Habits and Hustle - Episode 583: Dr. David Perlmutter: Brain Health Expert: The Daily Habits That Protect Your Brain as You Age

Episode Date: August 25, 2026

What if the health of your brain decades from now is being shaped by what you are doing today? We tend to think about Alzheimer's and cognitive decline as problems that show up later in life, once memory starts slipping or confusion becomes noticeable. But many of the factors associated with brain decline can begin much earlier. Blood sugar, insulin resistance, sleep, inflammation, muscle mass, exercise, social connection, oral health, and even the medications you regularly take may all influence the environment your brain is aging in. This matters because brain health gives you more areas to act on than most people realize. You can pay attention to metabolic markers before they become major problems, build and preserve muscle, protect your sleep, stay socially connected, take care of your oral microbiome, and understand which emerging therapies actually have evidence behind them. The earlier you start thinking about your brain this way, the more opportunity you have to influence how well it functions later. Dr. David Perlmutter is a board-certified neurologist, six-time New York Times bestselling author, and internationally recognized expert in brain health, nutrition, and neurodegenerative disease. His latest book, Brain Defenders, explores microglia, the brain's immune cells, and how their function may influence conditions including Alzheimer's and Parkinson's. His work focuses on giving people practical ways to protect brain health through metabolism, lifestyle, and emerging neuroscience. What's Discussed: (05:51) What research suggests about slowing or even improving cognitive decline in people already diagnosed with Alzheimer's through intensive lifestyle intervention. (10:47) Why Alzheimer's should not be viewed as purely genetic and how lifestyle and metabolic health can influence risk even when genetic predispositions are present. (12:19) How loneliness and social isolation may affect brain health through stress, cortisol, oxytocin, inflammation, and changes in the brain's immune cells. (20:50) Why the biological conditions associated with cognitive decline may begin in your 40s and 50s, decades before memory problems become obvious. (30:34) How exercise supports the brain through BDNF, irisin, and other chemicals released during muscle activity, and why both cardio and strength training matter. (38:00) Why restorative sleep is an active period for memory consolidation and brain recovery, and how fragmented sleep can undermine brain health even when you spend eight hours in bed. (1:04:34) What the science currently says about NAD, NR, NMN, and IV NAD for mitochondrial function, biological aging, and cognitive health. (1:12:04) How periodontal disease, the oral microbiome, and frequent use of certain antibacterial mouthwashes may affect nitric oxide, metabolism, and long-term brain health. (1:23:05) What emerging research says about GLP-1 drugs for Parkinson's and Alzheimer's, and why using or microdosing them specifically for brain protection is still ahead of the evidence. (1:33:25) Why homocysteine and fasting insulin are two blood markers worth paying attention to when assessing metabolic and long-term brain health.   Thank You to Our Sponsors! Magic Mind: Head over to magicmind.com/jen and use code JEN at checkout. Momentous: Ready to try supplements that actually do what they claim? Head to livemomentous.com and use code JEN for 35% off your first subscription.  Therasage: Visit therasage.com and use code JEN to get 15% off your order. Your skin Prolon: Prolon is offering listeners 30% off sitewide plus a $40 bonus gift when you subscribe to their 5-Day Program! Just visit prolonlife.com/JENNIFERCOHEN and use code JENNIFERCOHEN to claim your discount and your bonus gift. Tru Niagen®: For supplements that are rigorously tested, third-party verified, and actually deliver what's on the label, head to truniagen.com Find more from Jen Cohen: Website: jennifercohen.com Instagram: @therealjencohen Books: jennifercohen.com/books Speaking: jennifercohen.com/speaking-engagements   Find more from Dr. David Perlmutter: Website: drperlmutter.com Instagram: @davidperlmutter Facebook: David Perlmutter M.D.  YouTube: @davidperlmutterMD LinkedIn: David Perlmutte, MD Book: Brain Defenders  

Hi, guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it. Welcome to Habits and Hustle, where I sit down at the world's biggest thinkers, entrepreneurs, top experts to uncover the habits, strategies, and mindset shifts that actually move the need on your health, happiness, and success. And today, I'm sitting down with Dr. David Perelmutter, a board-certified neurologist, best-selling author, and leading voice in the brain health and neurodegenerative disease. We discuss why protecting your brain starts decades before symptoms appear, how inflammation and metabolic health impact brain function, and what you can do now to reduce your risk of cognitive decline.

We also cover loneliness, sleep, strength training, oral health, fasting, and insulin. Oh my God, the list goes on. This conversation is packed with practical ways to take more ownership of your brain health instead of waiting until something goes wrong. David breaks down that everyday habits, health markers, and lifestyle choices that actually influence how your brain ages, plus some of the emerging science

that can completely change the way we think about Alzheimer's and other neurodegenerative diseases. So now let's dive in. Before we get into today's episode, I have a quick question. Do you ever hit 3pm and feel like your brain's just done? That afternoon crash used to be really real for me. My focus would completely disappear.

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locator to find MagicMine near you. I promise you, you will not be disappointed. Like I said, I was skeptical when I started taking it, and now I really do notice when I skip it. And to me, that says everything. So go to Magicmind.com today and get 50% off your first order. You guys, we have a special podcast today. You know, I'm on this really big bandwagon of doing everything for our brain health, cognitive health, all the things. And we have a doctor named Dr. David Perlmutter, who I still can't believe I've never met before.

This is absurd, considering I've been doing this for many years. You've been doing this for even more years. And we just never, our path is never crossed. Well, the circle is complete now, isn't it? Yes, it totally is. The loop is now finally closed. Dr. What do I mean I call you?

David, Dr. Pearl. David works. David or Dr. Perlmutter? You know, you see Dr. Perlmutter. I keep looking for my dad. Okay, so I'll call you David, but yes. But I know, right? You still probably still look for your dad.

I know. I don't like when my kids' friends call me Miss blah, blah, blah. I feel like a very old person. I don't like it. I like them to call me Jennifer. So David or Dr. Perlmutter has written his 16th book, and this one is called Brain. Defenders. You may have read his book, Grain Brain, There's so many, there's so many books.

But we're going to talk all about the new book. And like I said, it's called Brain Defenders. I can never seem to see the harness the power of your immune cells to protect your brain for life. So thank you for being here. Well, thank you for having me. And the subtitle really tells it all. It tells the story of the power of the brain's unique immune cells called microglial cells. to really determine your brain's destiny, whether you're going to be along for the ride with your brain or the brain's not going to be there to participate in the rest of your life. So we fear things like Alzheimer's and Parkinson's and all of these issues that we run the risk of, but it turns out that we absolutely have a big say in determining whether that's in our future

or not, and it all has to do with what's going on with the brain's immune cells over which you have control. That's what we'll talk about today. Yes, I mean, this is why, you know, I was really eager to have you on the podcast for personal reasons. My mother was diagnosed with Alzheimer's. I just came back from Montreal to see her. And she's now past the point of mild, I would imagine, in the mid area of Alzheimer's. And, you know, we talk a lot about preventative things.

What I would love to hear from you is, like, where is the science? or is there any evidence that you can reverse signs of Alzheimer's, dementia, if you're already past a certain point? The answer is yes. How about that? Now, we've never been told that, have we? Here in America, there have been FDA-approved drugs to treat Alzheimer's disease that, according to a recent Cochrane analysis, have abjectly failed.

They do not have any meaningful effect on the time course of the decontal. in the Alzheimer's patient and are associated with a significant risk of side effects in at least a quarter of patients, either hemorrhage in the brain swelling or even death. And these are drugs that are FDA-approved. It's the best that pharmacy can offer us. And yet, when we look at research, for example, there's a study that came out last year by Dr. Rudolph Tanzi at Harvard, along with Dr. Dean Ornish, and they took a group of patients who were diagnosed with Alzheimer's already, not at risk because they had diabetes. diabetes or obesity or something. These patients were already diagnosed. Fifty-one patients,

20-week study, what did they do? They changed their diets. They changed their level of activity, and they reduced their stress. And these individuals, it didn't slow down their progression. In 70% of them, it stopped their progression or led to improvement in their cognitive function. There's never been any drug that could do that. And the side effects were in these individuals, that their blood sugar's improved, their body weight improved, and they overall felt better. And think about that. And you're looking at me right now with a look on your face like, I haven't heard of that. And you should have heard of that. And you haven't. What is it called? It's lifestyle intervention.

But this is the thing. I'm looking at you like that. Published in a peer review journal, and I wish you had heard of it. And I'm not blaming you for not hearing about it, but I'm blaming the emphasis in our modern Western world to really off, load the agency of our brain's destiny to a hope that a drug is developed. It's, I hate to say it's wrong. I sound so aggressive when I do that. No, it'd be aggressive. But my dad died of Alzheimer's, and had there been a drug, would I have been written the prescription for him? You bet I would have. I mean, his nursing home was, I could see his

window from my examining rooms in my office. That's how close my situation was with his progressive down-hear decline every single day. And so having said that, would I use a drug? I absolutely would have. What was drug called, though, again? Well, there was no, there was no drug. The drugs I'm talking about right now. It's lifestyle. It's lifestyle. Well, yeah, the drug is lifestyle. Yeah, the drug is lifestyle right now. And you cannot patent that. It's not a billion-dollar blockbuster.

You cannot patent that. This is my, but I know, but with your dad, though, you said that there was no, there was no potential, there's no drug or at that point. Right. Nor is there now. Right. There are these random drugs, but they have bad side effects. mother was on one for a little bit. They took her off of it. It wasn't doing anything. Well, here's the news. If they would do something, I would have a different conversation with you, Jen, right this minute. But here's what a recent Cochrane analysis revealed. This is the most highly regarded gold standard way of answering a medical question. Here is the two-part question. Part one, does it work? Part two, is it threatening? Is there a side effects? Right. Are there? And here's what the Cochrane analysis of 20,300 142 individuals in 17 studies, 18 months each study revealed just published. Number one, the threat of using these drugs is about 25% of people will have brain hemorrhages, brain swelling, or possibly even die. What about the benefit? The word they used was trivial. So the drugs don't work and they are really risky and that's very likely what they put your relative on and why they stopped it because likely

she was beginning to have side effects. And so, you know, it's not that your guest is really, as we talked about earlier, iconic classic, you had a different word for it. What? Irreverent. Yeah. And I am, I guess. And I'm irreverent because I see, you know, my mission is above all, do no harm.

And that's doing harm. And I will speak out about it. I talk about it in the book. Yeah. And that was before this Cochrane analysis. That just came out to be supportive of what I'm contending in this book. And I'm certainly not anti- drug. We talk about the potential of GLP1 OZEP-like drugs to treat Alzheimer's. I'm going to ask you about that.

Yeah. Am I open for that? You bet. Inflammation and metabolism. That story hasn't been fully written yet. And we're waiting for it. We can double click on that at some point, really go. Well, I want to ask you about that now because they're saying even for people, there's a couple of things. So you do talk about the fact in the book, in this book, and you've said it many times, that Alzheimer's is not, genetic, right? There's like, by and large, it is not genetic. Are there some genetic predispositions that an individual can have to increase her or his risk? Yes, there are. We know that carrying, for example, a variation in a gene called APOE4 is associated with increased risk. Either if you have one of those alleles, five times risk or two of the alleles, in other words, APOE44, that your risk may be 10 to 12 times increased compared to others who don't carry it. There's There are other genes. There are about 60 different genes that play a role, but by and large, important message here. Here's the soundbite. Alzheimer's should not be considered a genetic disease. It should a disease related to lifestyle choices that is very empowering because we could make better choices and reduce our risk.

Genes load the gun. Lifestyle pulls the trigger. So just to keep on this for one second, and we won't need to drone on and on about. my mom, okay? But this is why I thought this was a very pertinent thing to talk about. Because you don't know my mom, you never knew my mom, you don't know her. But so she's also in the medical field. Interestingly enough, she did everything, everything right. Her blood sugar was completely intact. She worked out every day. She like physically, even to this day, she's not on any medication except vitamin D. Physically, top notch. But her brain still declined. Now, she did, this happened because in my, when COVID started, she was extremely isolated and extremely lonely

because she was very, had a lot of anxiety around going to see people. To me, what that tells me is loneliness, isolation is probably predominantly more imperative or more of a trigger than let's say even exercise or nutrition. Would you say to that? I think it's incredibly underrated. And when we talk about the dramatic increased risk of Alzheimer's as a consequence of COVID, a lot of the discussion, at least in the medical science field, is what does the virus do? Does the virus increase inflammation?

Yes, we know that there's a virus affect mitochondrial function in brain cells and the brain immune cells, the microglia, the subject of this book. Absolutely it does. but you bring up an incredibly fundamental point. That for a period of time, it may have been more than a year, your mother had a higher level of stress, as many of us did, and isolation. And isolation is a huge event, especially as it continues, as it relates to brain health.

Why? The downside of isolation is increased stress, therefore increased cortisol, threatening to the brain's memory center of the hippocampus, threatened to the microbiome, the gut bacteria, and therefore increases inflammation that can shift the brain's immune cells away from being supportive to being destructive. The other thing, though, is when we are isolated, we're not experiencing love as much. We're not in contact with individuals

that we share love with. And why could that be relevant in what we're having, I consider a scientific conversation? And I wondered about that for a long time. When we looked at, for example, the blue zone, people have a lot of social connectivity, a lot of involvement in their communities, and have have a dramatic risk reduction for Alzheimer's, heart disease, various forms of cancers, and other degenerative issues. But why? Why Alzheimer's? What's the connection between connection and reduced risk?

And many things were at play. Cortisol lower, we know that. But here's something I found really fascinating. The book focuses on the shift of the brain's immune cells from being normally, wonderfully supportive to help the brain remain resistant to decline, shifting to a situation where our brain immune cells basically turn their backs on us. They become what I call in the book, The Evil Twin.

A powerful way of keeping them supportive and loving and nurturing is to stimulate these cells called the M2 supportive immune cells. And one of the powerful stimulants to keep them in their supportive mode is a chemical called oxytocin, a hormone called oxytocin, the love hormone that increases when we have relationships with people. Your mom's isolation for whatever length of time that was reduced her oxytotin, oxytocin, and at the same time increased her cortisol. And the brain has, you know, significant experience with that. It boats for a brain to be less able to resist decline. Now, you told me your mother's blood sugar was intact, that she exercised quite frequently,

did all of the things. What brain defenders does is, through the lens of the brain's immune cells looks at those things and so many others that influence whether those brain cells are going to be supportive or they will turn their backs on us and pave the way for the brain to decline. Because you keep one, you mention a lot in the book,

what was it called again, the immune cell? Microglia. Microglia. I've never heard that before. And you are going to hear about it left, right and center moving forward. See, that's because you also, in another book, you talked about urelic acids, was the other one. Euric acid. Uric acid.

I mean, so these are like, these are things that are not very usual, right? You hear about strength training. You hear about loneliness. You hear about, you know, even now, I know you wrote the book, Ray and Brain, but like, you know, no process, ultra-processed food.

But these are, those are the two things that really kind of stood out to me. Can you talk a little bit about what an immune, like what immune cells are? You are Canadian. Can I talk about? Yeah, about. You got me on the,

about. There you go. Yeah, sure, I can do that. Yes, his wife's Canadian, so. And I have my , okay. Add your Canadian. Residence. So it's a new paradigm in neuroscience and it's exciting because how'd you even get to it? Like how did it, like, after all these years of writing about it, like, all I know. I didn't write about it for all these years. No, no. I'm saying you've been writing about all of this neurology stuff for for years and years and now all of a sudden we hear about it. And what is so exciting, Jennifer, is that everything I've written about, whether it's the relationship of the gut to the brain and microbiome, grain-brain talking about gluten and talking about high-refined carbohydrate diets, uric acid in drop acid, how that threatens our metabolism. Everything converges on the brain's

immune cells. Finally, everything I've studied and written about and lectured about for 40 years has converged on the brain's immune cells. That's the upstream event in everything I've been interested in. But what took so long? What took 40 years? I think we didn't recognize that the immune cells in the brain, the microglia cells, through such a wide net and were upstream of all of these mechanisms. And it's just come to light. Really, mostly in the past five years. I've been talking about the microglia for decades, but we didn't really understand how they could change from being supportive to being destructive. Right. So let's talk about that. So explain what the microglia is and how it can go from being supportive to being destructive.

And that's the take-home message of our time together today. we can control it. Yes. Understand first that this is the upstream mechanism that underpins Alzheimer's and Parkinson's and MS and issues related to long COVID, PTSD, even major depression. All of these issues are fundamentally related to the change in the microgluella cells from nurturing our synapses, nurturing our neurons and blood-brain barrier,

to suddenly shifting and becoming the evil tool. twin, destroying the synapses, actually gobbling up the connection of one brain cell to the next, setting up an environment in the brain that leads to the neurons falling apart and leading the blood brain barrier, which we depend upon to keep the brain excluded from certain things, leads to that breakdown, just like the gut barrier. We have a very important barrier in the brain that needs to be maintained. So many things can threaten to cause these cells to turn their backs on us. Elevated blood sugar, changes in our proteins because they bind the blood sugar, like hemoglobin A1C. Increased inflammation anywhere in the body makes its way to the brain,

it sends a signal to these cells to shift and become destructive. Think about that. Where can that inflammation come from? A leaky gut. So your diet, whether it's supportive of your microbiome or not, through this mechanism of a leaky gut, can increase. inflammation tells these microglial cells, we're going to destroy your brain just because the gut changed, because you took antacids or overused antibiotics or other types of drugs, non-steroid anti-inflammatory drugs like ibuprofen. Okay, so let's start with, okay, so let's start with the idea of this. So is there a test or a way that people can even know where they, how healthy their microglio, I can never pronounce it, microglia cells are? Like, is there,

Is there like some type of blood test for us to know where we are in terms of health? Absolutely. One thing you can do is look at your calendar and ask yourself how old you are. 29? There you go. Because microglia shift more aggressively the older we get. Okay. So that's a very powerful metric.

The next thing you could do is... What age do we start shifting it? It happens earlier than you think. It happens around 50. Okay. Aggressively. But, you know, it happens in our 40s as well. Okay.

It brings me to a very interesting point, and that is the paradigm under which we live right now related to brain degeneration is one that would say, wait until you become cognitively impaired. Think about your mother's experience and your experience with your mother. Nobody paid any attention to her brain until suddenly she started complaining about things and went to the doctor and say, hey, I'm forgetful. No, just because she got very confused. But yes, until someone else recognized it. It was so bad. That's very, very typical. Yeah.

But why do we wait until then? May I ask how old your mother is? Well, now she's 83. But when did those issues begin? It started, honestly, like only a year and a half ago, two years ago. 81 or 80. Yeah. Is that normal?

Is that a normal age for this? My point is, those issues began under 40s and 50s. That's when the seeds are sown. So your audience needs to hear this, that the metabolic issues that will threaten your brain and presage the cognitive issues begin decades ahead of time. See, I did hear you talk about that. That's been out there. But then what are the signs?

Because you know when people are we all kind of joke around like, oh, you know, like I'm in menopause. I'm in perimenopause. Oh, I have got like, you know, like I've got, people think that when they're forgetful or just kind of just mindless, it's like their situation or circumstance. It's not necessarily that. So how do you distinguish between

if it's like decline of your cognitive functions or just circumstance? Yeah, let's get back to, I think, the original question. Where do we get the sense that we're already setting the stage your brain decline? Your blood sugar starts to elevate. Your fasting insulin level goes up.

You're working too much that you can't get exercise. You have fragmented sleep. You're looking at your Apple Watch or your o'er ring and you're seeing that you're not getting enough deep sleep. You are isolated. You're not spending time in nature. Your waist to hip ratio is increasing by a very sophisticated piece of machinery called a measuring tape. I mean, these are powerful indicators that your microglueal cells are shifting. You know, I'm noticing you're not wearing an Apple watch,

an aura ring, a whoop, none of it. And is that by design? No, because I do. Oh, you do? Okay. wear a continuous glucose monitor. You do. But I don't... You're wearing a suit, so I can see that part. Oh, I'm not wearing it right now. Okay. But I do these things not all the time.

You know, there's been some commentary that, well, can we get a little neurotic about it? And I find it's a little bit stressful for me. But I do want to know. So I wear my... I use an or a ring. I do it, you know, for several weeks at a time every month or two. Same thing with CGMs. I have, you know, boxes of them at home.

I work with levels hell, so I get as many as I want. But here's the point. I mean, this continuous glucose monitor is powerfully informative for you, Jennifer, as an individual, what is your blood sugar doing in relation to the foods that you choose to eat in your relationship to your level of exercise, quality of sleep, relationships, time, and nature, etc. You wouldn't know that if you don't measure. So you've got to measure. And you can buy a CGM at Costco without a prescription.

How wonderful is that? you know, it wasn't that long ago that there was an editorial in journal the American Medical Association saying, oh, there's a trend that people who are non-diabetic are wanting to get CGMs to learn about their blood sugar. And the comment was in the editorial, we shouldn't allow that because people are going to become neurotic about their blood sugar. With that logic, we shouldn't allow people to buy bathroom scales because they'll be, they'll wonder what their body weight is. No, we should have the option of knowing these metrics. Right. And taking the ownership in our own hands, right, and having informed information. That's my mission in life. Yeah.

Is giving people stewardship over their brains destiny. Right now in America, we offload that stewardship to pharmaceutical companies with the hope that we can live our lives however we want and there'll be a magic drug to fix the problem. That situation is non-existent right now. I mentioned before, would I be supportive? You bet I would be. That's my job. And I will put that drug in my toolbox, but we don't have it yet. So, okay, so let's just stay on this for the, because you're like, but that's a very, very good point. Like you're, if someone is concerned about a lot of these, you know, diseases that can happen in the 70s, 80s, it starts 40, 30 years before that. And when you're confused between if it's just like circumstance, like whatever, perimenopause, children,

stress, work, whatever it is at your, and or if it's something larger, some of the metrics are to check your blood sugar levels. What was that the ones to check your hip, your hip? Waste to hip ratio, your fasting insulin level, your A1C. And I think beginning at age 50, a little bit more sophisticated testing, one called P-Tow-217. very predictive of Alzheimer's. And I didn't know that when I submitted the manuscript for this book just several months ago, because that study came out three weeks ago

in the Journal of the American Medical Association, saying that this P-Tal 217 that we used previously as a diagnostic for somebody who's having cognitive decline to determine is it Alzheimer's, is now demonstrated to be predictive in terms of who's going to get it. So that would be a great test to have. I just had mine done. Where did you, where did people get that test?

Any lab could do it, and you don't need a prescription. Walk into a quest and say, I want a P-Tal-217, they'll sit down in the chair and they'll draw it. Really? You bet. I think this is also, you know Dr. Dale Bresiden, is that? Bredison. Very, very well. Right, okay.

He was on here a while ago. I think he mentioned that test, actually, or a form, is there another version or a form of that? No, Betaw-217. That's the one? There are others that he talks about, GFAP, neurofilament, live. those are ones that he's very fond of. But he's correct. And the other thing that Dr. Bredesen talks about is he believes that once we reach a certain age, like 60 or 65, that we should have annual evaluations of our cognitive function.

He calls it a cognoscopy. Yeah, I love that. How would we do that? You can do them online now. In fact, he has web-based tools that allow you. We talk about him in the book. In fact, I feature him in the book, some of his case reports. And, you know, I so honor his work.

And he is, you know, he takes a lot of criticism and wrongly, I believe, because he is a trailblazer. One of his recent books I wrote the forward to. And I talked about him in terms of a Nobel Prize because not only the work that he's doing, but the idea that he challenged the idea of modern science looking at one variable to test something, like a drug or a single intervention. you know, his approach to dealing with Alzheimer's brings in multiple inroads, diet, nutrition, exercise, identification of toxins, for example, and even heavy metals, all the things he talks about. And that is absolutely breaking the mold. And I'm grateful that he's done that because now we

see new studies coming out where people are doing multiple things at one time and seeing great results and reversing Alzheimer's disease. Yes, it is happening right now without drugs. I mean, how old are you? Seventy- 71. And you're like, sharp as attack. Hopefully. Yeah, no, no, no, you are. 16 books later. What is your day-to-day? Like, what are the habits and rituals that you do daily to be so, like, that you're, that you're doing for 10 years from, Like you're probably, you're probably doing things that you'll be healthy for your 80s or 90s. What can people glean from you? People asking this question a lot.

Of course they would. I was thinking about this the other day. And one thing I haven't said that I will say today that I think is so important are two words, have fun. Now, why do I say that? Because I think it's a question people should ask themselves. What do I do that I really enjoy that makes me smile? And I know the things that I do that make me smile, that bring joy to my heart. And I think it's a good question because that's really important for you to offload stress and to have a good time.

The other thing is, you know, I think the real actionable levers that I pull, I exercise every single day. Are there days that I will probably miss tomorrow because I have a 6 a.m. flight and I won't get home until probably 8 p.m. at night. But otherwise, I exercise every day. Exercise is so important. Yeah, for your metabolism, for your waistline, for your body weight. All the things you'll look good, you feel good, the brain loves it. Because your muscles, when they are activated, are secreting chemicals that do wonderful things for your metabolism.

Some of those chemicals go into your brain and keep shop. You know, they do a good thing. Talk about the BD and NAP. Do you know, I mean, of course you know what this is. It's like fertilizer for your brain in a way. I feel like the exercise, to me, I mean, I'm not the doctor, but I think exercise is the number one thing that could keep, kind of keep these diseases at bay.

Because what it does to your, for me, I work out, I mean, I don't work out for my, my physical well-being. Yeah, do I want to look good? Yes. But what it does to my brain, more focus, more alert, your brain turns on with exercise. So there are a lot of reasons for that. BD and F is one. So BDNF is brain-derived neurotrophic factor. And it is brain-derived. That's the B-D. And I think that's an important point, that while muscles, do create a very minimal amount of BDNF.

They actually create a chemical when you're using your muscles, i.e. exercising, called erasin, and this ericin then able to cross the blood-brain barrier, and then within the brain stimulates the production of brain-derived neurotrophic factor that does a lot of different things. It nurtures, the neurons keeps them healthy and functional, but it also increases the growth of new brain cells. Who wouldn't want that? Why, that's fantastic. WTF, right?

Yeah. That's fantastic, right? Yeah, I've never heard that one, my report, but yeah. But it's similar to growth of new brain cells, not throughout the brain, but in some very important areas like the hippocampus, the brain's memory center, the dentate gyrus of the hippocampus. Can I ask you a question on that just before you move on? Because I know strain training is extremely important as you wage for your bones and for falling and all the things.

For your actual brain, though, in terms of its workability, for it to be sharp and on the ball and all the thing, alert. Is cardiovascular more important? important than strength training, because I feel when I do the cardio part, that's when my brain is triggered and turned on. That's the lever that I pull if I need to be on point. Do you, is that action, is there science behind that? Yes. And what you're saying, I think, is something many people experience. I think with your audience hears you say that they're going to see, I feel the same way, then what's all the push about strength training? Now let's just wind back a little bit to our conversation

from about two minutes ago, that the muscles are creating these chemicals that are doing good things for the brain in the long term, not the, in the acute sense, you're right about the aerobics. So if you want more of those chemicals, then you need bigger muscles. So now you're going to have a bigger resource to create the erosin and the interleukin 6 and the cathepsyn D and all of the things that are good for amping up the brain function over the long term. You want a bigger resource so you can't forget leg day. Your leg muscles are the biggest ones.

And really, you're not doing leg muscles to look good. No one's really looking at your legs. Maybe they are. Everyone's doing triceps and biceps and pecks. That's men. Men, okay, right. Women are doing our butt and legs, by the way. But it's good because those glutes are pretty big muscles.

The biggest muscle. The biggest muscles. Well, hamstrings and quads as well. So you want to really emphasize your extensions and your squats. you want to really strengthen those upper leg muscles and calf muscles as well. Pecks can be big in some people, of course, but you don't want to forget leg day. Why? For all the other reasons, yes, and metabolism, of course, metabolism targets your microglueal cells,

but just to have more of those great salubrious chemicals produced that make their weight of the brain, they move, they're called myomuscle, kind, they move myokines, move from the muscle to the brain. So the muscles are endocrine glands. No, I thought the endocrine glands were the pituitary, the adrenal, the thyroid. Because the, and the definition of an endocrine gland is an area in the body, a gland or an organ that produces chemicals that go elsewhere and target other organs and do things, like the thyroid targets your brain and your muscles and everything else. And the muscles do that.

They secrete chemicals that target the heart, that target the blood vessels, that target the pancreas, liver, and even yes, the brain. So let's take full advantage of that. And yeah, your muscles are making chemicals. I want more of those, therefore I do strength training. So where does the rubber meet the road on answering your question? An interesting meta-analysis means it looked at multiple studies, more than 30 studies, was published by Chinese researchers and that tried to answer that question, what's better, aerobics or resistance training. The conclusion that they came up with was both. So that's the recommendation. Not that I feel that's the right thing to do. That's what the science tells us. So aerobics, very important. You feel better. Go for it. More of a cardiovascular

blood supply kind of approach. More metabolic types of benefits are going to come from the strength training and the added benefit of these chemicals that we talk about. This interleukin-6 that some would call an inflammatory cytokine, and it is. But at the same time, multisodes, multi-purpose, this interleukin-6 increases something called AMP kinase. And what does AMP kinase do? That increases our ability to burn fat, increases the functionality of insulin. It's how the drug metformin works. So that's why we want to build muscle and do both. Now, I'm going to add to that. The discussion is always aerobics versus drink training. What should I do? And I think there's a third leg, even a fourth like to this tool, and I would add that we need flexibility training, because if you're not flexible

and you overdo it at the gym one day, you're going to hurt yourself, then the exercise program comes to a crash. And if you're not working on balance training, then you run the risk of falling. And the older you get, you know, the higher that risk of falling, break a hip, then you're, you know, in women, hip fractures are associated with ultimately about a 40% risk of dying from that fracture over the long run. So you want to work on your balance. So you want to work on your balance so that you're not at high risk for falling. So balance, flexibility, and strength training and cardio. So the way, okay, so cardio is, but like you said, it is. It's more like in the moment because it turned on your brain. But you also talk about the metabolic piece of it,

which is, of course, strength training will help with it with your metabolism. That makes sense. And of course, so all four. So you really can't get away with just like picking one, basically. It has to be all four. All in. All it. Okay. So then finish what you're, okay, so I I kind of cut you off. So you say you work out every day. How long do you work out? What time do you work out? I want to know every detail.

So for me, it's the morning, and I'm not saying that's what everyone should do. What time do you wake up in the morning? I wake up about 6.30. Okay. Does it matter? Sometimes six. Well, I think when did you go to sleep? Right.

So my question is... So I want to get about eight hours of sleep. Of good sleep. I want to measure my sleep and make sure I'm getting restorative sleep, uninterrupted sleep. And that's, I think, very important because people say, well, I slept eight hours. hours I said, oh, great, how many times just wake up? Well, I don't think I woke up at all. I said, how would you know? Because you can almost wake up and not fully wake up to the extent you don't remember it, but you really dropped out of sleeping. And your aura ring is going to tell you

that, or your Apple Watch will tell you that. So I think it's valuable to know that. And you could fix that. It might be that if you have a partner that that person is snoring or moving around at night or got up three times to pee and woke you up in the process. So it's that valuable that you might need to make some adjustments in the sleeping arrangements. I was just interviewed about this idea called sleeping divorce, getting a sleeping divorce. It's a kind of aggressive moniker. But if you can't sleep with an individual and have a wonderful marriage or whatever the situation is, by all means, if you have the opportunity to go to a different room or put a bolster between you

or figure it out. Place some white noise in the background if that person's storing and keeping you up. You spend a third of your life, or you should, sleeping, eight hours of a 24-hour period. You don't exercise or you probably shouldn't for eight hours a day or eat for eight hours a day, right?

Or do brain training exercises, but sleep, you know, we used to think, oh, that's when we're taking time off. No, it's a valuable recovery period for consolidation of your memories, for activating your lymphatic system to take out the garbage, allowing your brain to have the optimal internal milieu or environment so that you don't stimulate

your brain's immune cells to shift to being the evil twin. You know, I feel like, again, like things have its ebb and flow and trends. Sleep has become like the new kale. You know, everybody, you know. I still love my kale. You still love your kale. Good. Me too. I like kale. Or cauliflower. I feel like right now, it's like everyone's on the sleep bandwagon.

No one talked about it 10 years ago. Now everyone's talking about sleep being the number one thing. It's like the panacea for everything. You know, to be more fit, sleep more. To be more, to be smarter, sleep more. To like, whatever it is, it's about sleep. Now, why now, like, why has nobody again talked about the importance of sleep? Well, I think it's getting a lot of press.

Well, now it's like a trillion dollar business. Of course it is. And I think it should be because it's taking us away from the idea that popping a particular supplement or deciding to push the limits and take a certain drug is going to be the answer. You know, it turns out back to lifestyle. I think that Morton Walker's book, Matt Walker, Matt Walker's book, Why We Sleep, really, it was a big hit, really raise our awareness. I think that, you know, looking at this whole science of chronobiology and the great research Sachin Panda is doing and getting out to the public really answers a lot of questions for us about why we're failing. And

You know, this notion of sleep being downtime, it's anything but downtime. When you characterize sleep as being downtime, it sort of makes you feel like it threatens your productivity. I was going to say that. I could have been doing something. I could have stayed up until midnight and really gotten a little bit more done. The answer to that is, no, you are more productive when you get a good night's sleep, especially important for young people to understand this.

Yeah. You know, kids in high school and in college, you know, cramming for the test, staying up really late. No, get to bed and consolidate those memories. You'll remember them. You've studied once. Go to bed, let those memories get more inculcated into networks. That's the ticket.

And, you know, from my perspective, when we look at the relationships between not getting enough restorative sleep and risk for Alzheimer's, risk for diabetes, risk for obesity, which contributes to Alzheimer's risk, boy, it is an incredible tonic. And I don't think this is going to be. to be a flash in the pan. You know, various types of supplements that we talk about, you know, come and go. A million. There's a million of them. But this has become such a big business now. So it's only, only be food, like people are jumping on the bandwagon because they can make a lot of money from it. But also, because it's something we all do anyway, right? Like, it's pretty brilliant,

right? We all sleep at least six, seven, five, whatever hours a day, can't get away from it. We all eat. Right. So it's like the one most basic function that we do. So the thing is, and everyone, I mean, I just find it interesting that everyone now was like, sleep, sleep, sleep, sleep. No, sleep isn't going away. Sleep, exercise and what we eat. Yeah. Because as you just said, it's things that we are already doing. Well, we may not be taking rapamycin. We may not be taking, you know, metformin and these things that have their moment in the sunshine.

And then the other things come out. They dedicate, well, you know, there's no real data here that indicates is what we should be doing. Right. Though it remains interesting. You know, we look at the JLP once, for example, man, that's having its moment in the sun. Oh. But we don't know what's going to happen in the long term. And, you know, I talk about it in brain defenders because you, I think, insinuated earlier that this is an intervention that has huge and positive metabolic effects, huge and positive metabolic effects that relate to things like mitochondrial function and blood sugar function.

I want to talk about that, actually. In fact, we still don't even have all your habits. Okay, keep on interrupting you. So far, you sleep eight hours. You work out every day, 6.30, you wake up. Tell me what else, and then we're going to move on. I don't have lunch or even breakfast oftentimes, well, which is breakfast? Because you're a funeral of the day.

You don't need breakfast? Are you inter... You break fast. So I do have breakfast, but it may be at one or two in the afternoon. It's more like lunch. Yeah, well, but you're breaking your fast. So are you intermittent and fast? That is, by definition.

You know, that's time restricted. eating, which is a form of fasting. But these terms are tough to define. What is intermittent fasting? How often do you do that? And what is the time period that characterizes that definition? I don't know. But that is something I do with regularity. So, okay, so because you also talk about fast mimicking diet, I believe, in there, too. Yes, Walter Longo. Walter Longo. And he's putting out some really powerful research. You know, a lot of his work, though he's recently published on Alzheimer's, a lot of his work has,

looked at the idea of increasing ketones and the body as an adjunctive way of treating cancer, along with standard approaches to treating cancer. And by all means, he's certainly not the first person to recognize that cancer cells thrive in a sugar-rich environment. Reducing blood sugar, getting it under control, and powering the body with ketones has been looked upon by not just Malta Lange, but many others, as an adjunctive therapy to go. go along with treatment of cancer. So is it just overall eat less? It doesn't matter what the name. It doesn't matter if it's intermittent fasting, fast mimicking diet, if it's this or that, the other. The thing is it's about eating less. Yes. And what you may consider to be trendy, but I think it's

here to say, is eat more fat. I mean, these lips uttered those three words. And, you know, there was a time that I wouldn't say that my medical license would have been yanked. But You know, I wouldn't say that to my colleagues because, oh, but all the data says a high-fat diet can cause your children to be born naked or some horrible thing is going to happen. Back in the day, everything was low-fat Oreos, you name it. Yeah, I remember snack wells and all the things. Low-fat because, of course, fat is the enemy. Let's nuance that a bit, that I am not saying eat all-fat that all-fat is good. We want to characterize those fats as being the right kinds of healthful fats,

not highly modified fats that are devoid of, you know, healing potential. So these are not the fats that have a shelf life of months to years, or the fats have been modified that they can go into these ultra-processed foods that have an extended shelf life. We want to avoid those, of course. But wonderful fatty foods like avocado nuts, fish, shellfish, these are providing to us fats that the body, Not just the brain.

The brain desperately needs fats. Of course, your brain is 70% fat. Dry weight. I'm not accusing you of being a fat head. Your brain is made from fat. The membranes covering every cell in your body, not just the neurons, are made of fat. It doesn't come from the air we breathe. It comes from the food that we eat.

Okay. I'm not going to interrupt again. I've interrupted. I know. Well, that's exactly. Okay. We both have. Okay.

So 6.30 or so you wake up. What happened to go to bed at night? 9.30. 9. 9.30. sometimes even earlier, depending on, you know, if I'm tired, I go to sleep. And I don't have any trouble going to sleep, but my wife, if there's computer time or television time, will have a lot of trouble. So it's either the blue light glasses or we just don't do it at night.

So, you know, read, read before you go to sleep. That works for us or talk. Talk. Who knew? Yeah, exactly. Talking, that's so archaic of you. I know. Okay, so you wake up. It's the best, though. I still look forward to it. Yeah. Just the goofy things happened that happened during the day.

And we're both trying to, you know, figure out life. Yeah. What does it mean? What should we be doing with parents? How do we raise our children? You know. How old are your kids, by the way? 38 and 36.

Wow. Okay. You're not raising them anymore. I guess they've been raised. You know it never ends. But is your son a doctor as well, right? Yes. So your dad was a doctor?

Your son's a doctor? Does he have a child? You're in two weeks. Oh, really? Oh, wow. So what type of doctor is your son? He is internal medicine. Okay.

And, but he is running a startup company and running the science research part of startup company called Big Bold Health. That is involved in something called Himalayan Tartary Buckwheat. You may have heard of it. Yeah, I have. Powerful polyphenol. He works along with a fellow by the name of Jeffrey Bland. Yes. Oh, my gosh.

I know that's your son works with him? Yeah. Oh, that's interesting. Did they get introduced through you? Probably. The blends and the Pearl Mudders have been friends for 35 years. Okay, yeah. Okay. So Jeff Plann knew Austin when he was five and six years old. We would spend time each summer together in British Columbia. So.

Really nice. Yeah. I want to take a quick break from this episode to thank our sponsor, Therisage. Their trilight panel has become my favorite biohacking thing for Heel. my body. It's a portable red light panel that I simply cannot live without. I literally bring it with me everywhere I go. And I personally use their red light therapy to help reduce inflammation and places in my body where, honestly, I have pain. You can use it on a sore back, stomach cramps, shoulder, ankle. Red light therapy is my go-to. Plus, it also has amazing anti-aging benefits,

including reducing signs of fine lines and wrinkles on your face, which I also use it for. I personally use Therisage Trilite everywhere and all the time. It's small, it's affordable, it's portable, and it's really effective. Head over to Therisage.com right now and use code be bold for 15% off. This code will work sitewide. Again, head over to Therisage. massage, T-H-E-R-A-S-A-G-E dot com, and use code be bold for 15% off any of their products. Okay, so not to digress again.

Get back to your healthy habits, please. Digression is totally cool. Okay, I'm digressing a lot here with you. It's good. Okay, good. I'm like, I'm going to get like in the comments, stop interrupting him. We're interrupting each other, you guys. That's what conversation is all about. It's a call the conversation.

It's very respectful, too. Thank you. Okay, so, but I am very curious because I wouldn't jot down what you're doing. So you wake up at 6.30, you don't eat breakfast. So what do you go right into the jail? Like, what do you do? Generally, I get my exercise done in the morning. And so what do I do?

No, not that early. No, I don't, well, I mean, my exercise begins often around, depending on what my schedule is like, but it could be 8 o'clock. Okay. Do you drink coffee in the morning? I do drink coffee in the morning. And some may say that that is a violation of the time restricted eating, but I, I don't I am here to say it's a ritual. I love it.

I feel great. I recognize, here's the self-selling, that it is rich in polyphenols, that caffeine is good for me. And so I, more than an affectionado, I am a devotee. And then... What kind of coffee do you drink? I drink purity coffee, as a matter of fact. Okay, what do you put in the coffee? Generally, nothing or I might use some whole milk, which is not.

another violation of the time of strict eating. I won't tell anyone. For the past, well, my life is an open book. Yeah, I'm teasing. And I often use allulose. Oh, okay. So I'm very, very big proponent of alulose. Then what is the exercise?

You should try these. These are really good. I'm going to try one. I could try during the show. You know, I forgot to do them. But they're basically, this one actually is no caffeine. This is magic mind, by the way. You guys have all heard me yam around. Ashraganda, right?

Ashraganda. Lions, Maine. Lions Maine. Yeah, all the things. They're very good. I'm surprised you don't know about this. Well, we just met today. I know.

We got a lot of ground to cover. We got a lot of ground to cover. My gosh, these are delicious. This is what I do before I work out, actually. It's like, keeps me focused. So my program, then, I have gym equipment at home, and I have a new piece of equipment, which is a stationer in bike called an avalon, which gamifies, which is great because my mind goes elsewhere.

But I frequently go to the gym. Wait, is it the bike. That's like, it's like an AI bike? It's just gamified. And I'm online with other people. And, but then I also go to a gym that's nearby that is run by the hospital. And I'm, believe it or not, one of the younger people there. Really?

Maybe I just think that. But it's, yeah, a lot of people in my generation there. Do you do cardio or a strange thing? All of it. So my cardio is, and I run outside too. But in the gym, my cardio. You run? I do run. Yeah.

What do you say? Because, you know, there's like a whole thing. blast from me now because I like to run too. Be like, so terrible for your knees and your joints. Actually, that's not with the data shows. The data shows pretty good preservation of knee and cartilage with running. Now, you can overdo it. Well, I think it's endurance runners.

Yeah, I mean, I did my share of that. Yeah. But so I've taken, not to take it to, but for the past probably decade, I've done elliptical machine. At home, I have a pre-core and I use that machine at the gym as well. So that is a zero-impact way of cardio. How much cardio? I'll do that for 30 to 45 minutes with interval training, which is great, because you see the graph.

And also when you do your interval, you see the curve come up. And I post that so people can see this is what interval training looks like graphically. Right. So kind of hard to post while you're on it, but we figure it out, right? Yeah, yeah, yeah. And so I really like that. And then I used a lot of weight machines, some free weights. And then when we travel, as I mentioned you before we went on, we live on a boat for four months.

on the boat, I have bands, tension bands, a stepping machine, and then I use TRX, which I'm sure many of your audience is familiar with. I love TRX. Yeah. So give me a stairmaster. A stepper machine. It's not a stairmaster. It's a little stepper machine. Oh, just like this?

Yeah. Is that enough? Oh, yeah. It's not a stair mill. No, no. It's a stepping machine, but I can actually run the boat while I'm on that machine. So I can get up on what's called the fly bridge. And I can run the boat with a remote control.

Our boat is really slow, so I'm not going to hit anything. And I could be on that machine while we're doing that. And then we get off the boat and hike virtually every single day. Oh, okay. And we're in nature and we forage for mushrooms. So we do that as often as we can. That's great. Okay, so basically you exercise every day.

Is there any foods that you are, like you are just addicted to that you have to have every single day? No. Okay. But, you know, I have my, we love salmon because we catch fish all summer. And we were generally able to freeze enough salmon to keep us throughout the year, the rest of the year when we're off the boat. Oh, wow. Okay. Yeah. So I think salmon's a great food. I love it. I love to catch the fish. I love the DHA content. I love the assured cleanliness of knowing that it's wild salmon because I caught it.

Wow. Yeah. Yeah. So I know that. For whatever reason, I could probably find a way of arguing my way into this. I love onions. I love the crucifers vegetables. I sprout broccoli seeds at home, and I'm doing it on the boat as well. That's a big one, too. There's like, that's huge. Broccoli, like the sprouted broccoli sprouts are supposed to be amazing for your brain? Well, it's amazing throughout the body.

I think the, really, the go-to person is a fellow by the name of Dr. Jed Fahy. He is probably the world's authority on sulfurane. And sulforaphane is that chemical that is created when we chew the broccoli. sprouts, the broccoli sprouts are rich in something called glucoraphenin. And when you chew broccoli sprouts, the glucoraphenin in the presence of an enzyme called myrosinates that's liberated by chewing, converts the glucoraphidin into sulforaphane. This sulforaphane then activates a pathway in your body called the NRF2 pathway that is hugely antioxidant, that is hugely involved in detoxification, and powerfully anti-inflammatory. So that is the home.

run that you're looking for. Dr. Fahey, Fahey, just published a new report on the effects of sulforphine on the brain and the research is profound. And I've only had him on my podcast and I will meet him in February. I invite him to be a guest at Integrative Healthcare Symposium as one of our speakers. I can't wait to meet him face for face. Is this your, is this your sympos? Is this your thing? I am the health, I am the chairman of that symposium. But this will be my first year as chairman. Oh, okay. But I've been speaking there for 25 years.

Wow. How big is this symposium? It'll have probably 800 people in attendees. What kind of doctors? Is everybody it goes? That's, it's integrative. That's all integrative. That's what we want.

So plenty of MDs, DOs, chiropractors, other healthcare practitioners like dieticians, acupuncturists, body workers, you name it. Really? Okay. I'll go. Let me ask you go. When is it? It's in February.

and I'll make sure you get invited. I would love to. I'd love to go and see what... It's in New York City. Yeah. Every year at the same Midtown Hilton. Really? Yeah.

And it's 25 years. Who's speaking this year? Let's see. One of our guest speakers, who hasn't spoken there before, is Dr. Lee Way-Sai. And if she's watching this, she'll understand why I invited her. Because Dr. Leeway-Sye is at MIT, and she has discovered that flashing a light into your eyes at 40 times per second, so we call it 40 hertz light, actually targets your brain's microgleal cells

and helps revert them back to being supportive. So she's in the book, and, you know, what can I say? Being chairman, I get to sort of influence who gets to speak there. Yes, you do. Yeah, that's true. So, you know, and there are a lot of wonderful other... That's really interesting, though. Oh, it's breathtaking.

And, you know, her work extends to humans, to allies, Alzheimer's patients, the findings that she is getting. You know, our main topic today of discussion is how do we preserve the function of the brain's immune cells to be supportive by making lifestyle choices. But what we talk about is that this is where leading edge neuroscience is exploring right now. So here is MIT looking at reverting the microglial cells to being supportive using a light flashing in your eyes at 40 times per second. How does that work even?

I guess I can ask her. How does it work? Okay, you'll have to ask me, but I'll tell you. Yeah, tell me. So what Dr. Sai made very clear is that the healthy brain has a beautiful background rhythm called gamma oscillation, a beautiful sinusoidal curve that is the orchestra playing a symphony. As the brain begins to degenerate, that gamma rhythm deteriorates, and it's cacophony. or every instrument playing a different thing, no more music.

And what she found was that when we have good gamma oscillation in the background of the brain's activity, that the microglia are being preserved in their function and being kept in their supportive role. She discovered that when you expose the visual center and the back of the brain where vision is represented, the occipital lobe, to this particular frequency that gamma is restored.

Can you imagine? So they do, at her laboratory, the Pekauer Institute at MIT, they put EEG leads on a person's head, and they discovered that flashing lights at different frequencies does different things. They tuned it in and right at 40 hertz, gamma is restored.

So people can then, how do people do that at home? Is there a way you can't? I have a box next to my computer screen, and it's always on while I'm working, and I'm constantly getting 40-hertz light flashing in the, you can buy a light bulb. So you know it's interesting. This is like the, you're like, this is kind of like the pink, not pink elephant in the room,

but something like that. Like you're leaving the, you're burying the lead. This is like something that anyone can, anybody can do to prevent or reverse any type of immune cell deficiency that would lead to all these terrible diseases. It's a definite lever that you can pull. So we've talked about, yeah, training our muscles, strength. training, aerobics, diet, et cetera. We talked about how to do metabolic health. Look at this, dare I call it a hack, I don't want to call it hack. A tool?

A tool? A lever to pull. A lever to pull. And there's a lot of other cool things that are being developed right now. I mean, I want to talk about other things that people can do. We talked about, of course, well, we haven't really talked about the mitochondrial health. Like, what does that mean to people? Like, how do people really have a strong, explain to people, or just to me, and then people can hear about the mitochondria, how we can and what we can do to have a stronger or more functioning mitochondria? Because that also is something you talk about in the book. So the question is then why?

Why do we even care about our mitochondria? Why does it matter? Yes, tell us. Because it is the fundamental that determines the shift of these microglial cells. It's the failure of their mitochondria, their metabolism, mitochondria, that dictates friend or foe. Is mitochondria metabolism one of the same? Yeah, metabolism is, by definition, it's the creation of new materials from raw material, but it also, from a cellular perspective, but most importantly for our discussion,

it's the formation of energy molecules from substrate. How do the mitochondria create ATP molecules from glucose? The reason I'm asking is because I've heard a lot. People are very confused, right? They hear a lot of these buzzwords. metabolic health, they hear mitochondria, they hear, you know, all about the gut, how the gut's the new brain. Like there's all these like very fuzzy social media things that people, cellular health. But nobody really knows and understands what this means. I mean, they pretend because I hear it so

often that you think that you understand. So I thought since you're such a novel, you know, you know so much about all of this is what you do. Like I wanted to kind of like really break it down, Like what it means to have, you know, to work, to have like, for your metabolic health, what it, for your cellular health? Is it the same? Is it not? Like, what can people do? Is there like a very, is there like a, like a, like a, kind of like a, like a cheat sheet of how we can

strengthen and improve all of these things to improve our ability or to, to improve our health, but also to like, help us not get these diseases later on, I guess the best. The answer is 100%. That's why I'm here today. That's why we're having this discussion. Because again, there's no fix when you get into this problem from a pharmaceutical perspective, and it doesn't have to be. It isn't a genetic issue by and large.

It's related to our metabolism. I'm going to break that down. That's what you want. And we can control that. That's what we're doing here today. Right. Why as simple as possible so people can take an actionable cheat sheet and be like, okay. Let me pave the way and then we'll talk about the actionable points.

Okay. So again, we just kind of opened the door on mitochondria. The energy producers of the neuron, rather, neurons very busy. They're sending electricity, connecting the networks, allowing us to think and do, right? That's what the neurons do. But the neurons are only 50% of the cells in your brain. We tend to think, oh, the brain is just a box of neurons. That's not correct.

When we talk about brain cells, oh, you mean neurons? Well, no, we're having a different discussion today. We're talking about some other brain cells, in this case, 10% of the brain cells, the brain immune cells called microglia. There are other brain cells called oligendrogliocytes and astrocytes. We're focused on the brain's immune cells and their metabolism. Their metabolism, how their mitochondria are working, creating these energy molecules or not, determines whether they're going to be destructive and destroy your brain, as we see in Alzheimer's, and Parkinson's and all the neurodidid conditions,

or they're going to support your brain such that when you're 80, and I'm really old, we're going to come back and have another podcast, and it'll be lucid. Okay? Okay. How about it? So, like, people, like, you know, the rage is NAD, right? People think that's when they think of mitochondrial health, cellular health,

metabolic health. Everyone is injecting NAD or, you know, taking a precursor. does that actually improve your ability for it and they take it because of aging they want to age better that's the whole idea they want to pro age or whatever you want to call it does it actually make a difference well i i think as it relates to oral precursors like nmine and nmine and r is the way i nicotinamide or nicotinamide am on a nucleotide i'd like to see the data to answer your question i have not seen it yet then we move to the intravenous forms, which people rave about.

Yeah. Because there is an indication that we can raise certainly blood levels and certainly tissue levels with IV, NAD. Yeah. But the question is, is there a payoff in terms of cognitive function, preservation of cognitive function, and even improvement? I haven't seen that data, but do I think that it makes sense? It does make sense.

when we recognize what NAD does both in terms of mitochondrial function, makes sense to try to keep NAD levels higher, decline as we age, we know that, and the role of NAD in terms of influencing the Sertouin genes. I think on both counts, it makes sense that we should do whatever we can to increase NAD. That's why we exercise. So I think that we still need to see the research that relates to the oral precursors to their ability to carry out these goals. That said, a recent study by Sinclair and Johnson

looked at epigenetic clocks, age-related clocks, in terms of using a precursor, for example, and did not find any significant ability of the precursor to influence our biological age. Interestingly, one of the best things that they discovered to reduce biological rate of aging, what's called the deneating clock, I think was the mark when the metric, was physical exercise. It's there for all.

Right. It's free of charge. Right. You got to buy a new pair of running shoes or whatever it may be, maybe from time to time. But I think we're going to watch this evolve. NAD is such a fundamental molecule in the functioning adequately of our mitochondria. To me, everything is about the mitochondria. Why?

because the mitochondria are determining the function of our microglia cells. That's upstream for how the good brain continues to function or the bad brain manifests. It's the function of the microglia, which are determined by how their mitochondria are functioning. So if the, if, because you say in the book, like many times brain defenders, that the, how your mitochondria is functioning is a correlation. of your brain health, yes? Absolutely. Absolutely.

So if NAD helps the mitochondria, it would make that there is a direct correlation. You're right. It would make sense. Do I think it does? I do. Do I see compelling science to indicate that? At this time, I do not. So my emotional response is supportive.

Okay. But there hasn't been any type of science to back it up. Although... I wouldn't say any type. Because I mean, I know that, I even know, like, you know, seriously, true nitrogen has done a million case studies for NR. Doesn't that count? It counts. But I want, you know, what you're asking, though, is there science that shows that taking a particular NAD precursor is going to benefit brain function?

There's some indication that it might, but it's not the solid home run that I'm looking for to be able to respond to your question that way. Now, do I think emotionally that this makes a lot of? sense to take something like this? Yes, I do. Okay. Or even any type of, even the IV or whatever. My sense is yes. My sense is yes. But I have to do better, I have to delineate between, you know, my visceral response and what I do for myself based upon that and recommend versus what does the science support. And that's what you want me to do. Right. You're trying to be, you're just trying to be, you're just, I understand. You don't want to be in a situation where you're saying something out of term without having the evidence to back it out. Yeah, out of term is well characterized.

Yeah. And the term here is, I, my sense is yes, but I want to be able to quote the study that shows that this is a powerful inroad to Alzheimer's prevention or even, dare I say, treatment. And not quite there yet. I understand. What about oral health? I heard you, not I heard, it's in your book that what brushing your teeth can starve away any type of brain decline? Is that the correlation? Well, I wouldn't say any type of brain decline again. Well, no, but I'm saying you're giving all these things. You're talking about genetic testing. You talk about metabolic health. You talk about, there's a whole chapter on oral health that I saw. There's also two tests that you, that doctors don't tell you about, right? You talk about that. The homocysteine test, and what was the other one? And the fasting,

and was it the fasting insulin test. These are things that I think are like these are all part of the cheat sheet in my opinion. Yeah. I'll answer both of those questions more, but I want to tell you, this is a great interview BTW. Really? It really is because we're just going to what really matters. Yes. I mean, I think the mission here is to give your audience the cheat sheet or whatever are the tools and you keep teeing it up. So I want you know, I appreciate that. Thank you so much. I appreciate that. I do. I try. I like to get to the meat of the matter. I like to like no yes, I like just to know the facts and giving people actionable things that they can do, you know? And then so that's why like I know we kind of like digress and we go on these tangents,

but I, because I'm a very curious person. And I, when I have someone like you who's like, who's very knowledgeable, I want to like, I want to kind of get as much, I want to extract as much possible information. And we only have two and a half hours more to go. So we better, we better step up the base. Exactly. Exactly. I know. Chop, chop. Let me get to the first question first, which was the oral health. Yeah. And it's a bit of a surprise. I mean, years ago, I wrote a book called Brain Maker that said, you know, there's a connection between the gut and the brain.

Well, who knew, right? Well, Hippocrates knew, but more recently it was, like, are you kidding me? I'm a gastroenter or not. What year? Did you write that one? That came out, I guess 12 years ago, something like that. See, this is what I'm saying. And now it's become like, everyone's just talking about it.

Like, it's been, like, so you were, that's what I'm saying. You were, like, writing about this stuff before it became, like, cool and trendy. I didn't want it to become, yeah, trendy, I went with cool as, no, I like iconoclastic because I always want to be, you know, on the edge. Irreverent. I love that word. I'm going to take that from you. You can.

Just give me the credit. I will credit you. Okay. You own the hashtag. Okay, thank you. But the idea that oral health is important. We know that gut health is important and the digestive system is important for brain health. and who knew the mouth is part of the digestive system.

This is where the tube begins, and we know where the tube ends. So it begins here. And the data that's coming out really relates very powerfully. Risk for Alzheimer's, if you have periodontal disease, goes up dramatically. I mean, to levels that you'd be surprised. We know that there are particular bacterial organisms that characterize periodontal disease that have been found in the brain or at least parts of them, if not all the organism. Like a root canal?

If you have a root canal, that can be. lead to... Well, more the periodontal disease, the area around your teeth being inflamed, bleeding. Isn't that like a root canal? Well, the root canal is more the tooth itself and the root of the teeth. I know you're not a dentist, but I'm just trying to like, you know... Yeah, but, you know, not that there's not some concern about root canals. We could talk about the idea that this gutta percha that's used in the root canal can harbor bacteria. But let's go back to the period disease, the gum disease, basically, that this correlation with heart disease and vascular disease, and brain disease, all of which are inflammatory.

But we're able to find this one organism, for example, that's getting a lot of attention that Dr. Bredeson, brought to light, called Porphromona-Ginjivalis that will not be on the quiz, but the idea that we find these organisms that are mouth-related organisms in the brain. So we begin to talk about something called the oral microbiome. with the same sort of skepticism and hopefully soon the same sort of appreciation that we previously applied to the gut microbiome that the oral microbiome is important i talked about it in drop acid the book about uric acid that's where our dietary nitrates from certain foods like beets for example get converted into nitrite that our body uses to make nitric oxide helps

blood supply to the brain and organs and helps insulin do its job. We don't want to sterilize the mouth. We don't want to be using mouthwashes that, say, kills 99.9% of germs. We love our germ. There are some germs that are bad in the mouth. I just mentioned one. But the idea of sterilizing the mouth once or twice a day with mouthwash, you know, when I first heard this from somebody on my podcast, he said, you know, if you go to the gym and work out, and then when you're getting your clothes on, you take a shot of mouthwash and spit it out, you've just offset the entire benefit of your workout out. And I don't you're talking about it. And I heard him say that. And I thought, well, you know, podcast you got to let people talk. And I thought, oh, how silly that is.

Then I saw the research that came, oddly enough from Puerto Rico that demonstrated that people who frequently use particular types of mouthwash that sterilized the mouth, that we're all familiar with the brands, I will not mention it, that frequent use of mouthwash is associated with a significant increased risk of hypertension, as well as a significant increased risk for becoming a type 2 diabetic, both of which are powerful inroads to becoming an Alzheimer's patient. Consider that. Is that really true? It's really what the science revealed. You actually saw the science on that. I did see the science. When I first heard this, my surprise was what yours was. Because I know what you're talking about because I heard the same thing.

And I was like, it's from the same guy who talks about this nitric oxide thing. It is all about nitric oxide. I didn't hear it from him. Oh, you didn't? I heard it from him. And I was like, what? I heard it on a podcast. And I was like, that sounds crazy to me.

I'm grateful this individual made this clear to me. And very close friend is he, it's Max Lugavere. You probably have money. I know Max. Yeah. When you told me this, I thought. Maybe it was him who told me to actually. Could have been.

I love that guy. I really do. I have so much respect for him. Yeah. He's very well. I made him breakfast one day. We did some kind of live thing. And he's great. He's great. Yeah, he's great. Yeah. He had a, you know, his situation with his mother. And has done his best to help others not go through that. Yeah. God bless Max Lugaberry. No, I love. Hey, Max. And thank you for the T-shirt. Yes. I'm going to clip this for Max. Because we love you, Max. We love you, Max. So that's interesting.

That whole mouthwash thing was very, very curious to me. But it doesn't mean we shouldn't take care of our teeth. It means we absolutely should. How about a tongue scraper? Is that why I'm so cool? You bet. Tung scraper, great idea. I travel with a water flosser. It's rechargeable, USB rechargeable water flasher.

It broke two days ago. I immediately was at the, may I say the name Walgreens, yesterday, I bought a new one. Really? So you even go that far. Oh, it fits in your, it's this tall. It fits in your suitcase. No, I was going to say, so you're saying like just, because I was going to say like flossing, a tongue scraper, you know, when you floss, you know, there's some that, like this is like so random. But like if it's not a good kind of floss, you're not getting in there and getting all the good stuff out of there.

I floss, but I don't like it. Yeah. I don't like flossing. I don't like sticking my fingers in my. Yeah, it's weird. Yeah. It doesn't work well. Doesn't get everything.

You always miss the water flosser. I'm going to get one of those. I mean, I use, it's a water pick, but not the kind that you have to plug in in your, in your bathroom at home. You can travel with this thing. USB rechargeable. Can you send me a link? I would buy one of those. I will absolutely do that.

Yeah. No, I love that. So, okay, a water flosser, no mouthwash. I have been using the more healthy one. Is that a good, is that a good ball? Healthy what? The mouthwash. I'm not using like.

I can't tell you because I don't know. If it has an antibacterial in it, I would think twice. Not yeah. The bacteria that live on the top of your tongue are important because their first step for your body to make nitric oxide. Nitric oxide you need. It helps insulin work and helps your blood vessels expand to improve the blood supply to your brain. Okay, so that's the part like I don't understand about this nitric. How does that fend off brain disease?

I don't get the connection. I'm going to explain the connection for you and you'll get it. you'll never forget. Okay. Nitric oxide is important for metabolism, i.e., insulin functionality, blood pressure, blood supply, and metabolism, when it's not appropriate, is what threatens your microglial cells. That's the connection. So is that why people are putting it in toothpaste or they're putting it in serums?

I don't think you're going to, you're not going to be able to put nitric oxide. They have, I was just said. No, but it's not nitric oxide. It's a precursor. So usually things like arginine are put into toothpaste. And what more importantly is happening with toothpaste, the bad things are coming out of toothpaste, which is really good. There's all kinds of issues that have been in toothpaste for an awful long time.

Sodium loral sulfate, which is somewhat threatening certain of the sweeteners. So I'm glad to see that there's been a real effort, conscious effort, to create various brands of, I use one called fig, FYGG, for your good guys. What does that mean? For your good guys means my mouth bacteria. I want to, I want to keep them healthy. They're on my side. They're along for the ride and this is their home. Yeah, I mean, like people like, it's also these things that sometimes common sense isn't so common, right? Like it's, it makes sense why that would make a difference. Like your mouth, because that's where all these like living organisms are in your, in your mouth. And if you have an infection or it'll go into your brain, it makes perfect sense. Do you know they even said UTIs?

Like anything like these, these, why would a UTI? Because a UTI is characterized by total body inflammation. When there's infection anywhere in your body, a urinary tract infection, lung infection, any infection in your body, inflammation. Those inflammatory chemicals called cytokines are increased in your body, and they make their way to the brain, and they polarize our microglueal cells away from being brain defenders

to being brain destroyers. That's why it's important to, you know, we think about the quality of the water that we drink, right? You're drinking the water. You want to avoid water that might have chlorine in it, certainly microplastics and all of that. Right. But what about the air you breathe?

No one talks about that. Right. It's in the book, too. You talk about that. You breathe 20,000 times a day. And we want to breathe clean, pure air without these PM2.5 particles that, you know, In the time of our discussion today, this is a time where wildfires are rampant in North America. I just came down from British Columbia.

The air quality index is terrible. The sky is yellow and you can smell the smoke. That's why I stay indoors with an air purifier. And when I'm outdoors, at times I'll wear a mask because it's threatening to the brain. It's associated with an increased risk of Alzheimer's because it increases inflammation. That is bad. Now, do people look at me in a funny way when I'm walking on the street with a mask? They might, but other people are doing it.

Yeah, makes sense. And I don't care. Yeah, but I use at home, even we live in Florida. I have an air purifier. It's in our bedroom. We're breathing pure air. It's called lichen air, L-I-C-H-N. The lichens are these things in the forest that keep the air pure.

So that's what we breathe. It measures the air quality. You can get an app. to look at the air quality index, the AQI, wherever you are. We were recently in Cairo, and the air quality index was mind-numbing. Literally, it was, you know, greater than 300. And I didn't want to go on these tours to the sites, the Sphinx, everything, but I did, and I wore a mask.

Yeah. Guarantee you, I wore a mask. So I wasn't alone. Yeah, well, again, it makes sense. So anything that brings the body inflammation, so at the end of the day, it sounds like inflammation is the core cause of any, really, any disease at the end of the day. You know, it's certainly not the cause of trauma, but it is a fundamental player. It is a fundamental issue here.

And upstream that we have to pay attention to is what is inflammation doing? What are toxins doing? What is elevated blood sugar and insulin resistance doing to our brains, immune cells? And all these things are doing and many more infections. are shifting our brain cells away from being supportive. And we want them to be on our side. So what if you take a GLP1 just for, not for your, not for weight loss, just for bringing the body's inflammation down? Does that work then just for that? Is it strong enough? Is it true? Is there any real backed research? To be fair to you, let me talk about the science first of all. And then I can

shift to being speculative. And I want to clearly delineate between the two. Yeah. So if you accept that what makes a good brain go bad are changes in metabolism, mitochondrial function, and how that plays out of the brain's immune cells, what if we were to target metabolism using a GLP1 drug? It's a powerful way of targeting metabolism. So in 2024, in the New England Journal of Medicine, April of 2024, was a study that involved 151 patients who had diagnosed Parkinson's disease. It wasn't a question. They had Parkinson's or medications, not doing well. And it was a one-year study that either treated them with placebo or an injection of a GLP-1 drug every day for the entire period. Now, the placebo patients basically didn't get treatment. What happened to them in the one-year period of time?

They declined in their functionality, as we see with Parkinson's. The group getting the GLP-1 agonist drug stabilized and actually demonstrated a tiny improvement. to me, that is... When you see tiny, how tiny? Well, the idea that they even stabilized to me is the home run. But even beyond that, they actually have a slight improvement, which we've never, ever seen, except for one study that we carried out years ago using intravenous gluteothion. But functionality improved by giving them a drug targeting their mitochondria.

So that's interesting, because I heard that... Someone was telling me, it was like a biohacker was telling me, oh, yeah, I'm taking, not the semi-glutide one, they're taking, either is it retitutide that works on the three receptors or the tri-epitide, too, whatever. True-epitia. Yeah. That they're taking, they're micro-dosing it for, to fend off Alzheimer's or dementia or any type of cognitive decline. Is there any accuracy at all to that then, or is it just speculatively? First of all, I don't know what a microdose is in the context of this person. Yeah, I mean, that's exactly a good, I know.

Yeah, I mean, I don't know what that means. I mean, what is microdosing of psilocybin? What is microdosing of JLB1? I don't know, define the terms. But is there any science to support what I'm about to say? Or is there any science to support the idea that's a good practice? No, there isn't. And we'll review what the science is in terms of Alzheimer's just a moment.

Because recently there was a completed trial called the Evoke and the Evoke Plus studies that were just completed that involved more than 3,000 individuals in over, I think, 500 institutions globally. Well, let me talk about that real quick. What did they find? This study did not reach therapeutic endpoint, meaning that the oral semi-glutide did not demonstrate benefit in existing Alzheimer's patients. But interestingly, one of the findings that is not talked about is the fact that the

C-reactive protein, a marker of inflammation, down dramatically in the group receiving the drug by so 30% that's important we don't know how that will play out could the study be refined IV or rather in subcutaneous injections gLP 1 and a different glp1 that might make its way to the brain a little bit better yes I think so we'll see where the science takes us the idea of a gLP 1 being good for the brain I think has merit and I actually mention it in the book I'm keeping an open mind to the idea that some formulation of a GLP1 may be good for the treatment of Alzheimer's in the future. Jennifer, Alzheimer's is an almost uniformly fatal condition.

It is the third leading cause of death of adults in America. And so the idea of using a drug that may have a side effect profile that may be helpful is something we have to keep our eyes open to. and I remain open to including it in the toolbox once we know which GLP1, which formulation can we use, how safe it will be, and how efficacious it is. So I think it's very powerful. I think just the hit and miss trials of GLPO1, because I think it's a good idea, I'm in a microdose. I'm not going to tell you what the dosage is because I'm not really sure I vary from day to day. That may be interesting for an individual, but it's not science. So you wouldn't take it?

No. Are you on any GLP ones? No. Because what do you think of the overall use of them? Do you think people are just like just at this point, they're just, they're being abused by everybody? Do you think it's going to go away? Do you think it's a trend? No, I think it's not a trend.

Barring some demonstration of a significant side effect that's widespread, I think they're here to say. And, you know, because on one hand, there's this huge effort to get people to eat crappy foods, these ultra-processed foods, that's not going away, despite what we see the effort being to make people aware of the GLP1, I mean, of the ultra-processed foods. I'm one of those people trying to raise awareness that consuming these foods is associated with Alzheimer's risk, specifically, and diabetes and obesity, and all the things. That's not going away, and therefore the GLP-1s will not go away. Are they completely safe?

They are not. We don't know how many people are going to suddenly lose vision by, one report, as many as 30,000 people have lost vision acutely as a consequence of using these drugs. That's a worrisome, you know, it's not a big number in comparison to the number of people who are using the drugs. So the incidence of that side effect seems to be low, but that's 30,000 people, no matter how you slice it. They don't care about the others. So the idea, though, of targeting metabolism, I think is very important.

And there may be supplements and drugs that are able to do that, that I will keep. an open mind for. In the meanwhile, most of what we talk about are the lifestyle, I don't want to call them hacks, but the tools that was your term, that we've talked about today that do a hell of a job in targeting our metabolism, like getting enough sleep, restorative sleep, and exercising in both forms that we talked about with the addition of balance and flexibility. Yes. And the type of foods we eat and connecting with other people. Do you think it matters if you're a carnivore or a plant, like a vegetarian? Do you think how much, what about protein? Do you think protein's being over, over, again, over, now it's so trendy? Protein is desir, no question about it. And it's trendy.

Did I have supplemental protein today? Because I hope I get enough. Yes, I sure, I sure did. We'll get back to the question in a second. We used some electrolytes after this interview. Some lights. But I, you know, at my age, it's harder to maintain muscle mass. And that's a huge risk for all types of degenerative conditions, for injury, and for Alzheimer's as well. I mean, one of the most powerful risk markers for Alzheimer's is sarcopenia, loss of muscle mass, and loss of grip strength because your muscles are weaker. So I'm doing everything I can to maintain muscle mass, and that means for me, making sure I get adequate amounts of protein,

exercising a lot, like I've told you, and I happen to use a testosterone gel just to make sure that I'm as anabolic as I should be, not as I can be. You know, there are other things out there that I am not doing. I mean, there are gene therapies now that help you build muscle. I have not gone that. Am I thinking about it? I'm considering it, but I'm not really willing to accept that risk just yet. Let's wait for more data.

Or peptides in general. Or peptides in general. I'm not using any peptides. Yeah. Would I in the future? Yes, but I want more data. You know, to me, it's really above all, do no harm. and talking about me now.

And so, yeah. Yeah. Well, it's interesting because when you talk to real, like, when I say real doctors, I mean real doctors, they don't want to be on a GLP1. They don't put their wives or their husband on GLP1s. But for patients, it's okay, right? Oh, that's very common. Do as I say, not as I do.

Exactly, because there are risks. People don't, it's not trendy to talk about it. It's not something that is popular because people like, people are visual and it's like easy and it's like a quick fix. It is a quick. A lot of it could be a quick fix. You're getting these things from China. You don't know what's in your body.

No one wanted to take a COVID shot. Remember, like, the conspiracy theories around taking, you know, the vaccine. But people are like shooting themselves up with 27 peptides. They don't know what those are. The hypocrisy is crazy. I would say to a patient who is asking me to go on a JLP one drug, let's just say for weight loss. Yeah. I would say, are you willing to commit?

to being on this drug for the rest of your life. Why did you ask me that, doctor? The reason I'm asking you that question is because when you stop, if you decide not to do that, and you're not going to out the rest of your life, and now it's time to quit, chances are significant

and most likely that you're going to gain back all your weight and then some. And that's where you're going to be when you decide you're not going to take this drug anymore. Now, that's a different conversation from the one I would have with the family and loved ones,

of an Alzheimer's patient if it were proven that this were an effective intervention. Right. Because we lack that right now. I would say that, you know, we're going to commit mom or dad to being on this drug because it does show significant efficacy knowing that if we don't do it, that this is a fatal condition. Yeah. So we have, you know, what do we have to lose? Right.

At that point, that's a whole different ballgame. Okay, talk about the two tests that your doctors don't tell you about. that could be very beneficial to knowing where you are. Neither of which requires a prescription. So you can go to your lab, ask them to do a homocysteine, H-O-M-O-C-Y-S-T-E-I-N-E. There's probably a graphic right now on the screen that says homocysteine. There it is. Magic.

And so homocysteine is an amino acid that when it accumulates and reaches a higher level than normal. We'll talk with that in a moment. It increases the risk of Alzheimer's, cardiovascular disease, is threatening to the lining of blood vessels. It's a bad player in your body. And it's simple as can be to fix. How do you lower homocysteine? If it's elevated, you take a methylated B complex,

not just a B complex at the health food store, but one that says methylated bee complex at the health food store online, buy it. So you can get the blood test without a doctor, and you can do the response without your doctor. And I put the parameters of where you want your homocysteine to be in the book. Now, there are genetic predispositions to having elevated homocysteine.

I have that. It's called M-T-H-F-R. If you've have it and you've got your genome sequence, you've heard of M-T-H-F-R. There's been mood disorders characterized by having M-T-H-F-R. The main thing for me is it causes me not to use regular B vitamins appropriately. So my homocysteine went up to 11. I took methylated B vitamins. I take them religiously. by homelessness range between six and eight, so I'm okay.

The other test, and we mentioned earlier, is a fasting insulin test that is predictive in terms of where your blood sugar is going to go, where your A1C is going to go in the future. Because the first thing that goes up is your insulin level, then the blood sugar elevates, then your A1C elevates. So that's the great test to know where you are in terms of risk of that critically important metabolic marker, your blood sugar, right now. So how about the, you said something in the book, I don't remember exactly, mood disorders, like anxiety, depression.

Does that cause inflammation in the brain, which then can also be a precursor for someone getting dementia or Alzheimer's? So there's a profound relationship between mood disorders, primarily depression but anxiety as well, and the presence of inflammation in the body. It is not to say that the mood disorder caused the inflammation. inflammation, it is the opposite, that the inflammation leads to the feelings of depression, etc. When you are sick, you have inflammation in your body, you have the flu, you have COVID, how do you feel about interacting with other people? You don't want to be with other people.

You feel crappy, you're weak, and it's because inflammation is actually changing your neurochemistry and leading to these changes in your mood. And that's probably good for the herd, right? That's probably good for all the rest of us that you decide you're going to isolate right now because you just don't feel like being around other people, you feel crappy. And so that might be why that happens. But to be sure, this is the inflammation that polarizes our brain's microgleal cells away from being brain defenders to being brain destroyers. Again, we can image the human brain in living people to determine the state of function of our microgleal cells. We can image the Alzheimer's brain. And, and see that it's lit up on this special type of PET scan called a TSPO PET scan I talked about

in the book. It lights up with those microglutic cells being shifted to their M1 configuration. But guess what? This TSPO imaging is positive in Alzheimer's, I mentioned that, Parkinson's MS, multisystematory, progressive supernaturally palsy, PTSD, a major depressive disorder, long COVID, autism spectrum disorder, all of which are. are characterized by this activation of these microglial cells. Well, that's interesting from a research perspective,

but it tells you and me something very important, that this is a huge net that is thrown, that if we can figure out how to rein in these microglial cells and bring them back to be supportive, that is a home run across so many areas. Okay, I have a couple other questions, random, not random. Don't stop. You're doing great. Thank you. Thank you. What's that erectile dysfunction medication?

Viagra. But not Viagra. It's another one. Cialis. Cialis. I heard that Cialis is actually, people are taking Cialis to lower their risk for Alzheimer's. Does that actually work? In an evaluation of more than several million medical records, a study was performed to determine, And is there any indication that people taking any particular drug that might, therefore, with crunching this data would be associated to low risk of Alzheimer's, it turned out to be these

types of drugs? It turned out to be sylendophil in particular, which is Viagra. Why would that be? It gets back to an earlier conversation we had that relates to the mouth organisms, nitric oxide. How do these erectile dysfunction drugs work? What is an erection? An erection is opening of blood vessels to allow the erection to happen. Blood fills the penis and it becomes, develops what's called turger pressure. Turgar pressure is what makes it hard. That's what an erection is. It's caused by blood supply increasing suddenly to the corpora cavernosa of the penis allows that to happen.

It is a dependency upon nitric oxide allowing that dilutation to happen. That's why these drugs work. Now, nitric oxide improves blood supply, improves blood supply, as I mentioned earlier, throughout the brain, and nitric oxide improves insulin functionality for better utilization of glucose, keeping the blood glucose under control. So, is there evidence that these people are doing the right thing? Hard to say there hasn't been an interventional trial that I'm aware of as yet. Do I think it has merit? I absolutely do. So should we all go on Seattleis or Viagra?

I can't have the answer. You want me to quote the science. That study hasn't been done yet. But is it mechanistically plausible that that is the right thing to do? The answer is yes. So which one has more nitric oxide, Cialis or Viagra? I don't have the answer for that. Okay.

I think that Cialis is designed to have a longer half-life. So it might be a more appropriate choice than Viagra in terms of keeping that nitric oxide elevated for a longer period of time. But there's no data that I can quote to you right now that that's an appropriate. appropriate choice. Okay. So that's interesting. Mechanistically, it makes sense. Mechanic, okay. The other one I have to ask you about is Benadryl. I heard not to take Benadryl because it does cause Alzheimer's. Well, I'm not going to say that Benadryl causes Alzheimer's. Taking it too often, though, can't. Oh, yeah. I mean, but is there a relationship between taking diphenhydramine, which is what Benadryl chemical name is, frequently, and risk, there is that relationship of risk.

there's a bit of a nuance, more than nuance. I think it's important to delineate between saying that taking Benadryl is going to give you Alzheimer's to the idea that frequent use of diphenhydramine or Benadryl or Valium or antichic drugs help you because you get up frequently in I-2-P and risk for Alzheimer's. We know that's true that risk is increased in men who take those types of drugs. Well, anticholinergics block a... Acetylcholine, acetylcholine is a critically important neurotransmitter. That might be the reason. So that may be the reason. There may be other reasons. How much is it too much? Like, can I take Benadryo once in a while? If you take it once in a while, I cannot imagine that's a huge issue. We know that, for example, people who take ant acids, these proton pump inhibiting antacids that are advertised on television where you see somebody tries to eat a sausage and they get heartburn. They've got to take this PPI. So anything, anything, when you overdo anything.

Yeah, but, I mean, people don't think they're overdoing it because the messaging is take it every day and you won't have acid reflux or heartburn. And, you know, people who take those drugs every day do have a dramatic increased risk for Alzheimer's disease. That's published research. I also heard Xanax, all these drugs, like all these anti-benzodiazepines. Yeah, those are, that's true as well. But for me, so I see this data that relates taking these proton pump inhibitors. I talk about it in the book. I know. Why might that be?

Well, these are drugs that block acid. They change the pH of your gastrointestinal system. What will that do? pH is tightly regulated and the organisms that live there, that's the environment they like. All of a sudden, you change the acidity and they don't like to live there anymore. They're going to move, you know, it's too cold to live in Indianapolis. I'm going to move to Fort Lauderdale. They don't want to live here anymore,

and they're not there doing their job anymore. Right, right, right. So the microbebomb has been one powerful explanation as to the association of non-stiorital anti-inflammatory drugs with Alzheimer's risk and with these anti-acid drugs as well. Certainly, and I talk about the book, antibiotic over-usage is associated with dramatic changes in the micro bomb and Alzheimer's risk.

Please be clear, I'm not saying we should never take an antibiotic. They're life-saving. They are wonderful. But, you know... You can overdo anything, though. Well, the research indicates that about 50% of the antibiotics used in America are used inappropriately, and 80% of the antibiotics manufactured in America are used in animals that we eat to make them fatter. Right, of course. 80%, more than are used in humans.

That's why organic, I think, is obviously that's why people don't want to eat regular, I guess, non-organic meat. It's just breathtaking that we have to have a special effort to find foods that aren't covered in chemicals. And I talk about that in the book, I cover a lot. Well, look at those chickens at Costco. Have you seen the size of those chickens? I have.

That's not normal. And what stimulates their growth? Antibiotics. Well, that's what I'm saying. They're like, oh, yeah, it's $5 a chicken. Yeah, but you're literally just eating a bunch of, like, antibiotics. Get a bargain now on the chicken and you will be spending more money in the future dealing with your illnesses. A hundred percent.

You pay now or you pay later. That's right. You know? I've one random other question for you. Were you ever, like, because you've been writing books for 100 years. Did you ever practice? Do you have like an act? Do you actually see patients?

Now I don't. Now I. Well, not now, but when did you stop? Well, I practiced for 30 years. So you were actually, like you were. I had the largest integrative neurology clinic probably in the world. Oh, excuse me, until when? Until I retired, which was about 12 years, 13 years ago.

So you were writing these books and also practicing. And raising kids and all the things. Oh, you were doing both. Coaching baseball, writing a book. Yeah, it was. Oh, I love that. Oh, it was great. Because the reason why I'm asking is, so many times I say this a lot on the show,

like, you know, people are on the show as doctors, but they're not really doctors. They just play one on TV, literally. Like they're media doctors or social media doctors. But they don't see a patient. They're not really out there because now they just want to, you know, be out there. That's the reason I do what I do now. Because I was in, you know. You were doing it all.

The one in the ER at night talking to the family saying, you know, what the outcome is going to be and wondering why did that patient have to end up here? Couldn't we have prevented this? That's what I'm saying to myself. That's not the discussion you have in the ER at night. Right, right, right. But, you know, why did the stroke happen? You know, why are there 800,000 strokes occurring in America right now? And, you know, and then in my office practice, dealing with people who mom, dad, spouse is now cognitively impaired.

And I wasn't taught that in neurology training about what are the causes of the problem, only what prescription to write and the story. Out they go, done. That's not good enough. So, yeah, I was not wanting to focus on the smoke. I wanted to focus on the fire. And I will say that having a father who died of Alzheimer's really solidified my dedication to this. Because patients would say to me, you know, doc, you just don't know how rough this is for our family. And I would say, as a matter of fact, I do.

Been through it, you know. And I remember that the moment I realized my father had Alzheimer's, I couldn't imagine how I missed it for so long. because I was, you know, a very good diagnostician. I could diagnose Parkinson's across the parking lot for crying out loud, but, and still do at the airport. And I go, oh, ladies your purse. Anyway, but I missed it with my own father until one day he asked me a question to the bottom of this stairwell. He yelled up this chairwell and asked me this question, and I finally went, oh, my goodness, because we just talked about something the day before.

Yeah, he didn't remember. And then I realized, and then everything else that he'd been doing made sense. I did miss it, the diagnosis in him. How old was he, by the way? He was in his, he was about 84. So he was also around my mom's age. He was older. And how long did it take?

Like when you notice it, was he already, he was in a mild form, I guess? It was very mild. And it took years to progress. And then at the end, it took about six, seven years to really progress. But then at the end, it progressed very quickly as we, generally see, you know, and that's why doing the things now with your mother are so important. Did I mention to you the study done by Rudolph Tansy and Dean Ornish at Harvard? Again, let's revisit that. That was an interventional trial in patients who are diagnosed with

Alzheimer's disease that in 70 percent, they either arrested their decline or even improved. What do they do exactly? I'm going to send you the entire person. protocol. Because right now my mom's in that middle to advance. She's not like at the end, like, she's now in a 24-hour care facility. She's very confused. Is it too late? Nope. Not at all. You'll send me that stuff. I will send me that stuff. A matter of fact, we have it right outside. You do? Yeah. Okay. And I mean, that'd be great. I would love to see it. Yeah. What else can we go over? It's been a hundred years.

Let's let what we just talked about sit for a second. A hundred percent. Because this is why we do what we do. we do. You can come back. Well, that's all right. You'll have another book pretty soon. You'll call it like it is. You're suffering. I know you are. And I've been there too. And it's so challenging because you're told there's nothing that can be done except for, and your mom tried the medicine,

right? She was on something that made her very agitated. Yeah. So again, thank you for having this time together today. Because this is, you know, I believe such a critical message. And

And I'm so glad that you've given me this opportunity to get it out there a little bit more. Absolutely. I really enjoyed your book. I think your book is very – there's so much in it. And even if people just, like, read a little bit, put it away, come back to it, like, you really cover the gamut in it. And so I'm so glad that I finally got to meet you. Me too. Thank you for coming on this show, really.

The book, really, I'm really – I'm honored to have you here. I'm honored and grateful to be here. Thanks for this opportunity. Thank you. And guys, pick up the book. It's called Brain Defenders. It's out now by David Pearlmutter. And that's it. Have a good one. Bye.