The Dr. Hyman Show - 5 Steps To Reduce Brain Inflammation Today

Episode Date: December 3, 2021

This episode is sponsored by Rupa Health and Athletic Greens. While inflammation is a natural part of life that can serve a beneficial role, we start to see disease when inflammatory pathways are constantly activated. That’s why many brain symptoms—like brain fog, anxiety, memory loss, and more—can actually be caused by systemic inflammation. The foods we eat, the toxins we’re exposed to, our stress levels, and our genetics are just some of the many aspects that can impact the body—and the brain’s—propensity towards inflammation.  In this episode, I discuss inflammation in the brain with Dr. Todd LePine. We dive into the many factors that can drive neuroinflammation, the range of conditions that are linked to brain inflammation, and how we work with patients to cool this inflammation. I also talk with Max Lugavere about how nutritional deficiencies affect the brain. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine, and is an Institute for Functional Medicine Certified Practitioner. He has been practicing Functional Medicine for over 15 years focusing on Optimal Aging, Bio-Detoxification, Gastrointestinal Health, Systemic Inflammation, Autoimmune disorders and the Neurobiology of mood and cognitive disorders. Max Lugavere is a filmmaker, health, and science journalist and the author of the New York Times bestselling book Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain for Life. He is also the host of the #1 iTunes health podcast The Genius Life. Max’s sophomore book is The Genius Life: Heal Your Mind, Strengthen Your Body, and Become Extraordinary, a lifestyle guide to living happily and healthily with proven, research-based lifestyle tactics, which we dig into more throughout this episode. This episode is brought to you by Rupa Health and Athletic Greens.   Rupa Health is a place for Functional Medicine practitioners to access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, Great Plains, and more. Check out a free live demo with a Q&A or create an account here.    Athletic Greens is offering my listeners 10 free travel packs of AG1 when you make your first purchase here.

Coming up on this episode of The Doctor's Pharmacy. Being in a place where there's a high concentration of air pollution might actually be creating this inflammatory insult to the brain. So it's like, wow, the gut is connected to the brain. Totally, totally connected to the brain. Literally, there are viruses, yeast, bacteria in the brain that may be triggering this cascade of inflammation. And then the question is, where does this come from?

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You can check it out and look at a free live demo with a Q&A or create an account at rupahealth.com. That's r-u-p-a-health.com. So many of my patients wait until they're sick to finally take care of their health. I've even had doctors as patients, well many actually, who just wait for their problems to get worse and worse and receive a diagnosis of disease before taking any kind of action. This is not the path to health. We can live longer, healthier, happier lives if we just prevent imbalances in our bodies in the first place. And nutrition is a key part of this. Many of us don't get the optimal amounts of key nutrients through diet alone, even with a

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Almost every modern disease is caused or affected by inflammation. Inflammation can result from chronic stress, a gut imbalance, mold, or even a lingering untreated infection. And inflammation can affect the brain just as it can any other part of the body. The most common symptom of neuroinflammation is brain fog, where you can't recall names or words or even think straight. On today's compilation episode, Dr. Hyman talks to Dr. Todd Lapine and Max Luckever about the causes of brain inflammation and how to treat it. They also discuss the importance of time and nature for a balanced mood, plus give suggestions for nutrients to support optimal brain health. Let's dive in. Certain foods may trigger brain fog and it is something that

I think is intimately connected to the gut. I think the, and I'll talk about that in this particular case, is gut fermentation is oftentimes a cause for brain fog. I mean it's like bugs fermenting the food you're eating, creating all those nasty byproducts. Yeah, and I don't know, Mark, if you've had patients who've had, this is a really interesting thing because I have patients come in and they say, I feel like my gut is just like bloating and I'm fermenting, and that's exactly what's happening. So there is a condition. I just recently had a patient who had auto brewery syndrome.

Yeah. And I've seen that. So you have your own like beer factory. Exactly. So when you want to make beer, what do you do? You take sugar and you add yeast to it, and you can actually produce alcohol. And I've had a couple of cases where it was missed. And it's actually not just the recent findings.

It's not just yeast in the gut that do this, but also Klebsiella bacteria. So both bacteria and yeast can actually produce these compounds, which are toxins. Alcohol is a toxin. That's why when you get drunk you're intoxicated and uh you you'll actually produce alcohol and other toxins which affect your brain it's interesting i never really had that insight before you said that word intoxicated you're toxic toxic yeah toxic exactly that's what i was like wow okay that's how i explained it took me 60 years to figure that out. Yeah, figure that one out. Exactly. But I think that what you're saying is very true.

I mean, I've had two times in my life when I've had severe brain fog. One was when I had mercury poisoning 25 years ago. And my gut was a mess then because the mercury poisoned my gut. I had terrible bloating, distension, diarrhea. And the second time was more recently when I had mold toxicity, and I had C. diff, and I also had colitis and gastritis, and my whole gut was a mess, and I had severe brain fog. And it was pretty debilitating.

You could barely focus, answer an email, talk to somebody. Oh, yeah, you can't concentrate. You can't concentrate at all. And people think, oh, that's just sort of in your head. It's not in your head. Maybe in your stomach. Well, it's manif of in your head. It's not in your head. Maybe in your stomach. Well, it's manifesting in the head. That's the whole thing.

And we have these artificial boundaries between the brain and the body and the mind, and they're all interconnected. And brain fog is a real phenomenon, and then you have to sort of figure out what's doing it. The other thing that is interesting that I see with some people with brain fog is just gluten and dairy. And I tell patients that one of the most addictive foods is pizza. And the reason for that is that pizza has gluten in it. That's true.

You can eat a whole pie, right? Oh, yeah. It's one of the foods that I'll occasionally indulge in, but I don't have it that often because it's not the best food for you. You have my cauliflower pizza with goat cheese and a cauliflower crust. You can make a healthy pizza, exactly, yeah. But the two foods which are interesting is that gluten and dairy both get broken down. The proteins in those get broken down into caseomorphins and gluteomorphins. And caseomorphins are the ones from dairy, and gluteomorphins are from gluten.

And those have morphine-like effects. So you literally become a little high. You get a little high. You get a little foggy in the brain. And it also can cause cravings. And it can sort of make you sleepy. You eat it, and then you get a little sleepy from it also. When children drink breast milk, they go to sleep after.

They conk out. That's because of the morphine like action in milk. Yeah. So that's true. I think, you know, it can be our diet. It can be food sensitivities like gluten and dairy, which are really common. And often people going on elimination diet will have an immediate relief of brain fog, which is something that you don't know you have until you don't have it anymore. Sometimes people just think of this sort of slow decline of their cognitive function. They're not realizing that it's actually something that can be reversed and it can be reversed very quickly. So the second thing is, you know, the, the factors that, that are in the gut, right?

Bacterial overgrowth, yeast overgrowth, we call it dysbiosis. That can also lead to a lot of cognitive issues because your gut's connected to your brain. And that causes this effect when the bugs are out of balance and it drives inflammation. And then you get inflammation in the brain, essentially is what causes brain bug. Absolutely. Well, and the other important thing,

and I think I talked about this last time, is that the blood flow from the gut has to go through the liver. And the reason for that is, is to filter all of the toxins that are there. So there's a, there's a lot of immune cells, the copper cells in the liver, and a lot of filtering processes and detoxification takes place in the liver prior to the blood from the gut, uh, then going into the systemic circulation. So sometimes you'll have, in addition to, uh, uh, uh, leaky gut, you'll have problems with detoxification in the liver itself. And that's, you know, an example of that is, uh, the condition, uh, uh, hepatic encephalopathy, which is brain fog. That's, that's essentially,

we'll talk about that. What is that for people who don't know what that sounds like? I learned, I learned, and I think I mentioned this before, and it was one of the things that really stuck with me is when I worked at the VA hospital, there was a lot of alcoholics, and when you're an alcoholic, you basically turn your liver into a pickled liver. You trash your liver, yeah. You trash your liver, and then you're not able to detoxify. And I would typically see this over and over where patients had cirrhosis of the liver,

and their liver was not able to detoxify. And then when they would eat foods, especially high protein type meals, they would get hepatic encephalopathy and literally go into a coma. So they would literally get delirium, confusion. Absolutely. Brain fog. Brain fog. That's like the brain fog on steroids.

And the reason is it was coming from their gut. And what I found so striking when I started learning about functional medicine was that here was a condition in medicine that we knew how to treat. By fixing the gut, we gave people antibiotics to sterilize their gut, to kill the bacteria that caused all these byproducts that made people have, you know, basically delirium or encephalopathy and brain fog. So it was like, wow, the gut is connected to the brain. Totally, totally connected to the brain, absolutely.

And in some cases, there have been cases of people actually having psychosis from gut dysfunction. Yeah, you mentioned auto brewery syndrome. I remember reading a case of a woman who was arrested for driving under the influence, and it turned out she wasn't drinking, but she had a high blood alcohol level that was coming from her gut. Yeah, it is. It's a very real phenomenon. You have to think about it. The way that you actually test for that is you can—it's actually quite simple.

You just have somebody do what I call a pancake challenge. You basically eat some pancakes full of carbs, throw some maple syrup on it eat it and get a blood draw at point zero you know eat the eat the meal and then half an hour hour later check your alcohol level that sounds it sounds like a fun medical test the pancake challenge so so so we've talked about the gut we've talked about gluten dairy food sensitivities uh there are other reasons too uh so infections infections can can do that uh another one that is tick infections oh absolutely yeah tick infections yeah oh that those are yeah those i would say that that that's in addition to brain fog you get a lot of cognitive dysfunction to memory issues it's more severe it's much more severe the the one thing that I see a lot is allergies.

I call it the allergic brain. And you can have food allergies that can potentially do that, or even environmental allergies or mold. And the high levels of histamine, because histamine is actually acts as a neurotransmitter. And I've seen this in a number of patients. I've had some patients with another condition, which we're seeing more and more of, is mast cell activation syndrome. It's sort of a buzz diagnosis now, but it's a very real phenomenon and is related to the mast cells, which are the types of immune cells in the body and the interstitial, the sort of the spaces between the cells where they reside, and they release lots of histamine. And if anybody has ever had hay fever, you see that the typical picture of a person with hay fever, they're like, you know, like this, like half asleep and like they're walking

through a fog. It's hay fever is an example of a brain fog. Yeah. And antihistamines can actually have a benefit with that. Naturally, things like quercetin and nettles can also be very helpful. And you probably have used it. This is something that I use. I've been using more is the drug chromaline sodium, which is, I've had some amazing success with that in more difficult cases. I wouldn't necessarily go to that for my first choice. What Todd's talking about is this drug

that's used for asthma and allergies that is usually inhaled. Yeah, usually inhaled. But there's a version you can take orally that, before you eat, inhibits your white blood cells from releasing histamine and creating an allergic response. And I've often found it extremely effective for some patients. So, Todd, talk about this patient that you had that had really bad brain fog. This was a guy who'd come to see you who worked a lot. It was a little less stress.

And that could be easily dismissed as, oh, you're just stressed and tired. But you went deeper. What did you find? Well, he actually came into me and he had already seen a variety of different doctors. And the background is that the gentleman as a child had lots of allergies and asthma. So he had ear infections, bronchitis, also developed some sinusitis-type symptoms. So he had multiple rounds of antibiotics. And I always emphasize to patients that when you have an immune dysfunction,

look for the gut because 60% to 70% of your immune system is in the gut. And just like with what's going on with the COVID virus or the COVID-19 syndrome that we're seeing by coronavirus, is it's not the virus or the bacteria itself that causes the problem. It's our immune system's response to it. And in general, we want to have a, I call it a balanced balanced immune system so we want our immune system to be idling yeah so basically just sort of sitting there and okay we're enjoying planet earth we're going out for a walk we're not reacting to the underreacting or overreacting exactly underreacting or overreacting and when you overreact that we call that an autoimmune disease when you underreact

we call that aids right so aids or cancer AIDS or cancer or overreactions allergies or right and then I and I think you know we talk about like you know a weak immune system or a strong immune system it's really I think an intelligent and a balanced immune system that's how I like to think about it and that's you know related to immunotolerance which is what the gut does so when we have a healthy gut we have an immune system that is tolerant to lots of things. And you can eat certain things. You can go out in the environment. You're not going to react to dog dander and all these other things. There are some genetic, some people have genetic predispositions towards being more atopic or allergic, but having a healthy gut, especially early on, the priming of the gut is so critical. Having a vaginal birth,

being breastfed, not introducing certain foods like gluten early on. Living on a farm. Living on a farm. Exactly. Being exposed. Being exposed to a lot of acid. And crawling around in the dirt and literally putting dirt in, I call it, your body's immune system samples planet Earth. Planet Earth is a very dirty place. There's lots of bugs and all kinds of things. And your body learns to be immunotolerant.

And one of the things that is really I also focus on is part of the immune system is called the Treg cells. The Treg cells are like the conductor in the Boston Symphony Orchestra. So you've got the wind section over here and the horns over here, and they keep everything in balance. And the Tregs are really, really critical. And what we're finding— They're regulatory cells. They regulate.

They regulate the whole balance of the immune system. And the Tregs that we find out, the two things that are really simple that people can use to upregulate your Tregs to keep things in balance are fibers. Fibers in the diet. Fibers are the key things that help with regulation of that. And then also, which I use quite a bit in the patients that I see, is vitamin A. Vitamin A helps to downregulate the immune system and helps to keep the Treg cells in place. So this guy came in with brain fog, and he had a lot of stress,

but he also had other things. He had mold exposure. Yeah, he was working in a building, and they found out that he was in a water-damaged building unknown to him, and he had mold exposure, which you've experienced yourself. I've been lucky enough to have. Yeah, exactly, yeah. And we live in, you know know a lot of people are in older

buildings um they you know and you don't know you might buy the building and there's water damage you don't even know what's there i mean 50 of buildings have water damage in america that's a lot really yeah wow wow it is that's a lot yeah so he was actually he came to me and he was he had the diagnosis of uh mold toxic in fact he actually learned about this through one of your podcasts. I think you were talking with David Asprey. Oh, yeah. Exactly. It was a moldy podcast.

So that's how he sort of went down that road. And he got treated with a variety of different therapies. He got some IV glutathione. He got some ozone therapies and other interventions. And he got about 50% better. And then within several months, he sort of went back to where he was. He was also, again, not sleeping much because he was doing a lot of litigation. It was a lot of stress.

He wasn't sleeping well. The big thing that I see with patients with conditions like immune dysregulation is stress. Lack of sleep is a stressor, probably the number one stressor. If people aren't getting a deep, restorative sleep, that is a stress to the immune system. I was trying to emphasize that you can do that for one or two days, but you can't do that on an ongoing basis. Really, really important. I always emphasize getting good, deep, restorative sleep with patients. So I emphasized that with him. So when he came in,

he also had a lot of digestive symptoms. He was actually on a whole bunch of inhalers. He was on like Brio, Spireva, Ventolin, onolair injections Flonase for his sinuses Zolair is a very expensive $20,000 a year immune suppressing medication and he still wasn't better no exactly

and that actually worked by stabilizing mast cells which you can actually naturally do Quercetin actually can help high dose Quercetin can be very helpful for mast cell civilization. Also good for COVID. Exactly. Yeah, yeah. So when he came in here, you know, I did a thorough workup on him,

and I did retest him for mold, and he did have some mold, but I compared it to his previous labs, and it wasn't that bad. So I empirically treated him with some binders to sort of help, but he already moved out of the quote the moldy building that he was in. You get out of the moldy environment and then use these binders to help get the mold toxins out of your system. Right because the mycotoxins they do tend to recirculate in the body the enteropathic recirculation so they'll get reabsorbed by the body. And what are the kind of binders you use? In him, I actually use very natural things. I used clay, meti clay, and I also used activated charcoal.

That was pretty much it. These are things that don't get absorbed that suck all the bad stuff out. Oh, yeah, exactly. And you worked in Meridian, right? We used to, somebody would overdose on drugs. We would give them charcoal. Yeah, that's right. You make them drink black charcoal. And every now and then they'd vomit up on you.

We've been there, done that. Yes. Right. Yeah. So this guy had also other stuff, right? He had gluten issues. Oh, yeah. A lot of gut issues.

Yeah. And unfortunately, when he went to the previous doctors who did help him out, they didn't go deep enough. They didn't sort of get all the pieces of the puzzle. So they did not check him for gluten sensitivity, which he would mark as if he was gluten sensitive, and also did the Cyrex testing on him for gluten and Cyrex for leaky gut, and both of those were markedly positive. So those are tests that we use at the Ultra Wellness Center

that are a little bit different than traditional food testing that looks at antibodies that aren't true allergy, but there are reactions that our immune system is having against foods. And we can tell what you should and shouldn't eat based on this, what's causing an immune response. Exactly. Exactly. did what I think is sort of the state-of-the-art, the GI map test, which does quantitative PCR for the DNA of bacteria, yeast, viruses, parasites. And he had probably one of the worst cases of dysbiosis I've ever seen. That's imbalance. Yeah, imbalance. Yeah, a lot of imbalances.

You know, I tell patients that everybody has, you know, hundreds of different kinds of bugs in their gut, and they're a little bit like weeds in the garden. No garden does not have weeds. You just don't want too many weeds. And the interesting thing about the digestive tract and bacteria is that there is a phenomenon which is known as quorum sensing. And quorum sensing means that when certain bacterias reach a critical level, they start acting as bad actors. An example of that is like

Clostridium difficile. So when patients get antibiotics and they wipe out the good guys, the bacteria, the C. difficile, somehow or another sense that there's not enough cops around and they take over the place and they start producing toxins. Same thing happens in this particular case. He had one of the highest levels of pseudomonas bacteria that i've ever seen and we typically see that uh in patients with cystic fibrosis um so he had bacterial dysbiosis that that organism plus other organisms he had a lot of gut symptoms right yes yeah yes yes exactly yep exactly very yeah a lot of uh mucus and that's that in my opinion that that mucus that sticky mucus is a biofilm opinion, that mucus, that sticky mucus, is a biofilm.

That's where the bacteria live. They live in that biofilm layer. And antibiotics and such are very difficult to penetrate that. So you're not having a smooth log that just comes out clean. There may be some problems in there. Exactly, yeah. And he also had yeast overgrowth, which was not unexpected. Because of all the antibiotics he had.

Oh, yeah, absolutely. And the acid blocker he was taking. He was on a proton pump inhibitor. That's one of my, you know, I hate them. They are good and bad. They can be helpful. But I remember when I was in medical school, we talked about this on the podcast, we were told, they just came out, and they were like, these are very powerful drugs.

You don't want to give them to any patient more than six weeks. It shuts down his acid production. It's risky long term. And now everybody's on it for life. They now everybody's on it they're over the counter they're over the counter over the counter and for life and it causes all sorts of disruption the gut it causes you to not absorb your nutrients it causes overgrowth of yeast it changes the ph leaky gut leaky gut i mean it causes irritable bowels osteoporosis osteoporosis pneumonia b12 deficiency yeah there we go we can keep going it's not it's a great it's a great way to keep the business going, isn't it?

Yeah, I wrote a textbook chapter on reflux, and I was looking at all the data. I was like, holy cow, this is not good. Exactly, yeah. And unfortunately, they're handed out like Pez candy. Yeah. And patients stay on them long term. Come on, what's wrong with Pez candy?

I used to eat that all the time. I had my little Pez dispenser. Those of you who are younger, you might not know what this is, but it's a little candy dispensing device with a little cute cartoon character on the top. Donald Duck. You pull it open, and a little candy would pop out, and it was so fun to eat. It was? Yeah, right. I quit when I was like eight.

So this guy had all this stuff, and he had gut issues, he had gluten issues, he had mold issues. And what I find really important to emphasize is that in functional medicine, it's about looking at the whole system and not just treating one thing. And often it's many things at the same time. Because when the system breaks down, lots of things break down. So all these guys' gluten issues, well, getting off the gluten wouldn't have fixed them. Or just fixing the mold wouldn't have fixed them. Or just fixing his gut wouldn't have fixed him.

You've got to deal with all these various things. And you had another thing that you found on him as well, right? Oh, yeah. His sinus issues. Sinus issues. He actually had sinus surgery for that, and it was really a big thing. And in fact, I actually just recently downloaded a paper from PubMed on the nasal microbiome.

So, you know, we have bacteria on our skin. We have it in our mouth. We have it in our digestive tract, in the vagina, in the sinuses. They're everywhere. They're everywhere. And so disruption of the nasal microbiome can also cause brain fog. Typically, you see that a lot. All the sclerosis was taking up his nose and everything was affecting him.

And it's also a dark, moist environment. So a lot of patients who have chronic sinusitis, it's actually been shown not so much to be bacterial as it is to be yeast. Fungal. Fungal origin. So you've got to really think about that. I typically will, you know, in his case, he needed surgery. So he actually had sinus surgery.

That helped a little bit, but it didn't clear up the problem, which is really a dysfunctional nasal microbiome. So I actually treated him with neti pot nasal saline irrigation. You can also do, there are certain machines. I like the Sinopulse machine. It's like a water pick for your nose. Exactly. And you put a saline in there and it rinses it out.

Rinses it out, right. For people who do have chronic sinus issues. And then in his case, I actually used Silversilin, which is not a colloidal silver, but it's a silver salt. And silver is actually a great antimicrobial. And I used that in him with great success. It was really very, very effective. So silver is also something that kills bugs. Kills bugs.

And put up your nose, it'll help deal with whatever latent infections are there. Exactly. And this particular paper that I was talking about, which is discussing the nasal microbiome, they were actually making a proponent to actually use probiotics, things like lactobacillus,

up into the nasal passages to recolonate the the nose incredible yeah and you'll translate up your nose exactly and you know and and dale bredesen uh who's been a leader in looking at the various causes for alzheimer's talks about the uh the nasal sinus passages as a uh problem when you have chronic inflammation in the sinus is being a risk factor for Alzheimer's. Because that is directly... Chronic inflammation, right. Chronic inflammation, exactly. It goes right up into the brain.

So you also did this nasal treatment. You also treated his gut. So what did you do for his gut? I mean, we did, obviously, we put him on an elimination diet. So you got him off of gluten. You got him off of gluten, exactly. Starchy foods. Yeah. Got him off sort of a low yeast, low mold type diet. Got him on, put him on a, I actually

did not treat him with antibiotics. I treat him with antimicrobial botanicals. I also used oral silver, which I'll sometimes use in conjunction. And I also continued with binders. He activated charcoal and then another product, GI Detox. And it was pretty remarkable, his success. Within a month, he said, like the light bulb went on in his brain. So you mentioned a product called GI Detox, which is something we use that actually has charcoal and clay in it, right? So it actually helps to bind up all the nasty things that get produced by these bad bugs when they're fermenting the foods that you shouldn't be eating, right?

So it's really, it's fascinating. So you also sort of looked at this holistically from a functional medicine perspective, which is really quite different than most people. So the fact that this patient had gluten and mold and imbalanced gut flora and sinus issues was the reason for his brain fog, right? But if you take 10 people with brain fog, we might have 10 different reasons. Absolutely. Just like you have 10 different reasons for a cough. Right. Mine was mercury. That didn't show up in this guy. So really, it's right. It's important. I think this is the thing that's so different about functional medicine is that we don't just stop thinking at the symptoms.

We go, what's the cause of the symptoms? Absolutely. If you say you have rheumatoid arthritis or you have a headache or migraine, migraine isn't a diagnosis. It's a symptom. It's a certain type of headache. Absolutely. Yeah. Migraine isn't a diagnosis. It's a symptom. It's a certain type of headache. Absolutely.

And so we really have to look at the different causes for each individual. So it's very personalized. Absolutely. Totally personalized. And it's often treating it not just one thing. It's treating multiple things in the right sequence to get people better. Exactly. And so he was building on getting rid of the mold and getting out of the environment and ozone and glutathione, which certainly helped.

But then there were other things, right? He got to get off the acid blocker. He had to get off all these nasal sprays that were suppressing his microbiome in his nose. He had to get sleep. He had to get sleep, right? He had to manage stress. He had to manage stress. He had to irrigate his sinuses and use natural antimicrobials to kill the bad bugs in there. He had to reset his whole gut system and get rid of the pseudomonas and build all this together in a protocol, which it sounds complicated,

and sometimes it is, I guess. That's what we do in functional medicine, and it's a very unique approach that is the future of health care. It's not something that most physicians are learning in school. It's something that is actually working far better than most traditional therapies for these kinds of things. If you have an acute problem, you go to the hospital. I had atrial fib.

You've got to go to the hospital, and I get my little electrical system fixed. It's fine. But I think if you have these weird symptoms that nobody can fix or that they're trying to medicate, it just doesn't work that well. Yeah, and you really really bring a very good point because regular mainstream medicine has its place. You break a bone, you have a heart attack, you have a stroke. There's definitely places for

acute care medicine. But when it comes to chronic care medicine, I would almost venture to say that the mainstream approach, which is either the scalpel or using expensive, potentially toxic medications, is actually doing more harm than good in most circumstances. It really is. It's unfortunate, but it really is. Nature is medicine because we're so isolated from nature. Both the light experience we have isn't based on natural light cycles. The temperature experiences we have aren't based on being exposed to the environment like we always have been. And it has really detrimental health effects.

So you talked about nature and how that is really, the disconnection from nature is really a source of problems for us. Major. Today, we spend 93% of our time indoors, in know, in big cities. And there's a lot of this research now coming out of Japan on forest bathing. There's actually a Japanese word, I believe it's karoshi or karyoshi, or I could be butchering it. But essentially, there's a very significant portion of the population that gets worked to death in Japan. And there, I mean, 90%, 93% of Japanese people live in cities, so they're far removed from nature. And so this

nature bathing line of research has really become a major focus. Wow. Yeah. And it's now being studied, you know, increasingly around the world, the relationship that we have with nature, especially as our cities become more and more dense and more and more polluted. But in the genius life, I talk all about the, how air pollution can affect cognitive function and put us at increased risk for Alzheimer's disease. Uh, 20% of Alzheimer's cases might be owed actually to heavily polluted air. And today, 52% of Americans live in environments with heavily polluted air. Isn't it like that? There's something likev app on your phone where you can tell the air quality air quality index yeah you can i believe you can actually i think the weather app on on

an iphone tells you yeah um the air quality but yeah my niece lives in houston she says every day they get warnings not to go outside i mean it's scary and our indoor home air can be just as polluted, if not more polluted, than outdoor air. In regard to outdoor air, what I think is really the most pressing of concerns where brain health is concerned is what's called fine particulate matter. Airborne particles that are two and a half micrometers or smaller that are actually able to enter. We breathe these particles in they enter circulation and they can pierce the blood brain barrier and enter the brains and they're doing studies now in very polluted parts of the world like in mexico city where they'll take children and they'll actually see like these fine these particles like magnetite which is made of iron in the brains of children. And what's very interesting, Mark, you know,

like Rudy Tanzi up at Harvard doing all this research on viruses in the brain and how it can- The microbiome of the brain. Yeah, the microbiome of the brain and how amyloid might be a response to an inflammatory insult in the brain. Amyloid is like the gunk that clogs up your brain if you have Alzheimer's and it's sort of a response to inflammation, sort of like a bandaid in a way. Yeah. What they're seeing now is amyloid presence in brains that, you know, of people who have inhabited very highly air polluted, you know, areas with very high level concentrations of air pollution. Yeah. So whether it's like magnetite, you know, or other fine particles

or the herpes virus, amyloid is like this protein, which may be actually coming to the rescue. But the point is that being in a, in a place where there's a high concentration of air pollution might actually be creating this inflammatory insult, uh, to the brain, which is causing this, this, a very early presence of the pathologies that we associate with Alzheimer's disease. So, so connect that back to nature because you're saying we should move. I'll move out of cities and become farmers more connected to nature yeah that would be good yeah i mean there are some things that you can do so spending spending more time in nature um i think is super important especially if you are at heightened genetic

risk for alzheimer's disease um so if you're an apo4 allele carrier you know making an effort to spend more time in in nature and that's a gene that increases your risk. If you have two of those genes, like getting Alzheimer's by 75%. Yeah. So doing that, also getting out in nature is crucially important because of the exposure to the sun. So exposure to the sun, I think, is very important. We were talking all about circadian biology. Exposure to bright light, crucially important.

Vitamin D deficiency is thought to be a risk factor for developing Alzheimer's disease. There's a review of environmental risk factors that I talk about in the book, and vitamin D was one of the top. Yeah. Well, I mean, it's a big deal because, you know, depending on the data you look at, up to 80% of us are insufficient or deficient. And the way the reference range works is it's based on a population measure. So you take a group of people, you measure, you know, the spectrum of the levels in a population, and then you look at sort of what's the average, right? And you have like two standard deviations from that. And you can kind of determine what's, quote, normal. But normal isn't optimal.

If you were a Martian and you landed in America today, 75% of Americans are overweight. It would be normal to be overweight. It does not mean it's optimal. So the levels we often see in the laboratory ranges are not really where we should be hitting. The levels can be 20 or 30, but you should really probably have 45, 50, 60 at least. And I think, you know, probably 80% of us are deficient or insufficient and that leads to depression. It leads to increased Parkinson's, Alzheimer's, cancer, so many different things. And I think, you know, there's been mixed data about where placing it, fixing it or not. And I

think it's complicated because when you're like, you know, people are eating, you know, garbage and they throw a vitamin D in there, it's not going to help. Yes, correct. You know, if they're not exercising, they're smoking, they're drinking a lot, they're not, they're eating crap. You take a vitamin D, it's not going to do anything. But if in all things being equal, people who are low in vitamin D have higher risk of this. And if you clean up your lifestyle and you're still low in vitamin D, it'll make a big difference. Yeah. I'm glad, I'm glad you brought up context because one thing that very few people know, you could be spending as much time in the sun as you want, frolicking all day in the beautiful

warming rays of the sun or even supplementing with vitamin D. But if you're not getting adequate magnesium in your diet, which 50% of the population does not get adequate magnesium, the enzymes that convert the vitamin D that your skin creates into its active hormone form in the body, all are magnesium dependent. And magnesium, half of us don't consume adequate magnesium. It's found in dark leafy greens, pumpkin seeds, dark chocolate, almonds. And a lot of things cause us to lose magnesium. Stress, coffee, alcohol, sugar, all those things we love. Exactly. Magnesium is like an anti-aging.

It's a macro mineral. We don't consume enough of it, and it's involved in all of the DNA repair enzymes. We were talking a little bit about DNA damage. They all require magnesium as a cofactor. It's involved in ATP synthesis, so energy production. So true. I see it so much in my practice and these patients come in with all these magnesium deficient symptoms and they think I'm a genius when I give them magnesium and they

go away. Things like migraines or headaches, constipation, muscle cramps, twitching, palpitations, anxiety, insomnia, anything that's irritable, twitches or spasms in any way or cramps is usually magnesium deficiency. And it's so easy when people take it, they go, my God, I didn't know I was so low. And I think you're right. It's so prevalent. I think as you age also, your skin doesn't really convert magnesium. I mean, the vitamin D as well either, right? Yeah. I make specific recommendations in the book for people, no matter where they are in their life, no matter what age they are. It's important.

Context is everything, really. But you're right. People who are overweight, people who have darker skin complexions, people who are older, they probably are going to need to spend more time in the sun to create the same amount of vitamin D. Yeah. I once learned from Michael Hollick, who's a vitamin D expert. He said, if you really want

to get adequate vitamin D without taking vitamin D, you have to basically be practically naked between 10 and two in the daytime for 20 minutes, uh, South of Atlanta. Wow. And I know that probably isn't happening for 99 of people yeah it's tough it's tough um i try to get into the sun as much as i can because the other thing about the sun we as humans you know we i think that reductionist approach that we were talking about it's i think we're hardwired to try to break everything down and i believe i forget who maybe it was michael pollan but in nutrition they call it nutritionism yeah where they like to break everything down. And I forget who, maybe it was Michael Pollan, but in nutrition,

they call it nutritionism, where they like to break down foods into just the bare essentials to see if we can replicate it in a pill form. And that hasn't really... Or identify, or we even do worse. We sort of identify the bad ingredients like saturated fat or sugar or whatever. And so we focus on regulating those in food. And then the food companies just kind of dial up or down different ingredients to sort of make it quote healthier, but it's not really, it's still junk food. Yeah, exactly. And so I think we can apply the same thing to the benefits of, of getting sun exposure, uh, on our skin and in through our eyes. So, I mean, vitamin D is created when the UVB rays from the sun reach our skin.

But UVA rays might actually be useful in terms of creating nitric oxide and actually helping us lower our blood pressure. Yeah, that's pretty cool. Yeah. So, blood pressure is another topic that I talk about in the book because it's so related to brain health. If you want your brain to be performing well, if you want it to age well, you really have to make sure that your blood pressure is in a healthy range. And getting the right amount of sunlight can help. Can help. Getting the right amount of sun.

Now, mental health is such a big crisis in this country. One in four people experience major depression in their life. It's the biggest cause of the economic burden of chronic disease, not from direct health care costs, but things like disability, loss of quality of life, not being able to costs, but things like disability, loss of quality of life, not being able to function very well in your life. And vitamin D is one of those things that seems to really impact depression. So you talk about a study in the book that has to do with vitamin D and depression. Can you talk more about that? Well, vitamin D is important for the synthesis of serotonin,

which is a neurotransmitter involved in mood. It's a happy chemical. It's a happy chemical. That's what Prozac does. It increases serotonin, right? Increases serotonin. You know, SSRIs, selective serotonin reuptake inhibitors can boost serotonin at the synapse, which is... Serotonin is also involved in focus and attention and executive function. Um, but yeah, so vitamin D is important in the, in the synthesis of serotonin

from its raw material, raw materials. Um, one of which is tryptophan and amino acid. So making sure that your vitamin D levels are in a normal, healthy range, uh, important, and you can easily get your vitamin D levels tested from a doctor. It's a very cheap test. Uh, the recommendations that I make in the book are to make sure that your levels are somewhere between 40 and 60 nanograms per milliliter, which seems to be a range where we see the lowest risk of all cause mortality. Um, yeah, I mean, I remember reading a study was incredible that women who had vitamin D levels less than 45 had a 60% higher chance of having preterm labor. And when you think of the cost of, you know, neonatal intensive care and taking care of preterm babies, it's staggering. And you're talking about pennies

for a vitamin that can literally prevent preterm labor. So it's staggering. And you're talking about pennies for a vitamin that can literally prevent preterm labor. So it's really connected to almost everything. And the difference is with vitamin D is that not everybody needs the same amount, right? So what should we be taking? Correct. Not everybody needs the same amount. You really, before you start taking vitamin D as a supplement, you ought to get your levels tested. You know, when we synthesize it from the sun, our skin basically makes what we need and it breaks down the rest. It's almost impossible to get too much vitamin D from the sun. Although, lifeguards can have levels of 150. That's amazing.

Right? Yeah. And that's not toxic. Right. I mean, it increases calcium absorption. So I always like to recommend vitamin K2 for people that are in, I mean, especially at those levels. But with a vitamin D supplement, I think generally there was a research calculation that suggested that for the general population, 2,000 international units a day would be ideal to get the average person

to an optimal level. But people, again, have different... People who are older might need to supplement more. People who are overweight might need to supplement more to get the same improvement. And also, again... Yeah, people who are overweight tend to be low in vitamin D because it's a fat-soluble vitamin.

So it all gets sucked into the fat and it doesn't get into our system that we need. Yeah, it gets sequestered by fat tissue. The same also can occur with other fat-soluble vitamins like A, E, K. Yeah. I don't know if you read this morning, probably not, because you probably don't read the JAMA Pediatrics Journal every day. Not pediatrics, no.

But I do. And I read this paper this morning that showed that women, when they were pregnant, took 2,800 units of vitamin D compared to 400, which is in the typical prenatal vitamin, that there was a dramatic reduction in the bad effects on bone when their kids were born. In other words, their kids, their babies, had much higher bone density, and then their risk later in life of osteoporosis was dramatically reduced. And that's almost 3,000 units, which most doctors don't even think about recommending.

And some people may need up to 5,000 or 10,000 if they're not good absorbers, and there's genes that affect that. Some people might need only 1,000, but I think 1,000 is minimum for most people. And it takes about 1,000 units to raise your blood level 10 nanograms per deciliter. So if you're 20, you need at least 3,000 to get up to 50, right? And then you can see how you do. But I think people need to measure it, they need to check it, and they need to make sure they're okay, and if not, take the right supplement. And not the kind that you often get from your doctor, I hate to say, which is vitamin D2, which is not an active form of the vitamin, but vitamin D3. And you can get that over the counter now, and you can get

1,000 units and others, but you want to make sure you measure it right yeah i mean vitamin d2 is the plant-based form of vitamin d and vitamin d3 is the animal-based form it's bio-identical to what we create in our own skin so you always want to make sure that you're taking vitamin d2 i mean sorry d3 okay so there that brings up a sticky question so it's usually made from lanolin and other things that you can get it from sheep and stuff. And they're fat. So what if you're vegan? What do you do? That's a good question.

I have vegan sources of vitamin D3. That's hard to get. Yeah, right. Yeah, it's just one more of those nutrients that you're just not really optimizing. And often people don't convert vitamin D2 to D3. And if you're a vegan, you want to make sure you're checking vitamin D3. And you can also check D2. So you might have a really high D2 but a very low D3.

So it's important to make sure. I once took care of this Hasidic rabbi, and he had a really bad thyroid problem. And I said, you really need to take this combination thyroid, but I don't know if it's okay. He's like, why? I said, well, it comes from pig. really bad thyroid problem and i said you really need to take this combination thyroid but um i don't know if it's okay he's like why he said well it comes from you know pig it's a whole thyroid extract from pig and it's not kosher he says it's fine as long as it's for your health and as long as you're not eating it and it's a medicine it's fine so i thought that was very interesting perspective a sense from your experience what are, what are the things that show up and how did you treat it and what happened?

Well, you know, I've had a whole variety of cases. In fact, a couple of cases that we've had at break or a manic break or whatever you want to call that. And we've had a couple of recent cases where the patient's underlying trigger was Lyme disease, which is a spirochial condition. And I always remember, this is something that I really like to emphasize to my patients, is that way back when doctors used to treat syphilis, we don't have a lot of syphilis in private practice today. It's just a condition which was readily treated and it's pretty much gone, although there's still some occurrences of it. But syphilis was caused by a spiral or is caused by a spirochetal bacteria. And that's the same thing as Lyme disease.

And Lyme disease is the great mimicker. And it also can cause dementia and psychosis. So that's one of the conditions that trigger neuroinflammation. And then also, there was a recent case of Bartonella also causing neuropsychiatric conditions and a diagnosis of schizophrenia. So it's really a fascinating, fascinating field. And the problem is, is that psychiatrists are not trained to think this way. And neurologists are not trained to step over into psychiatry. So they're like, they're two different fields, but they're really the same field. So it's neuropsychiatry. This is an area that is actually really, you know, quite fascinating to me. And I, you know, people always ask me,

you know, what kind of doctor are you? And I have my own description. Yeah, I can answer that question. Yeah, I'm a psychoneuroimmunoendogutologist. And basically looking at the whole connection between the brain, the gut, the immune system, and all of the body when it's all sort of interconnected. And it's really, really fascinating. And you can really help these people who are having significant conditions. So what happened? You said this patient with schizophrenia, right? And you found the tick infections. What happened then? We're able to get their symptoms down by treating the underlying cause, which is the underlying spirochetal infection. I also had another patient who had a mycoplasma infection, and it's actually known in the

literature, mycoplasma is an atypical bacteria, and it's another infection which can cause the brain to be on fire. So it's a really fascinating thing. And one of the tests that you can do that can check for this, it's not a common test, and I don't know if you've done this, Mark, is the NMDA receptor antibody testing. This is looking at the parts of the brain that are stimulatory. And this is something that any doctor who has a patient who has gone quote unquote crazy or had a psychotic break, they should have an NMDA receptor antibody test. Because if you have this, it tells you that there is some type of neuroinflammation that's driving their symptoms. Yeah, it's quite incredible. So I've had patients who have schizophrenia before or bipolar disease,

and you think these problems are just so intractable and so difficult to treat, and they can be. But, you know, in fact, the whole field of functional medicine came out of the field of psychiatry with Abraham Hoffer's discovery that you could treat schizophrenia you know using nutrients and helping to improve the biochemistry of the brain and then linus collingwood's seminal paper orthomolecular psychiatry and science magazine in 1969 which talked about the perspective of how do you straighten molecules in other words how do you correct the imbalances or dysfunctions

in your biochemistry that's called orthomolecular, which means to straighten. And that has really led to the whole field of functional medicine. And we then sort of expand on that with our understanding of the role of inflammation in the brain. And I, you know, many schizophrenic patients have high levels of, for example, gluten antibodies. About 20% of schizophrenics have antiglycan antibodies in their bloodstream. When you take the gluten away, they do better. That causes brain inflammation. And when you do autopsy studies on people with Alzheimer's or autism or schizophrenia or depression,

you find that their brains are inflamed. So, you know, when you start to think about that, it's like, wait a minute, we are treating this completely incorrectly. And this is what was classical traditional medicine. You treat the symptoms, not the cause. And functional medicine is really about the cause and why, not just what disease you have, but why do you have it. And in the case of these brain disorders, it's often not obvious. And the problem may be far away from the brain. It might be in the gut or it might be in your diet or it might be a toxin

or it might be an infection or it might be mold. And it might be all sorts of things that we are kind of missing the boat on. And so we have this potential to sort of rethink our whole approach to brain science. That's what's so exciting when we see the work of guys like Dale Bredesen or others and nutritional psychiatrists like those at Harvard and metabolic psychiatrists at Stanford. They're doing work in this field and understanding the connection between the brain and some of these systemic processes. Yeah, absolutely. And when you take a schizophrenic

and you look at them with a PET scan, the positive emission tomography, what you'll see is their brain lights up. And that's because their microglia, which is their immune cells in the brain, are literally on fire. And unless you actually treat that, uh, the, a schizophrenic is at high risk for developing dementia down the road because their fire is not being put out. And this Mark is, I'm going to mention this because when I was, I actually do, uh, I've, I've done, uh, some lectures, uh, for,

uh, American Academy of anti-aging medicine on neuroinflammation. And in the process of preparing for that, I came up against some really fascinating things. One is that when you look at the genetics of schizophrenia, there's, they did this whole genome-wide association studies of saying, well, what gene or what genes are associated with schizophrenia? And they did what's called a Manhattan plot. And on chromosome six, it sort of stood out like the Empire State Building. And what they found out is that on chromosome six, chromosome six is highly involved with the immune system. So that tells us that a lot of patients who have schizophrenia have an issue on chromosome six related to the immune system. And what I'm going to tell you next is absolutely positively fascinating. And this sort

of blew me away. There were two case reports. And remember, case reports are just like a doctor observing, okay, this is interesting. Look what happened. You know, why did this happen? And the two case reports were this. And this tells you how the immune system is intimately involved in schizophrenia. One is a patient had refractory schizophrenia and developed some type of cancer and needed a bone marrow transplant. The refractory patient with schizophrenia got a bone marrow transplant. A bone marrow transplant is basically giving you a new immune system. After he got the bone marrow transplant, guess what happened to his refractory schizophrenia? It was gone. What happened? Gone. Wow. It completely cleared up because it changed his immune response to whatever it was responding to. I don't know,

but his refractory schizophrenia went away. On the flip side, there was another gentleman who also needed a bone marrow transplant. He got his bone marrow from his brother who had schizophrenia. Guess what happened to him? He caught schizophrenia. He got schizophrenia. Wow. That's pretty amazing. That's pretty amazing. Yeah. It is amazing. I was blown away by that. And I think that, you know, in, you know, people who are doing, I'm, you know, I'm a clinician, I'm seeing patients, but those case reports are really, really seminal to change how we think about how gut microbiome and how that's so important related to the immune system, is that when you do stool transplants, you can literally transplant or infect a person and make them skinny, or you can transplant stool and make them fat. We can go both ways. They're doing this with autism and Parkinson's, right?

They're actually doing fecal transplants with autism and with Parkinson's and seeing real changes in the brain function. That blows my mind when you think about that. It does blow my mind. And the thing about this is we are still in the nascent period of really understanding this because it's not like you take this one chemical or you take this one probiotic and everything's fixed. It's a very, very complex array. And we have hundreds of different microbes and bacteria and viruses in the gut. So it's going to take us a while to figure this all out. But, you know, I think we're

also in a very good stage where, you know, we have, you know, massive computing power and we have artificial intelligence. And I think that we're going to probably approach these areas of understanding neuroinflammation and really difficult to treat conditions like ALS, like schizophrenia, like Parkinson's and such. And we're going to be able to biohack them and Alzheimer's, right? Alzheimer's. That's another thing though. This is, you're bringing up one of my favorite things. So for years, Mark, what did neurology focus on with Alzheimer's? It was what? It was amyloid plaque, right? Amyloid plaque, all you got to do is get rid of the amyloid and you get rid of Alzheimer's.

That's right. It didn't work out. So you get rid of cholesterol and you get rid of heart disease. Right. So guess what? The plaque, the beta amyloid plaque that was found in the brain, guess what that actually is? That's an antimicrobial peptide. The brain is producing beta amyloid in response to some type of organism, be it a virus, a bacteria, or a fungus.

So when we see that, those are the footprints of a organism that the body is trying to attack. Yeah, absolutely. And I think, you know, we actually probably should have Rudy Tanzi on the podcast. He's a scientist at Harvard who specializes in Alzheimer's and he has discovered the microbiome of the brain. So literally there are viruses, yeast, bacteria in the brain, which we thought was sterile, that may be triggering this cascade of inflammation and then the question is where does this come from and it seems like a lot of it may come from the gut which is crazy how does it get from your gut to your brain but it does and it triggers this sort of neuroinflammation that's driving things like alzheimer's you know i think i think we often get stuck on one thing though, right? In, in medicine, we stuck, it's stuck on it's this or it's that. And I think the important thing

people remember is whatever your diagnosis is, it doesn't immediately tell you what the cause is. So you could have 10 people with Alzheimer's, they could have 10 different causes. Um, and in one person you could have three or four or five different causes. Right. And I just remember one inpatient I had who was seven years old, really pretty significant. You know, Alzheimer's, not bedridden at this point, but pretty non-functional, also depression, and was struggling really badly. He was former CEO of his company, a family-run business, couldn't function anymore. Behavior was changing. His kids, grandkids, family didn't want to hang out with him anymore because he was acting inappropriate. And it turned out he had so many things going on. I mean, the biggest thing he had was high mercury, which he lived in Pittsburgh and had exposed to all the steel plants. And they used

coal ash for fertilizing land and they put it on the streets in the winter instead of sort of salt for the icy roads. And he also had a mouthful of fillings. And he also had a terrible history of irritable bowel for 30 years. It was on stelazine, which is just like an antipsychotic. So it's like a relaxant for your gut, which is terrible. But he had terrible gut issues and bacterial overgrowth and leaky gut and gluten sensitivity. And he also had insulin resistance. He had prediabetes. So essentially, he had all these problems heavy metals microbiome issues and he had insulin resistance or prediabetes which we know drives inflammation the brain they're calling alzheimer's you know often type 3 diabetes and he had all these other biochemical

issues genetically like methylation problems and and which are the b vitamins we're also driving inflammation his brain because he wasn't able to produce antioxidants and glutathione and when we started to address all these things we got the mercury out we fixed his gut we cleaned up his diet we got rid of the sugar and starch we optimized his b vitamins he literally came back from the dead like rip and we call and was able to function go back to work well he had a functioning member of his family again this is someone who would have just been said, okay, you have Alzheimer's and you are going to be a nursing home and that's the end of that. And it was pretty miraculous to see that. It sort of woke me up to how by really being diligent with these patients, you can really

help them either completely recover or dramatically recover. And I've seen, you know, the spectrum from, you know, in the tough cases of autism, Alzheimer's, you know, it depends how much they've got going on, how far down the road they are. But you see amazing stuff. But things like depression, bipolar disease, you know, mood disorders, it's often remarkable how quickly the brain responds, ADD. And it's something that we just, you know, unfortunately are not thinking about that well in traditional medicine.

And that's really why we do what we do at the Ultra Wellness Center. And we've treated nearly thousands and thousands of patients in this way. And we now do stuff virtually too, which is kind of fun. So we can see people from all over. And we have a great team of physicians and nutritionists and practitioners who really help guide people through this space. Because, you know, what kills me, Todd, and I'm sure it kills you, is you hear story after story. And I'm sure you get this all the time. Hey, could you help this one? Could you help that one? Or my mom or my dad or my sister or my friend? And people are just struggling to find answers. And when you hear the story, you go, oh, God, I know what's wrong with this person. But it's because we have a certain set of filters or lenses that we look at. And it's so gratifying. Can you think of any

other cases that you want to share that sort of illustrate this? Yeah. I mean, I think I'd mentioned this. This is a fascinating case. And I really can't 100% prove it. But I talked about it when we talked about the oral systemic health connection is the connection with the mouth. And there's some really good evidence of the particular bacterium, which is a bad actor. And it's called Porphyromonous gingivalis. And I've seen this in a number of patients who have had early Alzheimer type symptoms. You can also see this oral bacteria in patients with rheumatoid arthritis. So looking for this with DNA of the mouth organisms. And again, you know, this is to me is a really fascinating thing.

You know, somebody says, well, Alzheimer's runs in our family. Well, poor Firmona's gingivalis may run in your family. You may be spreading the bacteria from person to person. which is found in saliva, it stimulates the immune system in genetically susceptible individuals and can really lead to profound neuroinflammation. And in one patient in particular who I saw, he had Lewy body dementia, which is another form of, you know, inflammation. Lewy bodies, because on anatomical examination of the brain, they find these little things, they call them Lewy bodies, right? It doesn't mean that they understand it. It's just, Lewy found it, and that's why they named Lewy body after Lewy. And that's actually what, that actually is what Robin Williams had.

Robin Williams had Lewy body dementia with Parkinson's. You know, so we call it Parkinson's, we put it in this neat little category, and then we call it Alzheimer's, or we call it Parkinson's. We put it in this neat little category. And then we call it Alzheimer's or we call it dementia. We put it in this little category. And then we call it Lewy body. And they're all sort of this interacting, overlapping kinds of things. And yeah, they can have different clinical presentations. But as you said, there can be many, many factors that go into the origin of this neuroinflammatory process. And diet plays a huge role. You know, if you don't have the right nutrients, you don't have the right fatty acids, you're going to be more prone to all of your cellular membranes have omega-3 fatty acids. If you're not able to make the compounds in the body, which are called pro-resolving mediators or SPMs, and actually have this as a supplement. Now, um, these are actually quite fascinating, uh, uh, compounds. The SPMs are, uh, a selective pro-resolving mediator compounds. They're basically turbocharged fish oil and, uh, certain people, some people can't take the, their omega three fatty acids and turn them into these compounds. And, uh, I clinically, I have found them, they either work really well

or they don't work. I don't know about you, Mark, but these are other things that you can use as a nutraceutical to help turn off inflammation in someone who's got some chronic inflammation. Not to say if you take it, it's going to help with Alzheimer's per se, but it's one of the other tools that we can use to modulate the inflammatory response in the body. Yeah, so true. You know, we all fit in traditional medicine, don't know how to evaluate the brain properly because we're just looking at the brain, but we have to look systemically. And that's really what we do in functional medicine. And, you know, Dale Bredesen coined the term a cognoscopy, like a colonoscopy, but for your brain. And it's looking at all the things we've been talking about, looking at diet, looking at nutrient levels, looking at hormones, looking at toxins, at the microbiome in the gut, looking at infections, looking at mold, looking at allergens, looking at the overall health of the person and seeing what of those things are driving adverse consequences for the brain and for brain function. And any individual, the same cause might cause

different things. So one person might cause schizophrenia, another person might cause Alzheimer's, another person might cause depression. So we really have the tools to look at a true cognoscopy. And then the question is, how do we help the brain repair? How do we set up the conditions for the brain repair? So let's talk about how, from a traditional functional medicine point of view, we actually treat these people. Because it's a pretty systematic approach that addresses diet and lifestyle and also some of these underlying causes. Yeah. I mean, so we, as you mentioned, Mark, we do a lot of the testing. So we'll do organic acid testing, which is checking for the nutrient metabolites that are found in the body. We'll also

do gut microbiome testing, looking at all of the different bacteria, viruses, yeast, parasites potentially in the body. We'll look at markers for leaky gut. The other test that I do is a leaky brain. Just like you can have leaky gut, you can have a leaky brain. There's actually a test for that. Cyrex Laboratories does the blood-brain barrier test. You can check also for neuro autoimmune markers with the Cyrex 7X test. Again, you can do gut microbiome testing. The one that I like to use is the GI map test, because I think it's, it's quantitative PCR. So I find it to be very helpful. The, I think the whole GI realm area is an area that we're just learning. And I think as time goes on, these tests are going to get better and better.

But I find that to be very, very helpful to distinguish what's going on inside the person that I have. The other thing, which I think is also really, really critical, Mark, is sleep. And this is something that I really emphasize to people is that when our bodies sleep, our brains take out the garbage. Okay. And I'll guarantee you, when you have a patient who's got a neurodegenerative condition, one of the first things that you'll see is disruptions of their sleep. And what happens is during the day, you know, our brain only comprises 2% of our body weight, but it uses 20% of our body's energy, which means that there's a lot of metabolic activity. And what happens throughout the day is we get metabolic waste products that build up

in the brain and our brain flushes them out during deep delta sleep. If we don't get that deep sleep, we can't flush the brain and take the garbage out in the brain. And those toxins build up, those things that metabolic byproducts, misfolded proteins, inflammatory molecules, amyloid, et cetera, build up in the brain and can affect how the person's cognition is, their memory, their mood, et cetera. It's amazing. Yeah. And I think, you know, the diet is such a huge role too in the brain. I mean, we see that the diet we're eating is a highly inflammatory diet in this country of processed foods, inflammation that are driven by sugar and starch, excess refined oils, all the lack of things that are

anti-inflammatory, the whole foods with all the phytochemicals in them and the nutrient-dense foods. So we're eating a diet that's super inflammatory. So this is the first thing. And often dairy and gluten are among the worst. And then we focus on how do we get the right nutrients? Because if you're low in certain nutrients, whether it's the antioxidant nutrients or the B vitamins, your body needs these nutrients to regulate your immune system to function, whether it's zinc or vitamin A or selenium or vitamin D, vitamin C, all these are really necessary for proper regulation of immune function. So getting adequate levels of these is key. Also, we really get people on an elimination diet if we suspect or we test that they have sensitivity to certain foods.

We treat the underlying infections if we find them directly with antibiotics if we need to or any virals or sometimes we'll use herbal therapies or things like ozone and other approaches to deal with infections. We'll fix the gut. Often that's a big issue. So we have a whole functional medicine approach to fixing the gut. We've talked about a lot on this podcast. And then we'll address whatever toxins that are there and help you eliminate the toxins through a really focused detoxification program.

And so building on the framework of functional medicine, we can identify in each individual which of these things are the problem. And then we can start to map the right treatments for that person. And it's so gratifying when you see this in people's lifelong depression gets better. I mean, there was a woman who was severely depressed, who was in and out of psychiatric hospitals on lots of medications. Her marriage was falling apart. She wasn't able to really work at work anymore. She was about to get fired from her job, very overweight, obviously high in sugar, starch, and processed foods. And she did the Daniel Plan, which is a faith-based wellness program, but it's based on a whole foods, anti-inflammatory, pegan-ish diet, essentially. And she said at the six-week reunion,

she's like, Dr. Hyman, after three days of changing my diet, my depression went away. And I've been on piles of medications, in and out of hospitals, admitted for severe depression to hospitals many times in my life, and it's just gone. And I'm like, she goes, is that possible? I'm like, yeah, it's possible. If whatever you're eating was triggering the inflammation in your brain, you stopped it, yes. So it's really a sort of untapped reservoir of tools and tests and therapies that traditional medicine, psychiatry, neurology, you're just not using. And and is really where the money is. Well, and you bring up a really good point, Mark, because I, you know, I often ask my patients who are seeing a psychiatrist and I'm not going to bash psychiatrists, but I think the profession of psychiatry is in the dark ages. I can't remember the last time a

psychiatrist that I've seen has done a blood test or examined the patient. And I think that a lot of psychiatrists would actually do a good job if they actually took a side course in neurology to really understand how the brain is working. So if you're a psychiatrist and you're seeing a patient and you are not utilizing a good nutritionist, preferably a functional medicine nutritionist, if you're not doing some blood testing and you're not actually examining your patient, you may be doing more harm than good. And it's not, and the other, my other pet peeve about the psychiatric world is that we are now medicating young children in ways that are unexplored. We're doing polypharmacy in the young, polypharmacy in the old with these neuropsych drugs that are advertisedplored. We're doing polypharmacy in the young, polypharmacy in the old with these

neuropsych drugs that are advertised on television. And it is a complete, if you will, show. Excuse my French. It is awful. It's a terrible thing in this country. And I'll stand up here and I'll shout from the rooftops because this is a bad thing that we're doing to the brains of our people, the brains of our young kids. This is something that we should not be doing period. No, I mean, it's true. We, we really are. You're relying on, on downstream treatment. So when the neurotransmitters go awry, whether it's depression or autism or Alzheimer's or ADD,

you know, we go, well, how do we fix in our transmitters? And the question isn't how do we fix in our transmitters?? And the question isn't, how do we fix the neurotransmitters? The question is, why are the neurotransmitters so screwed up in the first place? And it's because of these phenomena. And one of the great examples I'll see is that the basic driver of inflammation is diet, but there are other factors. And anything that causes inflammation can interfere with our enzyme function and throughout our bodies. And there's a key step in converting serotonin, I mean, tryptophan into 5-hydroxy tryptophan into serotonin, which is the happy mood chemical. And when you get a high level of inflammation in the body, the enzyme is sort of blocked, and you end up with this byproduct called kynuret, I don't know if I'm pronouncing it right. I must

read it. I don't know what I said. Kynuretic acid, right. Yeah, kynuretic acid. And that level goes up, and you can actually measure it in these patients. And you see when they have high levels of these quinolinate or kynuretic acid, it indicates inflammation. And you know that the serotonin pathway is being screwed up and it's bypassing and producing these toxic molecules that cause inflammation in the brain. And so one, by getting rid of the inflammation, two, by giving the helpers for these chemical reactions, you can often really help improve the cognitive function of the brain. But it's really about the inflammation. And that's what's so different and striking about it. Now, did you know that most of you are inflamed and living an inflammatory lifestyle? That being

inflamed makes you fat and sick? And that being fat and sick makes you inflamed? It's a vicious cycle. So what is inflammation anyway? And why does it make us sick and fat? Well, inflammation can be a good thing, right? It's part of your body's own defense mechanism. If you have a cold or an infection, you bang yourself, inflammation helps your body heal. But it's bad when it goes out of control. Now, what makes us inflamed and what makes the inflammation get out of control?

It's mostly our diet. It's bad food, sugar, trans fats, food allergens that are hidden, lack of exercise, stress, even hidden infections. All these things promote inflammation. So how do we deal with it? Well, we detox from inflammatory foods, but just get rid of them for a little while, one week, see what happens. Things like sugar, processed food, junk food, caffeine, alcohol. But what else is important? And I want to spend a little time talking about this other factor that mostly gets ignored.

It's called hidden food sensitivities or hidden food allergens. And they're delayed. They're not like, you know, you eat a peanut and your tongue swells up and you have to go to the emergency room. I'm not talking about that. I'm not talking about shellfish allergy where you can nearly die from it. What I'm talking about are delayed, subtle, and often unrecognized symptoms that come from delayed reactions to the things we're eating. And these symptoms can include weight gain, fluid retention, fatigue, brain fog, irritable bowel syndrome, mood disorders, headaches, sinus problems, joint pains, acne,

eczema, and much more. Now, why do we get it? Let me just say something first. This is an unrecognized epidemic. And most physicians, most practitioners ignore this type of allergy. It just hasn't hit the radar. And yet it's the biggest thing I do in my medical practice to help people feel better quickly and to lose weight quickly. So you have to recognize that it's not the same for everybody, that one man's medicine is another man's poison. And if you're eating something that doesn't agree with you, that you've developed a food sensitivity to or an allergy, you can develop a whole host of problems. In fact, in this country, we have an epidemic of inflammatory and allergic diseases. We have 24 million people with autoimmune disease. We have 50 million with

allergic diseases. We have 30 million with asthma and over 60 million with irritable bowel syndrome. And all of these are connected by inflammation. So the question is, why have we become so sensitive? Why is our immune system acting this way? Obviously, we weren't designed to have an immune system go awry and create tremendous amounts of inflammation all the time, make us sick and fat. So something's gone wrong. What has gone wrong? Well, it has to do with the idea that food is not just energy, right? I've talked about this before. Food is information. So it can be good information,

right? Good information from phytonutrients, things that are found in plants, colorful antioxidants, detoxifying, and anti-inflammatory molecules found in plant foods. So that's good information. But it can also be bad information. And that can include bad information from allergens and from toxins. So when does it become a problem? Well, it becomes a problem when we get something called a leaky gut. The medical term for this is increased intestinal permeability. But it basically means that the stuff on the inside of your gut, which should stay on the outside of your immune system, gets in and leaks into your body and is exposed to your immune system, which then doesn't like it.

And the cause of this leaky gut or damaged membrane in your intestinal tract is a bad diet, lack of fiber, too much sugar. It's drugs, antibiotics, which kill all the healthy bacteria, hormones, which promote yeast overgrowth, anti-inflammatories, which damage the lining of the gut, acid blockers, which change your whole digestive process, and even stress can cause a leaky gut. So when this all happens, the lining breaks down and all hell breaks loose. What happens is then that on the inside of your intestinal tract, there's basically a sewer, all the stool, food, junk, particles, things that should be protected from your immune system. It starts leaking in across this leaky membrane and is exposed to your immune system, 60% of which is right under that lining. When that happens, your immune system goes, ah,

and starts attacking these, quote, foreign molecules. But it's really just food that you haven't properly digested or that should have been broken down, but it's suddenly exposed to your immune system. And that's when you start getting sick and fat. So it's designed to give your body a vacation from toxins and allergens. All you have to do is this, get rid of the bad stuff and get the good stuff and the body does the rest. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and

introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements, to gadgets, to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise. And all you do is go to drhyman.com forward slash PICS to sign up. That's drhyman.com forward slash PICS, P-I-C-K-S, and sign up for the newsletter and

I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes,

especially when it comes to your health.