The Dr. Hyman Show - Alzheimer’s Epidemic: Lifestyle Habits That Lead to Dementia
Episode Date: July 31, 2024Dementia and Alzheimer’s are rising at an alarming rate, affecting millions worldwide and costing trillions in healthcare. In this episode of “The Doctor’s Farmacy,” I sit down with Dr. Heathe...r Sandison to explore groundbreaking personalized treatment approaches that offer hope in reversing cognitive decline. Learn more about the impact of lifestyle interventions, the role of environmental toxins, and the power of holistic methods compared to conventional treatments. In this episode, we discuss: The rising prevalence of Dementia and Alzheimer's The importance of personalized treatment plans for cognitive decline The critical role of lifestyle interventions, including diet, exercise, sleep, and stress management, in reversing cognitive decline. How toxins, such as heavy metals and mold exposure, contribute to cognitive decline The advancements in diagnostics, including more accurate and early detection methods for dementia and Alzheimer’s How cognitive decline and dementia can be reversed through a multifaceted approach View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal This episode is brought to you by Rupa Health, BIOptimizers, LMNT, Cymbiotika. Streamline your lab orders with Rupa Health. Access more than 3,500 specialty lab tests and register for a FREE live demo at RupaHealth.com. Get Magnesium Breakthrough for FREE. Just go to magbreakthrough.com/hymanfree and get your FREE bottle today. LMNT is giving listeners a FREE eight-count sample pack of their vital electrolyte drink mix with any purchase. Just visit DrinkLMNT.com/Hyman today. Upgrade your supplement routine with Cymbiotika. Get 20% off with free shipping on all orders. Head to Cymbiotika.com and use code HYMAN.
Transcript
Discussion (0)
Coming up on this episode of The Doctor's Pharmacy.
There are a ton of things that you can do without the help of a doctor, right?
The foundations, like if that's the icing on the cake,
it's all of the functional medicine intervention.
The foundations really come back to diet, exercise, sleep, stress management.
It seems that every day more and more patients come into my office
bringing ever-increasing amounts of healthcare information with them.
And I love it when this happens because it means people are taking ownership of their health,
but it also means I have to stay on the top of my game. So as a healthcare practitioner,
how do you make sure that when a patient walks into your office and says, hey, I really want
a Dutch Complete or a GI map, that you have the right answers and tools? The answer is Rupert
University. They're the number one educational institute for root cause medicine with over 20,000
practitioners a year learning about functional and specialty lab testing.
Not only do they have absolutely free live classes hosted every week, but they bring
in industry experts to teach in-depth six-week boot camps on all the most popular functional
tests.
If you want to level up your knowledge of functional lab testing, make sure to visit
rupainiversity.com.
Today's episode is brought to you by Bioptimizers, a company dedicated to enhancing your health naturally. They believe that a deficiency in magnesium, one of the body's most
critical nutrients, can cause a host of health problems and that supplementing with magnesium
can significantly improve health. I couldn't agree more. That's why I'm thrilled to tell you
that they're offering a bottle of their top-notch supplement. Magnesium is a master mineral that
powers over 600 chemical reactions in our bodies. Everything from hormone balance and stress management to sleep quality and digestion is influenced by
magnesium. Yet up to half of Americans are deficient in this nutrient without even knowing
it. Supplementing with magnesium can be an antidote to stress. It can help improve your
sleep. So why wait? Start taking regular magnesium supplementation today and see the results for
yourself. And right now you can get a bottle of Magnesium Breakthrough free. Just go to
magbreakthrough.com slash hymen free and get a bottle of Magnesium Breakthrough free. Just go to magbreakthrough.com slash hymanfree
and get your bottle of Magnesium Breakthrough
for free today.
That's magbreakthrough.com,
M-A-G breakthrough.com slash hymanfree,
H-Y-M-A-N-F-R-E-E.
Before we jump into today's episode,
I'd like to note that while I wish I could help everyone
by my personal practice,
there's simply not enough time for me to do this
at this scale.
And that's why I've been busy building several passion projects to help you better understand,
well, you. If you're looking for data about your biology, check out Function Health for real-time
lab insights. If you're in need of deepening your knowledge around your health journey,
check out my membership community, Hyman Hive. And if you're looking for curated and trusted
supplements and health products for your routine, visit my website, Supplement Store, for a summary of my favorite
and tested products. Welcome to Doctors Pharmacy. I'm Dr. Mark Hyman. That's Pharmacy Winf,
a place for conversations that matter. And if you are losing your memory or you know anybody
who's got memory loss or who's experienced dementia in their family or in their friends, this is going
to be an important podcast because we're talking about the possibility of reversing dementia. You
heard me right, that's reversing dementia. And I personally have had this experience with many of
my patients using a very deep model of understanding of the biology underlying. And today's guest
on the Doctors for Pharmacy podcast is Dr. Heather Sanderson,
who's a New York Times bestselling author of Reversing Alzheimer's, the new toolkit
to improve cognition and protect brain health. She's a renowned naturopathic doctor specializing
in neurocognitive medicine and is the founder of Solerce Health Clinic, San Diego's premier
brain optimization clinic, and Merama, a residential program turning memory care
into memory recovery. She's dedicated her career to supporting those suffering with dementia and
is a primary author of peer-reviewed research published in the Journal of Alzheimer's Disease.
And she's really amazing at shattering common misconceptions about Alzheimer's and sharing
what she's learned about keeping your brain sharp at any age. This podcast for me was important because it really spelled out a lot of the science
behind our understanding of what goes wrong with the brain as we age and how to fix it.
You know, we often think of people who have cancer and heard of cancer survivors
or heart attack survivors.
But have you heard of Alzheimer's survivors?
Probably not.
But in this podcast, you'll hear about that and lots more. So
I'm excited. Let's dive right in to this amazing conversation with Heather Sandison.
So Heather, it's so great to have you on the Doctors Pharmacy Podcast. I've been following
your work for a long time. I'm very inspired to see how you're addressing this epidemic of
dementia and Alzheimer's in a totally new way that we're going to dive into today. So
thanks for joining me. Thank you so much for having me. It's a privilege to be here.
So before we kind of dive into the meat or maybe the vegetables or maybe the fat,
I don't know exactly what, I want to kind of give people a little bit of a background on where we
are in the world of dementia. And given how advanced medicine is, how much we've learned about addressing things like diabetes and heart disease and cancer, we've really missed the boat on dementia.
And we really have failed to stem the tide, which is growing dramatically.
In 2024, I think there's 6.9 million Americans who are 65 and older living with Alzheimer's.
The number is projected to go up to 8.5 by 2030, and I think 14 million by 2050. Across the world, it's also a problem. There's
55 million people living with it now, and this will go to 82 million by 2030 and even more.
And the cost is just staggering. I mean, I think the direct and indirect costs makes this the most
expensive health condition out there. The direct cost in 2024 were $360 billion,
a billion dollars a day. And there's also a lot of, you know, unpaid costs that are given by
family members and so forth. So it's by 2050, the cost will be about a trillion dollars. That's, you know, right now that's about one in
$16 of our economy. So it's a problem. And globally, the costs are now 1.3 trillion as of
2019 and 2.8 trillion by 2030. And yet we're kind of miserably failing. And it's not for lack of
trying. And I think what we're going to talk about today is we've been misguided in how we've been investigating this problem. We've been
misguided in where to look and what to do. We've been chasing down the wrong alley for the answers.
And we're really not much closer than we were a few decades ago, in my view. There's enormous
amount of research. It's not like there's a lack of research. I think
since the early 2000s, there's been about 292 interventional trials funded by the National
Institute on Aging. In 2024, there's 171 studies ongoing and 134 drugs for Alzheimer's disease and dementia. And yet none of them work.
And we're spending about $3.5 billion per year doing this research. And we're getting
no return on investment, really. I think the failure rate is over 99% for drug candidates.
And the drugs that get approved are basically marginally effective, and they're considered a success if they slightly slow the progression. No reversal,
just slightly slow the progression. So with that context, I kind of want to
say something really radical, which is that there are people out there like you and like others,
like Dale Bredesen and in my practice
as well, where we're seeing people actually reverse dementia, not just slow it down,
not just kind of delay the entry to a nursing home by a few months, but to literally stop it
and turn back the clock and bring people's memories back. Not always, not in every case,
not a hundred percent, but some are. And if that's the case,
then we should be deeply looking at the data around this. Now, one of the good things is that
you're thinking about this differently. And I think the issue has really been a thinking problem.
We've been thinking we're going to find this single drug, the single pathway,
the miracle cure for dementia. We just are not going to find it because it's a very complex
problem. It's not one disease. It's many, many different kinds of things that go into causing
someone's brain to dysfunction. And the common symptom is dementia. Just like pain can be the
common symptom of everything from cancer to dehydration to banging your head to a million
different reasons you can get pain.
The same thing with dementia.
It's just a symptom.
And the question is, what's the cause?
So with that in mind, I kind of love you to sort of talk about how you came to kind of
a different way of thinking about Alzheimer's and what you talked about in your book, which
was really a radical idea, which is called Reversing Alzheimer's,
the new toolkit to improve cognition and protect brain health. Now, that title alone should make
people stop. It's one thing to reverse diabetes, although some doctors still don't think you can
do that. But reversing dementia, pretty much nobody in their right mind would even hazard to
say that because it sounds like it's giving
people false hope and maybe it's just snake oil.
And why should we kind of be paying attention to that when we should be actually doing the
real research on what's going on?
So I'm kind of excited to talk to you about this whole idea of reversing dementia.
So tell us, how did you first come upon this and how did you first sort of understand that
our thinking was wrong and that we needed to kind of refocus how we were doing things around both diagnosis and treatment
for dementia? I came to this as a skeptic. I had heard, like most clinicians, I was trained that
there was nothing you could do. And as you mentioned, to suggest there was something we
could do for someone struggling with cognitive decline on their way towards Alzheimer's,
it would be to give them false hope.
And through my work, after being trained by Dr. Dale Bredesen, I saw what was possible. My patients proved to me that in fact, you could reverse this disease process. You could reverse
the symptoms associated with Alzheimer's. And my mind has changed. I think that there's actually a lot of hope and the false
hopelessness that comes with being told there's nothing that you can do for Alzheimer's actually
is I think, at this stage, criminal, right? We're told, I still have patients showing up in my
office saying, I saw the neurologist, very well informed, great guy. But he told me there's
nothing I can do, I need to get my affairs in order. They're going to take my driver's license away. And there's a couple
medications. They don't work very well. But I can come back in six or 12 months and they'll measure
the decline. And this is really unfortunate because there's a lot of great research showing
us that there is a multitude of things that we can do to support not only cognitive health,
but neuronal health, the cellular health of our brain.
Yeah.
That's quite an amazing statement is that you're seeing actually people reverse this.
And you mentioned a guy named Dale Bredesen, who's a friend and colleague of mine.
And actually, his wife was a functional medicine doctor.
And he was a trained traditional Alzheimer's dementia researcher.
And she kept pushing him to kind of
learn more. And she gave him a book that I wrote, I think in 2009, called The Ultra Mind Solution,
where I detailed how our bodies and our biology impact our brain function, everything from autism
to Alzheimer's. And I shared a number of cases that I had of reversing Alzheimer's. And I think
it got him very interested because he saw that what I was observing in the clinic were the same things that he was observing in his research
lab that he then saw a connection with. And then realized there may be a clinical pathway, not just
a research in a lab with mice, but actually a clinical approach that really helps to address
the root causes and to give people a chance of actually getting their brains healed. And that's, that's kind of how he started his whole
journey. And now he's been doing this for decades and now you learn from him and it sort of
makes me really happy. You know, I, I remember, you know, a number of cases I had, I'm just gonna
share a few cases that give people some context here. And then I'd love to hear some of your
cases, then talk a little bit more about what, what the meat of this is but you know i had a number of cases
that i had over my career one was a woman who was probably like early 80s and she was a very
smart woman who'd been in the chairman of many boards and it was very active in her community and
her doctors told her she had early dementia
and to get her affairs in order, just exactly you told her. And I, I just like you said, right?
I mean, the, the, the joke about neurologists is they're, they're basically say diagnose and
adios, basically here's the diagnosis. The only thing I can do is see you later.
And unfortunately that's just sad because there's so much that can be done. And this woman, she,
you know, she was really declining. And I did
what I usually do, which is ask a lot of questions. And I did a bunch of diagnostic tests. And I found
out actually she was very impaired in her ability to what we call methylate, which is to convert
the folate and the B vitamins from your diet into the right ones. And she was also very nutritionally
deficient in B12 because as you get older, you don't absorb it as well.
And so I gave her B12 shots and I gave her a high dose of methylating B vitamins, folate, B6, B12.
And literally like her memory came back like that. And that was a very quick, easy one. Not a long one like that, but it was pretty dramatic. And about maybe six or seven years
later, she called me and I thought, oh, maybe she's declining and there's something wrong and
she's going to need more help. She goes, well, Dr. Hyman, I'm going trekking in
Bhutan and I want to know what I should do to prepare myself. I'm like, great. So there was
that story. And I had another guy who was a seven-year-old guy who owned his own company and
it was quite a large company and was the CEO and just couldn't function anymore. It was very impaired, had severe memory loss, severe depression.
His family couldn't manage him.
And his wife brought him in kind of with the last legs, kind of hopeful that something
could be done.
And I said, look, I don't really know, but I'm just going to apply the principles of
looking at all the variables that could affect brain function and correct them.
And maybe it'll work and maybe it won't, but let's try it. And we found a whole bunch of things that we now
know are at the root cause of dementia. We found he had significant insulin resistance.
He had severe prediabetes. He had severe gut issues and what we call bacterial overgrowth.
And that bacteria was affecting his brain. He had also very high levels of mercury, extremely high, like on a challenge test.
You'll understand this, but his mercury was 350 after giving a DMSA challenge test.
It was actually DMPS at the time.
And normally it should be less than three.
Over 20 is bad, and his was 350.
And he also had really impaired methylation at high, almost 16.
He also had the genes,
the ApoE44, which is the Alzheimer's gene. He had the Alzheimer's risk gene. He had also
impaired methylation genes, glutathione genes. So he had a whole bunch of stuff that we corrected,
and we got rid of the metals, we fixed his gut, we optimized his diet, fixed his insulin resistance,
optimized his nutrients, and he ended up reversing his
cognitive loss and was able to go back to work and be a functioning member of his family again.
And, you know, at the time it was a miracle for me because I was like, wow, this is quite amazing.
And it kind of made me realize that we're not telling the whole story here. We're missing the
boat. So can you talk a little bit about the approach that you take? And you've done a bunch
of research. You published a paper that I think we'll talk about a little bit about the approach that you take? And you've done a bunch of research.
You published a paper that I think we'll talk about a little bit called Observed Improvement
in Cognition During Personalized Lifestyle Intervention in People with Cognitive Decline,
basically taking people who are already mentally impaired, cognitively impaired, and putting
them on a multimodal intervention to address all the causes and variables that you found.
And it's very personalized.
It's not, here's the treatment for Alzheimer's.
It's very personalized.
So can you share a little bit about the approach in general?
How do you think about dementia differently than other practitioners?
How do you think about the diagnosis of what the causes are?
And let's start there.
And then let's sort of go into some of the treatment modalities.
Yeah, I think it helps to start with this conventional model, right? What are we comparing
it to? So the conventional model and the incentive structure of sort of the pharmaceutical industry,
the insurance industry, the way that healthcare is set up is that what we want to find is a single
molecule intervention, right? That can be patented, that is very simple to dispense from a pharmacy,
that it's, there's simple instructions,
just take this one pill once a day, and you'll feel better. And that works if you've got a UTI,
right, and we can get a cure. And you can that can be in the past, take antibiotics for seven days,
don't have to think about it again, hopefully. Now, when we're talking about Alzheimer's,
this is very complex. And our friend Daniel Schmottenberger, he really taught me to think.
And I feel very privileged to have spent a lot of time discussing.
We would meet every Tuesday afternoon for four or five, six hours on these marathons,
just kind of reprogramming my brain about how to think through diagnosis of complex disease.
And put simply, when you think of any complex
system, whether it's a houseplant or a financial system or government systems or the brain,
what you're looking for is balance, right? And imbalance is going to create dysfunction in that
complex system. And so imbalance is going to be too much or too little or at the wrong time or
in the wrong place.
And when we think of the brain, this leads to disease when we have imbalance, especially over time.
And so we can say, okay, imbalance, this is helpful.
We'll simplify.
And then we want to systematize imbalance of what?
What are the causal level factors?
And I would argue that there's six of them. It's toxins. So imbalances
of toxins in the wrong place at the wrong time, too much, too little. Nutrients, right? You
mentioned insulin resistance and blood sugar becoming so high that it becomes toxic. That
can be a problem. But also you mentioned B12 and having too little B12 associated with genetics.
And maybe for one, maybe for your neighbor, they may need more B12 than you do. So we have these
individualized needs and requirements where we got to get that functional requirement met,
not just the RDA, not just that recommended daily allowance. So we have toxins, nutrients,
stressors. We can have too much or too little stress, right?
Some people want to kick their feet up and just relax in retirement, but they're not getting that
engagement. And then we also know on the flip side that caregivers, care partners for people
with Alzheimer's are at higher risk of being diagnosed with Alzheimer's themselves later on
because they have too much stress. Cortisol becomes literally toxic to the hippocampus, those memory centers of the brain.
So toxins, nutrients, stressors, structure. You mentioned getting hit over the head and causing
pain. Well, that can also cause inflammation in the brain and be a traumatic brain injury that
can put us at risk. You mentioned ApoE4. We can have molecular structure, genetic structure that
puts us at risk for developing Alzheimer's later on. So again, toxins, nutrients, stressors, structure, infections. We know there are a handful of
infections that are directly associated with the triggering of amyloid plaque production.
So things like P. gingivalis, which causes gingivitis in the mouth. Also, the Lyme spirochete has been found in amyloid plaques,
as well as H. pylori is associated. And herpes, the herpes simplex 1 virus is another one. The
gut-brain connection and infections in the gut can lead to imbalances in neurotransmitters.
And there's many other, I mean, in fact, I have a reverence for how complex the gut-brain
connection is and wouldn't pretend to understand it fully. But we know that there's many other, I mean, in fact, I have a reverence for how complex the gut-brain connection is and wouldn't pretend to understand it fully.
But we know that there's a lot of back and forth communication between the gut and the
brain and the microbes specifically in the gut have a lot to do with that.
So again, toxins, nutrients, stressors, structure, infections can lead to dementia.
And then signaling, are we getting the signals?
Dr. Bredesen has this phenomenal, I love this analogy of brain health, thinking of your brain like a country, my brain
is gone. If we are stuck in that fight and defend mode, if we're being invaded by infections, or if
we're being, if we need to defend against toxins like heavy metals, you mentioned, or mold toxicity
or chemical toxicity, then we're using our
resource to take care of that attack and defend. We're not able to use that resource to build the
infrastructure, right? To build new neurons and new connections between those neurons, the way a
country might build roads and schools. We want to use those nutrients to fully resolve those issues
that we're attacking and defending against. And it makes sense that if we're trying to do both, we're not going to be very good at doing either, right? We're not going to fully resolve those issues that we're attacking and defending against. And it makes sense that if we're trying to do both, we're not going to be very good at doing
either, right? We're not going to fully resolve the infections or fully resolve the toxic burden.
And we're also not going to be that great at having functional neurons to help remember our
neighbor's name or remember where we put our phone or our keys. So what we want to do is think really
holistically about this. You mentioned, you know mentioned there's multiple factors that go into brain health. And this is what I would think of as a comprehensive list, although I'm sure we will continue to know more. But it's a much more comprehensive way to approach each individual and what's causing them to go down this path towards this common diagnosis of Alzheimer's or memory loss associated with age.
Yeah. It's something I see a lot of. We get in this reductionist model where we're looking for
the single drug for the single disease like you've talked about. And it's why we spent
billions and billions of dollars and hundreds and hundreds of studies with zero real benefit.
And I think what you're speaking to is that this is a complex set of
diseases, not just one disease, even if it's called Alzheimer's or other forms of dementia,
they're really complex and have multiple causes. Not everybody who has that has the same causes,
they might overlap, but it's really important to look at what's going on for that individual.
Like that one patient I said, she had vitamin deficiencies.
Another guy, he had a whole host of things like mercury.
So you have to find out what the treatment is for that person, not a kind of one size fits all.
And it's just the intensity of how we do research.
I think what you're talking about also,
there's insults that happen.
Basically in the way I think about it,
it's too much bad stuff, not enough good stuff.
And I think you're talking about,
we were missing the things
that we need to make our brains work well. And we're having too much of the stuff, whether it's
infections or microbiome or toxins or sugar or stress that actually cause damage to our body.
So when you start to think about someone like this, you're thinking about a lot of these factors
that have modifiable solutions, right? It's not like,
oh, well, if you have a toxin, there's nothing you can do about it. Oh, if you have insulin
resistance, there's nothing you can do about it. Oh, if you're nutritionally deficient,
there's nothing you can do about it. They're all treatable, right? And so that's the beauty of this
whole approach of functional medicine and this approach to dementia is that it really helps you
to navigate a very complex set of variables and kind of understand
how to start assessing them and actually treating them. So when you start to do assessment,
you know, one of the things I love that Dale talked about was this whole idea of dementogens,
you know, and I wonder if you could kind of go through what you kind of did a little bit, but I think it's sort of worth, you know, going through what the kind of framework is of these dementogens
that he talks about and how those can impact our us and what we call the exposome, which
are the hidden things that tend to cause brain dysfunction.
Yeah. So when I work with a functional medicine patient, there are all these medical pieces that
I almost think of as icing on the cake. So I definitely want to go in this direction and
support people in knowing how to communicate with their doctor and knowing what to ask for and what
kind of testing. And certainly there are a ton of modifiable things that we can address. And I also
want to just take this step back to say, there are a ton of modifiable things that we can address. And I also want to just take this step back to say there are a ton of things that you
can do without the help of a doctor, right?
The foundations, like if that's the icing on the cake, it's all of the functional medicine
intervention.
The foundations are really come back to diet, exercise, sleep, stress management.
And so I, of course, want to, because we're both functional medicine practitioners, I
want to dive into that deeply.
And I wish that the whole medical system was coming in that direction.
But I also don't want to miss the opportunity to tell people, if you don't have access to
that, if cost is an issue, there are many, many, many things that have an outside impact
that really come back to what are the things I put in my mouth every day?
What do I eat?
What do I consume?
What are the nature of my relationships and my stress levels?
What time do I get to bed each night?
How much movement do I get each day?
Those are the things that really impact health over time.
Now, these hidden causes, these hidden things, this exposome, these dementogens, toxins are
a big part of that.
And I think of three flavors.
There's chemical toxicity,
which is ubiquitous. None of us are going to be able to avoid it all, but there are great
strategies for avoiding the things that we have control over. You talked about modifiable risk
factors and not modifiable risk factors. And just to give people kind of a sense of what the
difference is there, we can't change the year you were born, right? We can't change your chronological age. As that increases, our risk of dementia goes up. We can't change
that you're born male or female. And if females have higher risk of dementia, they're two-thirds
of dementia or Alzheimer's patients. And we also can't change your genetics, your ApoE status. This
is said. But what can we change? We can change our toxic exposures. We can increase
our ability to detoxify, whether it's one of these three flavors, heavy metals,
mycotoxins or mold-associated toxins associated with water-damaged buildings, which I see many
elderly folks who have been in their houses for a long time. Huge issue. Really big kind of
underrepresented issue. And my other mentor is Dr. Neil Mathen,
who I'm sure you've come across. I feel really grateful to have learned from him how to support
very sensitive patients and also to just be hypervigilant about that potential mold exposure.
And then these chemical toxins that I mentioned, so metals, molds, and chemicals. And although
you can't completely avoid all of them,
what we can do is we can measure how much we're being exposed to and see if there is some detective
work that can go into lowering our exposure to phthalates or petrochemicals or Roundup. Glyphosate
is a big one that directly impacts the nervous system. I'm sure you're familiar with the work
of Stephanie Seneff. She was at MIT and has done extensive research on how glyphosate impacts the nervous system.
And so understanding-
Yeah, she's been on the podcast.
We'll link to that in the show notes.
But yeah.
Yeah, she's fantastic.
And understanding what's coming into my system and then can my genetics tolerate those toxins?
And how can I increase my ability to get rid of toxins through my liver, through my bowels,
through my kidneys, through skin and lymph, maybe even through breath work, through the
lungs, so that we can optimize for cellular health?
Yeah, this toxin thing is big.
You know, there's other things we're going to point to that are modifiable, like diet,
like your microbiome, like infections.
You know, there's things that actually can be modifiable,
but the toxin one is huge. And I think like the case I mentioned, it's one of those things that's,
if you look at the scientific literature, there's ample evidence that toxins are linked to dementia.
But on our clinical level, nobody's really looking at this from a traditional medicine perspective. When you go to see a neurologist, they don't measure toxin levels. They don't ask you about them. They don't ask
you about exposures. They don't do any testing about it. And, you know, one of the challenges
is that it's very hard to test for some of these compounds. Mold, you know, there was a great lab
for mycotoxins that was run out of business because insurance companies didn't like it
because they were getting, actually, I think I was the cause of it, actually.
I think it was like 20 years ago.
But I had a patient who was in a house that was affected by mold.
She had chronic fatigue.
Her daughter had juvenile rheumatoid arthritis.
And they lived in different bedrooms.
And I had them go assess what was going on in their house and what was growing in each room.
And they were in different molds.
And then when we did lab work with Dr. Barjani's lab,
it was called Immunosciences,
that did these mold toxin lab assessments,
it matched exactly, like the mycotoxin antibodies or the mycotoxins that were in the room,
and then she got a million-dollar settlement,
and then the insurance company in California
came and shut down, through the government,
shut down the lab.
It was pretty bad.
But anyway, that aside,
it's not as hard to test for these things.
Heavy metals are easier to test for. You can look at blood testing. That's helpful. There's
challenge testing where you can take a key liter and collect your urine.
Let me ask you a question. What do you reach for after you finish a workout? If you're like
most people, you probably reach for a sports drink to replenish the water and electrolytes you lost. And that's great, except that most of these drinks are also
filled with sugar, food coloring, and other junk. When I want to get the benefits of a sports drink
without all the nasty stuff, I reach for Element. Their tasty drink mix has everything I need to
give myself a science-backed electrolyte boost whenever I need it. And there's no sugar, coloring,
artificial ingredients,
gluten, or fillers, which means it aligns perfectly
with my dietary choices.
Element is one of the most important tools
in my health and fitness toolkit,
and I know it can be for you too.
Right now, Element is offering my listeners
a free sample pack with any purchase.
That's eight single serving packets free
with any Element order.
This is a great way to try all eight flavors or share Element with a friend.
Get yours at drinkelement.com slash hymen today.
That's l-m-n-t dot com slash hymen.
Modern foods aren't nearly as nutrient dense as they used to be.
So we all need a little help from supplements if we want to function and feel our best.
But supplements can also be tricky.
Some use low quality ingredients that are difficult for the body to absorb,
and others add cheap fillers and additives.
And that's why I love Symbiotica.
Cutting-edge formulas they have, like liposomal glutathione and liposomal vitamin C,
use liposomal technology, making them the most bioavailable and optimal for absorption.
If you're unfamiliar, liposomes are fatty membranes, like little bubbles,
that encapsulate nutrients and prevent them from being broken down in your digestive system and increasing their bioavailability or the percentage of the active ingredient actually absorbed into your body.
Not only do they formulate their supplements for higher absorption, but Symbiotica is also extremely transparent about how and where they source their ingredients.
So you know you're getting high-quality products that are safe, effective without any seed oils, preservatives, toxins, or artificial additives. It also means
they taste great. Flavors like citrus vanilla made from organic vanilla extract and organic
orange peel oil. I also love they come in convenient packets so I never have to worry
about missing doses or packing big bottles when I'm traveling. Right now you can try them for 20%
off with free shipping on all orders. Just go to symbiotica.com
slash hymen and use the code hymen. That's symbiotica, C-Y-M-B-I-O-T-I-K-A.com forward
slash hymen and use the code hymen for 20% off plus free shipping.
But the other toxins which are ubiquitous like phthalates, BPA, glyphosate, PCBs, pesticides,
plastics, microplastics, they're very hard to assess. And I recently learned about how to
assess it in a different way. I want to tell you about it in a minute, but I'd love to hear how
you think about those rather than just your general, like try to reduce your exposures and
improve your own body's detoxification system, which is sound advice. What are the other ways that you kind of assess these?
Yeah. So we do tests through real-time labs, has an environmental pollutant panel. And so I do
look at urine, at urine levels of excretion. And what I've seen is many of the sickest people,
they actually don't collect much in their urine the first time. But
then as we start using some binders, some glutathione, some support, some biochemical
support, as we start getting them sweating, maybe get them on a detox breathwork practice,
we see that those numbers will go up. And so it's almost like, again, hidden, even with our testing,
some of those exposures and that total toxic burden, it takes a little
bit to uncover. And three, six months later, we see those numbers go up even when there isn't an
active exposure, but it's just that they're starting to actually mobilize more of it.
Also getting on a ketogenic diet, we start to mobilize fat soluble toxins as we are using the
fats to create fuel. We can get that from adipocytes. And then we're
releasing those toxins into the bloodstream, and then it's coming out in the urine a little bit
more. So I think that many of these toxins, initial testing can also be deceptive, right?
Most of my patients are over 65 65 they've had a lifetime to accumulate
these things and this can be such a scary conversation right it can very quickly go to
like overwhelm and anxiety about how much toxicity is in the environment we can only control what we
can control so i think getting testing your water or getting spring water find a spring.com i think
is a great source uh to find spring water near youaspring.com I think is a great source to find spring water
near you that hopefully isn't contaminated. I'd love your opinion on RO, water reverse osmosis,
is a great way to get a lot of toxins out, but it does require remineralization because it'll
take the minerals out of the water. So getting away entirely from plastic, from drinking anything
out of plastic, particularly because hot plastic will leach into the water.
But even just the screw cap,
it's like you've got plastic sawdust in there.
And so I think plastic water bottles
are just toxic for so many reasons.
But yeah, we could talk for a weekend
on all of the ways to think through toxicity.
I'm going to tell you something that might blow your mind.
And it's blown my mind, actually.
But before I do, I just want to kind of reinforce
that the approach you're talking about fundamentally is lifestyle.
It's what we eat.
It's how much we exercise.
It's sleep.
It's how we manage stress.
It's some basic nutritional support.
And those have a profound impact. And there are some trials
that have been done, the FINGER trial and the POINTER trial, which is underway, which are
multimodal lifestyle interventions with risk factor management that have shown not just to slow
dementia, but to actually reverse it, which is, again, something that all the drug studies
never show, right?
So even the best drugs that have been approved, there's not many of them, they don't show
that.
And I don't know why it's not something that's headline news because studies are published.
Your study should have been headline news.
Again, it was published in the Journal of Alzheimer's. Because, you know, if something is incurable and you actually reverse it, then don't you
think we should be actually spending the billions on that rather than more drug studies?
Yes, I can agree more.
Yeah.
So we're going to get into all these factors that were studied in the finger trial and
the pointer trial and your data as well.
But I just kind of want to get back to
the toxin conversation for a minute because, you know, I've personally had mercury poisoning and
I know what it does to my brain. It was bad. I've also had mold toxicity. So I know what that does
to my brain. It made me very demented. And I had terrible memory issues and cognition issues.
And I figured out how to treat that, thank God. But I recently had been using a
test out of Germany. It's a relatively new test that measures not just the stuff that comes out
in your urine, that's in your blood, which is, by the way, these toxins that you're talking about
are stored in fat. And so if you look at what's in your blood or what's cleared in your urine,
they're not going to be there.
Like they're just not, that's not what they're, it's like looking,
I don't know, it's like looking in your urine for red blood cells.
They're just, they're not supposed to be there.
So they're just not going to be there.
And this test that they do uses an analysis of cells, not blood,
but your actual cells and cell membranes, and using lymphocytes.
And they find the load of toxins in there that we've never been able to see before.
And it's kind of shocking to me how loaded people are and how loaded I was with everything from pesticides to phthalates to glyphosate to metals.
And I've been treating myself and a bunch of others with a
procedure called the PK protocol, which is designed to help replace the toxins in your
cell membrane to improve cell membrane function and fluidity and cell communication and mitochondrial
function, all of which are the things that go wrong when you have a neurologic
disease or dementia. And so I just talked to a patient actually a couple of days ago who
is a dementia patient. She's in her early 80s and very bright woman and was starting to go downhill
and was diagnosed with MCI, mild cognitive impairment, and was getting worse and worse.
And I did this test on her and I got the result and I was sort of shocked.
And it matched against what I would expect her history was.
For example, she was a smoker, so there was a lot of cadmium in her cells.
Cadmium is a metal that you get from smoking.
She also had lindane, which is a pesticide that's been banned for years.
She had glyphosate.
She had all these plastics, fungal toxins that were in her cells. And what we did is a protocol that basically flushes out all
that stuff using high doses of intravenous phosphatidylcholine, which is basically the
fatty substance that makes up your cell membranes. And then we poured her with the glutathione and
things to help detoxify and the B vitamins we talked about and
a bunch of other minerals and support. And I talked to her on Sunday and I was like,
how's it going? She's like, I don't know. It's amazing. My memory's back. I have full
short-term memory. My long-term memory is better. You know, someone can tell me something in the
morning. I remember the next day, you know, that was, she couldn't remember five minutes from
before when she had a conversation with her husband about something and 10 minutes later, she wouldn't remember it.
And it was so exciting to me because I'm like, wow, finally we have a way to actually assess
and to monitor and to treat in a way that I don't think I've ever seen before in my
practice.
I'm curious if you have any experience with that, what you think about it, if you know
what I'm talking about.
The lab is a German lab.
It's called IGL.
IGL.
I'm writing that down. I'm not
familiar with IGL, but I have been using the Patricia Kane, the P-fosfatocholine for a long
time, for many years, the IVPC. And we do the exchange by IV and then also oral PC, which we
know helps with gallbladder, basically the discharge of bile, that toxic
sludge that we build up. And so PC, I think also very clear that that helps with the brain as this
phosphatidylserine and choline is part of acetylcholine, a neurotransmitter, the most
abundant neurotransmitter in the brain. But choline, we do know that choline has a big role
to play in the brain. So not just the phosphatidylcholine, but choline found in eggs and
in other food sources and also in many nootropic formulas.
Right. That's the major neurotransmitter that goes down is acetylcholine in Alzheimer's.
You know, I don't know what doses you're using, Heather, but we're using basically 20 grams, which is a lot.
And over 10 weeks, we give two kilos, basically, of phospho-alkaline intravenously.
Are you doing the inessentielle vials?
Yeah, but we're doing 20 of them.
20 of them.
Wow.
Yeah, we do five typically.
Yeah, I think that's way underdosing.
Yeah, because I used to do five, and I didn't see the same results.
Uh, and it's, it's done over a period of time, but it's, it's essentially 20 miles twice
a week for 10 weeks.
And if people are wanting to know how to do this, uh, we do this at our center and ultra
wellness center in Lenox, Massachusetts.
I'll send Heather the protocol.
I would love that.
Yeah.
Cause are you dripping it in D5W?
Yeah.
It's dripped in, right?
You're dripping it in and then you drip in a bag of glutathione.
You have methylfolate and leucovorin and other biotin and a bunch of other stuff.
So it's a pretty interesting thing, but I did my before and after testing, and it was completely different.
I mean, I'll even share my results in the show notes because I think it's so compelling. And I think the before
and after was just striking. And I personally felt different, dramatically different. So I think
we're learning about all these things that we didn't even know before. Medicine is advancing
so fast. And unfortunately, there's not billions of dollars spent on researching
IV phospholipidine in dementia, but we should because if what I'm finding is what
I think is I'm finding, it's pretty exciting. And then of course, you know, for the mold stuff and
the metal stuff, there's other things to do. The phosphocholine actually also helps in the mold,
but there's other things you can do for mold, but it's important to really assess whether you've
got mold exposure because it's really one of those things that can be treated. And so can heavy metals, like I shared in my case study with the patient when we did chelation on
him. And other things like infections, right? I mean, Chris Christopherson had Lyme disease that
caused his dementia. When he treated his Lyme disease, his dementia got better.
Yeah, Rich Horwitz has also seen that the treatment of Lyme disease can help with dementia.
My patients, the first patient I
saw who really opened my eyes to this, Darlene was her name. And she came in soon after I was
trained by Dr. Bredesen in 2017. And she and her husband came in, she was entirely dependent on him.
She had a MOCA score of two. So the MOCA is the Montreal Cognitive Assessment. And we use this
as a clinical tool to tell us where on the spectrum of cognitive decline someone is. And a perfect score is 30. It's a one page worksheet that
some of your listeners may be familiar with. You copy a cube and draw a clock, identify some zoo
animals. And she had a MOCA score of two. So she was essentially answering. Yeah. She was answering
questions with like yes or no, and not much more than that. Their life had been completely changed since she had gone down very quickly with dementia and diagnosed Alzheimer's.
Now, her very dedicated, loving husband had read Dr. Bredesen's book and was all in.
I mean, he had, thank goodness, enough confidence for both of us because I had never done this.
And she was so severe that I wasn't hopeful at all.
But they asked-
I'm just taking this perspective.
It's out of 30.
So if your score is less than 25, it's a problem.
Two is, you know, nobody's home.
Yeah.
26 and above is normal.
Once you're down in the single digits, this is severe dementia.
This is where you are
dependent on others for activities of daily living. Your dignity is more or less gone,
right? You're not able to do anything on your own. And so she was in that state, but she had
this bright smile and her eyes would track me. And she had on this beautiful floral dress. And you could just see how much soul was in her.
And they just shocked me.
She came back six weeks later, and her mocha had gone up to a seven.
And of course, my initial response was like disbelief. I was like, oh my gosh, we must have done the test wrong.
Like, this isn't possible.
Like, what is going on here?
And her husband assured me, no, no, she's different.
Listen to her.
She was speaking in complete sentences.
They started bickering about something while they were in my office. And she was remembering things that he had said. And she wasn't going back to work. She wasn't 100% better.
But this was the moment. I mean, I remember it like exactly what I was wearing and the way the
light was shining in the room because it was so emotional for me to be like, what? If this is
possible for Darlene, what is
possible for everybody else who's not so far down along this path? There is so much suffering that
we could be avoiding by taking this approach. So what did they do? They moved out of a moldy
bedroom and they didn't have to move out of their house entirely, but they moved into their living
room. They started ballroom dancing three times a week,
even though they weren't very good at it. They were going on walks every day. They got on a
ketogenic diet. They ate only whole foods, got rid of all of the processed foods in their diet.
She got on all the supplements that we put together based on Dr. Bredesen's approach.
She got on bioidentical hormone replacement. She went and got the mercury out of her teeth,
her root canals out. She got all of her dental work taken care of very quickly.
And lo and behold, she improved.
And I really owe so much to obviously Dr. Bredesen, but also to Darlene and her husband.
Because that was the moment I could not deny how much better she had gotten.
Yeah.
What was her score after you'd done all that?
It was a seven then. And
she continued to go up a bit. Um, I, I've lost touch with them. They kind of, they,
they're doing things on their own, but they, we were together for a couple of years and probably
like your patients, you know, you hear from them years later and you think, Oh, have they gone down
or do they need extra help? And she'll probably be like, Nope, we're doing great. They were,
they were very motivated. It was really fun. And for people listening, I just want to point something out here.
This is something that you just don't hear about, right? The reversal of dementia is just something
in traditional medicine that's considered heresy. And if you talk like this, if you say what we're
saying, you're thought to be a quack. And, you know, I don't mind being a
quack. You know, it means I'm thinking differently. And I'm pushing the envelope a little bit. But
I don't really care. Because when I see my patients get better, that's what matters to me.
And I and I know we can have an impact on these people. Now, not everybody's going to get better.
I've had cases where I just didn't find the thing or the things to do. And there may be more of a more pathology going on that I didn't really
understand or that we couldn't figure out yet. But the good news is you can start to really
assess people differently. So maybe you can talk about how we start to assess someone completely
in what we do in traditional medicine and how that's different with the approach that
you're taking. I don't know what you call it, but I call it functional medicine.
Yeah. I'm trained as a naturopathic doctor, which essentially is functional medicine. And
going to Dr. Bredesen's training, I was very struck by, I have all of these tools. I learned
them all in naturopathic medicine. It's just applied to dementia and the brain. And also, I wasn't
stacking them. I didn't have, I think, a respect for how much synergy there is between doing these
things together. And when we're looking to reverse Alzheimer's, we really do need to throw everything
at it. So people will ask me, well, do you start with the gut? Or do you start with detox? Or do
you start with infections? And I say, no, we just do all of it. We throw everything at it because we're asking for a
miracle. We're asking for the reversal of this neurodegenerative process and we need to do it
yesterday. Now, if we're in prevention mode, it's much more of a luxury, right? If you know your
ApoE status, you're at risk for dementia and Alzheimer's, then start in your 20s. We know that there's
basically four stages of Alzheimer's. There's a pre-symptomatic stage where there are changes
happening in the brain. You might have amyloid plaque accumulation. There's things happening
that are going in the direction of neurodegeneration, maybe inflammation. There's lots of different
things that can happen in response. But that is happening before we notice that we're forgetting
anything. And then you have that symptomatic phase where it might not be measurable. We call it
subjective cognitive impairment, where you know that your brain isn't working the way it did five
or 10 years ago, but we wouldn't pick up anything on a MOCA score, for example, or on other
neurocognitive testing. And then we have something called mild cognitive impairment. As it progresses,
we start to be able to measure that your cognition is not as good. And there's lots of different ways
to do neurocognitive testing. We use the MOCA score in my office because it's quick, simple,
very inexpensive. And when we did the clinical trial, we also use the Cambridge Brain Sciences
battery of cognitive testing. And those matched. And so instead of charging patients a lot more
and taking more of their time, we rely mostly on the mocha these days. But that mild cognitive impairment stage, there's nothing mild
about it. It's actually quite devastating. It sounds like you've experienced it once or twice.
You're not a nursing home, but you're still not great.
Yeah. You might not be able to work anymore. You're not experiencing your relationships. I
had a patient come in. I saw her for the first time this week and she actually signed up and got
my book early. So she was able to read it six or eight weeks ago and started implementing a lot of
the program. And she, I mean, this just made my day. I'm sure you've heard this story. I read your
book and I'm already doing better. I want to get even better. And she had, as I was asking her, you know, are you forgetting words?
Are you having trouble with word finding or names?
I used to, but I don't anymore.
And her husband agreed.
Yeah, in the last few weeks, she's been doing a lot better.
Are you repeating words or phrases or stories?
I used to, not anymore.
Are you overwhelmed?
So many people, one of the early signs that this is
starting to take place is that they used to host Thanksgiving for their family, for 20 people.
And this year, nope, she can't do it. It's too much to take on. This woman owns a restaurant,
and she had felt so overwhelmed by payroll and employees. And she said she stopped going into
her restaurant because she would just cause more harm than good. Now she looks forward to going in and taking care of all the things that need
to be taken care of. And this just happened over the course of about eight weeks that her life
transformed so dramatically. And so these signs, this mild cognitive impairment, again, she was
basically kind of going towards retirement, forced retirement. She wasn't already at that phase of Alzheimer's, more severe Alzheimer's, where you're dependent
on others for dressing and eating and driving, of course, that kind of thing.
Yeah.
Well, I think what you said earlier was so important.
I want to come back to it.
And it's such a great story.
And it's so inspiring.
And the thing you said earlier was that people say, where do I start?
And typically, we have a very reductionist view in medicine where we just do the one thing.
And my mentor, Sid Baker, had a rule, which is called the TAC rule or the TAC rules.
The first rule is if you're standing on a TAC, it takes a lot of aspirin to make it
feel better, right?
If you've got mold toxicity or mercury toxicity or your guts are mass or you're massively nutrition deficient, you can take all the Alzheimer's drugs you want. They're not going to work, right? If you've got mold toxicity or mercury toxicity or your guts are mass or you're massively
nutrition deficient, you can take all the Alzheimer's drugs you want. They're not going to
work, right? And second is if you're sitting on two tacks, taking one out doesn't make you 50%
better. So you have to find all the factors that may be going on and address all of them.
And this is what we call network medicine or systems
medicine or functional medicine. It's the idea that diseases have multifactorial causes, meaning
there are many causes for any single disease in any one person. So it's not just there are multiple
causes in different people, but even in the same person, there may be four or five factors
that are driving the disease.
Like in that patient I said, it went insulin resistance and B vitamin deficiencies and gut issues and mercury toxicity, he had all of it, right? We can't just do one thing and hope he
gets better. And so that leads to what we call multimodal interventions. And this is a really
unique idea in medicine, which is that you do more than one thing, right? It's like, well,
how do you sort of prevent heart disease? Well, just exercise. Well, no, you have to eat better,
you have to sleep, you have to deal with stress. You can't just do one thing. It's like,
oh, I'm just going to... And I had this conversation with... We were trying to do a
dementia study when I was at Cleveland. I had a discussion with one of the head researchers there,
brilliant woman and amazing. And I said, well, we have all these things we want to do and look at,
and we need to do them all at once. And she's like, no, no, no, you have to study exercise,
and then we'll study diet, and then we'll study vitamin D, and then we'll study vitamin B12,
and then we'll... No, I mean, that's not how the body works. And it's very tough,
because that's how our research infrastructure is set up. But you did this study, which I'd like
you to kind of unpack for us now. It was published in 2023 in the Journal of Alzheimer's or Disease.
We're going to put that in the show notes, a link to it.
It was called Observed Improvement in Cognition During a Personalized Lifestyle Intervention
in People with Cognitive Decline.
So take us through the design of that study.
How many people?
What were the diagnostics you did? What were the findings? And
then what were the changes you made and interventions you did? And then what were the
outcomes? So walk us through that. Yeah, sure. So what we did was we recruited 25 participants
to go through a six-month intervention. And like I mentioned, we just threw everything at them. So
we did all of the testing. We had them make the diet changes, the exercise changes, sleep, stress management changes, all the foundational lifestyle changes. Plus we looked for
toxins and infections. And we did bioidentical hormone replacement when appropriate, supplementation,
treated their gut. We looked at anything and everything that we could, their cortisol levels,
their hormone levels, their thyroid levels, anything that was there that was out of balance, we treated. And we did this
aggressively, we did it quickly. And in those six months, 17 of the 23 participants improved their
cognition. So the reason I did this trial was I had patients asking me a question I didn't know
the answer to. If I do this, if I
spend the money, if I make the effort to do this for my mom or dad or for myself, how likely is it
to work? And I didn't know if it was going to be half the time, a quarter of the time, 80% of the
time. And what we saw was that when we recruited patients with MOCA scores between 12 and 23,
so again, a normal is 26 and above, perfect is 30. 12 to 23 is in that mild
cognitive impairment to kind of more moderate, even going, we had patients, we did include
patients with a diagnosis of Alzheimer's. And we saw that most of the time, 74% of the time,
people improved. We saw that there were statistically significant. Yeah, I mean,
it blew my mind. We also saw that there were statistically significant
improvements across the mean of all participants included in the MOCA, the Montreal Cognitive
Assessment, and as well as memory specifically and overall composite cognition on the Cambridge
Brain Sciences testing. We also saw improvements. So in English, that means based on validated
metrics that are used by researchers to evaluate the success of an intervention on cognitive
function, that this program that you did worked, and it worked better than most other drugs that
we find, right? Any drug. Yeah. This improved cognition measurably, statistically significantly.
And on multiple, basically everything that we tested had an improvement.
It was statistically significant for the mocha memory specifically.
And there was also verbal ability and focus.
And those ones were improved, but not statistically significantly.
And then overall composite cognition was also improved, as was quality of life and sleep. And so we saw these really
dramatic, amazing improvements. Now, I want to put my study in the context of other research
that's been published. So Dr. Bredesen and Kat Tewkes, Deb Gordon, there's a group of people
that have also published a trial that's very similar. So they took a nine-month intervention.
Our study was a six-month intervention, so a quicker intervention.
They had nine months, and they took participants with mocus spores down to 19,
and they had 25 participants.
Very similar intervention.
Dr. Bredesen's work applied clinically,
and they saw that 84% of their participants improved.
So we saw 74% with more progressed disease, right?
They would have worse cognition to start.
And we only did six months of intervention.
So neither of these trials were randomized control trials, which is sort of the gold
standard in research.
Both of these were feasibility trials.
The question we were really asking was, with a cognitively declined population, can we do this
complex intervention? Will they even be able to do it? And we saw, yes, not only can they do it,
can patients do it, but they will get improvements most of the time when they do. Now, really,
really exciting in the research. I'm sure you saw this, but just a few weeks ago in June of 2024,
Dr. Dean Ornish published a trial that is a randomized control trial.
And he took 49 participants through a five-month intervention.
So my study was six months.
Dr. Bredesen's group, they did nine months.
And Dean Ornish did a five-month intervention.
And he had a control group and compared the two.
And what they saw, I mean, I just got chills when I read the conclusions that they drew
in this trial. It was, it was, I mean, I just do a happy dance every time I think about it. But
it was a comprehensive lifestyle changes may significantly improve cognition and function
after 20 weeks in many patients with mild cognitive impairment or early dementia due to Alzheimer's disease.
I mean, this, and this did make front page news. Ashok Gupta on CNN did a docuseries related to some of these patients. And so I think the narrative finally, I mean, I just, I'm doing
a happy wiggle right now talking about it. The narrative is finally shifting.
That's so good. I want to talk to you about this actually, because I think, you know,
you're pointing to the phenomenon that this can get better. And the question is, what's the right
approach? And, you know, you mentioned earlier that you use ketogenic diets, which is extremely
high fat diet. It's like 70 to 75% fat. I think Dr. Ornish used a very low fat diet, like 10%
fat, vegan, 10% vegan. So how do you reconcile that in your mind between diets that have been
actually shown in other data to actually be effective around using ketogenic diets? I've
seen this in my own patients. When they go on a ketogenic diet, they get better,
which is the opposite of a 10% low-fat vegan diet. So can you kind of help us understand how
to think about that? Yeah, I'm just pinching myself that I get to have this conversation
with you because I think the food systems and talking about diet, this is such
the crux of what you've done and paved the way for. And it's so crucially important to this
conversation around brain health is what we eat. And so what I suspect will happen, I've used the
ketogenic diet in my practice. It's a plant forward ketogenic diet, right? So it's not a bacon and cheese diet,
this is a very nutrient dense, healthy diet. But metabolically, the goal is to get into ketosis and
burn fat for fuel. And oftentimes, it's like the lights come on, there is clearly something that
happens. And I think I again, have a reverence for how much complexity there is in that shift
in metabolism. Of course, we're getting more fuel, there's detoxification happening, there's less oxidative stress, I think there's a multitude of mechanisms
at play with the ketogenic diet. But I also think that one of the big things that happens with the
ketogenic diet is you get rid of processed foods that are so harmful. I think that also happens
in a vegan diet if you do it right. So you can have unhealthy keto, you can have unhealthy vegan
diets. But Dr. Ornish, they used a very healthy vegan diet. And I suspect that what we'll see will play out over
time. And as we compare these to each other, is an ancestral diet is really what's best. And what
was consistent about an ancestral diet was inconsistency, right? We were in ketosis sometimes
because there wasn't always carbohydrates available. And then we were vegan other times because there wasn't always meat available.
There wasn't always animal protein available. And so I suspect that what's best for our brain,
what's best for our body is to actually change diets. It's to not always be on the same diet,
but to get the metabolic flexibility of going in and out of ketosis. And what I recommend to my
patients now
is if you have cognitive impairment, get on a ketogenic diet for three to six months. There
are benefits, and I think there are healing benefits for the brain of being in ketosis
solidly for three to six months or so. And I don't have data to back that up. It's from my clinic.
Well, I have my clinical experience and what we've seen at the residential care facility that
we have where we have an immersive experience in this. So I haven't seen this published, but it's what I see playing out
as best for my patients. The thing with ketosis is it's not sustainable for the rest of our lives.
You're going to go to a wedding. You're going to go to Italy and want to have some pasta or
some gelato. You're going to go somewhere where you're going to fall out of ketosis.
And so then what choices to make then
non-process? I think the overarching message around what is a brain healthy diet is avoid
processed foods, eat whole foods that are nutrient dense, organic as much as possible,
and then shift your metabolism. Yeah. Because I think if you're going on a whole foods,
real food, nutrient dense diet, and you're switching from a standard American
processed diet, you're going to see a benefit if you go to being vegan like that. But the question
is what happens over time? How does that low fat affect your brain? You know, how would that compare
to the head to head comparison with a healthy ketogenic diet versus a healthy vegan diet?
You know, how do you address the other variables that he's not addressing, whether it's heavy
metals or the microbiome or nutritional factors? So I think it's complex and we need to
do more research. So I think it got a lot of headlines, but I do, I am concerned about,
you know, having a low-fat vegan diet as they kind of focus for dementia, because I think
it might be problematic, especially, you know, over time, these patients become more insulin resistant. I agree. I think that there can be benefits gained from changing your diet.
And then you don't want to stick with one diet for too long. I think that,
and especially vegan keto, right, to try to do both, I wouldn't suggest anyone do that,
because you start being too restrictive, and you end up with nutrient deficiencies. We know a vegan
diet, you're going to have to supplement with B12. B12, as you mentioned, talking about some of your cases, very crucially important to
cognitive function. And so having a diet that restricts that is not going to work long term.
And that's part of why this alternating different diets, eating seasonally, the way our ancestors
would have ate, it will, I think, help us to prevent those deficiencies and get
the right types of nutrients without getting the excess in terms of carbohydrates.
So diet's key. It's foundational to getting people better with brain disorders,
because what you eat determines the function of your body and your brain. So you just got
to deal with that. But there are a lot of other things that you do as well. And a lot of
these multimodal finger and pointer studies and Dr. Ornish's study also do this exercise,
stress management, sleep. Those are foundational. What I want to sort of dive into is some of the
other stuff. We talked about toxins, but there's some other things that are done to sort of assess
the overall function, like hormone levels, nutrient status, the microbiome.
Can you talk more about some of the other things that might not be that common that people know
about that you do as part of the treatment and workup? Yeah. Sleep is one of these pieces that
I think is really underrepresented. And I've had two patients in the past 18 months or so
who have come in with single digit MOCA scores. Two women who came in with MOCA scores of eight who nearly doubled those MOCA scores. One went up to 13 and then to 15 and the
other went up to 15 and then to 16. And both of them had undiagnosed untreated sleep apnea.
And that was a big part of our intervention. Now we did everything else, right? We measured
the toxins, we measured infections, we got them on hormone replacement, the progesterone helped them sleep, I'm sure.
We did all the things, right? But I think the big shift was getting sleep. And it made me wonder
when I saw both of those patients kind of in succession, how much Alzheimer's, how much
suffering is happening because people aren't getting access to sleep studies. One of these women was actually told by the sleep technician who did her study
that she didn't have sleep apnea when she came in. Oh, you're not overweight. You're not male.
You're not snoring. You don't have sleep apnea. And sure enough, she had severe obstructive
sleep apnea. Wow. Wow. And so I think many people are told that they don't have it or it's
not looked into. At this stage in my career, any patient with any cognitive decline, I am testing
for sleep apnea. And I'm really excited because there's new technology since COVID for doing at
home sleep studies. So it can make it less cumbersome. It's less of a chore. It's less
expensive than going into an overnight sleep study. That still is the gold standard. And there
are a lot of sleep disorders you can't rule out with these at-home sleep studies. But we have
caught many cases of sleep apnea using the watch pad is the one that I use. It's a watch plus a
ring. And so we're identifying sleep apnea and able to
treat it. What happens during sleep is that of course we get that rest, right? But we need about
seven hours minimum of sleep. Some people need more than that. And we want at least 90 minutes
of REM sleep and about an hour of deep sleep minimum so that we can consolidate memories,
so that we can take the bite out of stressful events that happen so our cortisol doesn't spike the next day when we remember them.
It also helps us to get rid of the amyloid. Amyloid can build up after just one night of
sleep deprivation. If you're in your 20s, 30s, 40s, just one night of sleep deprivation.
I know, right? That must be messed up because I lost so many nights of sleep as a resident,
intern, and medical student, and delivering babies, working in the ER. I must be messed up because I lost so many nights of sleep as a resident, intern, and medical student, and delivering babies, working in the ER.
I must have lost a lot of brain function.
Well, it's good you know functional medicine and you can clear that amyloid out.
And I hope you're prioritizing sleep these days.
So sleep is important.
And I get that.
I'm interested in some of the other things besides the foundational lifestyle stuff,
besides sleep and exercise and diet.
What else are you doing for these people?
Yeah. So looking at infections, we are treating Lyme aggressively. We're doing prophylaxis in terms of herpes. So if somebody has herpes outbreaks, we want to get aggressive
about that. There are epidemiological studies that show that that can be associated with dementia.
The dental work, I recommend going to a biological dentist,
making sure that even, I'm sure you've had patients like this with root canals that are
affecting their total body, their whole body health in one way or another, creating autoimmune
processes and inflammation in the brain. So getting really thorough workup of what's going on in the oral microbiome is super crucially important. And then, so from an infectious perspective,
getting ahead of all of that stuff and treating it aggressively, particularly if there's that
APOE status. The sort of realm of toxins is something that, you know, we did talk about,
but I think it's one of those factors that's important. Infections, and you just got to dig until you find what's going on. And sometimes
there's layers of diagnostics. I co-founded a company called Function Health, and in that
initial membership fee of $4.99, you get a whole suite of tests that your doctor typically doesn't
do that play a huge role in your cognitive function. You know, not only do we look at your levels of inflammation, insulin resistance, metabolic health, but we look at toxin
levels like mercury and lead. We look at also the nutritional status like methylmalonic acid and
homocysteine, which are really critical for memory and brain, which are often not tested. And we look
at vitamin D, omega-3 fats, and really get a profound, deep study.
We're also able to do APOE testing.
And soon we'll be adding something called AD-DETECT, which is from Quest.
It's a newer test, not available widely, but it looks at sort of early biological markers in your blood that can predict what's going on.
Are you looking at PTAL?
PTAL is Dr. Isaacson's doing that. And he's an incredible scientist. I've had him on the podcast.
I'm probably having him back in Perino's work, but he's developed another test, which is different
than that, but it's using PTAL. And it's a very useful biomarker because when you see people
improve, it gets better. So it's like a blood test to see whether or not what you're
doing is better, not just a mocha test or what people say is maybe a subjective or a little
squishy test, but an actual blood test. So I think we're going to get more and more sophisticated
about our diagnostics and assessments. I think people are listening out there and have a loved
one or have memory loss themselves. I wouldn't just take it at face value. I would say you
should be
aggressive about investigating other therapies and other treatments and starting with the
foundational stuff, you know, what you eat, exercise, stress management, sleep, community,
relationships, you know, becoming active, you know, those are things that really matter.
And then there's all these other layers of nutrition and infections and toxins in the microbiome and hormones and things that we talked about earlier, but it's really all
of it, right? Whether some people need more testosterone or more estrogens, people need,
you know, to have their thyroid fixed. I mean, you can have dementia from having a low thyroid
that may not be picked up. So I think there's so much happening in this world that's so exciting
and you're at the leading edge of it. I wonder if you share a little bit about your residential program because that's a really
unusual idea.
And I think part of the challenge is when we're thinking of doing research on this at
Cleveland Clinic, it's like I wanted to bring people in for like an immersive program to
be able to understand what's going on, to learn all about it, to be able to sort of
internalize what we talk.
Because in a doctor visit, basically it's hard to just sort of get everything and people are overwhelmed and kind of get, you know, kind of
deer in the headlights sort of sometimes. But an immersive program is very different. Can you talk
about what you've done and what you found? Yeah, sure. So around the same time we were
doing the clinical trial and getting this question, if I do this, if I put in the time
and effort and money to do this,
how often do people get better? We also were getting the question, hey, I know I want this.
I get it intellectually. I want this for my dad or I want this for myself, but I can't do it. It's
too much. I'm overwhelmed. Or of course, the sandwich generation of people who are working
full-time, raising kids, and their parent is sick, has a
diagnosis of Alzheimer's. They want Dr. Bredesen's approach for them. They want functional medicine
for them, but they can't spend their, you know, it's a full-time job to provide this sort of care.
And so this question was coming up, where do I send my loved one? And I looked around and there
wasn't a place that was really offering an immersive
experience, the organic ketogenic diet and non-toxic living environments, social engagement,
physical engagement, cognitive engagement, the management of all of the supplements and
medications. All of that takes a lot of labor. It takes a lot of time and effort. And so we thought,
well, I thought, how hard could it be to just create a
residential care experience for people and offer that up. And so we went, it was kind of nine
months and all of a sudden we had done it. And then COVID started, which is a story for another
day because we opened our doors March 1st of 2020. And then the world shut down about a week later,
but we had this, had this really, I mean, I just am so grateful to the families who've trusted us to support their loved ones.
And what we've seen, we opened a sister facility in Kansas.
So now we have two locations.
And the Kansas data is a lot cleaner because COVID wasn't in the mix.
But the first six residents have lived there for over six months, and five of them improved their cognition.
But we also see in this experience is that people
get off their antihypertensives, they get off their antidepressants, they get off their diabetes
medications. My favorite thing to hear from someone is I got my mom back, right? They get to
have another Christmas where their mom is able to pick out age appropriate gifts for the grandkids,
right? They get another anniversary,
another summer where they can really have a quality relationship with their loved one
because of what we see with being able to fully implement the program.
Now, is this a place where people go and then they leave or go and stay?
You know, that's the goal. I think as the narrative shifts, what I'm hoping is that
people will come earlier on in the disease process. So right now the answer is either whatever serves
that person. We had in this May of 2024, we had our first resident move home with a MOCA score of
30. So she came when her MOCA score was 24. She had found mold in her home. Her brain was not
working the way that it had been. She was getting measurable cognitive impairment was being picked up, but it was in the earlier stages.
So she decided that she was going to have her home remediated, come to Marama, move in. And
then sure enough, she was six points higher, MOCA score of 30 when she moved out May 4th of 2024.
It's amazing.
I would love for that to be what happens. Excuse me. So what I would love is that we don't have to relegate our elders to these senior living
facilities, right?
They are at the height of the peak of their wisdom and experience where they have so much
to share, so much value to bring to our communities.
And yet they often get relegated, siloed off in these senior living facilities.
And they become a detriment, right?
They become a liability to society.
It costs so much to care for someone
who has dementia and Alzheimer's,
as you mentioned at the top of the podcast.
And if we could get them back,
if they could help take care of the youngest generations,
their grandkids and great grandkids
and impart that wisdom,
I think that we would get so much back.
It's so powerful. It's such an incredible mission you're on. I think anybody listening to this
podcast, I hope it's helpful. And I think in my practice, I've seen this, you've seen this,
Dale's seen this, many others doing this. And of course, even in traditional medicine,
we're seeing this now with the finger trial, the pointer trial, Dr. Richard Isaacson's work.
It's tremendous. And I think we'll put links to all that in the show notes. And people need to
understand that we are in traditional medicine, mostly in the dark ages when it comes to dementia,
people are not getting the best care available. They're not getting to take advantage of some of
the things we've talked about today. And that it requires a little more effort, obviously,
than just kind of going to your doctor and taking a pill. But it really is worth the effort in terms of helping to slow and even reverse cognitive
decline as we get older. And by the way, a lot of these things are good from a prevention point of
view. You know, if you do these decades earlier, you're not going to end up with dementia, right?
So it's about getting on track early on. I really want to thank you for your work, Heather. It's
just been a pleasure to talk to you. It's been very inspiring to hear about your research, to hear about what we're seeing clinically, and to actually
give people a little bit of a roadmap. And your book is out now. I encourage you to go check it
out. It's called Reversing Alzheimer's, The New Toolkit to Improve Cognition and Protect Brain
Health. You can get it everywhere you get your books. And I think it's a great journey.
You can check out Dale Bredesen's work,
Richard Isaacson's work.
You can check out my book
that I wrote a long time ago,
The Ultra Mind Solution,
which I'm thinking of redoing
and writing a new book on this
because so much has happened
in the last 15 years.
And hopefully we'll see you next time
on The Doctor's Pharmacy.
Thank you so much for having me.
Thanks for listening today.
If you love this podcast, please share it with your friends and family.
Leave a comment on your own best practices on how you upgrade your health and subscribe
wherever you get your podcasts.
And follow me on all social media channels at DrMarkHyman.
And we'll see you next time on The Doctor's Pharmacy.
I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more.
And now you can have access to all of this information
by signing up for my free Mark's Picks newsletter
at drhyman.com forward slash Mark's Picks.
I promise I'll only email you once a week on Fridays
and I'll never share your email address
or send you anything else besides my recommendations.
These are the things that have helped me on my health journey
and I hope they'll help you too.
Again, that's drhyman.com forward slash Mark's Picks. Thank you again, and we'll see you next time on The Doctor's Pharmacy.
This podcast is separate from my clinical practice at the Ultra Wellness Center and my work at
Cleveland Clinic and Function Health, where I'm the Chief Medical Officer. This podcast represents
my opinions and my guests' opinions, and neither myself nor the
podcast endorses the views or statements of my guests.
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 your help in your journey, seek out a qualified medical practitioner.
You can come see us at the Ultra Wellness Center
in Lenox, Massachusetts.
Just go to ultrawellnesscenter.com.
If you're looking for a functional medicine practitioner
near you, you can visit ifm.org
and search find a practitioner database.
It's important that you have someone in your corner
who is trained, who's a licensed healthcare practitioner
and can help you make changes,
especially when it comes to your health.
Keeping this podcast free is part of my mission
to bring practical ways of improving health
to the general public.
In keeping with that theme,
I'd like to express gratitude to the sponsors
that made today's podcast possible.