Dhru Purohit Show - The Root Causes of Memory Loss & How to Build an Alzheimer’s Resistant Brain with Dr. Dale Bredesen

Episode Date: May 25, 2023

This episode is brought to you by BiOptimizers Magnesium Breakthrough, Pique Life, and Beekeeper’s Naturals.  This week on The Dhru Purohit Podcast, Dhru sits down with Dr. Dale Bredesen, one of the most esteemed voices and researchers in Alzheimer’s disease, to talk about the first steps to preventing cognitive decline and lowering your risk of Alzheimer’s. Dr. Dale Bredesen is internationally recognized as an expert in Alzheimer's disease and the author of the New York Times bestsellers The End of Alzheimer's, The End of Alzheimer's Program, and his latest book, The First Survivors of Alzheimer's In this episode, Dhru and Dr. Bredesen dive into: -Why nobody should get Alzheimer’s disease (2:38) -Why Alzheimer’s disease prevention isn’t talked about more (11:26) -Immune-system activators that drive Alzheimer’s (20:08) -Fructose and Alzheimer’s disease (27:30) -Saturated fat and Alzheimer’s disease (32:44) -The role of the microglia in Alzheimer’s disease (41:15) -Personalized medical interventions for successful Alzheimer’s treatment (47:36) -How to reduce your risk of Alzheimer’s (57:40) -Mold toxicity and Alzheimer’s disease (1:01:43) -Basic diet and lifestyle interventions for Alzheimer’s prevention (1:07:33) -Measuring biomarkers for Alzheimer’s disease (1:30:55) -What has changed where people are getting Alzheimer’s so young (1:38:10) -Steps you can take to prevent Alzheimer’s (1:48:00) Also mentioned in this episode: -Dr. Dale Bredesen’s dementia-reversal clinical trial, Evanthea -KetoFLEX 12/3 -Free cognoscopy assessment -The First Survivors of Alzheimer's For more on Dr. Bredesen, follow him on Facebook @drdalebredesen, and through his website, apollohealthco.com. Right now, you can get 10% off Sleep Breakthrough. And if you buy two or more you’ll get a free bottle of Magnesium Breakthrough. This is a limited-time offer! So just go to sleepbreakthrough.com/dhru and use code dhru10. Right now, you can enjoy 15% off Pique’s Pu’er tea bundle plus free shipping FOR LIFE. You’ll also get a bonus pouch with 12 of Pique’s other premium teas. Head to piquelife.com/dhru to treat yourself to the highest-quality tea out there. Right now, Beekeeper’s Naturals is offering my listeners early access to their Memorial Day sale. Between now and May 30th, go to beekeepersnaturals.com/DHRU and enter code “DHRU” to get 25% off your entire order. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

These diseases of neurodegeneration turn out to be network insufficiencies. You have these amazing networks that do things like help you remember or help stabilize your movements. And each one of these is a beautiful network that has its own supply and its own demand. And when you are chronically too low on the supply or too high on the demand, then you're going to get these. Whether it's Alzheimer's, whether it's macular degeneration, Parkinson's, ALS, front of temporal dementia, Louis body, Just go right down the list. These are network insufficiencies. Welcome to the Drew Prod podcast.

Each week, we explore the inner workings of the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Dale Bredison. Dr. Bredison is internationally recognized as an expert in the mechanisms of neurodegenerative diseases, such as Alzheimer's disease, and the New York Times best-selling author of the end of Alzheimer's. Dr. Bredison has held faculty,

positions at UC San Francisco, UCLA, and the University of California, San Diego. He's directed the program on aging at the Berman Institute before coming to the Buck Institute for Research on Aging in 1998 as its founding president and CEO. On today's podcast with Dr. Dale Bredesen, we're diving deep into the topic of Alzheimer's and cognitive decline by covering some of the latest research that's developed, especially in the last five years in this space. Now, a little bit more about Dr. Dale Bredison. The Bredison Laboratory, which he founded, studies the basic mechanisms

underlining the neurodegenerative process and the translation of this knowledge into effective therapeutics for Alzheimer's disease and neurodegenerative conditions. Their work has led to the publication of over 200 research papers. Dr. Bredesen is the principal investigator for the Alzheimer's Disease Research Center at UCLA. He established the Alzheimer's Drug Development Network, with Dr. John in 2008, leading to the identification of new classes of therapeutics for Alzheimer's disease. His group has developed a new approach to the treatment of Alzheimer's disease, the MEND protocol, and this approach has led to the first descriptions of reversal of symptoms in patients with mild cognitive

impairment and early Alzheimer's disease. Now, let's jump into our fantastic conversation with Dr. Dale Bretteson on all things Alzheimer's disease and neurodegenerative conditions. Dr. Dale Bredesen, welcome back to the podcast. A pleasure to have you here. A lot of new things to talk about. So I'm going to jump right in. You've shared something that is going to be pretty profound for a lot of people to hear. And that is that the current generation, and maybe you can clarify what generation you're

talking about, this is the first generation where it will be optional as to whether or not you end up getting Alzheimer's disease. That's like a pretty bold statement. Unpack that for us. Yeah, great point. And always great to talk to you, Drew. Thanks so much for having me. This is an exciting time. Things are changing rapidly with things like new tests and like this. We understand this disease much better than we did, even five years ago. So the point is that with what we know now, anyone who doesn't have symptoms, so anyone who's in the prevention mode or in the very earliest changes is part of the group that will now have, it'll now be optional. That is to say, if you're in your 30s, 40s, or even 50s or 60s or even into your early 70s, but you have no symptoms

yet. Now, to be fair, you know, if you're in late stage already, we don't see people who are at mocha scores of zero. We can see them get better, but we haven't seen them get all the way back to a perfect score of 30, which is our goal to understand how do we do that. But the great news is for my daughter's generation, they're both in their 30s now, as an example, they're the first generation that in your generation would be included in there as well. You don't have to fear this disease. Whereas for my generation, this was the biggest fear, as you know, health care-wise, it passed cancer about 12, 15 years ago as being the number one concern, losing your ability to think and to memorize and to interact with your fellow man, that has unfortunately been

the number one concern health-wise for my generation. But you guys and the people who are younger, you really don't have to worry about this as long as you get evaluated, get on active prevention. And we recommend anyone who's 40 or over get on active prevention. You can find out now whether you're in the earliest throws with some nice blood tests. And you can say, okay, this is not a worry because I can now head off the descent into dementia. Because dementia is really the fourth and final phase of cognitive decline. So you've actually got a long period that works up to that. And during that time, you can get evaluated.

You can determine what's driving the process and you can reverse this. And no question. We see it again and again and again, as we did in our clinical trial, with people getting better. Let's talk about that clinical trial. And what was the age of the participants that were part of that clinical trial? Yeah. So the clinical trial, people were from 55 to 75. So a little bit older than the generation you're talking about your daughter, my generation, we're in our 40s.

Probably a lot of people that are watching us today on YouTube. They're in that age range. And so how was the trial set up and give us some of the takeaways of what you found out from doing the trial? Yeah, great point. And to be fair, we can do much better even than the trial. The idea was the trial we set up for later stages, for mild cognitive impairment, which is the third of four stages, and for early dementia, which is the fourth. So preceding that, you have a period where you're asymptomatic, but you can already pick it up on PET scan or spinal fluid or now these blood tests. Then you have a second phase

that lasts about 10 years, which is called SCI, subjective cognitive impairment. Virtually 100% in those first two groups can do great and that they won't have to worry. The SCI people reverse beautifully. The MCI, most of them. And in our trial, we took people only with MCI or with early stage dementia. And those people, 84% of them actually showed improvement. Now, it didn't, not just that they didn't get much worse. Of course, the drug trials we've heard about are not making people better. They're not making people stable. But what they do is when the people decline, they decline slightly slower. In one, it's 27%.

In one, it was 32%. And one, it was 36%. So these are relatively modest slowing of the decline. Whereas in our trial, we actually saw people get better. And we've now had people who are on this approach for over a decade and who have sustained their improvement. So it's a huge difference. Why isn't that front page news?

Why aren't more people talking about a different approach to Alzheimer's. Yeah, you know, this is such a good point. And I think it's the crux of the issue. Why isn't functional medicine front page news in every newspaper in the country? Hey, we're doing, we're now able to do something about lupus and rheumatoid arthritis and insulin resistance and diabetes and cognitive decline and other neurodegenerative conditions and even some cancers.

Why isn't that? And I think it's because medicine has not been ready for that. change. Medicine is stuck in a 20th century model in which you make a diagnosis and then you treat with a drug or with surgery. It's a monotherapeutic world. And it's the way that I was trained in medical school way back in the 1970s. So we're looking for the one thing that's causing Alzheimer's. And if we find the one cause, then traditionally in conventional medicine, we're going to find the one hopeful solution. And that's when you read about these big blockbuster drugs that we're spending billions of dollars on. And that could potentially bankrupt our economy if everybody was on it who

had Alzheimer's. That's really what they're trying to do. They're looking for this one specific issue and this one specific cause. You know, it's such a good point because this has been the model, the idea. This goes back to Koch's postulates, of course, 1890. These were published. And And what he showed was in diseases like tuberculosis, you could actually isolate an organism. You could then re-inoculate it and give an animal model a disease. You could then re-isolate. So the idea was one pathogen, one disease. Micobacterium TB, you get tuberculosis.

Boom. Now what's happened is we're running into situations where coaxed postulates are not being fulfilled. A great example. Recently, a beautiful research showed that multiple sclerosis often follows Epstein-Barr virus. So it looks like Epstein-Barr virus is a critical factor in developing multiple sclerosis. Okay, but here's the problem. Let's take 1,000 people at random. 940 of us will have been exposed to Epstein-Barr.

Most of us have been exposed to it. But only one out of that 940 will develop MS. So this goes way beyond Koch's postulence. Something's missing. You don't just give them Epstein Bar and they get MS. There's not this one-to-one correlation that there was with TB. Same thing has happened recently now with Parkinson's. So Parkinson's has just now been linked. One of the microbiome changes is this desulfo-vibrio abacterium. And as it goes up, your increased risk for Parkinson's, as your Parkinson's gets worse, it goes up. So again, it doesn't fulfill coax postules, it's because you and I probably have some of it in our guts, but we don't have

Parkinson's. So it's not a perfect correlation. Things have changed. Medicine has gotten more complicated. And look, we're in the era of information. You know, look at the stuff you keep on your iPhone. It's amazing so that you can now start looking much more deeply at what is the relationship between changes in gut microbiome and changes in oral microbiome. So as Mark Hyman often says, you know, you're looking at all this, the whole list of things, as he says, all these different points. You're, you know, you're taking out the bad stuff. You're putting in the good stuff. And what we see coming directly from the laboratory and looking at people with cognitive decline is that you can literally go from the test tube to the human being. And what you see is

not a silver bullet, but silver buckshot. These diseases of neurodegeneration turn out to be network insufficiencies. You have these amazing networks that do things like help you remember or help stabilize your movements, which is the one that goes Orion Parkinson's, or give you the power, which is the one that goes Orion ALS. And each one of these is a beautiful network that has its own supply and its own demand. And when you are chronically too low on the supply or too high on the demand, then you're going to get these, whether it's Alzheimer's, whether it's macular degeneration, Parkinson's, ALS, front of temporal dementia, Louis body, just go right down the list.

These are network insufficiency. So for the first time, we're beginning to understand what these networks are, what it takes to supply them, what it takes to prevent the deficiencies, and how to do something about them, and not waiting, as you said earlier. To really drive that idea home, can you give us an analogy that might be something that people could follow along with when it comes to the idea of network insufficiencies, right? Whether it be a city or something that you can say that is an analogy, because that is so clear to me. Yes. And I think there might be some people that are listening today that are like,

okay, I think I kind of got it, but I don't fully. Is there an analogy that you have that can support that? Yeah, you know, it's a great point. And let's take a, so it's a little bit like a country. I mean, your brain is actually much more complicated than a country, but let's take it as an example. So you've got a country and you've got a president of your country. And in fact, amyloid precursor protein, APP, which is at the heart of Alzheimer's, is a little bit like your president. It's making decisions. So you're sitting there and you're the president and you're saying, okay, how are we doing? Is inflation a problem? No, we're in good shape. We're doing well. We don't have a deficit. We're not being invaded. We're not, we don't have a lot of pollution.

Okay. I'm going to suggest that we grow. We interact with more places. And this is exactly what your brain's doing. It's now making new synapses. It's making and maintaining synapses and memory. Now, what happened in early 2020? Well, we were told, oh, my gosh, there's a pandemic. We've got this new virus around SARS-CoV-2. And what were we told? Okay, we now are being invaded. In this case, we've got this new pathogen.

So we're going to pull back. We're going to socially isolate. We're going to not go to work. And what happens? The whole country goes into a recession. This is exactly what your brain is doing. it is literally making a choice. And this is what we found in the lab all those years ago,

where we were seeing that APP can go in two different directions. If you remove trophic factors, if you induce any sort of insults, then it literally changes from a constructive mode to a protective and downsizing mode. It literally is changing the mode of your signaling in your brain. So it's saying, okay, I'm not going to be able, to keep 500 trillion synapses, which is amazing that we have so many and you really have a

wonderful supercomputer in your brain. But it's now going to say, okay, Drew, you're going to be able to live, but you're going to have to live with fewer synapses. Okay, well, if you know what's driving that, then you can do something about it. And that's the problem that when we go to these centers of excellence, they don't ask what the problem is. They just say, oh, you have Alzheimer's disease, so we're going to give you this drug that doesn't work. You know, to even build on top of that on this idea of network inefficiencies or network Insufficiency. Yeah.

Even a step further is that you could be looking at a country, for example, and say, you know, there's countries on the brink of war, civil war. Yeah. And at the top level, it may look like it's just, you know, politicians fighting with each other. But if you dig a little bit deeper, you may see, okay, they're not paying attention to the middle class and supporting the middle class. They're not protecting, you know, we're required. this in San Francisco. We're not protecting small business owners from being shoplifted.

There's, you know, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, the, areas add up to a state of the country, the network, not being able to operate in a way that it needs to run, you know, a civil society. And when all that backlog builds up, obviously, this is just me just creating a fictitious situation, you then have all sorts of ramifications. So the same thing is happening in the body where traditionally we're looking for that amyloid plaque buildup and that's the reason why we have Alzheimer's. I think for the first time you're starting to see mainstream medicine pull a little bit back from that.

But you're saying that there's a whole bunch of other things. It's not just the amyloid plaque. And actually the amyloid plaque could actually be a self-defense mechanism that the body is doing. So what are some of these other things when it comes to Alzheimer's that are driving the disease in the first place? Yeah, this is a great point. And, you know, this is just like when it used to be that you either had diabetes or you didn't have diabetes. Right. Now we know well, you've got insulin resistance and you've got pre-diabetes. You've got this long run-up. And it's actually been measured quite well in Alzheimer's disease. And on average, it's 20 years between when you can pick it up on a PET scan or on spinal fluid and when you actually get a diagnosis. 20 years. So we actually have a huge ability, which is, again, why I say, this is now optional. Nobody should get this disease. I mean, and I know that's controversial. But the reality is, is if you go in, if you get on active prevention or earliest reversals, nobody needs to get,

or very, very few people ever need to get this problem because we know. Now, you ask what are some of the things? Absolutely. So we've been able to reduce this essentially to an equation. And we initially found that it really has to do with four major areas, which are toxins, inflammogens, anything is causing inflammation, and then energetics. and then trophic support. But you can really even collapse that further.

It's about one thing, IA over E. So immune activation divided by energetics. So you get Alzheimer's because your immune system is activated to the point that your energetics is not keeping up with the problem. So you've got those two major things. Then you can break those down further. For example, the energetic part of the equation, is cerebral blood flow. So you've got to have appropriate blood flow. It is oxygenation. And so

everybody who's got sleep apnea is at risk, upper airway resistance syndrome, anyone who's got issues with the oxygenation. And of course, no surprise, people who live at high altitudes are going to be at increased risk as well. The third part is mitochondrial function. Of course, we hear about the importance of mitochondria all the time. And they are absolutely critical in these neurodegenerative diseases, including Parkinson's, including Alzheimer's, including others. And then finally, it is combustible substrates. And by that I mean ketones and glucose. And of course, Professor Stephen Kahn from Canada has done such a nice job showing that just giving ketones alone actually improved many people with MCI. And by the way, it did much better

than these drugs that are going to cost $25,000 and up per year. So, you know, what did better than those drugs? Extra virgin olive oil alone. Ketones alone. These combined metabolic activators, which are four different things, just published about a month ago. And then, of course, the precision medicine protocol we developed did the best of all of those in terms of actually reversing cognitive decline. So that's the energetic part of the equation.

And then the immune part is actually really interesting because we think of the, when you get an immune response, you have the innate part first. That's the non-specific, that's the older evolutionarily part of the equation, part of the immune activation. And then, of course, in a perfect world, you hand that off to the adaptive system, which comes in with your T cells and B cells and making antibodies and things like that. And that is now helping to turn down the inflammation, turning down the innate system and resetting things, clearing the pathogen. So one of them, the innate one is the one that's kind of going on at all times in the background, just dealing with daily sort of cleanup. And that's the,

then that's exactly, I think you brought up as a great point that you brought up because it shouldn't be on there in a day. It should be very minimal. It should be very quiet in general. In general. And because it's just there to really sort of rise to the occasion when there's an insult on us.

Yes. But instead, what I'm hearing from you is that it's, it's not. It's kind of activated all the time. Exactly. And here's the problem. And when it activates,

what are the things that it makes? amyloid turns out to be part of your innate system. So as long as you are triggered to be protecting yourself against these various things, and that's where living in place with mycotoxins is important. Getting that beta-glucan exposure, getting that inflammation exposure, guess what else turns it up? Saturated fats. If you're out there eating a bunch of saturated fats, guess what else turns it up?

Things like glucose, and you had a great interview with Rick Johnson recently. And guess what? Fructose, same story. So all of these things are turning up your innate immune system. And that is putting you in this chronic situation where you are increasing your risk for Alzheimer's. And one of my colleagues, Dr. Alexei Karakhan, is an interactomics expert. And one of the points he's made is that if you look at Alzheimer's, it's really, it's not even just about the innate system. It's mostly about innate immune system memory. It used to be thought that we didn't have a memory in our innate immune system. We only had a memory in our adaptive system. It's turned out that no, in fact, we do have a memory in our innate system. And what it does is it's a little bit like if you're an abused kid, then you start growing up. And then when someone starts to pick on you, you kill them. You get really upset because you've had that earlier exposure.

So you've got this heightened concern. That's the same way your innate immune system works. It puts you, it ratchets up so that now if you get exposed, boom, you're out with a higher inflammatory response. And that response, the innate system memory, lives in three sites in your body. It lives in your bone marrow. So if you now get, for example, pneumonia, boom, you're coming out with more neutrophils than you would have otherwise.

Second place it lives is in your tissue macrophages. So in the course in the brain, it's your microglia, which, you're, you're, you're, are huge in Alzheimer's disease. These things are getting activated, and this is an issue. And the third place it lives, interestingly, is in your endothelial cells, as Dr. Corrachan has pointed out. So, in fact, what happens is your endothelial cells have gone from a situation where blood's flowing freely, no problem, there's no tendency toward thrombosis or toward cytokine production and inflammation to ones that are heightened, they're not going to stay away. from, they're going to thrombose at the drop of a hat. So unfortunately, you get this increased

likelihood to thrombosis. These things are unfortunately working against you when it turns to Alzheimer's disease. So having this phenomenon, this is why just extra virgin olive oil alone and just getting things like omega-3s, things like that and good fats will help tone this down. So they're now bringing down this heightened status of the innate immune system and putting you in a better situation. Now, your body is saying, well, gee, if you go out and get a whole bunch of exposure to pneumococcus, you're not going to be as quick and as heavy as a response. Okay. But we, most of us are living in places where we're not going to be worried about getting pneumonia every single day. And so we're doing pretty well.

Now, the same thing comes back with APOE4. APOE4, just like saturated fats, just like fructose and high glucose, is one of the things, in this case, of course, genetics that will put you at that higher risk that is now telling you you've got to have a bigger response. And we see that actually in the many, many genes that this actually interacts with. This was published several years ago, where you can see 1,700 genes that we discovered that, in fact, this is the work of Dr. Ramahen Rao, my colleague, who discovered that all these things interact with APOE4 in such a way that it's turning down

the response that normally turns down the inflammation. So you have a heightened status of inflammation. So again, people who are APOE4 positive, and that's 75 million Americans, should be thinking not only about finding it out, but also about getting on things like resolvins and diets that are high in omega-3s to keep that inflammation down. When I just touch on diet just for a second, you know, there's a lot that you shared and we're going to unpack that all. You mentioned my episode with Dr. Rick Johnson. Yes.

And you two, along with Dr. David Perlmutter, you guys released a paper talking about this mechanism that fructose has that it could have a connection to Alzheimer's. And we did a whole episode on that and we will link to that in the show notes. As part of that, naturally, anytime we talk about diet, anytime we talk about especially a lot of like whole foods and things like fruit, it's a good opportunity to help clarify because people hear something and they immediately want to jump into, okay, so you're saying is fruit bad? Or are you saying saturated fat is all bad? You know, so just want to clarify that here since we have folks' attention. So in that episode, and I've also heard you and Dr. Johnson be on an episode together with Tom Bill, you from Impact Theory, where you had clarified to people, you're really talking about large amounts,

pharmaceutical dosages of fructose and glucose together, which is kind of, coming from the standard American diet primarily in the form of consumption of highly ultra-processed foods and especially soft drinks. So we're not talking about, you know, having fruit, which is a healthy part of a regular diet, and you get all the flavonoids and the polyphenols and other things like that. And there is some concern about large quantities of fruit juice because it would be very hard in nature to eat that much fruit if you're drinking a ton, a ton of fruit juice, which could be exposing you to a lot of fructose.

But in general, if people are having whole fruit as part of a regular diet and their fasting insulin is good and their glucose generally is within range, they're okay and they're going to be thriving. Is that a fair way to say it? Yes. And I think, you know, Rick Johnson's research over the years has been so fascinating because as he showed, it's counterintuitive. You're eating something that is a simple carb that's there to give you energy. But your body recognizes that this energy is coming at the.

end of the summer because it's fruit related. You're about to go into this winter. So your body is smart enough to say, we're actually going to take this. And instead of burning it, we're going to turn down our ATP levels and we're going to store fat because we know that winter is coming. Well, unfortunately, for the Alzheimer's brain, that's the last thing that you want to do. So as I said earlier, this is about innate immune system activation divided by energetics. So when you turn down energetics, you're now increasing your risk for cognitive decline. Your brain is saying, I don't have the support that I did even a few days ago because of high fructose corn syrup. Just as you said, it's not about a piece of fruit. It's about things like high fructose

corn syrup and high glucose levels. And as he pointed out, you get a similar response to high salt. So you can get it with any of those sort. This is a stress-related response, which his research showed. So now, unfortunately, it plugs right into. our equation and shows that you're now increasing because you've got less energy, you now got to make up for that as well. And actually just like the conversation around fruit. And we talked a little bit about salt in the episode with Dr. Johnson as well. Another thing that often confuses people again, because people are looking for and you have a ton

of them. We're going to go through a bunch of them. They're looking for action items, right? You're saying that this disease is optional or should be optional for this generation that's in their 30s and 40s. If they're addressing things and getting tested early and looking at these root factors early, and there's a bunch of new tests that are available now. We're going to chat about that.

So people are naturally thinking, okay, well, is avoiding saturated fat completely? Part of this thing that Dr. Dale Bredesen is saying as part of our reducing our prevention. So let's talk about saturated fat just for a second. You know, it is from my understanding of some of the research that's out there, we're talking about large concentrations. Again, similarly how we're talking about fructose of saturated fat and even maybe potentially added saturated fat inside of the diet. Is that your understanding of it? Yeah. So again, we come back to the fact that the human body, unfortunately, when it gets chronic illness, it doesn't get the symptoms

until relatively late in the course, just as we were talking about with Alzheimer's disease. You go a long time before you know, oh my gosh, I've got kidney failure or I've got, you know, I've got, you know, any other of these chronic illnesses, you know, lung fibrosis, you know, what have you. So, So the point here is that you want to optimize your biochemistry so that you know that you're not going down year in, year out. And so you want to know, for example, your omega-6 to omega-3 ratio. Your arachidonic acid, you know, AA to EPA ratio is another good one. And then, of course, it's good to know where you stand with your APO-B. it's good to know where you stand with your LDL particle number.

All these kind of tell you, back to the network. Is your network working well? So I don't worry, if people are in the kind of 800 to 1,200 for their LDL particle number, I don't worry about that. If it's got a normal, you know, APOB, et cetera, that's all good. But, and so those people, no problem, they can have some saturated fats. We'd like to, you know, we'd like to make it so that you don't have a lot of inflammatory. Of course, omega-6 is not a saturated fat, but you can change your ratios and

get into a pro-inflammatory state either because you've ingested a lot of saturated fats or because you have a high omega-6 to omega-3 ratio. You know, typical American has a ratio of like 15 to 1. We'd really like to see it more like 1-to-1 up to 4-1 or 5-1, not 15-1-1. many people have. In the ratio. And there's a ratio. And luckily, there's some pretty low cost tests that are out there, like a megacquant for like 99 bucks, you can get your ratio done and get a whole breakdown. Exactly. Yeah. So you want, yeah. So again, you know, you, these things are all, it's not that they're good or bad. Right. It's that you want to look at them in the context of how things are going. And for the context for saturated fat, is that for the same things that impact

cardiovascular health, you're worried about them impacting the brain? Like, what is the, what is the connection? Like I get LDL, right? And I get the APOB in the context of cardiovascular health. We talked a little bit about that on this podcast. I've had my own personal cardiologist kind of review my numbers with everybody because I'm one of those individual, which I understand that it's about 20% of the population that they have familial hyper-collestracellemia. And so even if I make changes in my diet, which I've done, my APOB is quite high and it's very hard to bring it down. Okay.

And in my LDL also too. But I was explained, and again, this might be taking us a little bit off tangent, but I was more understanding that is the reason that you're worried about APOB and LDL something separate for Alzheimer's disease or do the same things that impact the heart, impact the brain? What's the connection? So, you know, so it's a great point. And we hear about this a lot that, oh, you know, what's good for the heart is good for the brain. It's not one to one. There are some different things. But yes, we do want your blood flow.

So that part is no question similar. We want your blood flow to your brain to be optimal. You know, it's interesting. We always think that, okay, you know, our brain, we get, you know, we get plenty of blood flow to the brain. It's got, you know, it's got no problem here. But in fact, as we're getting a little older, your brain is slowly. There is a natural, you can do MRIs year in and year out. There is a very small reduction in brain volume for people who are asymptomatic year by year. And in fact, as you might guess, it's greater in people who have MCI or dementia. And interestingly, in our trial, we actually reversed that. People's gray matter actually grew, even though they had already been diagnosed with MCI or early dementia. And is gray matter

and blood flow directly connected? They are related. Yeah, so generally if your blood flow to the brain is good and ample and not reducing year over year, which it is for a lot of people, generally you're going to either maintain or potentially in your instance you're showing that you can grow great matter. You can actually increase it. Now, it is fair to say there are things that damage the gray matter without changing the blood flow, for sure. But they are typically matched.

But then there's a separate thing, which is that are you activating microglial cells? If you're activating microglia and they are producing cytokines, you are decreasing. increasing your synapse and a synapse number. And interestingly, you go back to this idea that you're talking about the immune system when you're talking about A-Beta. It's really part of the innate immune system. One of the things that was discovered a few years ago is that many of these synapses are covered with complement.

And guess what? Amyloid actually interacts with one of the components of complement, C1Q. So you're now also, again, back to the same thing. This is part of your immune system's response to these various insults. So the second piece besides blood flow is your microgleal status. And then the third piece is mass cell activation. And it's interesting, mass cell activation is relatively common in people who have ongoing inflammation and who are developing cognitive decline.

And actually inhibiting that turns out to be helpful. So again, it's a new part of the armamentarium and something that we all need to be looking at if we have any sort of suggestion of mass cell activation. So it does go beyond just your blood flow. Got it, got it. And again, break this down. You know, you talked about it on a previous episode, but just to catch people up, if this is the first time hearing from you, microglial and the brain's detoxification system, connect that into what you were talking about, about our innate immune system. You kind of high level we're talking about it. But what is the role of these cells inside of the brain? What are they trying to do? So, yeah, so it's really interesting.

You know, you've got, your neurons are basically talking to each other, but they need a lot of help. So you've got the oligodendroglia that are, of course, wrapping the myelin around them. That allows you to have the very beautiful, you know, quick connections and quick communication. This is like around the cable. You've got the astrocytes that are like the assistance. They're helping. They're mopping up some of the toxins. They're supporting the neurons.

And then, as you said, you've got the microglia. And then, of course, the endothelial cells are supplying. and they're an issue because of their cytokine production. But your microglia are essentially going around and eating things like bacteria. And unfortunately, you know, we used to think of the brain as an area that is completely sterile. And unfortunately, it turns out that, in fact, there are all sorts of things that gain access to our brains. It's a little bit scary to think about. And so a few years ago, there was a really interesting experiment done.

And what they said, look, everyone knows about the blood brain barrier. Oh, that's going to exclude all these things. So you don't have to worry, you know, you get something in your bloodstream. It's not going to get into your brain. So they actually took laboratory animals and injected them with some candida organisms and just said, let's see how many days, weeks, or months. It takes these things to get into the brain, to cross that in uncrossable blood brain barrier. And the answer was a couple of minutes. So the candida gained access to the brain within a few minutes.

And what was the response of the brain? It was what looks like early Alzheimer's disease. Wow. So it's back to, yes, this is part, as you said a few minutes ago, it's part of your protection. You're saying, I can't focus right now on growing and maintaining synapses. I got to focus on protecting myself. And it comes right back to the analogy that you and I talked about earlier, the country that is now suddenly being invaded where it's got to focus its resources on the invaders,

not on building new bridges and making new colleagues and things like that. So big difference. And the microglia are a critical part of that. Now, very interesting thought about microglia. Several years ago, two different institutes said, okay, we've got the problem, you know, we've solved the problem for Alzheimer's. One of them said, all we have to do is turn down the microglia, because they're the ones that are making all these cytokines and destroying the brain in Alzheimer's, we turn them down, everything's going to be great. The other one says, we got the answer to Alzheimer's. All we have to do is turn up the microglia because the microglia are there. They're going to eat up all that amyloid. They're going to clear that all out. Everything's going to be great. And that's the problem.

Everybody wanted to do the simple idea that they're only good or bad. No, they're both. They are there to help you. They're not trying to give you Alzheimer's disease, but they're fighting the insults. And when they're fighting those insults, you know, soldiers are dying on the field there. And unfortunately, that includes your neurons. That includes loss of your synapses and things like that. So these things are making, they're hyperactivated. They are making cytokines. They are damaging the brain.

But they're also trying to clean up the problems, just as you said. So we've got to, therefore, get rid of the insults, tone down the insults, tone down the response initially, and then figure out what. what those insults are and get rid of them and increase the energetics. That is the formula for improving people with cognitive decline and, of course, preventing it to begin with. If you had to your best knowledge of what's available today, and of course, as you've mentioned before, even what has been discovered in the last five years is a much better understanding.

So things will probably change slightly. Sure. But based on your work so far, the trials that you guys have done, you have one ongoing right now that I believe that you're recruiting for or in the process of recruiting for. If you had to prioritize and rank big picture, understanding that there are vast differences between individual patients. And we might want to chat about that too, but that in general, there are themes that are there.

If you had to prioritize and rank the insults, the things that can go wrong inside of the network system that can contribute to ultimately developing Alzheimer's, how would you rank them accordingly? Yeah, it's a great question. And as you said, it is so different for each person. And, you know, we see people that are just so different. We see people where the biggest problem is innate immune system activation. And they've just got chronic activation of this. And it's often because of their insulin resistance. It's often because they have problems. with their diet. Processed food, I think, is a big player, unfortunately.

It's often because of leaky gut. And, you know, it's sad for me to say it. It's often because of mycotoxins. And the... Which just for those that are not familiar, these are the toxins that mold secrete. Yes. Whether it be in the home, in some instances, mold can,

from my understanding from our conversation last time, can kind of take up sort of housing inside of the body. Yeah. and produce these toxins as a way to defend their territory. And those toxins are damaging to ourselves, but most importantly, our mitochondria. Yeah. And, you know, I think Dr. Ritchie Shoemaker did a tremendous job years ago where he called attention to this and said, hey, there are all these problems.

And he was really looking more at peripheral problems, things like rashes and, you know, lung changes and fatigue and things like that. But he did point out, and some of these people get Parkinson's. And he pointed out that. this was related to exposure to these toxins made by molds. And I think it was a brilliant finding. And, you know, I think he deserves, you know, every major award for that, for figuring that out and studying it. And he's really shown us epigenetic changes and what are the things that are critical for this. And it's really spawned a whole new field. And but the problem has been

that the standard of care does not even recognize. recognize this as a cause. And microtoctines could be an issue. No. And in fact, I've read a few places where people would write about this and say, how ridiculous it is that people would say that these things are contributors. Well, anyone who's taking care of patients and measured them and seen the patients improve as you lower them realizes, of course, it is, and it makes perfect theoretical sense because these are, when you want to have an inflammatory response, one of the best things you can do

is expose people to molds and things like beta glucans. These are things that unfortunately give you that problem. And by the way, you know, again, hate to say it, but it's the truth, things that are adjuvants. So you get boosters and vaccines and things like that. As we know, it's not, you know, it's not black and white. You should or you should. We have people who are anti-vaxxers and people who are pro-vaxers and they're, you know, equally vehement.

But the reality is there are positives and negatives. We all know. And we see that people who are getting boosters may get Gilan-Barray syndrome, you know, may have other inflammatory responses, may have myocarditis. And of course, they may, unfortunately, have responses. And we do see people sometimes whose cognition declines after it has been improving because they get this adjuvant where they're now getting their innate immune system activated once again.

So I think, you know, as you ask the common things are on the inflammatory. side, it's things like a processed food and leaky gut. Sometimes, oral microbiome changes sometimes, periodontitis is an issue. And it is, unfortunately, exposure to these biotoxins that happens a lot. And then on the energetic side, it is sleep apnea is a common one. And people who don't realize they're dropping their oxygenation when they sleep at night. And then it's people who are just, who kind of let themselves get out of shape. This is one of the reasons. I think that I'm so interested in EWAT exercise with oxygen therapy. And also these Katsu bands, things that will improve your ability to deliver oxygenated

and substrate-containing blood to the far reaches of your brain. What's happening is you're not delivering it to the far reaches that you were before. And so just stepping that up is helping many people. So pausing there for one second, just to kind of give people a little bit. bit of a lay in the land. So you have a group of clinicians. I think you said now it's 2000, that you have trained in your approach, your protocol, your methodology. You've written about this. You know, the last book was called the first survivors of Alzheimer's. You would tell people, hey, we all know a survivor of breast cancer or other cancers that are out there. But, you know,

we don't know a survivor of Alzheimer's. Well, the first survivors are now there and they've worked with, you know, clinicians that are part of this larger. network that you've trained in your methodology, the Bredesen protocol. And they've gotten very tactical care, personalized care, not looking for one situation, one specific thing that's causing their Alzheimer's, but rather a whole list of things that are possible. And then you find out what is causing that patient's particular situation. As you mentioned, it could be a lot of things. It could be gingivitis that's inside of the teeth and the oral microbiome that is now crossing the blood-brain barrier and that is ending up in the brain and that contributes to it. Mold.

You mentioned mold. Being insulin resistant and having a diet that's super high in ultra-processed foods and carbohydrates, which usually goes along with obesity. There's a lot of different things that you just mentioned. But essentially, these clinicians are part of this larger network that you've trained. They would be sitting down. They would be doing an evaluation with the patient, getting a chance to really understand through blood work.

and there's some new ones that are out there. We'll chat about that. Blood work, memory testing as well. Is there any advanced imaging that they're also doing as well, or it depends on the situation? Yeah, absolutely. So it depends on the situation. If you're completely asymptomatic, you don't have to have an MRI. If you are symptomatic, you should definitely have.

Or if you're concerned, if you've got this in your family, for example, which is a common issue, then you want to make sure to include an MRI with volumetrics. The volume metrics in very little addition to the cost and huge amount in terms of the actual data. So you can see what your hippocampal volume is. You can see what your parietal lobe volume is. You can see what your temporal lobe volume is, things like that. It's so critical. And then for some people, you'll also want to have a PET scan.

Less and less need for PET scan and for spinal taps. Now that we have better and better blood tests. So you can kind of look at what's going on in the brain without actually having to do these very expensive pet scans and these, you know, and these spinal taps that none of us wants a spinal tap. So these are all a combination of different assessments that these clinicians are doing to establish a baseline. Exactly. And once you have a baseline now, obviously under the care of a doctor, because these things are quite sophisticated, right? You're trying to come up with the best treatment plan that's been inspired by functional medicine to end up. getting to the root issue of that particular patients, challenges, and then you're retesting

and you're getting a chance to see based on the testing, the imaging, the blood work, but also the patient's own experience, is this person getting better or are they not getting better? And you often find that people who go through this protocol and work with, you know, a clinician that they do get better depending on the stage that things are at. Right. So this is just putting a little bit of context around it. And, you know, you mentioned something before we were recording, which is, I think something important to, you know, mention here is that you were saying that this is much more like surgery, the work the clinicians are doing with the individual patients, than it is like just popping into the hospital and getting tested for something like,

you know, that's a lot more standardized and easier to follow. It takes a lot of heavy lifting. And it's also a little tough for the patient. They have to change their diet and they have to do these other things. But again, you're doing it all because it's giving you a sense of potential hope that something is possible on the other end of things. Yes. And you know, we've seen some amazing stories. So we've seen people go from mocha scores of 18. And can you explain to mocha score? Yeah. So Montreal cognitive assessment, a simple test just takes about 12 minutes or so. And of course, we have more sensitive tests like CNS vital signs. But mocha scores are classic. They're very, they were actually first set up to deal with MCI patients. And so you go from zero to 30. And, you know,

most people, you should be 28, 29, or 30. And if you've got MCI, you're going to be down 27, 26, all the way down to about 21 or so. In the 19 to 22, you may have dementia already or you may have late MCI. We saw people go from 18. That's demented to 30. Perfect scores. So it's amazing. Now, we saw other people go from 21 to 23, so we don't see everyone improve dramatically, but we see people who can improve dramatically. We've seen people go from zero to nine. Now, that's not back to 30, but they can dress themselves again, and they can speak again and do all sorts of things.

So as you said, it is much more like surgery. That's been the really interesting thing for me, that people have a huge armamentarium, and it's back to some really serious internal medicine to look at, okay, what is this network? How can I improve that? Because ultimately, you are trying to improve network function. And you are trying to get people to have their synapses functioning once again. And if they're fairly far along, they may have lost many neurons as well, not just their synapses, but the neurons themselves. So it may be harder to rebuild, whereas for some people, if they mainly have chemical functional changes, without anatomical changes, they may do very well.

And so there are people who are really good at this and who are getting almost all their patients to do better. And then there are some who aren't getting such good results. As you mentioned, we've trained about 2000. Six of the ones that are really fantastic are all working on this trial that's just started now. So very excited about that. And this is Hollywood, Florida, with Craig Tannio. Who's been on this podcast before? Great guy.

Yeah, great guy. And he's getting some really exciting results. Very excited about what Craig is doing. And then Dr. David Hossi in Nashville, also getting some excellent results. Dr. Nate Bergman in Cleveland, Ohio, just outside of Cleveland, which is Rocky River, for everyone who knows Cleveland. And the reason I mention these locations is because you should be within one hour drive of these locations to be part of this trial.

And we are actively looking for people for the trial right now. And then also Sacramento, and it's right outside of Sacramento Folsom, which is where Dr. Christine Burke is. is, then Dr. Kattoops, who's in the East Bay out in Pleasanton, and then Dr. Anne Hathaway, who is in San Rafael just outside of San Francisco in Marin County. So six absolutely fantastic physicians who all have had very good success with their patients. And we've spent over a year just in the planning stages for looking at all the things that can be done to get optimal results with these people. And Anne and Kat, along with Deborah Gordon, who's now retired, but was in the first

trial, got excellent results with that trial. And, you know, 84% of the people actually showed improvement. So we're very enthusiastic about this. And I think that the long-term outcome is going to be to combine targeted pharmaceuticals. Now you can know, okay, here are the things that I need to tweak to get the best outcomes. Maybe I do want to decrease, for example, Maybe I do want to decrease the phosphorylation of tau. You can do that with GSC3 beta inhibitors. By the way, lithium is one of those inhibitors. So, you know, we have a huge armamentarium.

We've been taught that there's nothing that can be done. A classic line, and it was on websites for years and still on some, says there's nothing you can do to prevent reverse or delay Alzheimer's disease. We've completely and unquestionably shown that is not the case. as have others like the finger study, the finger trial, which is a prevention trial out of Finland. So we've got to quit saying that there's nothing that can be done. So I think there's a couple different types of people that are watching and listening today. There's one camp that, unfortunately, there are a lot of people that are out there that either they himself or a loved one has either some form of cognitive decline that they're paying attention to or they might even have a full-blown diagnosis.

that's there, right? And largely those individuals are going to have to go and try to, if they're interested in exploring something like this, they're going to have to go and try to find a clinician that they can work with hand in hand to figure out their unique combination of insults that are impacting their network system. Because when you know what's going on with you uniquely, did you have mold exposure, did you have insulin resistance, do you have this, do you have that, then you can put an appropriate treatment plan together. Yes. And that's a little bit of what we've been talking about most of the interview. Then there's this other category. These are people who might know of somebody, right? Could be a friend, could be a relative. I mean, everybody

pretty much knows somebody that has had dementia. Unfortunately. And they're thinking, they might be in their 30s, 40s, 50s, 60s, 70s, and they're not having a sense that they know of right now that they are diagnosed with something or that they have a level of cognitive decline that is sort of seriously impairing their day. They may still have it. They just don't know that it's kind of going on. Yep. And at least they haven't been told.

And they're looking for what are the things that I can do to at least based on your experience, especially if I don't have access to one of these clinicians, what are the things that I could be doing today that could be potentially reducing my risk of developing Alzheimer's? Yeah, it's a really important point. So if you're 40 or over, we recommend that everyone get a. cognoscopy. So we all know when we turn 50, what are we supposed to do? We're supposed to get a colonoscopy. And it can really reduce your risk of dying of colorectal cancer. Of course,

pap smears did a tremendous job for reducing cervical cancer. And by the same token, getting a cognoscopy if you're 40 or over, and especially if there's been any sort of family history, but in general, for all of us, because we are all at risk. It, you know, it dwarfs the pandemic. We're talking about one million who've died in the U.S. from the pandemic. About 45 million of the currently living Americans will die from Alzheimer's if we don't do something about it. So again, nobody should get this. There's a tremendous amount you can do. Get a cognoscopy, which is some blood tests and some in a simple online cognitive test, as you mentioned earlier, and then MRI with volumetrics. And some simple things you can do, we talk about the seven basics.

And before we go to the seven basics, just since we have you here, I want to tease these out a little bit more and really make sure we understand. So for the blood test and the cognition test and some imaging, are people convincing their current practitioner that they want to get this done? And do you have a link or a resource or do they have to find a specialized physician, functional medicine, you know, somebody that leans heavily towards lifestyle medicine to run these tests for them? It's a great point. And we see yes and no. So I would say what I'm seeing is about a quarter of the people their doctor will say, sure, I'll do these for you, no problem.

Especially when it comes to the blood work. What's some examples of some of the blood work that they're running? Yeah, so they're running things, again, which makes sense when you look at what's, do it, what is important for innate immune activation and for energetics. So they're running HSCRP and they're running, you know, homocysteine. And TGF Beta 1 is actually a very good thing to know about yourself. that or MMP9. Again, these are things that are responding to, typically to biotoxins and other inflammogens. And then you're looking at your Homa IR. So you're looking at your fasting glucose.

You're looking at your fasting insulin. You're looking at your hemoglobin A1C. You're looking at your methylation. You know, we're now, there are some new things so that you can now look at your epigenetics. And you mentioned earlier, the advanced lipid profiles. So you're looking at, you know, how are your lipids looking and do you have an inflammatory pattern or not? And then you're looking at do you have toxin exposure? And we see this a lot where people will have biotoxin exposure, often in association with low platelet counts and or low white blood counts. And this is something that Dr. Joe Pizorno has pointed out many times in the past,

that many of us are exposed to toxins. And one of the things that we see and that we don't often pick up as physicians, is that people will have often low white counts and or low platelet counts. And it's telling you there's something that is interfering with these. And what would fall into the category of biotoxins, right? What are some of the things that people have probably heard about on this podcast? Like what exposure would they have had? What kind of toxins are we talking about?

Great point. So if you go back, the toxins that cause cognitive decline are break down into three groups. There's the inorganics, and that's air pollution and mercury and things like that. heavy metals because actually not only does amyloid, not only is it part of your innate immune system, it is a metal binding protein actually quite tightly. So it binds zinc and copper extremely well. Secondly, organic toxins. So things like formaldehyde and glyphosate and talewine and things like that. But then thirdly, as you mentioned, biotoxins. And these are typically things made by molds, although there are other organisms that make biotoxins as well,

but they are typically trichothecines. Those are the ones that I worry about the most, because these are made typically by stachybatris. So it's, you know, the five big mold species that you worry about with these are stachybatris, penicillium, aspergillia, espergellus, ketomium and wallimia. Those are the five typical bad guys. And so, and they are making things like trichothecines and okrotoxin A and gliotoxin, and gliotoxin and things like that that actually turn out to impact your immune system.

And, you know, the mold wants your immune system to be turned down so that it can live, so that it can stay there. And so it is trying to turn that down, unfortunately. And, of course, your immune system is saying, no, I want to recognize this, and I want to get rid of it. So these are ones that I am most concerned about. Yeah. The mold thing, you know, I'm not a physician.

I'm not researcher. I'm not trained in any kind of classical way on any of these things. But from being in this world and kind of being somebody who knows people, I get a lot of friends that are asking me about mold because either they feel, you know, I think the estimates by the World Health Organization or that 40% of buildings have some sort of, you know, toxic mold exposure that's there, right? That's just like the standard estimates that are there. And there's more and more people that have been talking about it.

There's new tests that are available. People can test their urine and they see that this is an issue and they might feel they have one of the symptoms, which is tough because mold can pretty much cause any kind of symptom that's out there. And I find that, you know, mold is tricky in a sense that it's hard to identify in the home. There's like a whole debates on this topic. I'm sure you know all about it because most mold that people are looking. for you're not looking for moldy food obviously nobody should be consuming moldy food you're looking for mold

contamination from leaky faucets pipes drywall construction and often it's not visible it's not like you go into a room and you kind of you know pull a little bit of paint off the wall and you have a bunch of black mold sometimes it's that yeah some most often it's a lot more complicated it's rotting wood it's tough to find and usually it's people who have had symptoms for a while and maybe hear a podcast like this and are like, maybe I should talk to a naturopathic doctor or a functional medicine doctor

and that's somebody who helps them kind of dig into it a little bit. So finding the mold in the house is tough in the first place. And then on top of that, especially if you're a homeowner, treating and deciding how to treat and remediate the mold is very tough too because it could sometimes be so baked into the building that people are literally deciding do they move, do they stay, right?

Because it's that difficult to remediate. All this is to say that, you know, I've found that it's very tricky to go down the mold rabbit hole, but that doesn't mean that people should not understand that it's a central part of cognitive decline for a lot of people. That being said, for this category of people who are listening, who maybe aren't diagnosed with something yet, I think that it's important that, you know, And please feel free to push back on this, by the way. I'm putting out a theory.

I think it's important to remind people that in addition to like good ventilation and air filtration in the home, which only does so much, making sure that people actively are working out, that they are doing strength training, that they're doing, that they're avoiding ultra-processed foods, that they're working on becoming not insulin resistant anymore and cutting them out of large pharmaceutical dosages of carbohydrates because those things, even if there is mold exposure, they can't reverse it, but they can at least minimize the impact to the body. And that's a lot more in people's control than the topic sometimes I find, as somebody who's in the space, of mold can be so complicated to dig down.

It's such an interesting point. And, you know, it reminds me of these old movies you see, you know, where there are 10 people, And it's a rainy night and they're in a hotel together and then suddenly they're only nine one of them gets killed and then there's eight and you know and they ever they keep looking at each other to say who is the murder here you know you're looking at this now there's seven murder mystery murder mysteries. It's like those one with John Cusack years ago and so the mold's a little bit like that's like we're looking around like what what is causing this decline like could it possibly be this mold that like is everywhere and you know. know, it kills me to say that it does seem to be a common contributor. I asked the physicians who were doing the trial, what percentage of your patients do you think mycotoxins are a contributor? The answer was 80%. I couldn't believe it. So now, that's not to say it's the only contributor. It's one of many. Would they, would you, if you would ask them again, would you say that if you had to kind of really sort of stress-tested idea, would they listed of all the

insults that you know, of all the potential contributors, causes, et cetera, contributors, I don't want to say causes, would they put mold in the top three? I think a lot of, top five. Yeah, for sure it would be in the top five. I think in many it would be in the top three. What we find, we published this years ago, that probably 15 to 20 percent, it's the main thing. It's the main thing that you're really out of focus. But, you know, Dr. Christine Burke over here near Sacramento, I thought made a really interesting

observation. And others have seen this, but I think she brought up a really good point, which is when she sees her patients and she does exactly the things you're talking about, she gets them to be metabolically flexible. She gets them to do the basics. We started to talk about the basic seven. So when she does the basic things, she buys them nine to 12 months. They do well.

And then after that, if she doesn't find the specifics that are causing this, if she doesn't find, oh, there's pathogens that I need to deal with or there's mycotoxins. If they don't deal with those specifics, they won't sustain that improvement. But I thought it was a very important observation. And we've seen it before, and Julie G, who works with us and who herself is at APOE4 for, she's the one who founded the website APOE4.Info. and has done such a wonderful job and has taken herself from 35th percentile to 98th percentile. She's sharp as a tack, and she's now over 10 years on this overall approach. She had about four years, so she was doing things, you know, really, really well, got on the right diet and did the right, you know, basically resilience, getting herself resilient.

And she had, she bought herself about four years or so. Then she started noticing a little bit of backsliding. This was now several years ago. And she contacted me and I said, well, you know, there are some things that haven't been checked on you. And you need to be looking into these other things. So it turned out, and she kind of put it off for several months. And it turned out she had babesia, so a tick-borne illness. And so that was treated.

And she now improved once again. Which would be in the category of an infection that is sort of dampening and putting a lot of pressure on the immune system chronically so your body can't function as well as it normally you could. Absolutely. And then she found out that she actually had a large mycotoxin exposure. And it was interesting, you know, when I finally convinced her to get a TGF beta 1, because that kind of tells you, are you fighting this ongoing inflammation? And you shouldn't have, it shouldn't be more than 2,380. Hers was 40,000. So she had massive, massive ongoing inflammation. and it turned out to be due to both Babesia and to mycotoxins.

And she's done a great job and she's, you know, she's doing well to this day. So unfortunately, yes, you've got to search. This is, you know, you've got to do a little Sherlock Holmes work here to figure out what's actually driving this decline. But the good news is exactly what you said. Everyone can do the basics. The basics. And everyone can get a response to those basics.

But then you're going to want to sustain that response. You're going to want to then continue to. to target the things that are actually driving the problem. Yeah, and when you're doing the basics, I think also you are sort of buying yourself time for a lot of these technologies, these treatment protocols, these plans to become more widely available and the price for them to also come down. Even something as simple as like testing your home for mold is actually a little bit of complicated, right?

There's a lot of different tests that are out there. They, everybody, every lab has a different sort of reporting. There's a lot of debate. Like there isn't a lot of different things of, is this test conclusive? Is it not? Then there's urine testing that people can do from like labs, like real-time labs. So just doing the basics. I want people to just remember that the basics, not only are they supporting your hopeful reduction

and sort of increased prevention in developing Alzheimer's, but they're actually going to make your heart healthier. They're going to make you stronger. They're going to make you more likely not to develop circopinia when you get older. Like Alzheimer's is one thing. It is the scariest thing. But there's a bunch of other things too. So I just want to make sure that people don't leave this conversation feeling like this feels so complicated.

Where do I get started? Because the folks that have been diagnosed or feel like they're rapidly seeing, when you start to notice that you have cognitive decline and I've had members of my family that have, your entire priorities change. Right. And you're willing to spend money, effort. time, energy to really make that the number one priority, at least if you have some sense of education.

Then in the bucket of the people of prevention, I often worry about let's make sure we double down on the basics for everyone so that they remember that there's no need to get overwhelmed. There's a lot of things that can be done right now. So let's talk about those seven basics. If you could walk us through. It's a great point. And, you know, the only way for us to be efficient, because you can't do a million dollar workup on every person.

So my argument is, look, everyone do the basics. And then most people will never have a problem. A few people will fall through the cracks. Okay, now they need more evaluation. So let's start with the basics, as you said. And those are, start with diet, a plant-rich, mildly ketogenic diet with appropriate periods of fasting. And by the way, the most common thing I've heard is people say to me, well, you're telling me, I got to go figure out where to buy organic stuff.

I got to figure out what kind of grass-fed beef to get, where to get wild caught fish, how to prepare all this stuff. This is now getting simpler and simpler, and I give great credit to nutrition for longevity, of course, founded by Volter Longo and his partner, Jennifer Maynard. They did a fantastic job. So they have now, starting today, literally, put together the Ketoflex-123 diet. And this is a diet which is just based on synaptogenesis. How are you going to make and keep your synapses?

And yes, it's heart healthy as well. By the way, it's also anti-diabetic because it's going to improve your insulin sensitivity. So you can now order meals. I've had them. They're actually delicious. I was impressed with the job that they did. And you mentioned before we started that you've actually been out to their farm. Yeah, been to their farm in New Jersey.

Yeah. And they've done a really good job, just building, you know, this. organic agriculture, the assembly of all the different recipes, by one just tiny, tiny little piece of thing that I would add for my listeners over here is that, you know, we've had Dr. Longo on and he's published some incredible research and his work. And he has his philosophy on protein and how excess protein has certain links to EMTor and it's role in longevity. We've also had some people on that talked about maybe some of the nuances around that. I personally have been, this is my own bias. I've been convinced that, yes, plant rich, you know,

ketogenic forward, healthy fats, everything. And if we under eat on protein, then we don't have enough skeletal muscle. And skeletal muscle is the number one thing that helps us use up glucose inside of the body. And also as we get older and we lose, from my understanding from the different researchers out there, every decade after the age of 40, we're losing about 8% muscle mass, 8 to 10% if we're not actively working out or eating enough protein, regardless of what source animal or, you know, vegetarian if people can get the right amino acids. So that's my only component is that to supplement with the appropriate level of protein that you feel that you desire, just so you can maintain healthy skeletal muscle mass and avoid sarcopenia into your later age.

I couldn't agree more. And actually, you know, Volta is one of my colleagues all the way back from UCLA when we were both starting out. He was actually a graduate student and I was a young assistant professor. and actually he and I published some papers together with his mentor there, Dr. Joan Valentine. So really enjoyed Walter from his first day. And it was interesting to me. He was the grad student of all the ones I met over the years who knew from day one what he wanted to do. What experiments he wanted to do.

Very impressive graduate students. So it's just great to see all the great work that Walter is doing. And I give great kudos to nutrition for longevity for coming out with KetoFlex 123. And as you mentioned, it's a different strategy. So I remember actually when I was at the, when I was on the NIA council, Walter came and presented to us at the NIH and presented his idea, this was many years ago, presented his idea for what became this longevity of associated diet. Initially, they were using it for cancer-related things.

And of course, it has a nice anti-neoplastic effect. And this is something that you do intermittently, whereas Ketoflex-123 is something that helps your brain every day. So it's a different strategy. And you can do both because you can do the intermittent work, for example, with fasting-mimicking diet or with a longevity-related diet as well as doing this ketogenic, mildly ketogenic plant-rich. And yes, it absolutely has protein. There's a pescatarian option we have and a flexitarian option.

So it does have grass-fed beef. And it does have chicken and all that sort of stuff. Oh, that's great. It's fantastic. Yeah, so it's got all these things. And we agree that you do not, you want to avoid sarcopenia at all costs. Would you say, are you familiar with the work of Dr. Chris Palmer at Harvard? Have you seen his work?

I'm actually in the middle of reading his book right now. So brain energy. Yes. Very interesting work. And, you know, he makes a compelling case. And I know he's got data. I'm looking for that first big series to say, okay, we did this in X number of people. and what percentage actually got better.

But I agree with you. And actually Rob Lustig was the one who told me what a wonderful book that was. And so I got it and I'm reading it right now. So I know you're in the middle of it, but potentially, you know, he was a very popular guest on this podcast. He came on here when his book first launch. And, you know, a lot of Sympatico work. You know, I actually think if you guys aren't in communication, happy to put you guys in

communication. That would be great. Very much this understanding that, you know, how our brain utilizes energy. is central in how it's going to be working. And if our brain is overloaded from this high quantity of calories from processed foods, primarily, you know, insulin resistance also inside of the brain, then you're going to have all these downstream mental health effects. But I was going to ask you, even though you're partly into this book,

potentially that even somebody who's looking to adopt some of the dietary recommendations that he talks about, they could potentially be going on this program as well. Like there's a lot of reasons in addition to Alzheimer's that somebody might want to eat this way that you're talking about. Absolutely. And, you know, it's interesting to me. He looked at mental illness. We looked at neurodegenerative illness. We came to the same conclusions that there's a mismatch.

And, you know, not enough supply, too much demand. In my case, we're looking at demand for synaptogenesis. In his case, he's looking at demand for good mental health, basically. But, you know, you look at, for example, the studies in schizophrenia, there is a reduction in the number of synapses. There is a change in the structure of the neurons. So there are things just beyond, you know, DSM, I guess they're up to DSM-5 now, just looking at symptoms. There are functional and structural changes. And so energetics seem to play a large role in both the neurodegenerative side and on the mental health side.

points out in his book. And I think, you know, they're also going to be turned out to him important in things like autism and ADHD. I mean, all these things are coming to the same conclusion. And I should mention, you know, we were talking about the seven basics just to not forget those. So diet, exercise, sleep, stress, brain training, detox, and some targeted supplements. Those are the basic seven things. And for each of them, we can optimize them. And there are things that, you know, we've talked about before and you've talked about with others as well. So as you mentioned, you want to have strength training. You want to make sure that's included. As I mentioned earlier, I like EWAT because it's giving you that not just the aerobic part,

but it's also giving you profusion with oxygenation. So I think that has tremendous opportunity. And where would somebody go if they wanted to learn more about that or do that practice? So yeah, you can actually look up, there's a number of these. You can look up, you can look up Live-O-2, L-I-V-E-O-2, as an example. That's one of them. And it's a facility that you go to? And you, well, so you can actually have them at home. Okay. Or you can go to facilities.

And actually, some clinics are now starting to put them in their clinics because they seem to be so helpful. Yeah. So what it's basically doing is you are pedaling a bike or, and then you can use it with cross-country if you want. But the typical story is you're pedaling a bike. But instead of being your typical Peloton, you're now pedaling a bike while you're, while you're breathing 100% oxygen.

So it has similar effects to hyperbaric oxygen without the hyperbaric part of it. You're essentially, you're using the exercise part of it to get the perfusion. And this all goes back to increasing blood flow and getting to the farthest regions of the brain. Exactly. If somebody had access to hyperbaric, is that something that you would recommend for people? Absolutely. Yeah, that's another way to go. That part doesn't give you the exercise part of it.

But it does give you the increased atmospheric pressure. Now, some people have claustrophobia issues with that in some. And again, some of these things are huge. But in the small ones, some people can have some claustrophobic issues. And others don't. So that's another way to go. It's EW. O-T.

O-T. So it's exercise with oxygen therapy. Okay, great. And live O-2 is one example. That's one example. We could put that in the show notes if people want to check it out. And there are others out there as well. You're getting hyper-oxygenation, but you're also getting a workout in.

Absolutely. Do you do it? Do you do it with like a bike? So I've been doing it without the oxygen just because I haven't gotten to the point where that was a concern. And I'm just now looking into getting this. Okay, great. My age is getting advanced now and I'm looking at adding that part of it. So I think it's a good idea. So going back to the basics, you know, we covered the dietary component, really cleaning

up the diet, getting off of ultra-processed foods. And if people have room instead of their budget, you now have this partnership available with nutrition for longevity. And I should say they can go on, you can look at KetoFlex.123.com. KetoFlex.123. And I think it'll be fantastic for people, whether it's someone in at home, someone at an assisted living facility, someone who's at an independent group like the villages, someone who's in a nursing home for any of these people.

It's a very simple way and much less expensive than going out for food. and in fact in many cases it's going to be less than going and finding all those things yourself and preparing it yourself. That's great. That's a great solution. We need more of those solutions out there. Also, another low-hanging fruit because it goes back right into the work that you, Dr. David Perlmutter, Dr. Richard Johnson did, which is, you know, people getting off of liquid forms of calories.

If a lot of your calories are coming from liquid forms, primarily soda sweetened beverages, sugar, sweeten beverages, that is immediately going to be a win because it's going to help your waistline, but it's also going to reduce this exposure to fructose, as well as the blood sugar roller coaster that comes from the glucose inside of it as well. Absolutely. So that's the dietary side. We just want to touch on sleep because I think that more and more people now are putting like sleep number two or number one right up there with diet, right?

Because of, and sleep is one of those things that the more that you learn about it, the more that you realize that chronic sleep issues are tied into so many different diseases that are out there. Yeah. Cancer exposure, Alzheimer's. You mentioned something the other day that was really interesting on Twitter. People who have restless leg syndrome are more likely to develop Alzheimer's because it seems that restless leg syndrome is something that disrupts your sleep quality. Yeah.

I found that very fascinating. So do you recommend that the first step on improving sleep is for people to get like an at-home sleep study? Yeah. Or just even oxygenation. Even you can get an oxymeter, put it on your finger. You can get an Apple Watch and wear that. You can get an aura ring. Now, you can even fit bits and things like that.

All of these will measure your oxygenation. In a perfect world, you'd have an SPO2, your oxygen saturation, that would remain. 96 to 98% while you're sleeping at night. For many of us, it starts to drift down, and it can be from sleep apnea, it can be upper-rary resistance syndrome, it can be for waking and sleeping. A lot of us will have bursts of adrenaline while we're sleeping, which interferes with deep sleep. You could spend hours, and I know Matthew Walker, Professor over at Berkeley, has done a beautiful job with his book, Why We Sleep, and looking at all these issues, because your ability to get that deep sleep is huge for detoxification for your brain. Your ability to get enough sleep

and to get enough quality sleep, get enough REM sleep, all of these are different pieces that are critical. And so many of the things we do from, you know, poor sleep hygiene, staying up too late, having exposure to EMFs all night, to watching TV late at night, getting activated. I know, I am definitely guilty. I'll be doing emails late at night and then try to just shut down the email and go right to sleep. And it does not work very well. So we want to take some time to ease into sleep. We want to make sure that it's dark enough.

We want to make sure that it's quiet enough. We want to make sure that we have enough sleep. So many of us, again, you know, you're going to get more work done if you only get four hours of sleep at night. The very first patient, patient zero came in. And one of her big problems was she was working. like crazy for the government and getting four to five hours of sleep per night. That was one of her many issues. And definitely improving that has really helped her.

And by the way, she started in 2012. She's now 11 years into this. And she's now a brain health coach and doing great. That's amazing. Incredible. So bottom line, prioritizing sleep. And if there are any kind of conditions, disorders that are interrupting, don't see it as a light thing.

really tackle it and get the help that you need. Yes, because it's so critical. And so many people will ignore that. And that's an important part of getting optimal outcomes. So we talked about a diet. We talked about the sleep. You mentioned some of the other seven. Let's just kind of quickly go through them

and any kind of action items that would be there with you. Yeah. And so stress. And again, that's another big one. One of the interesting things is as long as you see that threat. So we talk about the biochemical threats and the microbiological threats, the P. Gingervalis that's worked its way into your brain. the herpes simplex that's gone up your trigeminal nerve into the ganglion and gone up into your brain,

the candida that's circulated, the Lyme disease, all these things. But what we tend to forget is there's also a mental stress and threat. And this is equally important. As long as your brain is saying, I am being assaulted, whether it's by organisms or inflammogens, or whether it's by concern that, oh my gosh, you're going to get fired from your job, or someone's pushing you to have something due by tonight and you're going to be up all night working on it. I think about all the times as an intern when I was up two and three nights in a row without any sleep whatsoever and how horrible that was for me. So that sort of thing is going to

give you a problem. So managing the stress and look, check your heart rate variability or HRV. Easy to do. And let's see how you do for your age. And by the way, way, notice, you can see your heart rate variability jump two or three fold by one minute of slow, deep breathing. It's striking. So telling your amygdala, I'm not dying, I'm not under that much stress. Things are going to be okay. And yeah, short periods of stress with resolution, fine. It's that chronic, oh my God, I've got something due every day and just keep going. It's a problem. Then we've got brain training. This is Professor Mike Mersenik, who is the father of brain training, He did a great job, started posit. Neuroscience has developed Brain HQ and has worked with Tom Brady and so many others who want to improve.

In his case, it was improve his visual field and it worked very well for him. So improving your cognition and reducing risk for decline, things like brain HQ and stimulation, and by the way, other forms of stimulation, photo biomodulation. Great. Things like V light and neuronic and in groups like that have done a really nice job. Mild stimulation in appropriate wavelengths and with appropriate frequencies has been very successful. Even in that category would be being regular about getting your morning sunlight. Absolutely. When you first wake up in the morning, going outside, not necessarily looking directly in the sun, but looking towards that direction and getting that morning sort of reset on your circadian rhythm.

and then seeing evening sunlight if you can as well, that seems to be an important part of protecting our mitochondria and photobiomodulation. Yeah, and your circadian rhythms, huge. And then there is detox. And, you know, again, you could spend a lot of time just talking about detox, but there are some basics from filtered water to your, you know, elimination, you're sweating. The study that's always quoted out of Finland, people who did saunas six days a week versus those who only did them two days a week.

huge issue, a huge difference in the risk for dementia for that group. So the people who did more saunas, much lower risk of dementia. And the effect was large. And then so, you know, all these sorts of things for detox and making sure that you don't have exposure to toxins. And again, to go back to Robert Lustig in his excellent book, Metabolical, much of the food that we eat really could not be classified as food. It should be classified as poison because it doesn't have nutritive value. and it does have toxicity in it. So, as he pointed out, it's more correctly classified as poison. And so, you know, doing, just getting that detox, getting rid of that, getting on, you know,

whole foods, plant-rich, diet, very helpful. And then finally, some targeted supplements and, you know, improving your BDNF with things like Whole Coffee Fruit extract, actually first mentioned me years ago by David Burlmutter. So thanks to David for that. I think it was an excellent suggestion. And many, many people, of course, have used that strategy. Of course, you can also increase it with things like exercise. And then for many of us, we're too low in magnesium, too low in zinc, too low in iodine, too

low in potassium, making sure that those are optimized. Many of us are too low in chlorine and vitamin D as well. So making sure that we're okay there. And then many of us too low in B12, for example, which will increase your homocysteine, which is, again, another risk factor for cognitive decline. So again, the Armentarium is huge. On the topic of supplements, because people always want to know, you know, you didn't mention fish oil.

If you can have access to a good high quality fish oil, especially when it comes to the mega three to omega-6 ratio, would that be in your top five? I take it every day. Okay. Yes. Yes, absolutely. Yeah, and I think the key is a high-quality one. Look for brands that are reputable that haven't been oxidized because I think there's

different debates about, is fish oil even healthy for you if it's been. oxidized, which typically is going to be the lower quality fish oils that people are buying from like big box brands or not reputable brands or things that are imported in from overseas that might not have the high standards that are out there. Absolutely. And so a good multivitamin that would cover a lot of the ones that you were mentioning. Yeah. Right?

Maybe you need to add a little bit of magnesium to get to the threshold. Yeah. And again, you can check your RBC magnesium. So again, you kind of want to make sure that you are in the right range. and an optimal range. So those are the basics. And even for a lot of people, just getting good at that and mastering that, like, that can be a whole life's work in itself.

And it can be a life that will keep you from having cognitive decline until you're 100. I mean, that's our goal is to make everyone get to 100 with good cognition. And you're right. Look, if we just optimize their energetics, get them so that they're doing good exercise and that they have insulin sensitivity and that they don't have chronic inflammation and don't have chronic stress, most people are going to do very well. And then the few people who begin to have symptoms do not wait. Do not let your doctor tell you it's normal aging because you don't have to have this

with aging. Get in there, get evaluated, and then, you know, get optimized for those things. And that way, most people won't need a lot of evaluation. They can do some basics and do questions. quite well. So we created both pre-code for prevention of cognitive decline, which is a smaller program, and then recode for people who actually have some degree of cognitive decline, so that it was for reversal of decline. And then the best of all, we can now get feedback. So you can look with this, the new blood tests you alluded to earlier, you can now look at your phosphotau 181.

Yeah, could you explain that? You mentioned that previously. What is phosphatow and when you're looking for it inside of the bloodstream? Like, what is, what are you sort of looking for that marker? What is it doing inside the body? Yeah, that's a great point. So what happens is we're now able more and more to look at the intracerebro pathophysiology with blood samples. And this is something, by the way, that Dr. Lee Hood was saying 25 years ago, you know, we're going to be able to sample various organs with blood tests. And at the time, there really wasn't a good way to do that other than some simple things like, you know, so-called liver function tests looking at ALT and AST and things like that. But we're now able better and better to look at these biomarkers from what's going on in the

brain. So when you have problems with your brain, just as we were talking about earlier, and you are in a synaptoclastic mode, you're pulling back on the synapses instead of synaptoblastic mode where you're making the synapses. What happens is the tau is like, it's like bolts that are stabilizing your microtubules. So when you're putting out those processes, you're reaching them out, you bolt those into place with tau. Now, what happens when your brain receives the signal? Uh-oh, Drew, pull back. Things are not good. I'm pulling back now. I'm going to put my resources into the things that are causing inflammation. I'm going to put it into downsizing, fighting, giving the amyloid and killing things. What happens is you've got to pop your tau off there quickly.

And so you change the actual structure of the tau by phosphorylating it. And that pops it off the microtubule and allows you to collapse. So it's telling you when your phospho-tow is high, it's saying you are actively pulling back on your neurites. And you can now measure that in the blood. It's been around for research for a while, but it's been very clearly correlated with cognitive decline. And the great news is, although it takes several months, you can now improve. prove it. You can see your phosphatow be high, and now you can see as you're getting better that your phosphatow can start to come down. And actually LabCorp has now got, you can order Phosphotile 181.

The other one, which may be even a little better, which is Phosphotow 217, is coming. It's not available commercially today. And by the way, all of these are part of our new trial. So we will be able to see what happens with Phosphotau. Also, A beta 42 to 40 ratio. That's another thing. The 42 goes down. as you are in that pro-inflammatory state in your brain. Then the next thing is neurofilament light. So this is part of actually, again, the structure of your neurons. So when you have neurodegeneration, the neurofilament goes up. Now, the negative there is it's not as specific as the phosphatow,

which is more specific for Alzheimer's disease. That just tells you you have some neuronal damage. But each of these things complements the other. And the last one is GFAP. which is glial fibulariacetic protein. What I like about that one, although, and that one's not available today, but will be within a few months,

that one is the earliest one to come up. So it's been shown that if you're going to develop dementia 20 years down the road, your GFAP is going up very early, even before your phosphatow. The negative of the GFAP is that it's nonspecific. So anything bad, if you have chronic traumatic encephalopathy, if you've got some bad vascular disease, and you've had some mild strokes, things like that, head trauma, any of those things can drive it up

or other neurodegenerative diseases. The good thing about it is if you get one that is completely normal, you're not headed for Alzheimer's anytime soon. And so it's a good way to follow it. So with this combination of these, we'll be able to see where you're headed, and then we'll be able to apply the approaches that we've used and we've shown improvement in cognition. we should be able to see now improvements in biochemistry as well. Powerful, especially once it all becomes available. Yes. Part of it is also, I'm sure, if people give these results to their normal doctor,

they may not know the reference ranges, they may not know where to sort of intervene. So this guidance that you are putting together for people to have access to is really exciting because anything that we can do to test and sort of see early will give us the best shot at addressing it earlier. Exactly. I want to ask you a question that sort of is a friendly stress test of an idea, right? I've heard you say previously that when you were in medical school, it was quite, it was much rarer to see an Alzheimer's patient.

Is that accurate? Or was that a young Alzheimer's? Young Alzheimer's patient. So we never saw people in their 50s. And yet it's one of the most. common presentations now. And by the way, that's backed up. That was published about two years ago statistics from the whole country. And what was shown was dramatic increases in people in their 40s and 50s with dementia. And to some extent, in their 60s, but it was the young people

that were having the increases. So when I was in medical school and also as a neurology resident, you know, we would see people in their 70s with Alzheimer's disease and sometimes in their 60s. But I never saw an Alzheimer's patient who was 52. It's one of the most common presentations now. Yeah, it's so sad. So the question and the stress testing of the idea, this is genuine, you know, curiosity that I'm asking from is that, you know, when you were in medical school and you didn't see these young Alzheimer's patients, I think you said now that the most common one is like a 52-year-old woman that is coming in, right, which is a lot of the audience that's probably listening or watching on YouTube today. People weren't doing everything perfectly back then.

Right. So do you feel that it's just that the level of insults have increased so much that the body cannot cope? Because probably people were still eating a little bit of processed food. You know, people were not obviously taking supplementation at that time, at least here, you know, in America. You know, we weren't seeing people were probably a little bit more active and there was less obesity that was there. So what do you think happened so dramatically that now we're seeing, young Alzheimer's patients. If people weren't doing everything perfectly back then, that you talk about in sort of the seven basics. Yeah, it's such a good point. And I've wondered about this. What has

changed so dramatically? And I think it's fair to say that if you follow that curve with type 2 diabetes and with obesity, again, Robert Lustig has done a great job with following this and looking to see what has changed in our society. And I think a lot of things that were enacted in the 60s and 70s. I remember, you know, when I was in medical school, not only were we not seeing people who were, you know, who had Alzheimer's who were young, but we were getting introduced to snack wells and we were getting introduced to all these low-fat things. It was a different world. It was, hey, we can now have a low-fat diet. We can kind of cheat. And, you know, we were getting introduced to a lot of fast food. And to be fair, fast food has been around much longer than that.

But it was more and more accessible. And there were more and more, much more pervasive. And I don't know if you've seen Super Size Me Too by Morgan Spurlock, who did such a great job with Super Size Me. But if you haven't, take a look at Super Size Me Too. He goes into this and says, everyone's telling me that fast food is healthier than it used to be. Is that really true? And he goes around and shows, no, it's not true. What they've done is put a health halo around. It's the first time I'd heard the term, health halo.

You put some green stuff around the stuff that is killing you in the middle, and then you say, this must be better for you, but it's not. And so he ends up opening a chicken fast food restaurant that is honest that says, you know, this chicken we're selling you is going to kill you. It's terrible. And yet people eat it. It's amazing. So anyway, interesting documentary, and I think he did a great job.

And I do think that that's part of the answer. But when we've seen these people who are in their 50s, who are the very young people developing Alzheimer's, and even into their 40s, they typically are people who have large toxic burdens. So just a few examples. One of them was in the World Trade Center Cloud and developed this a few years later. and then, by the way, developed a World Trade Center associated cancer shortly thereafter. So it was pretty clear that she had really been affected by the major toxic exposure of the World Trade Center cloud.

Another one had been in a place where they burned paraffin candles 24-7 and just had massive, massive exposure. And you could see it in her blood work. Other ones have had major, major mycotoxin exposure. others have had chronic tick-borne illnesses. And along those lines, I say, Dr. Richard Horowitz has done a great job and has shown that DAPSone is something that's quite promising because it has this interesting combination. It's a medication. It's a medication.

So Dapsone is currently used for leprosy. And as he's pointed out, he's been using it in patients who have tick-borne illnesses and shown that it actually does seem to help cognition. There's a very interesting paper where they showed people in who were being treated for leprosy where they included Dapsone had much better cognition than those where they didn't include the Dapsone. Very interesting. Much lower risk for cognitive decline. So I do think, again, that things have changed because of our toxic exposures, because of our processed foods, because of, you know, all of the glyphosate and all of the glyphosate and all. the different, and I want to just point the finger at that one, there are others, but the way that

we're treating this stuff, we are living, unfortunately, we are living a more toxic lifestyle than we lived 50 years ago. And I think that that's part of what your show and your approach is changing. And you know, you and Mark and so many others, you know, Jeffrey Bland and Sarah Godfried and David Perelmutter and all these people who are sounding the alarm bell. and saying, hey, what everyone has been told is okay and what we've assumed is okay is killing us. It is. We're seeing cognitive decline in people we never saw it before. Scary, but also hopeful because there's so much more awareness of the 360 approach,

you know, advancements in one area add to the work and people build on each other. like the paper that you published with Richard Johnson that we referenced to earlier, all these things are kind of coming together and the momentum is building and the solutions that can help people make it easier, like you creating these meals together with nutrition for longevity, because we need those. We were chatting about this earlier, but we're not going to go back to this romanticized time where we all live in these tribes and we're cooking together and having dinner every night. We can wish and we can hope, and that might be accessible for some families,

but it's going to be through the advent of some sort of modern technology and the resources that we have and using things like our phone to order healthier meals, that's going to help people, you know, break through and actually try to do something about this. So it's scary, but it's also so exciting because there's so much more in our control when previously the answer was when people would go to WebMD and says, is there anything that you can do to prevent Alzheimer's and just literally was like, nope. Yeah. And we still hear this all the time.

And so we're very interested in creating ultimately a place where people can come from all over the world that have any neurodegenerative illness. Because the time is right now for us to be able to address these things. We're beginning to understand like never before the networks themselves, the different network that's associated with Parkinson's disease and with Lewy body disease and with Alzheimer's and with macular degeneration, ALS and on and on. So we should be able to address those things. And, you know, it's interesting to me, the first human genome that was sequenced cost several billion dollars for one human genome. Now you can get your genome sequenced for far less than $1,000. I don't know if it's 600 or 500, but it's somewhere in that sub-thousand-dollar amount for your entire genome. And so that's the way this is all going to go.

We start by finding the problems, and that's what we're talking about. You see some of them and you say, oh my gosh, they're insurmountable. Well, yeah, the human genome was insurmountable once, but now it's been surmounted. So, you know, it's getting better and better. So then we say, okay, how do we do this? And then how do we do it more and more practically? I look forward to the day when we have a global, essentially a what would be not a vaccination, but a global program to reduce the global burden of dementia.

It's doable. We have to get people to, again, it's a, multi-tiered approach where everybody does the basics, and then the few people that have problems do some more, and then you just go right up until there will just be a very few people that actually have to go into the hospital to get treated seriously to find out what the heck is driving their cognitive decline. But it's a new day, and I think that this is what's so exciting about what you're doing. People are going to listen to this and realize that there is so much that can be done. People do not need to get dementia.

Dale, this has been great. And it's really through the work of researchers like yourself that we're even having this conversation in the first place. Give us one to two action items for both of those buckets of individuals that we were talking about. People that are looking for an immediate solution for themselves or a family member that's been diagnosed, right? One or two action items for them.

And then one or two action items could even be something that you've shared before. That is a good next step for people that are in the bucket of looking for generally wanting to reduce their risk of developing Alzheimer's in the first place. Yeah. So some of the basics that I would think about now, number one, I would get a cognoscopy. Find out and include, find out what your phosphatal 181 is. See if you're already in that synaptoclastic state or not. And as soon as GFAP is available, which is going to be probably in the next several months,

include that as well. See if you're, are you in a good situation? Now it's a blood test. You don't have to have a spinal tap anymore. You don't have to have multiple thousand dollar pet scan to do this. And they can go online to sort of follow some steps on this? Yes, yes. You can do some basis.

And just, yeah, you can go to mycognoscopy.com to get a cognoscopy. So that would be the first thing. Second thing is just what you said earlier, I think do some of the basics that it have been clear that will help most people. Get yourself into metabolic flexibility. Do some of those basics. get into a plant-rich mildly ketogenic diet, make sure that you do some exercise.

Again, you know if you've got a few extra pounds on, you know it. I know I've got a couple extra pounds right now. I need to work on getting those back down. So there are lots of things we can do, the basics, to reduce your risk. And maybe the most important thing of all, if you start noticing, I don't remember faces the way I used to. I don't remember navigation the way I used to. I don't remember phone numbers the way I used to.

It's the change that's so critical. Then do not wait. Get in. We were told before, oh, my gosh, it's probably not Alzheimer's, so don't worry. Well, look, whether it's Alzheimer's or not, you want to improve it, right? So don't wait until you come back and they say, oh, yeah, it is Alzheimer's and we don't have anything to offer you. There is, again, there's so much that we can all do.

for prevention and especially the earlier, the better in terms of treatment. Fantastic. Dale, this has been great. I appreciate you. I appreciate the work. I appreciate you being on the Now podcast. I think this is our fourth time getting a chance to talk together, third or fourth time. You always come with so much hope and detail that people who are confused and are hurting finally feel a sense of, okay, there's some possibility.

And I appreciate you bringing that to our audience. Thanks so much for having me. And I'm just finished by saying one thing, Julie G coined a term false hopelessness. And I think she's right on. We've been hearing about false hope. Neurologists will tell you what we don't want to give false hope about these diseases. Well, now we know there's a lot that can be done. So let's not create false hopelessness. Let's tell people, yes, please get on active prevention or earliest treatment. There's a lot that can be done. Beautiful. And if people want to keep in touch with you in your organization? Yeah, easy. to do. So you can look at, so I'm on Facebook, on Twitter, I'm on Instagram, Dr. Dale Bredison. I'm also at Dr.bredison.com. So any of those ways. And also can look at the books. We've published three books, the end of Alzheimer's program. And as you said earlier, first survivors of Alzheimer's. And great stories from people who've actually improved themselves. Dr. Dale Bredesen, thank you. We'll have the links to all. those in the show notes. Appreciate you being on the podcast. Thanks so much, Drew. Thanks for having me.