that, hey, autism, we don't know why it's increasing, but a big part of it seems to be increased awareness and diagnosis, right? Like there's a group that's in that camp that's out there. Which, by the way, the literature definitely shows that it's not just increased diagnosis.

We had Dr. Suzanne Goh from the cortical clinics, Harvard graduate, a big researcher on all things autism. And her team at Harvard, I believe, was one of the first teams that showed that 80% of kids on the autism spectrum have mitochondrial dysfunction. And that was a big breakthrough in terms of our, you know, understanding what plays a role in autism. you know, the autism spectrum and could anything be done about it, which is how her clinics, Kortica, ended up coming. But so one group is saying, hey, this is just because we have an increased awareness. There's more diagnosis. And part of what I'm hearing you saying is that that's actually kind of true.

Maybe not on the national landscape, but there's definitely this regional component where in a place like San Diego, easier to find providers, easier to get into the system, more awareness about that, parents getting seen earlier compared to, you know, the town that you mentioned in Texas. Mm-hmm. Mm-hmm. So there is some element of that aspect. Yeah.

Yeah. Yeah. So, um, right. So there was actually a study done by Dr. Hertz Pichodo. I'm probably mispronouncing her name, so I apologize. Um, but, uh, she did a study from mid-90s, California to mid-2000, the aughts, California. And she found the change in the way we're diagnosing it was responsible for about a third of the increase in autism. So for every extra 100 kids diagnosed with autism, about a third of those

were because of the change in the way we're diagnosing it. And that's the only study that I could actually find. So the other side where people are saying, oh, don't worry about it. It's just, you know, better diagnosing and more awareness. I haven't seen anybody produce a study. Yeah. That says that. And the director of the New Jersey site, Dr. Walter Zerodny, he's got a great quote from the latest ADDM release, he said, like, this is like a bad version of Groundhogs Day. I have to keep saying this over and over again. He's like, it is not just better diagnosing. This is real.

And my point with that comparison between Laredo, Texas and San Diego is that it's probably a lot more like San Diego. Yeah. That if anything. It's actually even more common. It's more than we think. It's more than we think. And it's probably increasing more than anything.

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or have autism. But they also look at the number of four-year-olds is kind of like an early warning sign, kind of like in California. You got those buoys out there way out in the ocean to detect tidal waves coming in. They kind of monitor four-year-olds in the same way to see what's coming in. And it's looking like there's going to be a lot more autism coming in. Wow. Yeah.

Scary. It can be. Yeah. Yeah, it can be. And then I hate to make it even more scary. But unfortunately, the other thing that counters that idea that, oh, this is just, you know, we're just diagnosing subtle kids is about two-thirds of kids who are diagnosed now. They either have intellectual disability defined as IQ-70 or below or borderline intellectual

disability defined as an IQ of 85 or below. So it's two-thirds are intellectual disability or borderline intellectual disability. And that's actually going up. So the number of kids who are not having borderline intellectual disability is actually defining. And then... So not only are we seeing an increase, but the ones that are also getting it on average are much more likely to have the intellectual disability. Yeah, or borderline. Or borderline.

Borderline, yeah. And then the profound autism is kids with autism who are barely verbal or nonverbal. And if they could even test it, the IQ is... is less than 50, that's about a quarter of all cases now. And that has doubled in 16 years. From 2000 to 2016, it doubled. So if that rate keeps going, I mean, you want to talk about scary, by the end of the century, you're looking at most eight-year-old, most kids having severe, profound autism. And these are kids who, they need somebody with them 24-7, they can't really even use the bathroom by themselves. I mean, you know, they call profound autism or severe autism. Heartbreaking.

Yeah. And also not just for the kid. Yeah. But for the families that that love them. I think that yeah. There are some statistics that are out there that having a child that's neurodivergent are on the spectrum, especially if they have a higher rate of disability, intellectual disability, you have increased rates of divorce, just from some loose stuff that I've seen that's out there. Just the strain that it places on families because of how much caretaking this beautiful child needs. Exactly. Which is the right thing.

And then separately, our infrastructure, our school systems, they're not designed for this. Not only they're not designed for it, but they're not. designed for this tidal wave that's come. So it's like it's just overwhelmed the system. So like we talked about getting your kid diagnosed or finding services for your kid, it's hard, especially if you're looking for quality providers. Well, let's take a moment here to come back to the book because there's hope and there's a message inside of the book. And that message is there are evidence-based ideas that are out there that could help us prevent. the likelihood of seeing autism increase in your own families that are listening. And the hope is

that the more this message spreads out there, and I think there's a lot more people that are paying attention that are willing to say that, hey, I'm willing to have a nuanced conversation about this. I'm not here to blame any one thing. Right. You know, we were chatting about it a little bit beforehand, but Dr. Joel Gator, who was on this podcast, you listen to an episode. Yeah. He came on here and he said, listen, I take care of families that have had no vaccines that have kids on the autism spectrum. And then you've had other individuals that have courageously said, people like Dr. Suzanne Go saying, hey, we have to see that there is a mitochondrial component in this that would make some kid, why is that one kid gets autism and another kid doesn't?

Could there be something that's going on with their immune system, their mitochondria that would make this one child more susceptible to something that another child could handle? And that could be therapeutics, that could be a bad diet, that could be, oh, whole host of different things, some stuff that you talk about over here. So the hopeful message is is if we can pay attention to this, raise awareness, ask questions, and push the people that are in powers of research to pay more attention to this, then maybe we can do something about this. That's right. That's right. Yeah. So pretty much from every study I read, the consensus is it's an interplay between genetics and environment. And that's, you know,

So for instance, with identical twins, it's not 100% that they both get autism. So there must be something environmental there. It's anywhere between, you know, 50, 90%, depending on the study. So that kind of made us to realize, well, there must be something else going on. It can't just be genes. And also that wouldn't explain why the increase in rate. Let's go into one of the first ones. And I believe that we also have a slide for this as well, too.

Yeah. But talk about one of the first things that you want parents to be expecting mothers and just individuals who care about this that are listening that want to know about this topic. What's one of the first things that you found that's part of the evidence space of decreasing the likelihood of a child ending up on the autism spectrum? So the flagship proposal from my book, and it's just a proposal. It's not a, I'm not saying people should do this. Everybody should talk to their own doctor. But this is not medical advice. Not medical advice, you know, talk to your own doctor.

But the flagship proposal from the book is taking a prenatal vitamin with methyl folate, not folic acid, but methyl folate, take it five days a week and start it before pregnancy. Ideally, a month or so before pregnancy. But even within like maybe the first day or so of pregnancy, that's the flagship recommendation. And then I can – so that's one that hopefully we'll talk about most of the first. But yeah, go ahead and- Let's tease that apart. Yeah. Because there's a few different layers that are inside of there, right? And actually, I'm going to, I'll give you a quote.

So this isn't coming from me. So I'm going to give you a direct quote from this study that we got here. There's the Boston Birth Cohart Study. So these are Johns Hopkins researchers. This is an NIH-funded study of almost 20 years in the making. And they looked at whether prenatal vitamins taken by the mother from the very start of pregnancy could reduce the rate of autism. And they found amazingly those who were taken at five,

days a week at a 70% reduction in the rate of autism in their kids. That is wild. Amazing. Amazing. Yeah. So prenatal vitamins from the start of pregnancy or even before pregnancy, five days a week, 70% reduction in the rate of autism. And their conclusion in this study, and they're aware of all the other studies that

were out there, it says the results confirm the protective effects of adequate vitamin supplementation from autism spectrum disorder. So I'll say it again with some nuance there. So the results of this study, confirm. They don't use the word suggest or hint or are associated with. They use the word confirm, which is pretty powerful. And it's their word, it's not mine. The protective effects have adequate vitamin supplementation.

And the word adequate is very important there, and we'll cover it later. So a prenatal vitamin, not a regular vitamin, not just folic acid, not just folate. but adequate prenatal vitamin protects against ASD, autism spectrum disorder. So that's their words, which is amazing. This study here, which is on our slide that we're looking at over here, right? Which was published in pediatric perinatal epidemiology. Is the name of the study? I mean, is it the name of the paper?

Yeah. Or the journal, sorry. This was published in 2017. How come there are so many doctors that literally don't. know this information. These days, like many of us, I'm spending more time cooking at home and meal prepping to stay on track with my goals and healthy eating. But there's something most people don't realize. Our cookware could actually be undoing so much of our hard work. Most nonstick pans are loaded with PFAs, the so-called forever chemicals, linked to serious health risks. And here's the scary part.

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Right now, OurPlace is offering my listeners 10% off sitewide. Just go to From Ourplace.com slash Drew and use the code Drew at checkout. With a 100-day risk-free trial, free shipping, and free returns, there's zero downside. Just safer, smarter cooking for you and your family. That's From Ourplace.com slash D-H-R-U and use the code D-H-R-U, Drew. That's me at checkout. myself that all the time because I tell you, I tell you, I mean, I think the nurses are a little nurse's station are sick to me because every doctor, when I change over, ask them, you heard

about this? And they all say, no, I never heard about that. And I've asked, every doctor I know, never heard about it. Every specialist who treats my son, I've asked him, nope, never heard about it. Don't know anything about it. Just amazing. I think part of it is there's no real special interest here. I mean, the entire prenatal vitamin industry is tiny. It's, I think, like, pharmaceutical industry is like 3,000 times the size of the prenatal vitamin industry. So it's just there's nobody really make, I don't know, I mean, this may be a little cynical, but there's nobody really making a lot of money off it. So there's nobody out there pushing it.

There's no special interest out there pushing it. I think that's part of it. And then I think the other part is there was this one study that didn't show benefit. And we can go to that in a little bit later. But so everybody's kind of doing that, well, yes, this study says yes, but on the other hand, And then they go into this one other study that didn't, but it's one study. It's literally one study out of eight major studies. And was that study as long of a study as this one?

You said this one was 20 years? Almost, yeah. So the other study, it's the Danish National Birth Cohort Study. It was published in 2016. And it looked at births in Denmark from 1996 through 2002. And they just looked at folic acid. So they did not. So remember that word adequate vitamin supplementation?

Right. They just looked at folic acid. And they did a little bit multivitamin, but again, not a prenatal. And I can go into that a little bit later too. But and this observation didn't come from me because it was a part that I had trouble getting over too. I was like, gosh, I read this Dana study. I'm like, well, I guess maybe I'm wrong. Maybe there is nothing here, you know. And it was kind of disheartening.

But you really have to look really, you have to really dig in the weeds to find what was going on. And so their neighbors to the north, right across that little straight there, the sound in Sweden, they had a similar study the next year called the Stockholm Youth Cohort, and they found benefit with folic acid multivitamins. And they said, what is going on in Denmark? We've got all these other studies showing benefit, and this one in Denmark doesn't. And what they noticed was the folic acid level was lower, that the women in Denmark in that study were getting lower levels of folic acid.

So in the charge study, in the marble study, these U.S. studies, there was a cutoff of 600 micrograms of folic acid daily. That was the cutoff. And this Danish study didn't reach that cutoff. And so the women in that study were taking, in the folate arm, were taking less than 600. And even that, it was pretty close to 600, but even that was calculated differently than they do with the charge study. It's a little more complicated, but folic acid absorbs a lot better than folate. Right. And so even that critique from the Swedish researchers of the Danish researchers, it looked at all folate sources.

And natural folate just doesn't absorb as well. You think differently. You think it would, but it doesn't. So folate from, you get from eating a Caesar salad or some spinach, it actually doesn't absorb as well as the artificial folic acid. And so that, even that calculation where they got close to 600 was including all the food they're eating. Whereas these charge in marble studies, which the U.S. studies that set 600 as a cutoff, that was a 600 cutoff with just folic acid. So it's even probably lower than what the Swedish observation was.

It's fascinating because there's so much nuance that's there. Yes. And your average physician, who I believe does care a lot and pediatrician, they care so much, you know. Yeah. And sure, there's bad apples in any industry that are there, right? just like in medicine as any other place that's there, but largely people get into medicine because they want to make a difference. And you're seeing so many patients, you're not, you know, there's no representatives from

the prenatal industry showing up at your office, ready to buy you and your staff lunch, wanting to sit down with you to show you about this paper, educate you about how these vitamins work and the difference between this and the Danish study. The doctors can ask questions. They go back and forth. That's what drug reps are. Right. There's nobody doing that inside of this space.

Right. So there's no opportunity to really get that. And then we'll link to the show notes, but there was that there was that big review showing that on average it can take like 12 to like 17 years before the latest science makes its way to the clinical setting. Right. Exactly. And so typically the people that are the champions of this, you hear from functional medicine. doctors, hear from precision medicine doctors, and you also hear from individuals like yourself, whether they're a pediatrician or not, who just are people who care about this because their

own families were impacted by this. Would you say that that's been the number one reason that you've been more open-minded to this topic? Like, were you into health and wellness prior to this? Yeah, yeah. You were a little bit. I went to school up in Santa Cruz. I'm a banana slug. Okay, got it. So you're a little bit of a hippie. Yeah. You're a little bit of a hippie. I go up in Michigan. I live in Texas now, but yeah, I kind of dabbled with that. Okay, great. So there was a little bit of background, but nothing gets you to pay attention to a topic until it is your own family that's impacted by it. I mean, that's what may be just obsessed with it. Yeah, absolutely. Yeah. So let's come back to this because there was a few layers of recommendations. Number one, you said, first of all, so everybody's with us. This is a large study, right? Do you know how many people were part of this study?

It was about that ended up being about a thousand. mother child pairs. That's pretty large comparatively to like the studies that would be out there for that particular type. It was a long study, almost 20 years, right? Reputable group of individuals and researchers behind it. And their key finding, as you mentioned, adequate levels of a prenatal vitamin started as early as somebody could, right? At the beginning of the journey to becoming pregnant. Yeah.

Right? That's right. Yeah, and if I could mention more about that. Please. So there were, there's been some great work done here at UC Davis by Dr. Schmidt. And she wrote both, she was a lead author for both the charge study and the marble study. So these are two similar studies that were done here as well. And in both of those studies, what they showed, they looked at actually each month, whether there was a benefit from taking the prenatal or not.

And so they said, well, okay, how about before pregnancy? Were you taking a prenatal then? And then they compared the women who were taking a prenatal in each month compared to those who weren't. And so they could tell from each month where they got benefit in terms of autism reduction. Well, the benefit disappeared by month two. In other words, it has to be really early. And when we say month one, it's important to know what that means gestational pregnancy age.

Okay? So we don't measure the pregnancy age from the time that actually the woman gets pregnant. So you think that, you know, making the baby would be the most memorable part. But nope, apparently not. It's the actual last menstrual period. So that's what people remember best is the last menstrual period. And so we go from the first day of the last menstrual period before the pregnancy. on average women get pregnant about two weeks after their last, the first day of the last

menstrual period. But so if somebody, let's say, has their first day of their last menstrual period is June 1st, they get pregnant on June 14th. On June 28th, we don't say that they're two weeks pregnant. We say that they're four weeks pregnant. That's the gestational age of their pregnancy. So when you look at these studies and you look at these slides and you say, oh, I've got a month before I start taking my prenatals, I'm good.

It's not a month. It's actually two weeks, technically. And what you see is by month, too, it's almost gone. So my bet is all the benefit comes from people taking it in those first few days or before the pregnant. This is probably why you see so many practitioners recommending to people to start on your prenatals, even while you're just thinking that you might want to get pregnant one day. Yes, exactly. So that is actually the recommendation of the American College of Obstetricians and Gynaecologists

their recommendation is to start a prenatal with folic acid at least one month before trying to get pregnant. So that is kind of the most respected obese society out there, and that's their recommendation as well. And that's partly why. A lot of it's related to spina bifida reduction, but it looks like that's true for autism as well. And so what happens, unfortunately,

what happens is for a lot of women, is they, so very few women are actually doing this. And I think they would if we told them, if they knew they would. And there's actually studies showing this, too. And that's part of the reason why I want to get on your show and spread the message is that what happens all too often is, you know, the woman maybe is trying to get pregnant, maybe, you know, doesn't care, maybe try, maybe not trying, or just trying a little bit. And then they wait until they miss their period. And then maybe a few days more. And then they test and they're pregnant.

And then they start taking the prenatal. Or even they'll wait until they see their period. which often doesn't happen until 8 to 10 weeks of pregnancy. By then it's too late for both spina bifida and it looks like maybe for autism too. And so the idea is to take these prenatals before pregnancy, to start them before pregnancy ideally. That's the idea. And that's probably the single biggest message because the studies show anywhere from maybe

5 to 30 percent, depending on the study of women are taken before pregnancy. taking a prenatable forefront. Such a powerful recommendation. And just that recommendation alone, if that came from like the Surgeon General or somebody that was in a position of power that could also get institutions where you're going to be reaching people

who aren't listening to podcast. Right. Right? And that may be because this is such a, you know, this is going to sound like harsh words or negative words, but I'm not putting any, I'm not putting any blame on the kids themselves, but this is such a burden to society from a sense of if something could be done about it

and we could protect these kids and not have them go through the challenges that they potentially go through. Not everybody does. That could have huge impacts on our society because we're actually helping families protect themselves. I mean, could you imagine a better. scenario, if I told you, hey, Drew, what's the best scenario you could imagine that we could maybe even solve or partially solve this autism crisis? I mean, can you imagine a better one than

this? I mean, they're cheap. I mean, it's like a quarter a day. Maybe on average to get a reasonably good one, they're everywhere. They're, you know, little towns at the Walmart, they've got them. I mean, I couldn't imagine a better scenario or a better option. Even if it made a 5% reduction, 10% reduction. Right. Right. You know, a 25% reduction. Yeah. And again, this is your number one recommendation, has the strongest date on it.

So the likelihood is that if everybody was doing it, it would have a much higher impact in society. And it just probably just goes to show you that at least from what we know, probably through a combination of ancestral diets and not being exposed to as much chemicals or other things that are there. we didn't have as, even though there isn't data from way back in the day, just observationally of what people see who study sort of evolutionary biology, we didn't have the rates of autism back then, right? Back then is when? Is that 200 years, 300 years, 500 years, 500 years, 100 years, 1,000 years, whatever, back then? So we probably were having better diets, right? In some regions, some regions. Less toxins. Less toxins is a big part of it as well, too.

We'll talk about that. And especially in some traditional cultures, you know, things like organ meats and instances or other stuff. Yeah. And we already know that even organic food is less nutrient rich today as it was many years ago because of the soil and how we crop and other things. I mean, there's so many things that are there. But bottom line, this recommendation is very strong and could make a huge, huge impact.

Yeah. And it's already recommended. It's for other reasons, right? I mean, it's recommended to prevent spina bifida mostly. But spina bifida is so rare. It's maybe now it's about, you know, we, since we started enriching our grains with folic acid in 1998, the rate of spina bifida has come way down. I mean, I'm a doctor.

I can't remember the last time I saw a case of spina bifida. It's about 1 in 1700 is the last figure I could find. And so it just doesn't, I mean, it just doesn't scare people. Right. And so it's not enough to, I don't think, to motivate people. Take action. To say, oh, do this because you'll prevent spine. but I think do this and you might prevent autism.

That's huge. I think that is a lot more powerful. So going back to the top, there was a couple of the things inside of your statement that is worth teasing out, right? First one is you were saying that these vitamins are everywhere, you know, your local Walmart, Target, other stuff. Are there good prenatals and like not great prenatals? What should people be looking for?

Like, does everybody move to the adequate level? of nutrients that this study talks about and the right versions of of methylated vitamins that are needed? So this study, this Boston birth cohort study that showed a 70% reduction in women taking prenatals five days a week, not seven, but five. It was just whatever prenatal they could get. And it was mostly indigent patients, mostly Medicaid patients. So it wasn't, you know, these weren't fancy prenatals.

So I think we can do even better than 70%. So I think there are certain ones that may be better than others. But the lesson of that study was just any prenatal is great. But yes, and it's in the book. But methyl folate is only in maybe 15 or 20 percent of the prenatals. More of the higher end ones have that now. So folic acid is actually the artificial man-made version of folate. And methylfolate is the more natural version of that.

And so our bodies can just use it more easily. there are certain people who have problems converting folic acid to the useful version of folate and they can get buildup of harmful folic acid. This study actually showed that as well so that people had higher levels of unmetabolized folic acid. They couldn't metabolize it down to the natural version of folate. They had actually doubled the rate of autism in the kid, the top quartile versus the bottom quartile. Didn't reach statistical significance, but it did for black children, actually.

because the study wasn't big enough for other groups. So a lot of companies now are moving over to methyl folate. So if you go to a health food store, most of those are probably going to have methylfolate rather than folic acid. So I think I do like that idea of having one with methylfolate specifically. And then we'll get into it probably a little later, but I like iron ferris bisclosinate as the iron formulation and preferably a higher dose, like up around 27 if possible.

And then vitamin D, I like it higher than what's standard. I like it more up towards about like 2000 or so. And there's some studies to back that up as well. So those are kind of the general. And then you usually want to pick a prenatal that's got some third-party testing. So they're very lightly regulated. It's kind of funny. I think you can almost label anything of prenatal.

I mean, by custom and tradition, we don't, but they're very lightly regulated by the FDA. And so the FDA doesn't, for instance, test them to make sure they've got, you know, the good stuff in there, the bad stuff out. So you want a company that does that, that actually voluntarily submits to a third party to analyze it, to analyze their prenatal and make sure the good stuff is in there and the bad stuff is. In the book, I can't remember when I went through it. Do you have brands that you recommend that are out there like a list or a place? I do. I don't really recommend any specific. I do.

You kind of want to stay a little bit away from that. Yeah, I don't take any sponsorships. I make my money as a doctor. Totally. So I see patients. This is more about education and awareness. Yeah, I do give some examples, but they're just examples. It's more the general principles.

Principles. But yeah, I do give some specific points as well. And just to get it out the way because, you know, I always like to disclose stuff. I'm an advisor to a company that makes a prenatal. I'm not going to mention it or anything like that, but we've done some past episodes on it. But there's a ton of great ones that are out there. Yeah, right? If you start looking in this space, there's a ton of great ones.

The company I'm advisor to is called Wii Natal. The reason I got excited is that, you know, there's emerging research that also more for the fertility crisis that we're in. That men also need certain things to support sperm health. And that's what got me excited. And I know their founders were running Vita very well. But like you mentioned, there's a ton of great companies. that are out there. And the key is start early,

ideally even just when you're thinking about it. Because the same things that are in a prenatal, the good ones that are out there, the same things that are prenatal are going to be beneficial for a woman's health in general, right? And so there's not going to be any harm to it. Now, one area that you mentioned that I was a little bit confused about,

which was this secondary part, this takeaway from the study, was the component of five days. Right, right. Yeah. So that's the, yeah. So my. My wife is on a prenatal, right?

And it's been taking one for a while. But she just takes it every day, right? What do you want people to know about this topic? And how strong is the research around that? It's not as strong. And I'm on my own saying that five days a week. You won't find that from any other society or anything else. And that's why these are proposals.

And part of it is I'm going to be excited to see what the feedback is on this. Okay, okay. I see what you're going to say. I could slam for all this. So let's talk about the five-day-a-week part. Yeah. So the five-day-a-week part, what it is, so the big one was, this Boston birth cohort study and realize how hard these studies are to do. I mean, this study was

almost 20 years in the making. You have to follow these. You have to follow the mother. And then you have to follow them after the pregnancy. You have to follow the child for up to, you know, seven or eight years. I mean, these studies take a long time. And there's no payoff at the end. There's no pot of gold at the end of the rainbow. There's no patent at the end that somebody's going to make billions of dollars. So these studies are really hard to do and take a long time. So there's not many of them out there. So this one published in 2018, it's the only one that I could find that really looked at this question, and they said, gosh, there's five days a week. They're doing much better. So it was seven days a week. There's about a 30% reduction or so in the rate of autism for those women. But then again,

from there, there was another 50% reduction by doing five days a week versus the seven days a week. And what it looks like, what they noticed in the study was, is that, so I'm going to go off in a little detour here. So the word vitamin, the first time it was used was in 1912 by a Polish scientist named Casimir Funk, which is like the greatest name ever. But, and he called it vitamin. And he thought that there are amines and all the vitamins. Because the first one discovered was B1, which is thiamine, thiamine. So we called it vital amines, you know, Vita, life, amines, these carbon nitrogen combinations. And so he called it vital amies or vitamins.

That was in 1912, and it stuck. It was then shortened to vitamin. Well, the very next year in 1913, there's Gabrielle Bertrand. He's a French biochemist. He noticed that, wait a minute, if we give too much of these micronutrients, that also causes a problem. So too little is bad. You can get deficiencies and illness from that, but also too much.

much is a problem as well. And in what way? What way is the too much a problem? What were they noticing? Well, I can't tell you with Gabriel Bertrand, what he noticed. But I can tell you here in this study, what they noticed was for women who had high levels of B12, it's like a U-shaped curve. So if you look at it where the autism rate is on the Y axis, and on the X axis is the B12

concentration of the mother. it's like a U-shaped curve. So on the left upper U is high rates of autism for those with low B-12. As we get towards average, the B-12 levels go up to that nice middle sweet spot, and the rates of autism come down, the bottom of the U. But as we get up towards 80th, 90th percentile, that rates of autism go back up again. And so it's like a U-shaped curve.

And they showed this in a follow-up. They showed this here in the Boston Birth Cohort Study, And then there was a group from Finland that followed it up. And they've done some amazing things. They actually bank the blood from all the women there in these studies. And they hold on to it and then go back and look at it years later. Wow. So, yeah.

So anyway, they did that in Finland. And they said, you know, we want to check this out. See if this checks out. And sure enough, the same thing. Another U-shaped curve. So that the too high of B-12 was also a problem. And same thing with folate. So they saw that in the Boston Birth cohort study.

and then there was another study which I can go into a little later but same kind of thing so it looks like that that this bertrand rule they call it for micronutrients seems to be in play and so that's the idea so it won't be harmful to take seven days a week you just might not get all the benefit or the same benefit as doing a five days a week and that's very preliminary so that is yeah from just a few studies but it was so dramatic and we're and it's the I would argue the best we have right now So just like in this study, so a follow-up question I have is it just like in this study, people were not taking the methylated version of folate, right?

They were taking. We don't know what they were taking. Oh, we don't know. They were just taking a- Any kind of pre-neutral. And on average about 15%. And it's usually the higher-end one. So probably it was folic acid. It probably was folic acid.

Yeah. So the researchers noticed that having two high levels of folic acid came with some problems, including this problem that you're not getting as strong of a benefit. But in that same way, B-12, most of the B-12, that's, on the market is cyanacobalamine, right? Yeah. It's not methalacabalamine, right? Methylated version of B12.

Right. Could there be a similar thing going on that the non-methalated versions of these vitamins are causing some sort of reaction or that people are also getting them from, I don't know what other foods would be having B12 inside of them? Typically not a lot of foods have it. Maybe meat has it. That's why a lot of vegans take B12. or if it's added to different things.

But is there anything that you know or maybe could think that the methylated version, the non-methalated version of these vitamins, which is not as easy absorbed to the body, could be a part of this equation? So really just for methylfolate is the only one that I've seen, where it makes, where they've shown that there may be a difference. But yeah, I mean, I like the methylated version of Cobalamin better as well.

So most of the ones that have methylfolate, those prenails they generally have methyl cobalment as well. Yeah. Yeah, which is, again, the higher end of the spectrum. Yeah. Probably not something that if you look at the general population, they're not taking that. So you're- Although you can get them now.

You can get them now. They can even- But this being a 20-year study that finished in 2017, probably less likely for that. That's right, yeah. Yeah, one of the nurses that I work with, she's pregnant, and she found some of these at Target. Yeah.

With methylfolate, methylcobalmen, great ones. their target and reasonably priced. So let me make sure that I understand it correctly and for my audience as well, because obviously we don't want to, you know, we want to make sure we get your words accurate that are there and we're not fear mongering or anything else like that, but you're proposing something. This is why we're having you want. Right.

The proposal is that the women, especially in this larger Boston birth cohort study, that did not have these increased over-the-top levels. Do you know how they were measuring it inside the blood? what the numbers were? There's a way you can measure unmetabolized folic acid. It's not a common study that we get clinically,

but there's a way to measure it that they can do for the studies. So sometimes people get blood work done and they see their B12 is really high because B12 isn't a lot of supplements. People take B12. It's in a lot of shake powders

and other things like that. But the theory is that those that were doing the prenatals five days a week, again, this is a preliminary idea proposal that you're putting out there, that one of the reasons that they did better

because they didn't overdo it on some of these nutrients. And that was actually the finish team came up with this birth tranquil idea. It wasn't my concept. But it just, I mean, just as a doctor knowing what I know and, you know, so like B12 and folate, they're water soluble, they're flushed out by the kidneys. We can regulate those pretty. Our bodies can regulate them pretty quickly.

But it just seems like maybe if we give our bodies just a couple of days of a break that we can get back to the balance. and then maybe just taking it every day, it might be harder to regulate it as well. I can imagine, you know, there's a lot of women that are listening to this podcast and the men who love them, you know,

who are helping them, you know, get the right brain needles and beyond there. You know, my wife heard from her OB was like, yeah, take it every day. And yeah, don't, you know, if you miss a day and you're traveling, whatever, that's fine, you know,

but when you can get back on it. Yeah. So generally speaking from knowing a lot of obese and people that are in the space, that's sort of the recommendation that's there. If somebody is hearing this information and feeling like, okay, this, this, this, this, this, this, this, this, this, this, this, this, this, this, this, this, this, this, he cares about his son and has been looking into this. And it's honest about what the research is, what it isn't, what his ideas are. How do I make sense of that?

And, and there's also the fear that if I'm not having it on a regular basis, am I going to, you know, be committed at it? Do people take two days of a break? and then take a third. Right. What do you think people should do with that information besides keeping it in the back of their mind? Should they bring it up with their doctor? You can.

I would definitely take my book if you do because they're going to say, what is you talking about? They're not going to have a clue. Yeah, so this got like no popular press. If anything, what the Los Angeles Times had an article about it, and they were almost like, hey, don't panic. You know, keep taking your prenatals.

You know, even though the higher B-12 had the higher rates of autism then the middle portion of the ones in the sweet spot would be 12. You know, hey, don't panic, keep taking those prenatals. To me, the lesson was taking five days a week. I mean, that was, but you really have to dig into the studies. You really have to dig into the research. I mean, some of these journals are not well read. And so I would say this is just one, this is just me.

I don't have a team of researchers. I don't have a government agency. So, I mean, I would listen to your doctor. I would listen to, you know, what the experts tell you. But this is what I noticed. Yeah. And so I'm proposing it as an idea to kind of stir the pot and see if this could maybe gain some traction. Sure.

But there does seem to be something there. And the more we're looking at it, the more of these studies are coming out, they're saying, yeah, there does. This Bertrand's rule seems to be a real thing. Hmm. And that maybe, you know. And it's called the bird. Bertrand. Bertrand.

Bertrand. Gabriel Bertrand was the French. Yeah. And it's not that high levels of. B12 were, you know, causing autism, right? Obviously, there's not that. It was the suggestion that the most protective benefit happened when the B12 levels weren't at the highest cohort.

Right, right. Yeah, so it wasn't like the seven-day week was worse than the none. Right. It was still better. Seven days a week was still far better than zero. It's just the best benefit came in four, five days a week. Yeah, yeah. And then the other thing to answer there, since this will probably be the highest profile place that I'll have to talk about it, is since we, so one of the ideas would be, oh, well, are we going to have more spina bifida?

Because now they're, if they take it five days a week instead of seven, are they getting less folic acid? We're going to get more spina bifida maybe. And I don't think so. So there's been some studies since we started fortifying our grains with folic acid. it's actually been shown that these supplements don't make that much of it even anymore. So we're kind of getting enough just through our grains. And so the studies that have looked at it showed there actually wasn't much benefit for spina bifida intake and a prenatal over just eating a regular diet.

Amazing. Yeah. Anything else you want to say about prenatal before we go to the next one? So just one more thing is that there actually was another really recent study that came out from China in 2024, lead author Zhang, same thing, 65% benefit. It wasn't quite as high of a quality of study. But we're not going to have randomized controlled trials. Those would be unethical at this point since we know, since the Hungarian randomized control trial came out in 1992, showing lower rates of spina bifida and those who took folic acid, prenatal with folic

acid. We can't really do another randomized controlled trial now because we're know there's a benefit. Right. So at this point, all we can do is kind of that next, in the hierarchy of evidence, the randomized control trial for original primary research is the top, but the next one down are what they're called prospective cohort studies. And that's kind of like how we found that smoking causes lung cancer, the British doctor study.

They basically just wrote a letter to all the doctors in Britain in like 1952 saying, hey, do you mind participate in a study? study and about 50,000 replied yes. And they just said, hey, do you smoke? Do you not smoke? And then they followed those doctors going forward. And so there's a lot less biased than that kind of study. It's more expensive. It's more time consuming. But that's kind of the next best thing. We're not forcing people to either take smoke or not smoke or take a prenatal or not take a prenatal so it's not unethical. They're just doing it of their own free will. And that's kind of the next best study we can do. And it's actually the results of that study and another one from the American

Hansa Society as that started rolling in the 1950s that caused all the problems for the tobacco companies. That was the evidence that was coming in that the admin had to deal with, you know. But this is the same kind of study. So it is probably as high qualities we're going to get. I mean, I'm not a research myself. I'm a doctor, but we're trained to read research. I mean, our journals are full of research articles. So as far as I understand it, that's about as good as you're going to get, and then combining them into like a meta-analysis or a systematic review. And then the other thing to keep in mind for people who are maybe doing a meta-analysis

or doing a systematic review, we didn't go over this. But in Norway, what they said for that Norwegian mother-child study, in there they put, they didn't even have prenatal vitamins in Norway at that time. So the modern prenatals that we used for the charge study, for the marble study, they didn't even exist in Norway. So they probably didn't exist in Sweden or Denmark either at that time. So what they said is either got 400 of folic acid, and that was what was recommended.

There was no recommendation for a multivitamin. But every multivitamin on the market in Norway at that time had less than 400 of folic acid. So looking at those Scandinavian studies, just realize those are not prenatal vitamin. So if somebody does do a meta-analysis or systematic review, just keep that in mind. Those are great studies.

They're like these studies. I mean, the Norwegian study was like $45 million just the recruitment phase. I mean, it was a heroic effort, but just realized that those, they weren't taking prenatals. And it still showed a benefit, by the way. The one in Sweden and Norway, there's eight major one, seven of the eight still showed benefit. But just for anybody who thinks to look into it a little more, because what happens is, is so much what I read is, well, on the one hand, it works, but then on the other hand. Right, and that's a sign that they don't know what they're kind of talking about.

There's this Danish study. What's going on? And that's what everybody says. What my message is, at least the way I read it, there's no other hand. There's not another hand. It's just what they said in the Boston Birth cohort. Adequate vitamin supplementation protects from autism spectrum disorder, at least the way I read it. And that's what they said.

So they knew the Danish study was before this study, before the Boston Birth Cohort State. So they were aware when they wrote that of the Danish study. But so much, I think it's the biggest hang up because the charge study came out in 2012, you know, benefit. Again, Norwegian mother child study, 2013, you know, showing a big benefit. And then this Danish study came out in 2016. It just kind of took the winds out of the sale and the whole thing. But since then there have been everyone is shown again, there was study by Levine and Israel.

And then there was this study, the Boston Birth cohort. And then there was the marble study up in UC Day. They're all showing, and then the most recent one from China, they're all showing benefit. But people are still stuck on this Danish study. That's why I'm talking so much about it, even though it seems like I'm probably beating a dead horse. But I think that's heart of the barrier. Yeah. Is it people are just stuck on this one day and it's not one hand.

It threw them off. I think so. It threw them off. It's like on one hand, but on the other hand. Yeah. But there's no other hand. Like at least the way I read it. There's no other hand.

It's just adequate vitamin supplementation works. Yeah. Do you want to make a quick note about maintaining? You kind of mention it, but this is another. recommendation of the book. Maintaining sufficient iron levels. Yeah. Oh, yeah. Yeah, very important. So other than taking prenatals, this is, I think, the second most important thing that I have in the book. So 50% of women in North America, in North American studies, are iron deficient at some point in their pregnancy. Twenty-five percent are severely iron deficient. So usually that just comes from

menstruation. And then now we got a lot more vegans, or maybe not get as much iron. So when we, So iron is mostly in our blood. And so when women menstruate every month, they lose those red blood cells. They lose the iron. It has to be replaced. And so for a lot of women, it's just either they have heavy menstrual periods or they don't get a lot of iron. So iron deficiency and anemia. So eventually iron deficiency leads to anemia.

They're really common. I mean, you know, my brother's joke to me. He's like, I could open a whole practice just treating, you know, women with iron deficiency. Because, you know, they get depressed and cold and fatigued. and they just don't feel well. And if we give them some iron, it's so common. They feel so much better. And this is just with established guidelines.

This isn't even anything that's, this is traditional medicine. So anyway, the idea is if to go into a pregnancy, iron deficient, to me is not a great idea. Because it's going to be hard to make up that extra iron. So the blood volume expands during pregnancy to accommodate the child. so you need even more iron. And then morning sickness hits too. Food aversions. Yeah, about four to six weeks into pregnancy for most women.

So it's really hard to catch up later. So the idea is to try not to go into the pregnancy already kind of in the hole, already down. And so there is, there are guidelines out there. So this one actually I can go and say, hey, there's an international guideline. This is the Figo, which is the, international federation of obstetricians and gynecologists, they do recommend screening for iron deficiency for all women of childbearing age.

Just keep screening them. And it's called a ferretin blood test. It's really cheap, easily available. CBC, same thing, really cheap, really easy to get these. They recommend screening everyone. And certainly, if there's any symptoms of iron deficiency, like fatigue, depression, feeling cold, brittle nails, brittle hair.

It's really easy to get that. And then to catch up on that even before the pregnancy, even IV iron if they have to, to catch up on it with traditional guidelines that are already out there if they need the IV iron. But to catch up on that before the pregnancy, because 50% in pregnancy are iron deficient. And what they've shown is that can lead to higher rates

of intellectual disability, nearly double the rate of intellectual disability. If there's anemia early in the pregnancy, higher rates of autism and higher rates of ADHD. And so it's early in the pregnancy that really matters. That first month. So think about every cell in our body has the same chromosomes. There's 46 chromosomes that has all our genetic material, all our DNA,

23 chromosomes from mom, 23 from dad, the company 23 and me that looks at your heritage. So they all have 46. So what makes us, what makes one cell become an eye cell, versus a kidney cell, or there's a liver cell. Well, it's through what genes get expressed and what genes get suppressed. So the eye, the kidney, the same chromosomes, but there's that differentiation that happens, especially in the very earliest phases of pregnancy.

So it's the most rapid growth and the most differentiation. So it's important to have the right vitamins that can facilitate that. And so folate is part of that. Iron may help give enough energy to facilitate that. So it's really just during that earliest phases of pregnancy. And so in the charge study, in the marble study, I'll keep hearing me say this over again. But these are the ones from UC Davis, Dr. Schmidt,

looking at whether prenatals help. They also looked at iron. And they showed the women taking the higher levels of iron had about half the rate of autism. Wow. compared to the women taking the lower levels of iron. And again, same thing. Like, you hear about people saying pay attention to iron levels, but you don't hear people screaming for the rooftop

about the connection between this and autism. Oh, this one is almost nobody's talking about this one either. Yeah. And okay, so I'm going to go back to the Scandinavian studies again. Yeah. In Sweden, they looked at it too, and they said, oh, but the iron didn't make a difference in the Swedish study. Well, in Sweden at the time, they recommended taking iron from week 20 to week 24.

So it wasn't early enough. It's apples and oranges. It's an apples and orange appearance. But you still see this. Well, on the one hand, these two studies showed a help. But hey, on the other hand, this study said it didn't. So we don't know what to do. We're not going to make recommendations.

But if you really dive into it, the Swedish study was from week 20 to 20. That was when the recommendation was in Sweden to take at that time, was the recommendation would take iron from week 20 to 24. Now, I don't know. The study doesn't say exactly the women taking iron if it was in that range or not, but I would guess it was. Whereas in the marbles and the charge study, the U.S. studies, it was early iron.

They talk about the very early iron that made the difference. So in the first, again, month of pregnancy. And then... And by the way, again, another reminder of, like, so many women don't even know they're pregnant that early. Right. Right. I mean, until they notice they've missed their first period and they start to have suspicions,

but there's a lot of women that have irregular periods in this day and age. So there's also the feeling of like, oh, okay, I sometimes miss a period here and there. So all the reason to start a prenatal, even when you're just thinking about, you know, one day having a kid. Exactly. Yeah, exactly. And then if you, I mean, even if you don't want to do that, I mean, maybe even, you know, have prenatals around. And if you do something that could make a baby, I'm going to stay. G-rated.

My kids will probably watch this at some point, but you do something that could make a baby. You know, I have some pre-nails around and start taking them, you know, in the first day or so. Yeah. Just have them lying around. A quick note,

there are some women because a lot more people are paying attention to their nutrition. A lot of people that listen to this podcast are probably taking different types of supplements or might be eating different foods or paying attention to including certain types of foods. So there are some women. My wife is in this category who's always had really great iron levels.

And if anything has been told by her practitioner, like, hey, don't take a supplemental iron. And in fact, when she first started taking a prenatal, she had to get off of one because her iron levels got too high. Again, this is much less common. And she ended up switching to a prenatal that didn't have irons, right? I think the brand was called Needed. You know, not affiliated with them, but just to give people an example.

So that's a much less thing that's out there. If it would exist, it would probably exist in a community that probably listens to this podcast as my core audience. You're a little healthier. you're paying attention, you're including things like red meat, you're on top of, you know, your nutrition in a lot of categories. But again, going back to the vast majority of the population level data that you talked about, most of those individuals on a whole, a huge percentage of them are dealing with being

anemic or borderline being anemic. Yeah, so that's why I love the recommendation of Figo is just get tested. Get tested. And for ferreton, just screen women of childbearing age with a ferreton every once in a while and just make sure they're on levels. And if they are, you know, off the charts, sure, right? I mean, there's a condition called hemachromatosis where women have or men have really high levels of iron. They wouldn't want to take an iron.

Right. So it's, it's, if you can, the best would be to individualize that. And ACOG now recommends that, actually. They say we should really individualize the prenatal care, even the preconception care. I had a friend that had that. And the treatment was he had to go give blood every so often, right? He didn't know what was going on with him for years. Finally, a doctor that was.

based in LA, Dr. Don to Sylvia, functional medicine doctor, MD from UCLA, I think she was practicing there before before she had her own practice. She discovered that his issue was he had this, he had this what was it called? Hemachromatosis. Hemachromatosis and genetically would just hold

on to iron and needed to give blood every so often to get rid of it. They call it bronze diabetes. Bronze diabetes. Wow. Wow. Okay, so we talked about the importance of a prenatal vitamin. We talked about maintaining appropriate iron levels by primarily getting checked. Here's one that a lot of people don't know about.

And I want you to talk about the research around it. Check thyroid levels before becoming pregnant. About 3% of all women in the U.S. of childbearing age have hypothyroidism. A lot of them don't know that. It can be just very subtle symptoms like fatigue or constipation, cold intolerance or cold all the time, simple things like that. And they can be really subtle. and so they don't even know it.

And yeah, the rates of autism are higher in women who have hypothyroidism. So if we can pick that up early or even before the pregnancy and treat it, there may be a benefit. Now, the research on whether treating it helps is still in the early stages. So it's more like there may be a benefit. We're not sure. But it certainly doesn't hurt to get treatment for hypothyroidism, find it and treat it. That won't hurt anybody. but whether that reduces the rate of autism,

that research is still kind of being done. So not as strong as the first two recommendations, but something to pay attention to. Yeah, I would say, yeah. And especially if somebody, there are people that are out there that have, they're not taking your pre-name up, especially not early enough.

Their iron levels are low. They have thyroid stuff that's going on, but nobody's really addressed it. So it's also the combination of all these, which a lot of people fall into many of these buckets. You have a bunch more. And I would love to just throw it in and chat GPT and say,

how many women would you estimate of childbearing years, right, that want to have a kid one day, would fall into at least 80% of the stuff that you're talking about here. And my guess is it's going to be very high. Yeah, yeah. I mean, I know one woman who wanted to have a kid. And I mean, her her ferretin was six, which is, you know, anything less than 15 is low.

We consider low. That was very low, severely iron efficient. And for vitamin D with 10. which is also very deficient. And that's another one of the recommendations. It's so good that she got it checked ahead of time and got ahead of all that. I mean, it was just great.

As you and your partner were going through this, you know, the mother of your son, and you know, you're both becoming aware of this, right? Besides feeling like you wanted to be an advocate for families that are out there, right? And, you know, we didn't talk about this, but you guys also wanted to have another kid. And I believe you have another boy as well.

We have four total. Yeah, four total. So you have three other kids after Luke. Yeah. And three dogs, because there's just not enough chaos with four kids. You've got to have three dogs. Okay, so three dogs, three kids.

Four kids. Is it said all boys? Our youngest is a girl. Okay, youngest. So two more boys and one girl. Yeah. And again, you know, just because it's part of this conversation, no of those kids have had a diagnosis of autism?

Correct. Yeah. Yeah. And so, you know, an important anecdote to include in part of the conversation. So, but when you and your wife, your partner were going through this and you were learning about this, was there any feeling, and I'm asking you to look, you know, kind of talk about it from a physician standpoint. Were you guys at all feeling that you guys as a couple that, you know, because nobody had educated you about some of these things. Were there any one, two, three, or four that you thought, wow. Me and my wife probably went through this when we were in the, you know, preconception conception phase and maybe they played a role. Yeah. I mean, certainly on the prenatals taking it that early. I mean, I didn't know. We didn't know. So, yeah, I mean, that would be probably the big one.

Yeah, yeah. And the other reason why I also want to bring it up is that just so everybody's clear, like you could be doing all these recommendations right. And we just don't know enough. about what plays a role into autism. But these all have evidence behind it. So the feeling would be that you'd be less likely to be there. But the reason I bring that up is because there's also serious questions,

limited data, but there's more and more that's coming, and hopefully there'll be more that comes in the future. There's serious questions about environmental toxins. I saw Dr. Rhonda Patrick, and I think I shared it with you. I saw Dr. Rhonda Patrick's study that showed that women that had the highest levels of BPA in their bloodstream from one small study. I think it was like less than like 20 women that they had looked at, maybe 50 women. We'll go back and we'll put a link to it.

The highest levels of BPA that primarily were coming from a large consumption of canned foods, canned soup in particular, I think that they were seeing, were much more likely to have a child on the autism spectrum. I sent you this, right? I don't think I, no, I don't think. I'll send it to you afterwards. You can take a look. I've seen studies like that.

It's floated around. People have talked about that. So we have no idea about the role of environmental toxins and the role that they play, right? Forever chemicals that might be there. And your podcast on microplastics and glass bottles just killed me. I was like, Chimotham, and that was like, oh, come on. The glass bottles too have microplastic. It's like, really?

Well, the good news, for anybody that's not familiar with that, I dissected a study that I looked at with my team. It was a French study. that looked at a bunch of different beverages. They looked at water, both in glass bottles and plastic. And they looked at soda in plastic and glass. They looked at beer in plastic and glass. And they looked at wine in glass. So they looked at cans.

They looked at plastic. They looked at bottles. And the headlines that sort of took over on the New York Post and everywhere else was glass bottles have, I think it was four to five times more microplast plastics than plastic. But even... I just killed me. But when you dig into it and this is why it was important to do the podcast, that

that water still had the lowest levels of microplastics out of all of the different beverages that were looked at. The other thing that was buried in the study was the plastic was coming from the painted lids. So, you know, if you have like... That one little part, that one little piece that's not glass. If you have a glass bottle, you know, lid on top of plastic. and it's painted, they were finding the same color paint chips that were inside of it.

Right, yeah. But the biggest concern was, you know, that's just looking at microplastics, but we know that plastic bottles of all beverages that are out there, soda, as other things, water, is it, they have bisphenols. They have forever chemicals, you know, microplastics are one thing, but on average, I'm still drinking water out of glass when I'm out and about, and that's what we have in our office. Yeah.

Because, sure, it might have a couple more particulates of microplastics compared to plastic, but plastic has all this other exposure that's out there that we know that is an issue. But anyways, I was going on a tangent to say that I asked you about your kids. You had had three more kids since Luke and using the education that was there. I'm sure you probably had the prenatal early for those. No, I wish I could probably sell my book a lot better if I said, I figured this. I want the honest truth. Yeah, but I know.

I want the honest truth. The honest is no. Okay. I mean, I knew a few things. Like on Tylenol, I knew a few things like that. But this, I didn't, until I had this conversation with my brother and looked at Dr. David Berger's website. Which was after all your kids were born.

Yeah. Okay. So just because I know the audience is asking this and I'm trying to make sure I ask it in the most sensitive way that's there, right? But we're having an honest conversation. So you learned about most of this, if not all of it, after. Generally, you guys are a healthier. you know, couple, and you mentioned your background and living in Santa Cruz and everything

like that. So you can't point to anything specific that you feel anecdotally is the reason that you didn't have any more kids on the autism spectrum. I mean, the only thing really was, was kind of, and we can talk about later, but just avoiding a lot of Tylenol. Avoiding a lot of Tylenol. But that was the only thing that we did in the last few that I knew about. Yeah. So, and the reason I'm bringing it up is it doesn't take away from any of the evidence space that you have there. I'm adding to the fact that there's so much more of the conversation, you know, that we're still learning about.

And environmental exposure is one of those that still needs a lot more research that's there. So the ones on that that I find the most exciting, and I sent one of them to you, it was called the Murek study. And they showed that women, it was done in Canada. It was on one of the supplement ones I sent to you at the very end. And what they showed that women with higher levels of lead in their blood during pregnancy, had higher rates of autism in their children. I saw this study.

This was published in JAMA, right? No, sorry. Jamma. Okay, okay. But not if they took folate. Interesting. So the folate seemed to detoxify the baby's brain from the lead. Wow.

There seems to be a protective benefit from adequate levels of folate inside of the diet. Going back to your first point about having, you know, know, prenatals and starting them early when it comes to protecting from things like environmental exposure of lead. Yeah. So there aren't a lot of these studies that are very difficult to do. But this one I found really exciting. And there's three more.

But basically higher levels of lead in the woman's blood while she's pregnant, higher rates of autism with child, but not if she's taking folate. The folate broke that relationship. So it didn't matter. If they had higher levels of lead, didn't matter. The rate didn't go up if they were taking prenatal folate. And kind of go along with what I talked about with Bertrand's rule, only were if they're in that middle sweet spot on the folate. And this study was from the 10th to the 80th percentile on the folate.

So for those in that kind of middle range. Yeah. With their folate levels, it broke that relationship between higher lead and higher rates of autism. And the other studies that were been done mostly through, well, I think it's Dr. Schmidt's lab at UC Davis. They did the same for air pollution, nitrogen dioxide. They did the same for pesticides. Same thing. Prenatal folate seemed to protect against those things.

So it was lead and thalates. Lead, thalates, pesticides, and air pollution. So those studies are fascinating to me. So it doesn't prove that's what causes autism. Right, right. That's one study. But even though it's preliminary, that was fascinating to me. And the theory they put forth in the Murek study was that folate seemed to be involved in repairing DNA

and lead seems to be in can damage DNA. So it's kind of like this folate acts is almost like a shield kind of protecting the baby's brain. So it's almost like there's little arrows from the environment that those are harder to control for us. But that folate, that prenatal vitamin, the iron, the vitamin D, that acts is almost like a shield. And that we can control. or at least it's easier for us to control. Yeah. And so that, those studies to me were fascinating.

Super fascinating. I want to come back to one other point, you know, that you mentioned at the beginning of the conversation. There's this interplay between genetics and our environment. Right. Right. And I think what I was getting to is that there's more and more that's being known now that individuals like you are talking about the evidence base that exist out there.

There is more that is a cause for. for concern. We just talked about it, the environmental toxins being something, but it's limited research and hopefully it'll be growing research that goes into that category in relationship to autism. And then like all things in life, there's a genetic component too. Right. Right. There's a genetic component. So that could have been a factor for you, for other families that are there. But as you mentioned as well, these are all layers that are important parts of the conversation is that genetics alone does not explain the population level increase that we're seeing. Right.

Yeah, I would say that's right. Yeah. You know, you mentioned it a couple of times, and it's the next one on our list. Tynanol, what do you want people to know about tynol and treating fever during pregnancy and the relationship between those things? Okay, yeah. So in the charge study and in the Norwegian mother child study, these large studies that were done looking at things that happened during pregnancy and then the rates of autism later in the child, in those two large studies, they found that women who had fever had higher rates of autism in their children. And the idea is that there's this inflammation that comes from the fever, that inflammation may just kind of harm the brain as it's forming.

And it can be even as low in the Norwegian mother child study, it was as low as 99 degrees Fahrenheit. So even just the mildest fever could lead to higher rates of autism. And then even the more fevers the women got, the more likely they were to have a child with autism. And what they showed, though, especially in the charge study, was that if the woman took something to bring that fever down, then the rate of autism was about the same as that they had never had a fever. So Tylenol or sometimes they took other things too in these studies. So in that case, taking the Tylenol for someone who had a fever, that was, I mean, just putting simply a good thing, right?

But there are a lot of other studies that show a lot of Tylenol, taking too much Tylenol may increase the rate of autism. in the child, maybe. And that's controversial. The ACOG doesn't really believe in that. There was a later study in JAMA, sibling-controlled analysis that showed there wasn't any relationship between Tylenol and autism, Tylenol during pregnancy and autism later.

But there are a lot of studies that show that there was. And so I like what ACOG's position is, which is just, you know, like any medicine, take it if you really need it. Yeah. But if you don't really need it, it's probably a pederid opioid medicine. Don't get a fever, ideally. If you do get a fever, treat it early, right? Like, treat it appropriately, treat it early, right?

And go and see your doctor. And see your doctor. And if it's a strep or urinary infection, you know, get that treated with antibiotics. But if it's just, you know, cold or flu or something, you know, treat the fever with anti-feber medicine. Yeah. And then if you're sort of tyanol is over the counter. If you're self-medicating, some people just odie it, you know, like they just take too much because they maybe grew up in a household that just took a lot of medication or whatever,

or tyanol. Or they don't know. Or they don't know. They don't know. And, you know, be aware of that slash don't do that slash talk to your doctor before you are going beyond the recommendation that would be on the label. Yeah. I mean, what I say in the book is, you know, if you got a little headache, maybe just, you know, go in a dark room. Yeah, there are a lot of people that are just used to like, oh, I need to take my Tylenol.

I need to take my ibuprofen. I need to take this. I need to take that. and don't be too trigger-happy with the medication unless if it's an actual, you know, in the case of Tylenol, unless you're dealing with like an actual fever particularly. If it's just a light- A fever or, yeah, I mean, you know, I mean, some pregnant women are in a lot of pain. You know, sometimes they'll have fever.

I mean, I get it. Or not even fever, but really bad headaches. I mean, I get it. I mean. Take a precautionary approach. Yeah, do the best you can. Yeah. Okay.

Take it if you really need it. So this one is pretty interesting. I didn't know about this, even though the idea of, you know, people having, you know, gluten-related celiac disease is something we've talked about on this podcast. I didn't know that if somebody actually is diagnosed with celiac disease specifically, that there's some things that might be related to this conversation. Can you talk about that? Yeah, and it's further down on the list.

But it's one that I put in there because it's so common that people don't know they have it. So there's a study in Norway, and only a quarter of people, the people who actually had Ciliac disease, knew they had it. So it's only about 1% of the population, but it's that 1% that have it, most of them don't know they have it, because the science can be pretty subtle. So, you know, Ciliac disease is when they eat gluten. The most common symptom is, you know, just diarrhea or stomach cramping. But it can be really subtle.

It can just be fatigue, depression, irritability. It can be other signs like that. Or sometimes people have just had this their whole life. And they don't even know what it is to feel good. I mean, they just think, oh, every time I eat, I get stomach cramping and diarrhea. That's just the way it is. But it turns out that a lot of people have it that don't know they have it. And that treating it with a gluten-free diet before pregnancy or early in pregnancy may make a difference.

Yeah. And so the theory is that eating gluten for people with celiac disease kind of inflames their intestines, and maybe they don't absorb things as well, like nutrients or micronutrients. And so by doing a gluten-free diet, the intestines heal, and then they can absorb those nutrients better. So that's the idea behind it. And there is a study that I quote that shows a lot of other issues that can, you know, pregnancy issues that can come up with psiliac disease. those get better if they do a gluten-free diet early in the pregnancy. Yeah.

So, yeah. And not to be confused with sort of non-celiac gluten sensitivity, right? That could be just people who don't do well with a lot of gluten inside of their diet or might feel a little sensitive or don't feel good. There's not much, there's not any research on that that you know of. Nothing I know of, no. So it's more the people who actually test positive. Yeah.

And for somebody listening out there today, what's the standard way that now people test for celiac? You know, obviously there's a hardcore way, which is like biopsies and stuff like that. Yeah, yeah. You know, from there. But I think that there's like blood work that can pick up. Yeah, there's a, it's called a T-TG-I-GA. It's transglutaminase IGA. So it's just a blood test.

Yeah, yeah. But often, just so everybody's listening, I've had multiple friends now, multiple, actually just means probably a couple, so two, who were in their 30s when they found out that they had this. and they heard a podcast of mine or they saw a guest on a documentary that I've been involved with in the past. And they thought, I don't know. I think I might have this. What should I be doing? And we told them about, you know, talk to your doctor and this test and other stuff.

And they found out for the first time. And they were like in their, you know, early 30s, mid 30s. And they had no clue that they had it before. And it's a spectrum. There's some people that have celiac when they're a kid. And it's so bad that the parents, like I have a buddy of mine from Canada. he had it from the time that he, you know, it was so bad from when he was a kid.

His family, like, immediately went to the doctor. It was like, he can't keep anything down. He's throwing up. He has the stools. He's this, that. And they caught it early. But not everybody's in that same boat. And so, you know, you have to advocate for yourself a little bit.

If you think that you might be there and you can, you know, there's plenty of resources. Luckily today, there's probably a ton of awareness out there and a lot of forums and places you can go to online. In the Norwegian study, They just took a huge group of people and just did blood tests on all of them. And then made the diagnosis. Only one in four who had celiac disease knew they had it. Yeah. Yeah.

So, yeah. I mean, it's a great point you make. Yeah. I want to jump into the next one. And this is, you know, we've been talking about a lot of things that if they're low or if you have a fever or you have to protect yourself from this and that. But here's something that everybody could be doing. and especially women who are wanting to get pregnant or are pregnant. And that's the idea of eating fish or taking DHA omega-3 fish oil.

Why is that so important for this conversation? That was one of the lower ones on the list. There's not a big evidence base behind it. But it makes sense intuitively. In relation to autism. In relation to autism, exactly. Yeah. 15% lower rate of autism in their children.

There was one study that did show that. Several others didn't show that. So intuitively it makes sense because that DHA, that omega-3 fatty acid, that's the most abundant fatty acid in the brain. And so it just makes sense that that's such an important building block for our brains, that it would make sense to have it. There have been studies with fish oil, the supplements, and they haven't shown that same benefit.

But it seems to be eating the actual fish is what helps. At least the one study that showed it, it was eating actual fish. And the Norwegian mother child study, the one that looked at prenatals, that also looked at fish oil, and it showed no benefit from fish oil. So the fish oil itself, it may be beneficial in other ways or other pregnancy complications, but in terms of autism, they haven't shown it. But yeah, it just makes sense. I mean, the brain is basically DHS.

I mean, the biggest component of the membrane to the brain, the fatty acids are DHA. It just makes sense. Yeah. I don't know if there's any research on this specifically, but I know that there was a lot of friends in my community and even researchers that I look up to, like I mentioned it before, but Dr. Ronda Patrick was talking about how when she was entering into the third trimester of one of her children that she had, she was eating she was eating salmon row a couple times a week

which has like a highest concentration of DHA comparatively speaking to like just eating fish alone and so and I know in a lot of traditional cultures or in Japan they'll encourage people

like have a little bit of salmon row and other things like that especially pregnant mothers and so I just always thought that was pretty fascinating because it has like a higher concentration of DHA yeah and one thing I add

is if possible, Alaskan fish is the lowest in mercury, because mercury can be harmful. A lot of fish has mercury. So any low mercury fish, and then Alaskan is probably the easiest to find. So even in little, I look now, when I go a little grocery store in the middle of nowhere,

I check and see them, I wonder if they have any Alaskan fish here, and they do. I mean, so it's in, especially frozen, like fish sticks, whatever, you can get Alaskan sourced. It's right on the package. And that's the one, I think, has the lowest levels of mercury

and maybe the best option. Is there something that you wanted to talk about that I didn't give you a chance to talk about yet? I've been itching to go into vitamin D. Okay. Let's go into. I haven't gotten there yet. We kind of touched on it, but then we didn't go into the full deep dive. And it's important because it's a much higher up on the list of your recommendations.

Is that correct? Yeah. Okay. So, vitamin D. In terms of autism, they're not great studies on that yet. But what they have shown, the Generation R study, lower levels of vitamin D. and the mother have been associated with higher rates of autism in the child, higher rates of autistic traits in the child.

I can't show you a study that says, hey, this group took 600 IU, and this group took 2,000 IU, and the 2000 IU had less autism than their kids. But what I can show is some fascinating studies. So one was just came out from Taiwan just in 2023. So Taiwan, Taipei is about at the same latitude as Miami. it's a subtropical climate, lots of opportunity for sunshine.

And they looked to see what was the, at the first prenatal visit, so at about 10, 14 weeks, something like that, what are the levels of vitamin D in these women, these pregnant women? So normal is greater than 30. These are the kind of guidelines from the endocrine society or the traditional guidelines from the endocrine society. Normal is greater than 30 nanograms. 20 to 30 is insufficient and less than 20 is deficient. So normal, insufficient, deficient, 30, 20, and below 20.

So I'm going to ask you this question. I don't expect you to know it. What percent of these Taiwanese women did you think had normal vitamin D levels above 30 at this first prenatal visit? Just knowing how low it is even in places like L.A., I can imagine that it's super low. Like not many women had normal levels, even in a subtropical climate. Let's say only 30% had normal levels. Lower. Lower.

Keep going. If you don't mind. You'll play. Based on your face and your tone? Okay. Now I'm really going to go aggressive. I'll say 5%. Lower.

Okay. All right. Keep going. 1%. Lower. 0.8%. Wow. 0.8%.

It's just shocking. So what they did is, they gave some of them, it wasn't a true randomized control trial, but they gave some of them at once, say, 2,000 IU. So the standard dose that's recommended right now by ACOG is 600 international units a day of vitamin D supplement during pregnancy. The Endocrine Society, interestingly, is different. They say more like 1,500 to 2,000 in their past guidelines. And I like that one better. But they just gave 2,000 international units of vitamin D to some of the women, the others they didn't.

And what they showed is the women who were able to get up to over 30 with that vitamin D into the normal range, they had 40% less preterm deliveries. Wow. Than the ones who didn't get the extra vitamin D. Wow. 40% lower. I mean, it's shocking. And that's just in 2023.

You think we'd have this nailed down by now, right? Vitamin D is practically free. It's so cheap. 40% lower. It's shocking. And preterm delivery is associated with higher rates of autism. So it's kind of like a two-hop thing, but if we can bring down preterm deliveries, we can probably bring autism to. And vitamin D was made a dramatic difference there. And there was another study from Middle East in 2018. And it was basically the same thing. So the average vitamin D level in the Taiwanese study was 14. So remember less than 20's deficient.

The average was 14. And this Middle Eastern study, you know, where women cover up more. It was 11. Wow. I mean, that's getting close to like Ricketts, ostimulation level, like severely low vitamin D levels. And so for those women, when they treated them, they had a little different protocol, but they were able to reduce, again, the rate of preterm delivery by 40% with higher levels of vitamin D, just orally taking it, just taking the pills. And then preeclampsia was lower by 60% and gestational diabetes was lower by 50%. Wow. With vitamin D.

I mean, isn't that just incredible? And the author of this commentary on it, Dr. Hollick, he called it monumental. He said, this is a call to action. And so, yeah, so that's where I was itching to get to vitamin D because the research face is just so great. You have this quote here that we brought up as a slide. And can you read it for our audio audience? Yeah. So they observed a remarkable decrease in adverse pregnancy outcomes for women,

who were screened and received vitamin D supplementation. These included some of the most serious adverse complications during pregnancy, including 60%, 50% and 40% decreases in preeclampsia, gestational diabetes, and preterm delivery, respectively. The results from this study are monumental. That's his words, not mine. Wow. You rarely see researchers.

say things like that, right, monumental, you know? They're usually like, this is interesting and more research is needed. Right, right? So for them to say monumental, it's like pay attention to your vitamin D. Yeah, yeah. So, I mean, this is one thing. And ACOG, this researcher specifically has just been pounding on this, Dr. Holic. And so even ACOG now says, hey, 1,000 to 2,000 IU of vitamin D during pregnancy, it's basically.

They're saying most experts I'll tell you, it's safe. So there's no downside, according to ACOG, or more or less no downside, going up to 2000 IU a day. And this huge upside. Huge. Huge. So to me, I mean, it's just me. I'm just a country doctor, but I don't get it. I don't get what we're still doing 600.

Why aren't we doing 2000? I don't get it. So hopefully, that's part of the reason why I wanted to come in your podcast and maybe get the ball rolling a little bit on that and say, why are we doing this out there. Yeah, exactly. Why aren't we doing a little more? When you stack those things together, especially the first. first ones that you mentioned that have the highest, you know, evidence base around them. You have the prenatal vitamin and ideally starting that early, right, even before you know you're pregnant.

Maintaining iron levels and for the vast majority, that's going to be also a lot of prenatals high quality are going to have iron in them. Prenatals that are like gummy bears, the gummy prenatals? Yeah. They do not have iron. Okay. Interesting. So keep that in mind. Yeah. Luckily, I don't know personally that many women that like are taking prenatals that are taking gummies, but I'm sure because people love gummies and they like sugar, that there's people that are out there that are doing that. Yeah. So I just want to throw that in there.

So just I've seen that in there. I've seen that before. We're like, oh, I'm taking a prenatal. Generally, would you tell people to stay away? No. No, actually, I'm okay with them. You're okay with them. Because some people, if that's what it takes to, I mean, I know some people, that's all they can take.

Okay. They can't. I mean, and a lot of women get really attached to their prenatals, so you don't want to match with their prenatal. But they should know that it doesn't have iron. It just doesn't have iron. Because you can't have it in the gummy farm? I'm not sure why, exactly. There are gummies that have iron.

There is such a thing as a gummy with iron in it. But the prenatals that are out there now, as far as I know, none of them have iron in them. Okay. I would also imagine just because you cannot, you know, if you would take a prenatal and a lot of the higher quality ones, it's multiple tablets, right? to get the appropriate dosages that they believe that is not just going to help you, you know, support a lot of the conversation we're having here, but hopefully support other aspects that are there in the nutritional base. If you would take them and you would dissolve,

you would open them up as capsules and you just put in water and taste it, it does not going to taste good. Just like a multivitamins not going to taste good. Right. So my guess is a gummy may not always have the appropriate levels of nutrition that would be there. So just like double check it, you know, to make sure that it's, that it's good enough. I mean, it wouldn't be my first choice.

It wouldn't be first choice. Yeah, but if that's all they can take, sure. Yeah. So zooming out again, that some of your top recommendations, starting with a prenatal, making sure you have iron, appropriate iron levels, knowing that most women are just through the natural menstruation process prior to becoming pregnant, as well as, you know, food aversion, morning sickness are going to, you know, they should be checking their iron levels. And one other one I didn't quite hit as hard there.

There's one version of iron called Ferris bisglycinate. Right. So it's chelated. So a lot of prenatals have the older iron salts like ferrous sulfate. Those really irritate the stomach. They don't absorb as well. If you take them with food, they don't absorb as well. It's really hard to take it, that older version.

this newer version absorbs better. There are studies shown it gets the hemoglobin levels up higher, the blood levels up higher, way less stomach aches, way less issues with constipation. So it's called Ferris bisclosinate. So that's the one I think is a real breakthrough. And so a lot of prenatals have that in it. And it's a little bit more expensive,

but it may be worth it. Yeah. That's a great point. And I do believe that some of the ones that I mentioned previously, we need all needed. There's a bunch of that are in that functional sort of category that are made by people who are, you know, consulting a lot of the experts that are out there that have the best versions of those, you know, forms.

And I think I learned this on your show. It's probably better to go directly to the, if you're not going to buy it at Target or Walmart or health food stores, probably go better to go directly to the manufacturer's website. Yes. This is a big problem. Yeah. Don't go to Amazon. Amazon.

as much as I use Amazon for a lot of things. There are, it's when it comes to cosmetics and supplements in particular, although Nike did say that they had this problem. You know, one of the reasons that Nike got off Amazon years ago and issued this whole letter is that they said that they could not tell people who are ordering from Amazon whether or not it was a genuine Nike product because you, Amazon does something called co-mingling of inventory. So whether the company itself makes the inventory or whether that inventory is from a third-party

supplier because they just have so much demand, so many different warehouses, as long as anybody that's selling, you know, Nike and it's not saying it's used, they will mix all that inventory together. And the same thing happens in supplements. And I have a friend that owns one of the largest clean cosmetic businesses that are out there. And they mentioned that they have on average something like 1,500 knockoff brands every month that they have to flag on Amazon and take off. Because regularly there are people, these can be companies that are in Mexico, India,

even in the U.S., China, other places that see an opportunity, get really good at making a fake, and make the product so that it's kind of like it, but they don't put in all the extra work or getting the cheapest version of what it might be. And that's happening in supplements as well. I wrote a whole newsletter about

this previously. Yeah. And it's a big problem. That's actually I learned about it was from your show. Yeah. It's a big problem. So yes, if you can try to get this directly from the brands and not from Amazon or if you're going to get it from a retailer or a natural food store or Target carries a lot of these brands

as well too, you know, you know that they've probably done the vetting and are ordering directly from them. Yeah. So that takes care. That's the prenatal, the iron levels. The vitamin D, vitamin D is often in a lot of good quality prenatals at the, you know, the appropriate levels, right? Generally, have you found that? No, so most are going to have 600. Okay. So the ACOG recommendation is 600 right now. Okay, so maybe, it's very rare to get

C1 with 2000. So usually what I say is to consider adding an extra vitamin D in. Okay. So add an extra thousand or 1,500 of vitamin D into the prenatal. Yeah, I'm used to the brands that I was mentioning to you and the ones that the advisor, but those are not the ones that most people are buying. I hope they do one day. Right. But yeah, you're right, that most of the standard brands that are like a prenatal in one pill or one tablet or two tablets, they're not going to have appropriate levels of vitamin D. Collin is one that we didn't touch on, but that's often in a high quality prenatal is going to be in there.

But talk to us about why coline, whether it's through prenatals or often you hear, you know, obese or doctors talking about eating eggs, why is that so important to this conversation regarding autism? Yeah, I can't give you a direct study showing, you know, We're just getting into where prenatals might prevent autism. Yeah. So there's not one on coline yet. But there are studies showing that generally cognition may be better in kids who take

colon. And where the mother takes colon, we're probably not getting enough. It's sort of like a B vitamin. We can make it. But not enough, it seems like. So we have to supplement it with our diet. Eggs are the biggest source of coline. and so we're probably not getting the RDA from just diet.

It's kind of a pain because it's usually a separate pill. So most prenatals don't have very much coline. So to get what's recommended, you almost have to buy a separate pill. So it adds maybe an extra $10 or $15 a month. See like a prenatal regimen. But it's probably worthwhile. Just like I said, the brain, the structure of the brain basically is DHA. Well, it's actually DHA.

attached to coline in the form of phosphatil colon. That's a gross oversimplication, but that basically is the structure, is the loudest work

of the brain? Is DHA attached to phosphatil coline? And then colon also is acetylcholine. It's involved in neurotransmitters. So it has all these benefits. So it makes sense

that taking more of it will help. And even with kids with autism, they recommend it. So it's lower down the list. It's, you know, if I were to say whether one, you know, if you couldn't afford it and there's one you wouldn't want to do, that would probably be the one to drop. But if you can, it's probably a good idea. So zoom out a little bit. These are all part of these evidence-based proposed guidelines to prevent autism, things that can be recommendations from doctors that are listening and even friends that are out there that are listening that are saying, hey, this is something to pay attention to, you know, pick up a copy of this book.

We have the link in the show notes, by the way. I hope everybody picks it up. Autism prevention, five days a week, evidence-based proposed guidelines for parents to be. So these are evidence-based things that people could all be doing. And bigger picture, we touched on some of the larger items that are there, which are, you know, being aware of environmental toxins. We've had a lot of people come on this podcast talking about try to live a low-tox lifestyle,

do your best, you know, if you're used to using, a lot of air fresheners in your house or your bathroom or other things. Like there's not research on these yet. There's animal research about these things not being great for animals. And we know that a lot of the compounds in some of these things are not great for the body and can increase the toxic burden. So try to live a low toxic lifestyle by getting rid of them, you know, having a water filter at home as well too.

We just, you know, our city municipality water systems were, designed in like the mid-1900s and they aren't set up to take out all the new sort of substances that we're all being exposed to. And besides the common things of alcohol, smoking and vaping, which I think a lot of our audience is aware of, what are some of the other lifestyle things that you want to touch on? So diet is one. There was a study. They actually, they went back and looked at some of the older data. So from the Norwegian mother child study, another study that was done in Scotland,

they kind of go back and look through these studies and all the data that's there and come up with new things. And so one of them was that kind of a healthier diet, there were lower rates of autism for mothers who had like a healthier diet. And basically the Mediterranean diet. Yeah, doing your best to minimize ultra-process foods. Yeah. And what was interesting was actually moderate adherence to the diet.

was actually even a little better than high adherence. I mean, they're basically both the same. But the idea is, you know, don't get upset if you cheat a little bit. You know, just do the best you can. Totally. Just try. So, but yeah, just eating a healthier diet, Mediterranean-style diet seemed to help.

And then, like you had mentioned, the toxins, you know, Universe California, San Francisco has a great website on this, you know, things to avoid during pregnancy, dry cleaning. is a big one. Talk about that. Dr. Dorsey went over that. Yeah, I was fascinated by your talk with Dr. Dorsey. Yeah, so we had Ray Dorsey on.

Originally from University of Rochester, one of the top sort of advocates around how environmental toxins are largely the driver of this explosion in Parkinson's disease, including pesticides, air pollution, but in particular dry cleaning and this compound that's banned. now but then has some derivative compounds that are very similar but I think it's called tetrachlorohydrine something like that and it's a it's a dry cleaning chemical that was extremely common and it was also commonly used in solvents that a lot of people used as degreasers that were living on farms and maintaining farm equipment or working in the military back in the day and taking care of like tanks and

military equipment. And from what I understood from Ray, it's like it's causative in animals to create Parkinson's disease. Like, and then, and then there's a lot of really strong human research to support that. And he said autism quite a bit too. And I kind of picked up that he was kind of, that was not his primary focus, but he mentioned that a bit. Right. That's, that's definitely something to be aware of. So avoiding dry cleaning, and if you have to do dry cleaning, you know, look for some of those eco-cleaners that are not using these super harmful. They say you can actually ask them to wet wash. Wet wash?

Yeah. Okay. They can do a wet wash. Not as familiar with that, but yeah. Yeah. It's on the UC San Francisco side. I'm not either, but it's on their site. So dry cleaning?

Anything else in that toxin category? Like simple things would be like heating up something in the microwave on a plastic plate. So, you know, use ceramics or something like that. That's a big one because you get a lot more of the EPA or plastic. Yeah. And if you have, anybody who's listening that has like water bottles that are plastic, you know, a bonus thing is also, we don't think of this as being heat, but it exactly is. It's heat, it's friction dishwashers.

So if you have a bottle, try it, that's plastic that you like drinking out of and you haven't switched yet. You know, there's so many great options that are, you know, metal, you know, glass, you know, that have rubber on that. outside that you can get from places like Whole Foods and whatever. But if you're using something that you're regularly eating off of that is plastic, try to hand wash it and not put in the dishwasher because the dishwasher, there's a reason why these plastic bottles that people use. It was really common when people who would go to the gym would have those shaker bottles that had like the blender bottle inside, the little blender ring and you'd shake it up.

I used to have one of those back in the days. And you'd take it and you'd put it in the dishwasher, you know, because it had a bunch of protein crested on the outside that you used. There's a reason that those plastic bottles become kind of opaque after a while and like foggy, right? It's because friction causes degradation through the heat and the water in the dishwasher

and that's leaching all these chemicals outside and you're regularly getting exposed to those that are there. if you use a blender a lot trying to look for and you're you're running a blender a lot this is again bonus and this is coming for me not not you okay if you have like a vitamix you know if you know vitamins are designed to stay for 20 years right 30 years there's designed to be around for a long time are those class or they they're they're plastic they're plastic they're plastic containers but if you're okay spending a little bit of money on it you can go on you can go on uh their website and third-party retailers that make this and sell it on Amazon.

One of the things I'm actually okay with people probably buying on Amazon, it's a metal, it's a metal blender container. Okay. Right? So you're not dealing with long-term sort of exposure to like plastic, even though the Vitamix ones and I think the Magic Bullet, they're like BPA-free, but still they have all these other plastic chemicals inside of it.

Right. So we're getting into the weeds a little bit of this. stuff. But bottom line, we're trying to live a little bit more of a low toxic lifestyle. How's your son doing today? Oh, he's great. He's great. Yeah, we're really like it am. So he is, he's this great little companion. And like if it's sometimes other kids have things they want to do and I want to go here and I want to go there. And Luke's just so easygoing. So if I've got him for the day and I'll say, Luke, what do you want to do? And I'll say, Daddy, I just want to do what we need to do.

I want to go and pick up my brother and go to the grocery store. I just want to be with you. Yeah. So, yeah, he's doing great. I mean, he's, we're lucky to have. He's a really, I mean, his brother, they watch like these stupid Netflix shows, you know, these comedy, kids comedies, you know. And they can say the whole thing.

Like they can, they just get, they've memorized the whole show. Like some of these episodes, they just get together and just laugh and laugh and laugh. sometimes especially right before bed. My second youngest will rile up, Luke, and get all riled up right before bed. But they'll just get together and laugh. And so part of the message was, too, is, you know, is even if you do have a kid with autism,

it's not the end of the way. I mean, he's in some ways, Luke is my most human kid. I mean, he loves me. He needs me more than probably any. and I'm really lucky to have him. So it's not necessarily a reason to avoid having kids or not have kids. And if it does happen, you know, it's hard, especially earlier. He was a little aggressive when he was younger.

And people kept telling me that, yeah, a lot of times they grow out of that. And I'm like, when? You know, when's this going to happen? When is he going to stop being aggressive? And yes, yeah, he's mellowed out. But a lot of times we'll pick him up at school and they'll be like, oh, Luke was the best one at school. today. He was a least of our problems.

Like all these other kids are going crazy. Luke was great. So. I appreciate you mentioning that. It's a tough conversation for a lot of parents to have. Yeah. Especially who are paying attention to this topic because it's all the layers and all the layers are true. Layer one, you're here today because as you said earlier, like

you know, nobody wants to right? If you could avoid it, most people would want to avoid you know, being in a position where they have, and I don't even want to say you have a kid with autism. It's a little bit of like autism is happening to your kid a little bit in that way, right? Like it's not a guarantee that it has to be that way, even though it's this delicate balance between genetics and, you know, the environment that's there.

So nobody wants to have a kid with the autism being on the autism spectrum. And at the same time, too, all my friends that do have son or daughter that's on the spectrum, they could never imagine. They wouldn't change it for the world. Right. Right. They would never say they wish they didn't have this kid. Right.

Even though they all, the third layer, they all, with other parents that can understand this, they all have been super honest with those parents and somebody like myself who doesn't have any, you know, who wants to hear the honest truth about it. So I'll say that he was tough at times. And it's not that they want to, you know, paint it all with, you know, know, or see it all through rose-colored glasses. Yeah. It's like, okay, it was tough, especially the ones that have more behavioral challenges or more

intellectual disability that's there. And, you know, so it's all these things are true. You love your child. Mm-hmm. You are there for them. And in your position, as a physician who's been looking into this, you also want people to know what's out there. Mm-hmm.

And, yeah, I think it's just, it's, I think the reason that I'm having sometimes a little bit of tough time with finding my words around this is, one, I want to be delicate to you. I want to be delicate to your child. I want to be delicate to the people that are listening, but I also want to capture the human experience that's there, which is that what have we just cared about kids, parents, families, and the state of health of our country? How do we have this delicate conversation? And a lot of times when people are talking about autism on both extremes, you have one side of the extreme that's typically associated with people that are, feel that any conversation around mitigating risk and what people can do is blaming parents,

right, blaming kids, and is also unhelpful to the larger aspect of, you know, we just need to figure out how to have more funds to be able to take care of the situation, right? And it's all happening primarily through increased diagnosis. There's the other side of the spectrum, and sometimes these usually lie on like political spectrums too, which is it's just vaccines. if we could finally get the vaccines out of the conversation, we wouldn't have this thing, which is another insensitive way of talking about the situation. And there's all this area in between

that there actually is research that's there, and we can talk about the nuances and talk about what people and families can do. How do you think about this landscape? And do you ever get pissed off as a parent who has a son who he loves so much on the spectrum? Do you ever get pissed off when you see these different, you know, debates happening?

I wouldn't say that I get pissed off. And on the vaccines, because I know that's really important to a lot of people, you know, they say if you want to avoid conflict and conversation, avoid politics and religion, I would add vaccines to that. Because I actually had those conversations with people. I try to take, you know, not a really judgmental side. And people are very passionate about it. and because they think that their position is right and that it can harm children.

Either way you go, whether it's giving or not. Either extreme you go. Right. Either giving or not giving, you know, people think it could harm the child from their perspective, depending on what they believe. So if people believe that vaccines are good, they believe that people who don't give vaccines are harming children. And for people who believe that vaccines are not good,

they believe that the ones giving vaccines are harming children. And so it's a really deep set belief for most people. And the reason I don't really go into it in my book is because there's just so much out there already on that. So whereas this stuff that we're talking about, I was never able to find any podcast anywhere talking about this. I couldn't find anything anywhere where it was like, okay, how would we do this in a concrete step-by-step-step way? What would this look like? You know, taking this research that's out there because so much of it was more about vaccines. but those books on vaccines have already been written.

And so you had one of your guests in Dr. Warsh, and he kind of tries to take a middle-of-the-road approach. You know, there's kind of the pro side and the anti-side. But just for me, that would be a whole separate book, and there's already so much on that. So I didn't want to, and I think it would overwhelm everything else we're talking about. If I went into that, I think that's all people would focus on. It becomes a distraction for these other things that's, as you mentioned,

need to be talked about a lot more and nobody's talking about them. That's right. And generally, everybody can get on board with these things. It's not something, you know, is there one of these that you feel is like super controversial? Not really. I was reading your book and saying,

none of these are controversial. There's strong evidence that's out there. Yes, there's a difference between, you know, the quality of studies, but you've also explained why we're not going to see placebo-controlled trials with certain things like prenatals because we already know that prenatals are very helpful. for people, but how we still have good qualities, you know, research that's there.

So the conspiracy isn't that any of these are controversial. The conspiracy is we're just not giving this area enough love and attention. And there's just not enough education. And so the one little tiny thing that we can do, which I super appreciate it, is that I was excited to host a conversation about it. You flew out here from, you know, Texas and on your own dime, by the way. you know, we're willing to be a part of this podcast, which I super appreciate that ability. And that's what we can do.

And hopefully somebody hears this and picks up your book or sends this podcast to a friend. That's another thing that they could do. And then another conversation happens and another conversation. Yeah. I'd love to see you on way more podcasts that are out there talking about the same. I'm going to try, but I just, I'm so glad that I was able to get to this one because I just have so little time. Unfortunately, I'm going to try, but I want to. I mean, I wish I could talk to everyone, every couple that want to.

to get pregnant. I wish I could talk to their mother, their aunt, their grandfather, anybody who knows them and talks to them. Like, I wish I could talk to everybody. Jeff, I so appreciate you being willing to be vulnerable about your family's journey in this process and turn it into something that people can take and improve their lives, improve their lives of their family, improve their lives of their kids as well. And I hope to meet Luke one day. Yeah, maybe that'll be our next interview. Yeah.

We'll test your range on your interview skills. See how you can do with a 10-year-old. This has been fantastic. The book is out there, right? People can order it. Yeah, it's available for pre-order on Amazon. It should be coming out in a couple weeks. It should be available in a couple weeks.

So probably by the time this podcast is out, people can find it. And whether you can pre-order it, order it, we have a link in the show notes. It's called Autism Prevention 5 days a week. Evidence-based proposed guidelines for parents to be. And then my website is autism5.com. You spell it out, F-I-V-E-A-A-A-O-V-E-A-R. Great. Jeff, thank you so much. Thank you, Drew.

Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend. Share it with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been

working on that I'm super excited about. It's my weekly newsletter and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy to digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-O-H-I-T dot com and click on the tab that says try this.