The Dr. Hyman Show - Brain-First or Gut-First? Rethinking Parkinson’s Disease w/ Drs. Ray Dorsey & Michael Okun

Episode Date: October 8, 2025

Today we tackle Parkinson’s as a preventable epidemic—not an inevitable fate. I’m joined on The Dr. Hyman Show by two of the field’s top neurologists, Drs. Ray Dorsey and Michael Okun, co-authors of The Parkinson’s Plan, to unpack why cases are exploding and what we can do about it right now. We look at how toxins drive disease, why Parkinson’s goes far beyond dopamine, and the early signs most people miss—plus what you can do today to protect your brain. And we connect the dots between environmental exposures—whether from food, water, or even recreational spaces—and the growing burden of neurological disease. Watch the full conversation here or listen wherever you get your podcasts. [YOUTUBE THUMBNAIL] We also explore: • How to spot early signs—like loss of smell—long before a diagnosis • Everyday ways to cut toxin exposures in your food, water, and home • Why Parkinson’s is a whole-body disease, and what that means for prevention • The kind of exercise that protects your brain and slows progression • Simple nutrient checks that can support medication and brain health Parkinson’s isn’t inevitable. Protecting brain health starts with small daily choices. These are steps you can take right now for yourself and your loved ones. With awareness and action, you can build resilience today and help shape a healthier future. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by BON CHARGE, PerfectAmino, Function Health, Timeline, Big Bold Health and Pique. Head to boncharge.com and use code DRMARK for 15% off your order. Go to bodyhealth.com and use code HYMAN20 for 20% off your first order. Join today at FunctionHealth.com/Mark and use code HYMAN100 to get $100 toward your membership. Support essential mitochondrial health and save 20% on Mitopure. Visit timeline.com/drhyman to get 20% off today. Get 20% off HTB Immune Energy Chews at bigboldhealth.com and use code DRMARK20. Receive 20% off FOR LIFE + a free Starter Kit with a rechargeable frother and glass beaker at Piquelife com/Hyman.

Adjusted for age, the rise of Parkinson's is going up 60% far faster than Alzheimer's disease. It turns out by 2035, we should have 12 million people with Parkinson's. There's a big myth about Parkinson's, and the myth is that it's just a brain disease. This is a whole body disease. We have to start thinking about Parkinson's in a different way. Ray Dorsey, MD, MBA is a leading neurologist in Parkinson's expert. He's the director of the Center for the Brain and the Environment at Atria Health and Research Institute. He's a professor of neurology at the University of Rochester. Michael Oaken, MD, is a distinguished professor of neurology at the University of Florida, and he's co-founder of the Norman Fixel Institute for Neurologic

Diseases and Medical Advisor for the Parkinson's Foundation. Both have been recognized by the White House as champions for change for their dedication to advancing research, care, and advocacy for people living with Parkinson's disease. There are all these symptoms that are non-movement that actually appear early, and they call them pro-dromal feature. Constipation, acting out your dreams, loss of smell in your nose, those olfactory nerves, gut dysfunction, and changes, and even some of the neuropsychiatric things. For all those golfers out there, is it a risk for people? Should they be worried? Should they stop golfing? What do they do to protect themselves? Individuals who lived within one mile of a golf course at a hundred and twenty-six percent

increased risk of developing Parkinson's disease compared to individuals who lived six or more miles apart. Oh my. Do you know where else they find these toxins? You find them in the breast milk of nursing women and it's all preventable okay you've got someone to walk in your office with Parkinson's disease what do you do sleep is one of the most powerful tools we have for healing and I protect mine like gold especially when I travel that's why I never leave home without my bond charged sleep mask it completely blocks out light something I'm extra sensitive to after long flights or nights in new time zones this mask helps me drop into deep restorative sleep no matter where I am and when I'm in recovery mode, like after my back surgery, it's been an essential part of my healing.

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and resilience from the inside out. You can learn more at bodyhealth.com, and don't forget to use code Hyman 20 for 20% off your first order. All right, Ray, Michael, welcome to the Dr. Hyman Show. So good to have you. Thank you much for having us. Mark. Great to be here. Amazing to be here. You both have come all the way from Florida and New York to Austin, Texas, to talk about your new book, The Parkinson's Plan, a new path to prevention and treatment. As a functional medicine physician doing this for over 30 years, I was like, finally there's these straight up neurologists from top academic centers who get it. They get that we are living in a sea of toxins, environmental toxins, everything from heavy metals to pesticides to plastics

and the list goes on that are impacting our health in real ways and that we have to confront in face as a society. And that the canary in the coal mine, which is another story of the coal mine when they put the canary in it and if it dies, you know, the air is bad and the coal miners have to get out, the canary in the coal mine here is Parkinson's disease, which is what your book's about. For those of you don't know what Parkinson's disease is, I want to let you explain that, but essentially it's a movement disorder where you get really slow and shuffly and you talk soft and it's just like a, it's a very debilitating disease that happens as people get older, but it's happening in younger and younger people because we're living in an increasingly toxic world

that's impacting our health. And not just across Parkinson's, but across everything from autism to Alzheimer's, to cancer, to diabetes, to autoimmune diseases. I mean, the whole shebang, you guys are both neurologists, but as a, what I call myself is a, not a sub-specialist or a super specialist, but as a super generalist. I know a lot about it, a lot of things. And not, like, Not as much as I'd like on many things, but I go pretty broad because I see the patterns and connections between things. And so what really got me excited was that, you know, finally, there's two neurologists who were talking about, you know, how to think about this particular disease, Parkinson's in a different way. And also pointing out that what a dramatic increase we've

seen in the incidence of this disease. It's always been around, but, you know, why all of a sudden is it skyrocketing? Most people think, oh, it's genetics and most diseases are genetic. But the truth is, and Eric Burden said this, who's been on the podcast, and 93% of disease, chronic illness, is not genetic. It's basically the environment influencing our gene expression where we might have predispositions, but we're not predestined to the problem. Also, it was really interesting in literature to me in Parkinson's.

It's one of the few diseases that I've always said, you know, throughout my 30 years of talking, that even traditional health care and doctors and neurologists understand that, that, toxins are a major risk factor for Parkinson's. If you're a farmer, that's the most dangerous occupation on the planet, not because of injury from factory farm equipment, but from the toxins that they are exposed to. So why don't sort of, I guess start with Ray and Michael, just sort of talking to me about, you know, Parkinson's, what is it? Give us a little background on

the biology of it and then the increasing incidence of it. And what you think are the major reasons why we're seeing this, this increasing, dramatic increasing incidents. It's like orders of magnitude. It's not just like a 10 or 20 percent increase. Parkinson's the first major description of the disease was by Dr. James Parkinson in 1817 in London. Yeah, why do these guys named disease after Alzheimer's, Mr. Alzheimer's, Dr. Alzheimer's. He didn't name it after himself. He called the shaking palsies. That other guy, the father of modern neurology named after him. He didn't have an ego. So he's 61. He's a surgeon, actually. And he's actually even a geologist. And he sees something new on the streets of London. Something so new that at 61, he bothers to write a case series.

He basically writes his case series on six people, five, at least five of whom are men. They're all older. And they have tremor, which has long since been described, but they have this stoop posture, this hunched posture, and this tendency to walk faster and faster, and to fall forward. And he said in 1817, this has not been described in the medical literature. Really? This is 1817. So in 1817, Dr. Parkinson says that the disease, became known as Parkinson's, has not been described in medical literature, ergo, I'm describing something new. And this was the beginning of the Industrial Revolution.

And it's the beginning of Industrial Revolution. And where is it? It's in London. Yeah. And air quality in 1800 London is equivalent to what is in Delhi, India today, is equivalent to what was over the New York City with the Canadian wildfires. You remember two or three seven years ago. Yeah.

The sky's turned orange. That was every day, 1800 London. Yeah. So I think Dr. Parkinson is describing the effects of chronic exposure. to high levels of air pollution. And so Parkinson's, we think as... And by the way, it was coal. Coal.

Because coal was what they used to heat and do industry with, and that's full of mercury and lead. Exactly. And so we look in the brains of people with Parkinson's, they have high levels of heavy metal. And so when you look at smog in L.A., for example, you're seeing little pieces of dirt and soot

that are suspended air. The fancy term is particulate matter. Most of them we cough out or sneeze out. But some are so small, less than 1.30th the width of our hair, they penetrate the nerve that hangs down, the response for smell that hangs down in our nasal passages. And hitchhiking on those pieces of dirt and soot

are toxic metals. Wow, so it's a super highway from your nose to your brain. Exactly. It's the front door to your brain. Wow. And it's the blood-brain barrier. You remember from medical school, right, doesn't let let things in.

Well, kind of it does. It's a little leaky. But this is the front door. This doesn't go through the blood-brain barrier. It's just going through the olfactory nerve, the nerve response for smell that. hanging it, and it's hitchhiking are these metals lead from gasoline, iron from brakes, platinum from catalyst converters.

And so people with Parkinson's and Alzheimer's both have high levels of metals in our brain. No one's really been able to explain why, but I think one of the reasons why is air pollution, which is one of the toxins that are inhaled that lead to Parkinson's. Yeah, we're exposed to, I mean, listen, we're exposed to mercury in the fish we eat, lettuce, you know, in their food. And, you know, if you eat a lot of kale has grown in urban environments, it just picks up all the left. You know, what, what you said was so interesting to me about the leaky brain because, you know, when I was in sort of my early years of practicing, we were talking about

a leaky gut. And I used to get laughed at all the time by traditional doctors because they're like, oh, that's nonsense. It's just, you know, you're quack. And for a long time, I've also basically been saying that there's a leaky brain. Well, Michael, you sort of just sort of brought this attention because I think people don't really understand what that is. I mean, leaky gut is when the barrier breaks down and food and poop leak in and affect your immune system and then start to cause all kinds of havoc. And as you mentioned, Michael, Michael, that you basically have this barrier, this blood brain barrier, but it becomes permeable and then all of a sudden things get in from the outside. So it's not like a completely impenetrable barrier. And I think we're seeing increasingly things that cause a leaky brain like stress and many other things like toxins.

So maybe you could talk a little bit about this leaky. brain phenomenon because it's really how the toxins get into the brain that are causing all these problems when you do biopopsies and you're finding toxins and heavy metals in the brains like what's happening yeah and you're absolutely you know spot on when you talk about leaky gut too and it turns out the gut is also a a pathway you know where you can hitchhike in and potentially cause Parkinson as well and we talk about now brain first Parkinson and gut first Parkinson and so this leakiness you know, this permeability to, you know, to stress and other factors that can get across is really important. So if you think about the brain as having like a force field, if you're a Star Wars fan, you know,

it's kind of got like a force field. And we've always kind of taught all the medical students. We've taught everybody in medicine that this is this impenetrable force field. Nothing's going to get through this force field. It's actually not correct. Not only is it not right, but as we develop, you know, treatments and as we develop, you know, different, you know, therapies, we're actually able to defeat the blood brain barrier is what we call it, or the BBB. We're able to defeat that. And it's so super important for us to remember that things can get through it. We can use that for therapeutics. We can also need to be thinking about that for cause and getting to the root cause of Parkinson. And one other thing I do, and even treatment, but one other thing I just wanted to

bring into the discussion. And I'm so glad. that you mentioned the gut is there's a big myth about Parkinson. And the myth is that it's just a brain disease. It's a whole body disease, Mark. And we see it in the gut. You know, we see the proteins in the gut. We see it in the skin. We see it in multiple systems. And so we need to. Proteins that are expressed in the body in Parkinson's. Absolutely. And so. And misfolded. Yeah. And misfolded. I mean, we have twice the risk of malignant skin cancer, you know, melanoma and Parkinson's disease. Twice the risk of osteoporosis. And, and Parkinson disease. This is a whole body disease. And as we think about it, and I love, you know, kind of how you describe yourself as someone that, you know, thinks of everyone, thinks of the whole.

We have to start thinking about Parkinson in a different way. It's not just a brain disease and it's not just the disease of dopamine. There are certainly multiple circuits in the brain. And then, you know, this barrier that we, you know, have, you know, invested so much in in all of our textbooks, we've got to rewrite those. So essentially what you're saying is the encabon. connected to the shin bones connected, the knee bones, the hip bone, everything is connected. And we can't separate out the body into these organs. I mean, it's such an unfortunate problem we have now because as we're beginning to understand the body as a network or as a system, network biology, you know, traditional medicine is organized

according to parts like geography, whereas in your body, your head, is it your stomach, as of your joint, is it your knee, or like whatever. So you've got all these specialists that are specializing their organ, but if you start to read across specialties, you see there's these common themes that are like, implement. mitochondrial dysfunction, oxidative stress, the microbiome involvement, and misfolded proteins, things like all these things you're talking about aren't just about neurology. They're about everything.

And so that's why, you know, you can start to really help people by understanding how they assist you. And we miss it, Mark. Like, so we miss the point and we miss the diagnosis and we miss the treatments and we miss the approaches because no one takes a step back. Everybody's doing their super, you know, specialists. And Ray and I are completely guilty, you know, we're guilty. You know, we're guilty of a lot of things, Mark, but we're definitely guilty of being super specialists, right?

On top of, you know, neurology, which is already a specialty, then we have a subspecialty of Parkinson and Basil Gingley and all these crazy brain circuits, right? And so we have to step back, create navigators for people that are, you know, suffering and, you know, dealing with these symptoms and help to think of this as a whole body disease. It really is. And, you know, we were chitch chatting before, and I mentioned this paper I read, well, like, I don't know, 20 years ago, was in gym, I think. And I forget the exact title, but it was essentially explaining how Parkinson's, the biology of Parkinson's disease and what happens.

And, you know, one of the key things we talked about in functional medicine is the mitochondria, which is our energy system, how we take food and oxygen and combust it in ourselves, and through a very series of steps, we actually can produce ATP or energy that runs the body. And ultimately, the end result of what's happening, And you can explain this probably better than I can, is there's mitochondrial damage,

particularly in the area of the brain we call the basal ganglia, that is responsible for movement. So this is a movement disorder. Tell us about the increasing incidence of this and why we're seeing so much more. It's not just the prevalence, which will grow as the population grows, but the actual incidence of how many new cases per population is actually happening and why we're seeing this accelerate over the last 50 years. Yeah, so when Dr. Parkinson described, he described six people in 1817 with the disease. 2017, the global burden of disease said he estimates six million people have the disease.

How do you go from six to six million in 200 years? Aging alone doesn't explain it. Adjusted for age, the rise of Parkinson's disease is going up 60% far faster than Alzheimer's disease, 60% adjusted for age. Which is shocking, right? Yeah. Did you just say faster than Alzheimer's? And Alzheimer's is very, very fast. It can't be genetics because our genes, you know, don't change, generally speaking.

for just 200 years, so it has to be in our environment. And if you look at a map of the world, areas of the world that are most industrialized, like the U.S. and Canada, have the highest rates of the disease. Areas of the world that are least industrialized, like Sahara and Africa, adjusted for age have the lowest rates of the disease. And areas of the world undergo the most rapid industrialization

and pollution, India and China, have the fastest increasing rates of the disease. And so these chemicals, the ones that are limpcane Parkinson's, are all mitochondrial toxin. means that they damage the energy-producing parts of cells. You know that the brain is only 2% of our body weight, but 30% of our energy consumption is going to the brain. And nerve cells are the chief drivers of that.

75% of energy demands are from nerve cells or neurons. And so these toxicans, whether it's air pollution, whether it's dry cleaning chemicals, if you can believe it, whether it's pesticides, they all damage the energy-producing parts of the cell. Some of them we inhale, some we ingest, some Parkinson's disease begins in the nose, some Parkinson disease begins in the gut, right?

So when Parkinson described the condition, he thought it began the brain. So I'm describing a brain disease. It must begin in the brain. Actually, Parkinson's disease, Pair Borgheimer, one of our colleagues in Denmark says that there are two forms of Parkinson's, one that's brain or nose first,

pathology beginning in the nose, and one that's body or gut first, pathology beginning in the gut. Yeah, interesting. And so these toxin, I said to him, I emailed them. I read all his papers, I print them out on my Sunday evening and Sunday afternoon, and I just read them all. I thought I was in my pen.

And I'm like, holy cow. And I emailed him, I said, well, how does this fit with, like, chemicals that we eat or swallow or ingest, being to a gut first form of the disease and chemicals that we inhale? He was skeptical at first, but we wrote a paper called the body, the brain, the environment, and Parkinson's disease, arguing that Parkinson's that begins in the gut is due to chemicals that you ingest, like well water that's contaminated with pests. decides. Chemicals that you inhale leads to a nose first. Chemicals that you breathe in, like if you live near a golf course, for example, might be breathing in the chemicals. Yeah. Or air pollution will lead to a nose first form of the disease. I co-founded function because people deserve to stay on top of their health in every season. Now, with access to biomarkers impacting immunity, you can see where your body may need backup

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you can join Function at Functionhealth.com slash Mark and use the code Hyman 100 to get $100 off your membership. And that's only for the first 1,000 people this week. After a few major back surgeries, I wasn't sure how quickly I'd get back to doing the things I love, like tennis, riding my bike, and even hot yoga. Recovery can take a toll, and I knew I needed to give my body the best support possible. One of the key things that's helped me bounce back is supporting my mitochondria, the tiny power plants in our cells that make the energy we need for everything we do. When mitochondria aren't working well, our energy, recovery, and even aging, can really suffer. That's why I take mitapure every day. It's a unique, clinically studied form of urolithin A that actually

helps renew mitochondria and keep them functioning at their best. I've noticed the difference in my energy and how quickly I can recover after pushing myself. If you want to support your own mitochondrial health, I recommend giving Mitopure a try. Support your mitochondrial health and save 20% on mitopure. Visit Timeline.com slash DR. Hyman to get 20% off today. What you're talking about is just such an important concept here around the load of toxins and the gut. Yes, we eat toxins from pesticides. and chemicals and ingesting all this stuff. But I think it's more than that.

I read a paper years ago where there was a 400% a four-fold increase in Parkinson's and those people are constipated. And I don't want to scare you if you're constipated. You can fix that with magnesium and probiotics and I've written a lot about that. But that's a really interesting phenomena.

And the, I don't know if you're aware of this phenomenon, but in the metabolic health, there's something called metabolic endotoxemia, which means, in English, that there's bad bacteria in your gut that release toxins, we call them LPSs or lipopolysaccharides, which are like little endotoxins or little poisons produced by these bacteria that we absorb across a leaky gut

that interact with their immune system and cause inflammation, which then leads to insulin resistance, which then leads to weight gain, lends these and diabetes. So I'm sure this metabolic endotoxemia also could be affecting the brain, Not just because you're ingesting toxins, but the microbiome itself is so messed up because of our lack of fiber and polyphenols and probiotics and the use of antibiotics and so on and this gets back, right?

Mark, to this whole thesis of like Parkinson is a whole body disease. You're making the argument for us. And, you know, it's really, you know, interesting, you know, so for almost 20 years, I've been the medical director advisor for the Parkinson's Foundation in addition to being a professor at University of Florida. And when early on, when we started to look at websites, and, you know, you and I and Ray were old enough to remember the early days where you get an analytic and you're like, oh, my gosh, all these people are actually clicking, you know, on these things. Well, we actually used that, you know, in the early days to see what people were interested in searching on the Parkinson Foundation website. And guess what kept coming up, number one? Constipation. You got it, Mark.

I mean, it's just sort of like, my gosh. And so fast forward now, you know, so, so, you know, a couple of decades ago, Ray and I, and I'm always the skeptic of the two, I work a lot in a, in more of a science laboratory setting and developing devices and things. And so, so, you know, fast forward a couple of decades, you know, ago, if you said to somebody, Parkinson's, you know, could be set off by a toxicant or an environment or whatever, people would say, you're crazy, right? And now, as we've learned more and more, we learn about. hey, do you know what? Parkinson actually sets up many years in advance of when you see, you mentioned movement disorder, but there are all these symptoms that are non-movement that actually, you know, appear early. And they call them pro-dromal features.

Just like pre-diabetes, but pre-Parkinsonsons. Ah, exactly, you know, spot on. And so these are things like, and what are they? Constipation, acting out your dreams, loss of smell. You talk about the hitchhiker, you know, and, you know, in your, in your nose. olfactory nerves, you know, gut dysfunction and changes, and even some of the neuropsychiatric things.

So when you see middle-aged men now, there's a study in Parkinson showing middle-aged men in their 50s suddenly start to get anxious, right? They've not been anxious before. That's, you know, they may be the beginning of developing Parkinson symptoms. This is a whole body issue that's going on. And so I think it's important to keep those perspectives. But there's nothing crazy about constipation, Parkinson and how it ties in. Well, it may be both a cause and an effect, right? Yeah, both. It's like, you know.

So, exactly. So I think it's actually an effect of the toxin. So we mentioned that the toxin can be ingested, right? And so you know the enteric nervous system, which controls the gut motility. That's the gut brain. The gut brain. And then the highway that connects the gut to the brain is the biggest nerve. Vegas nerve.

How am I doing, Doc? We're doing good. You're doing good. So in 2003, in 2003, a German pathologist. really smart guy, Hico Brock, says Parkinson's disease, the pathology does not begin the brain. He said the Parkinson's, which you consider a brain disease, does not begin the brain. He says, I first see the pathology in the olfactory bulb, the smell center of the brain, or in the dorsal motor nucleus of the vagus. So he says the pathology of Parkinson's begins in the gut, and it ascends up, like, this most folded protein, like a fall of dominoes.

This misfolded protein spreads from one nerve cell to another and goes. goes from the gut, up the vagus nerve, and then up from the vagus nerve to higher parts of the brain that are responsible for sleep, for controlling our blood pressure, and then only later to the part of the brain, the basal ganglia that you were talking about earlier. The constipation is actually probably one, is a sign that the pathology is affecting, for example, the vagus nerve, and we're getting reduced gut motility. Is it over-active sympathetic activity? Well, it's the damage to the to the parasympathetic things. So you got over-exemptive. For those listening, you've got the fight-or-flight response and the relaxation response,

the sympathetic nervous system, the parasympathetic nervous system. And what you're talking about here is the parasympathetic nerve that keeps you calm and relax. That's why anxiety increases actually stops working as well. And you get a relative increase in the sympathetic nervous system, which then when you're running from a tiger, you don't want to be pooping. So your gut shuts down and a whole bunch of other bad stuff happens, right? You got?

I personally, I'm waiting until I'm like 90 or 100 to start golfing because it's kind of kind of slow for me. But I play tennis and they live seven years longer. But anyway, for all those golfers out there are no criticism, there's a tremendous amount of toxins sprayed to keep those golf courses looking so great. Is it a risk for people? Should they be worried? Should they stop golfing? What do they do to protect themselves? For sure, don't lick your golf balls, which I know people do to clean them. Tell us, like, if you're a golfer, WTF. So Dr. Prytony Krasnowski is a geographer. She's the Baroneurological Institute, and she worked with her colleague, Dr. Rodolfo Savica, one of our colleagues of Parkinson's Specialist, the Mayo Clinic in Rochester, Minnesota. And she was concerned about the effects of living near a golf course because golf courses used huge amounts of pessimists.

And a lot of people live on these golf course communities. And a lot of people live on these golf course communities. So she looked at Rochester, Minnesota, which has a very good job of measuring new cases of Parkinson's disease. And she found that individuals who lived within one mile of a golf course had a hundred and twenty-seven. 6% increased risk of developing Parkinson's disease compared to individuals who lived six or more miles apart. Oh, my. So why?

And so she spends a lot of time in her paper discussing water supply. And so we talked a little bit about how pesticides can get into the water. For example, people who drink well water, not really by the Safe Drinking Water Act, prone to contamination from nearby farms and rural areas have a higher risk of developing Parkinson's disease. So she's focused on that. I worry a little bit about the pesticides that are sprayed into the air. There was a small little report in the analysis of neurology that two neurologists found that

18 of their patients lived near a golf course and 15 of the 18 lived downwind of the golf course. So I worry about pesticides being sprayed on golf courses or on fields and people living downwind and inhaling them. We talked about how many individuals, most individuals perhaps, Parkinson's begins in the nose. so I worry about nerve toxins being inhaled into the nose. So what to do? Pickleball. Pickle ball.

You know, why can't we ask golf courses? Pickleball is one of those dangerous sports. You know, so many people who are short of shape. Listen, that's a whole other discussion. Are filling the emergency rooms with pickleball injuries. I have a whole pickle ball for Parkinson talk so we can talk about to keep people safe on the pickball. Back to the golf. So ask the golf course what pesticides they use, see if they can use less.

toxic pesticides, right? Can they use less? Can they tell you when they're spraying, right? So you can take interventions, especially if you have Parkinson's, maybe, you know, get out of town when they're spraying. You can close your windows. You can get an air purifier. These are all things. You get like an air-conditioned golf cart? Well, you can go ahead and don't drink the water from the court. And it turns out not just living near golf course has been an increased risk. Three different studies have found green space workers, including landscapers, to be at higher risk for Parkinson's. and one study found that green space workers are a higher risk for ALS or Lou Gehrig's disease. So there are lots of clues of what's causing these brain diseases, whether it's Parkinson's, Alzheimer's, or ALS.

Lots of clues telling us that this is a preventable disease and lots of clues saying that if we pay attention to our environment, like Rachel Carson said we should. But realistically, like, can people really, like, reduce their exposure if they're out on a golf course for 18 holes? Well. Like, isn't it just in there? they're going to be walking on it, it's on their shoes, it's on their clothes. It's like, I'm like you, I'm not a golfer, but I can't imagine that golf courses couldn't be using 50% less pesticides. They're organic golf courses.

There are, actually. In Martha's Vineyard, they have organic golf courses. If we have organic wine, we have organic produce, if we're organic cheese and dairy products and meats, why can't we have organic golf courses? Why can't we enjoy a nice sport without having to worry about getting a park? Maybe we're going to get President Trump on this. Regenerative golfers. But practically.

speaking, you have a right to know. So ask the course, when do they spray the pesticides, right? Maybe you don't want to play right after they've sprayed the pesticides. Watch the water that's there, get a carbon filter, maybe bring your own water. And when you're smoking, for those of you that smoke, I'm not saying you should smoke. When you smoke your stogie and your cigar, don't put it on the ground like while you're, you're going to hit the ball and then pick it right back up because you're going to put pesticide in your mouth. Thank you. Thank you. That was a good answer to a hard question, which still feels like a bit scary to think about golfing. But anyway, for those of your golfers out there, just take care of yourself, get your liver working, and reduce as much exporters as you

can. I mean, this is just such a great conversation because I think I'm like honestly pinching myself because I feel like, you know, I wrote this book, you know, how to fix your broken brain by fixing your body first. And here you guys are neurologists starting to talk about these things. And usually neurologists pay no attention to anything but a little neck, you know, which is just dumb. Guilty. It's just, guilty. And no, it's like, Like, you know, you can't ignore the science anymore. And here you are two of the most esteemed neurologists in the world who've written collectively, I don't know, a thousand papers and many books and have led organizations and advised governments

and done everything. And here you are going, holy crap, you know, maybe we're living in a stew of toxins, and that's a big factor. So let's talk a little bit about the biology. And then I want to go into the toxin story. and how you kind of came up with this because I think it's important to understand that there's fundamental biological processes

that occur in the body that are common to most diseases. And where it hits you depends, I think, on your genetics and who knows well, we still don't understand. But like the phenomena of, you know, mitochondria, and you mentioned, you know, the brain has a lot of them. Every cell in the mitochondria has, sorry, and the brain has more mitochondria

than any other cell, the heart cell is next. So even more than your heart, your brain has more mitochondria. And they're very sensitive. They're little creatures. They're like little bacteria that we kind of co-evolve with a kind of hitchhiked in our cells, produce energy for us, and we can make them have a home and it all works out. Embiotic, really.

Yeah, and the problem is that they're very sensitive to insults. So from your microbiome, from toxins, from stress, from, you know, inflammation, from food, from infections, from, I mean, why do you feel like when you had the flu or COVID, like you can't move when you're tired and you have brain fog? Because your mitochondria are being poisoned, right? But this chronic low-level toxicity is something that is not been really accepted by traditional medicine. It's like, oh, you got acute poisoning, you come to the ER, you know, we'll give you something

to fix that. But most traditional physicians just dismiss the idea that low-level toxins are an issue or that there's anything you can do about those. Can you talk about how you kind of first discovered this and a little bit about the sort of the insights that led you to realize that this is really the big problem? Michael and I were both very, very traditional academic neurologists, and you know, I went to the oldest medical school in the country, and, you know, we're not told a lot about toxins. We're told a little bit about lead. We're told a little bit about asbestos. We're told a little bit about mercury. We're told a little bit about smoking, which we'll get to in a second. But we weren't taught to generalize this beyond the specific disease. And only acute. And not related to any chronic illness. If you're poison, you're poison, otherwise. They'll talk about asbestos and mesothelioma and stuff like that. But, you know, it was, it was narrow.

So I had the gift of a sabbatical. I'm an academic. I was an academic, so I had the gift of a sabbatical about eight years ago, and I devoted it to reading the papers of one of my colleagues, Dr. Caroline Tanner, who's at a neurologist and an epidemiologist who's now at UC San Francisco. And for 40 years, she's been quietly, diligently telling us that chemicals in our environment are fueling the rise of Parkinson's disease, whether that's air pollution, whether that's pesticides, whether it's a dry cleaning chemical called trichloroethylene.

she's been telling us that these chemicals are causing it. So I'll give you an example of chronic exposure to a toxicant. Lung smoking and lung cancer. So in 1900 United States, there is almost no lung cancer. Lung cancer, the leading cause of cancer death in the United States around the world simply just did not exist in 1900. Yeah. It was so odd. It was considered a once-in-lifetime oddity.

All the doctors and medical students would gather around when they saw a case, thinking they'd never see a case again. attacks and diabetes and autoimmune diseases, right? These diseases just didn't exist. And it wasn't until cigarettes, that 25 years after an introduction of cigarettes, you got a corresponding rise in lung cancer. In United States, we stopped smoking, decreased smoking in 1970s, 25 years later, corresponding. So the challenge with these diseases is that it's not an acute exposure and you get the disease. That's much easier to identify, right? You take too much acetaminophen and you get liver toxicity, you know, it's a lot easier to make that relationship. With smoking lung cancer, which connection really wasn't made in the 1950s

because there was a 25-year lag between the exposure. And now we're seeing the same thing with Parkinson's. You don't get exposed to the pesticides as a farmer and develop Parkinson's the next day, next year, next decade. It could be 25 years later, 30 years later. They did a study at Camp Lejeune, which is the marine base in North Carolina, containing with this dry cleaning chemical.

The Marines were exposed at age 20 to the chemical in their drinking water. dry cleaning like from their uniforms yeah so there was a there was a dry Marines need a dry clean their uniforms there was a dry cleaning base ABC dry cleaners on the base that inappropriately disposed of their dry cleaning chemicals got into the drinking water for the Marines at Camp Lejeune the Marines even knew about it in the later years but for 25 years a million Marines their family and civilians were exposed to a cancer-causing chemical in their water that's since been linked to Parkinson's Dr. Tanner and her colleague, Dr. Goldman,

looked at the Marines. What was that chemical? Tri-chloralethylene, T-C-C-E. Yeah, yeah, you wrote a paper about that. And they looked at the Marines who were 20 years old when they were exposed. They were only there for 25 months, right? If you're a Marine, you move from base to base. Yet 34 years later, they had a 70% higher rate of developing Parkinson's disease.

So exposure to toxicants when you're young, some of them were teenagers. When you're young, sets the stage for developing a neurodegenerative. genitive disease, 34 years late. So, true, I mean, I was sharing this story before I had a patient early on, which sort of clued me into a lot of this stuff, who was about 50. And that's pretty young to get Parkinson's. And she came in with Parkinson's, and, you know, I took her history. And, you know, in functional medicine, and we do, we start, like, with what did your

mother eat? And what was her, like, in uterog environment like, and, like, what was your first year like? And we go through the whole thing. And she was like, yeah, I lived in the Bronx, and we were very poor. and I you know we were lived in this cockroach infested apartment and the cockroaches would crawl across me at night and it'd freak me out and so when I married and you know had a little more means that we moved to Long Island and I just had the exterminator come every week inside and outside and

by the way I have a barrel of lindane which is a banned pesticide and that is so bad I was like this is this is a big deal. And then, you know, you start hearing of farmers are the most dangerous occupation, start to kind of start to dig in and you see what's going on. But I've also had patients who are exposed to other things that can, like, mold, which can be a toxin, or or even tick infections, you know, which you wouldn't think, but do contribute. So it's a whole host of things together. And I think, you know, we talk about the effect of toxins on your neurology, but, I mean, Rachel Carson talked about it on fertility. There's a book called Our Stolen Future I read, again, two or plus decades ago.

Sean a Swan wrote a book falling down. You know, Colburn about the effect under reproductive health and the change in fertility rates. And, you know, I mean, it's, it's, I just did a whole talk with a Stanford urology professor about the declining rates of male fertility and what are we doing about it. And it's all, it's affecting everything. So tell us about the most common toxins that you found are associated with them. Where do we get them? And how do we start to think about, like, avoiding them and dealing with this?

There's a pesticide called chloropyrifos that used to be found on over half of apples in the United States, widely used on golf courses, utility pools. It turned out that chloropuraphos was used to kill insects and apartments in New York City. And this amazing scientist, Virginia Rao at Columbia University, looked at the children of women born who were. were in the homes that were sprayed with this pesticide. She finds that pesticide in the umbilical cord blood of the children in whose moms were sprayed, the homes were sprayed with is chlorpyrifah. The higher the level of the pesticide in the umbilical chloride blood, the lower the IQ at 3, 5, and 7.

Yeah. And then two weeks ago, she follows them out to 6 to 12 and she does MRIs, and they have structural brain abnormalities and they have slowed motor function. In the lab... And these are developmental issues that kids experience as a result to being exposed

to these cockroach pesticides that are used commonly in the homes. In New York City, they're no longer allowed. And then she also found in addition to having structural brain abnormalities

on their brains as early as six years old, they have slow motor function. In the lab, that pesticide damages the dopamine-producing nerve cells that are lost in Parkinson's.

Which is the basal ganglion cells, right? Yeah. So pesticides as a whole is one is the, certain pesticides had the most robust evidence for their role in Parkinson's disease. One of the Parkinson 25, Mark, we talk about is don't poison yourself. It seems like a no brain or no pun intended, but, you know, don't poison yourself. It's hard, though.

I mean, we, we, you know, I'm on the board of the Environmental Working Group, which is a great organization that has done a tremendous job to catalog, identify all of our exposures across food, across household cleaning products, skincare products, you know, meat, fish, vegetables, and it really provides a very good guide on, that's evidence-based on how to reduce your exposures, filter your water, air purifier. We can talk about all this stuff.

You know, what's really sort of concerning is that these toxins, you know, are found everywhere. That the average newborn has 287 toxins in their umbilical cord blood. This was a study done by the Environmental Wingrable. They took 10 newborn babies, and there was like stuff like DDT that's been banned or dioxin that's been banned, which is Agent Orange. Which is really bad for Parkinson, those two, by the way. Wow.

So the toxic exposures are pretty ubiquitous, and it's hard to get rid of. And there was a big study that was done of the children of farm workers in California, and they collectively lost 41 million IQ points. So it's just exactly what you're saying. Exactly. And some of these toxins are so small that they cross the placenta, right? they go into the child and some are fat soluble so you know your brain's covered in fat do you know where else they find these toxin they find them in the breast milk of nursing women you know i i know

that and it makes me so sad and you know i'm not a designer and engineer but if there's any geniuses out there and want to design a good breast milk filter that would be a huge food to humanity because breastfeeding is still the most important thing you do to keep your kid healthy and you know, you're, I mean, we're already born pre-polluted, right? So the question is then, you know, it's the degree, the amount, and you can, if you take a good history, you can actually really find out what people's exposures are, right? And it's all preventable, right? This is all, this is what your book, right, forever, this is all preventable.

We need not have DDT. We no longer have DDT. We got rid of lead and gasoline. But we made progress. We lead levels today, right, are 95% lower in kids than when you and I were children. are smarter because we got lead in gasoline and lead out of paint. And the world did not spin off its axis, right? The air quality in Los Angeles today is 50% better than it was in the 1960s when

Governor Ronald Reagan said we should eliminate all unnecessary driving because you couldn't see across the street just like you were talking about China. That was 1960s Los Angeles. We fixed our ozone hole because we got rid of CFCs. If we get rid of these chemicals, we get rid of a lot of autism, we get rid of a lot of ALS, we get rid of a lot of Alzheimer's disease, and we get rid of a lot of a lot of. lot of Parkinson disease. The central thrust of the book is that Parkinson's disease is largely a preventable disease. Is a product of the Industrial Revolution and chemicals in our food,

water, and air? We get rid of these chemicals in our food, water, and air. We get rid of Parkinson's we create a world like 1817 or 1717 when there is no Parkinson disease or it's extraordinarily rare. I only have one word to say to that. Amen. It is a big lift because the industrialization of the world and the amount of chemicals we use, we all benefit from. And it's really tough to start thinking about how do you re-industrialize to remove those? How do we reduce our exposures? I don't remember there was a World's Fair. I was living in Queens in 1965 when they had the World's Fair, and I went to it, actually,

because I lived in Queens. And they had DuPont up there, and they were like, better living through chemistry and all these Teflon and all these things like the PFAS chemicals. I just did my function health testing, which is, a company I co-founded. And one of the things we offer is PFS for forever chemical testing and phenylase testing and heavy metal testing. And it's hard to test toxins because they're fat soluble.

But it's amazing how polluted I am. And I'm like, I'm a guy who tries to be careful, you know, like, and glyphosate levels. And I mean, I eat out and what can you do? Like, it's just, it's really tough. And there's a reason when 31 children have autism. There's a reason that more young adults are getting colon cancer, right? When we were in medical school, I mean, no one got. colon cancer unless you had a rare genetic cause. No one got colon cancer before 50, right?

No. Why do one in eight women get breast cancer? Why do one in eight, one and ten men get prostate cancer? Diseases have causes. And why is it not uncommon to see young people with Parkinson? You said young people with Parkinson maybe that's rare when you were describing the person they met. Not so rare. You know, we're seeing lots of young cases. And in fact, you know, it does increase as you age, you know, over time. But we see people in their teens, 20s, 30s, 40s certainly gets more common the longer you live but um but this is something that another myth that should be busted for people that this isn't just a disease of uh of i don't like to say older i say more seasoned this isn't just a disease of more seasoned people what you're both saying is it's just so important ray what you just

said uh i want to just double click on because you kind of went over really fast diseases have causes now you would think in medicine that that's what we pay attention to but unfortunately it's not. What we pay attention to is what I call the name it, blame, and attainment game. We name the disease by saying, here's the symptoms, here's the science, here's a lab test, here's the imaging results that explain that you have this pathology. So we focus on the symptoms and the pathology we can see in the microscope, but not on the cause or the mechanism. And so by understanding the mechanisms and the causes, you can really do something. And the other thing was struck with Ray, you said, the brilliant thing you said was cancer, you know, autism,

Alzheimer's, and the list could go on, autoimmune diseases. Now these toxins are called autogens, obesigens, obeseogens. These are toxins that cause obesity, toxins that cause autoimmune disease, toxins that cause neurologic disease, toxins that cause cancer. So, even heart disease. But unfortunately, if we're really being honest with ourselves, if this is true, and it's clearly increasingly true, the evidence just mounting every day about the role toxins across all diseases. What do we do about it other than reducing our exposure? So we'll talk about that. And I want to talk about, like, medically, what can we do? Therapeutically, what can we do? And again, it may not be your guys' expertise is what I've been

for years, but we can kind of jam on it a little bit. But I'd love to hear your perspective on this. You know, I'll just say, first, for people that are listening, they should know that we should be embarrassed that we spend just two cents out of every dollar on prevention, right? And so it shouldn't be a big surprise that we haven't done the trials, we haven't done the research, and we haven't looked upstream. And so the L, so the P and the Parkinson Plan is about prevent. The L is learning why we got to look upstream, right? And I just want to go back just for a moment and something that you said that resonated. And we had done an interview in the book and we talked to Buzz Jenna at Emery and Matt LaVoy at University of Florida. And talking about how, you know, one of the goals

here should be the zenness of the cells in your brain, right? And we call it. The zenness? Like Z-E-N? Z-E-N. And we call it the zenness. Like a Zen Buddhist. Yeah, because, you know, again, you think about, okay, so it's, in scientific terms, we say homeostasis, right? But, but, you know, for purposes of talking to a population, we're talking about how zen are your cells, right? And so you have, you know, a group of circuits and a group of cells that are in the brain, and it's like a thermostat. And what happens in your house when your thermostat goes out, you know, or that things, right? And then, and then you end up with, you know, real problems. And when you do that over prolonged periods of time, that's an issue. And so when we talk about both the prevention

of Parkinson, but also the treatment of Parkinson, Zen is an important word. So we talk about, you know, you want to keep yourselves then. And we know that when it comes to toxicants, we know that they tend to go to the mitochondria and other areas in the brain. We know that the brain has to get rid of things, right? It has, it's like a garbage disposal, right? And that's normal. It has, actually, there are cells that, you know, that have to eat themselves, right? You know, in order to stay healthy. Autophagy, right. Autophagy. So, you know, so it's really important. And then we discovered a system in the brain. We didn't even know exist. The glyphatics is. The glyphatics, man. We're like a mad look. Now we understand how important these things are. And then you

start to say, ask yourself, okay, we got to know why, learn why. So we got to look upstream, right? We got to understand why does a disease start? Why does it spread? Right. Why does it progress, right? Those are key elements so that you're not looking downstream. You talked about the canary in the coal mine, everything. We need to understand those things. And actually, that's why prevention is so important and so important for us to think about because we're thinking as far upstream as we can. And we also need to shift our science at the same time to be thinking more upstream and to be thinking. So when we talk about a few pennies on every dollar, we're also, you know, need to shift our basic science, you know, to be thinking about these systems and the

systems that are in place early on. When you look at a toxin and you say, okay, everybody's listening here. Let's, we got the toxin. You know, I've been the medical director, advisor for the Parkinson Foundation. Mark, just get rid of the toxin, right? Just get rid of it, right? Well, there's an acute exposure, right? It's an acute exposure and a chronic exposure over time. And then you take something like Paraquot, which has been in the news a lot, like a pesticide that sprayed. And by the way, you know, it's doubled in use in the United States here. Weed killer that sprayed on corn, cotton, soybean fields, and it doubles in use. And it's banned in 32 countries or over 30 countries, you know, and Great Britain ships it to us, but they won't give it to their own people, you know.

I mean, so you look at known toxins like this. Well, it's a challenge, right? Because Paraquot gets into the system quickly, and it goes quickly to the mitochondria. It goes quickly to these systems, and it clears quickly, and it hits your lungs. It hits your brain. It hits all of these things. Hard to measure, right? So we're going to need primary prevention to just step up and get rid of that.

Well, this is a political problem, right? This is an EPA problem. So the prevention isn't going to be a pill. It's going to be a policy. Prevention is going to be policy, not a pill, right? I love that. Prevention is going to be policy, not a pill, 100%. The fall into winter seasons is when our immune systems need the most support. It's colder, stress ramps up, and we're exposed to more challenges.

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We're hoping you're going to fix that. The lack of attention to detail on the speed of which it was done meant a lot of the links were all messed up. But that, the basic framework and content was right. And one of the things that had produced was like 40 or 50 pages on the role of toxins in health. And it got removed down to just a paragraph basically saying, well, pesticides may be an issue, glyphosate may be an issue.

But the science really doesn't show it yet. So we don't really know. So forget about it. And that was like, so disappointing to me because there were a whole bunch of scientists that worked on this project that actually documented this. For generations for their lives. So it's really, you know, we've got the agricultural and industrial complex, which is a real thing

that even the government is actually supporting indirectly through crop insurance and subsidies, which then are used to buy the agrochemicals that then are used to spray, that then are used to, you know, help the crops and help the farmers, but ultimately hurt them. And I think hurt the farmers most and hurt their families and then the rest of us downstream. You know, we have to kind of go from field of fork on this. We have to go from, you know, factory to our closet and to wherever we have to figure this out. And it's not going to be easy, but the problem is that there's such a dearth of research, really, on funding this.

There's also, I think, a real lack of research on what to do once you have the toxins. And this is, this is an area that's sort of been on the margins of medicine. I want to get into it in a minute with you because it's like you can go to the environmental working group and you can kind of read their stuff and get a pretty good sense of, okay, here's the vegetables I never want to eat if they're not organic. Here's the fish I never want to eat unless, you know, like unless it's ever, like, I'm not going to eat shark, I'm not going to eat swordfish. We're all like cesspools and the question that becomes is you can do all these things

and you don't drink out of plastic bottles, filter your water, have an air filter, eat organic when you can, you know. These are all things that you can do, have better skin care products, household products, that's that's easy the hard part is okay you've got someone to walk in your office with Parkinson's disease who's been exposed to chemicals exposed to heavy metals what do you do um so first of all we're all assessables and we're all victims right yeah yeah yeah but some people take it take it i don't mean i know you don't but like we're all victims right these are unnecessary these are involuntary yeah right these are involuntary if you're drinking like a six

pack of soda every day you know what you're doing yeah but like you're But the Marines at Campbell's June didn't know that they were drinking and the burn pits and the Asian orange and the list goes on and on. And people who work with these dry and cleaning chemicals, they don't know. Many of the farmers don't know that the pesticides are linked to Parkinson's. The vast majority don't. So the first thing you do is stop getting exposed.

So if you are a smoker and you get diagnosed with lung cancer, what's the first thing the doctor's going to tell you to do? Stop smoking. Smoking. But if you're a farmer and you're coming with Parkinson's. Not farming. I mean, like, do we even... I have a patient with ALS as a farmer, and he, you know, it's heartbreaking because it's

one of those, again, when those neurologic diseases is caused by toxin. And sometimes you find it early enough, you know, we could maybe stop it. Yeah, no, I stopped it and reversed it with him. So there are ways that we can do this. So if you're working with Parkinson's, we give you in the book, the Parkinson's 25, 25 actions that can reduce your risk if you don't have the disease, if you're one of 330 million Americans who don't have the disease, we give you 25 actions to reduce your risk of ever getting Parkinson disease, ever getting it.

If you're not exposed to these chemicals, you are highly unlikely to ever develop Parkinson's disease. And if you already have the disease, they might slow the rate of progression. So I'll give me an actually concrete example. They looked at people who already had Parkinson disease, and they looked at people who lived in highly polluted areas of the country and those who lived in low polluted areas. People who lived in highly polluted areas had an increased risk of being hospitalized due their Parkinson disease if they lived in areas with high air pollution.

So you got an air purifier in the corner. We can get an air purifier when you're driving through traffic. They're just for you guys. Thank you. When you're driving through Lincoln Tunnel, you know, roll up your window. Put the recirculation on. Exactly. Recirculate the air.

If you happen to live near fields that are being sprayed with pesticides, you know, close your windows. I mean, there are lots and lots of things that we can. I hold my breath while I felt my gas thing. I literally, I hold my breath. I like. And, but we need to create a world where we don't have to take all these actions. So what are things that we can do in our community?

Can we stop spraying pesticides on kids, schools, and playgrounds. That would be a good idea. Right? And we wonder why one in 31 children get autism, yet we spray nerve toxins on their schools and playgrounds. What did TX actually said when you heard of the theory of evolution? How stupid not to have thought of that. So there are lots of things in our communities that we can do, and what are some of these societal actions that we need to do? And I'll let you talk about additional ways to address. Well, so the other thing is that if you awareness is important. Yeah. If you're a smoker, you know, what's the first thing you do? You know, if you get lung cancer or whatever, stop smoking, right?

So, so, so, you know, this idea that, you know, you, you, once you have the disease, okay, or once you have the diagnosis, that you stop, you know, with these things is sort of another myth that needs to be busted, you know, it is the way that you live. You even talked about some of the people that you see within the functional medicine, you know, you know, in that paradigm, you're thinking about how can we help people to live better, right? Yeah. So the global burden of disease study told us something. This is for those who don't know.

That's like 195 countries, a study of chronic illnesses all across the world. It was a large epidemiological study, one of the best ever done, and it gave us a lot of information about who's suffering from what, where. So just so people know what it is. Yeah, so 100%. So back in 2012, I had written this book, 2013 or something I can't remember now. But we wrote a book called Ten Secrets to a Happier Life with Parkinson, and it kind of became this runaway bestseller. But it was like 10 simple things that you do, right? And in the prologue of the book, I made either the unfortunate or the fortunate choice of two words called the Parkinson pandemic and came under

a lot of scrutiny from colleagues and everything. And rightly so, right? I'm a scientist I should be able to take it. Turns out you're a prescient. Well, you know, so I'm like you have to put it forward. You have to, you know, these things need data. So then we write the book ending Parkinson's disease in 2020. We have the first cut of that global burden of disease data. And guess what? Ray's better at math than may. He crunches all the numbers. And it turns out by 2035, we should have 12 million people with Parkinson's, which is like, wow, growing faster than Alzheimer's. So like percentage-wise, how much of an increase in that is like in 50 years? Oh, well, and just in 1990s, it's estimated that 2.8 million people have the disease. And I'll steal a little Michael's punchline. In 2021, they estimated

that 11.8 million, a quadrupling, a quadrupling. Adjusted for population to... So if you adjust for population growth, right, the population growth hasn't quadrupled between 1990 and 2020. No, but it's still two or three or plus times the amount. All in just the last 30 years. After medical school. Yeah, right? You're supposed to have 12 million mark in 2035.

How many do you have today? 2025, 11.8, according to you already got the 12 million, 15 years before we thought it was going to happen. And when you went to medical school, you know, Parkinson's was there, but it wasn't like everywhere. Oh, no, no. I mean, I've seen so many people with it. But now, like, anyone over 50, if you're over 50, you have friends, you have family members, you know, our inboxes are, like, it doesn't stop. I walk the streets of New York, and I'm like, Parkinson. And when I see them, I get pissed off. Why?

Because it's a terrible disease, and I think it's largely preventable. Yeah, yeah. Right? Suffering that's part of the human condition, right? You write about this, but preventable, needless suffering, really? Yeah, I agree. I think that's our goal. I mean, for me, my life goal is to prevent needless suffering because, you know, we can't change everything. So just for the audience, what are the air, food and water things that they can do to reduce their exposures? So we give you the 25 recommendations in the book. I'm going to read you number one. Wash your produce, even your organic ones, marking you know this better than we do. Pesticides have contaminated our food supply. Remnants of pesticides are found in 20% of common foods. Organic produce, dairy products, and meat can reduce exposure, but can still have unsafe residues of pesticides. So wash your produce at least with water and consider simple vegetable washes, vinegar,

or salt solutions too. When the government measures the pesticide residues on a piece of fruit, they do that after they've held it under cold water for 15 to 20 seconds. If that's what the government's doing, think about what you should do. I'll do the second one. I'll give the last one to Michael. Number nine, use a water filter. A simple carbon filter, water filter, widely available in supermarkets, can reduce exposure to pesticides, volatile to organic chemicals like trichlorathleen, and other chemicals that may be in your water.

These carbon filters can be installed for the whole house at the point of entry or at the point of use, such as faucets or even water pitcher. My colleague at Atria Health and Research Institute, Robert Kachko, will tell you reverse osmosis is even better. And I'll let Michael maybe take number 10. Yeah, so, you know. Yeah, I do reverse us, but in terms of your air, you know, number 10 is consider air purifiers. They're an easy, effective way to lower your risk of disease from indoor air pollution. Air fire, air purifiers do a range in cost. They can be as little as $10, as high as $1,000.

I'm sure the one Mark Howes Us Breathing here is got to be the $1,000. No, it's not actually. It's $300. All right, 300 bucks. And require periodic cleanings. And remember, they need filter changes and they may need to be installed in multiple places depending on the size of the home, school, or workplace. Be sure to use air purifiers that have carbon filters.

They're designed to remove the volatile organic chemicals, VOCs, like trichloroethylate, which you all know from dry cleaning story and everything is so important in Parkinson. This is great. So these are simple things that people go into every day. I have an air filter in my bedroom, and in the place I spend the most time,

I have a reverse-husmosis water filter. You know, I think those are the two most, simple things you can do at home. Plus, go to eWG.org and make sure you clean out all your crappy household cleaning products and your skincare products, and you'll get like 80% of the way there. And a shout out to Ken Cook, the outstanding leader of the environmental working group. He and his team are helping us understand the role of these chemicals in our environment, in our health, and how to get rid of them.

You know, we could talk about, you know, the role of toxins for a long time. But, you know, we kind of covered a lot of the sources. But I kind of want to spend a little time on people who, actually have Parkinson's and who are struggling, you know, there's been really shitty drug development in this disease. There is some really exciting new surgical interventions, the deep brain stimulation, you know, Dr. Machado at Cleveland Clinic, who I worked with was one of the pioneers in this, a neurosurgeon. And I, this guy's one of the pioneers right here. Yeah. You, obviously, I read your work has been, has been very involved in this. And that's a huge boon.

It's a, it's a big win. But it doesn't address the, it's just like a downstream sort of better mousetrapped to fix the problem, but it's actually, we still have the mice. I would love to hear from a perspective from like a diet, lifestyle, supplement, detoxification, what you guys know, I would love to sort of unpack what people can do. And can, in the answering of that, can you actually reverse it or stop it? Because right now there's like clinical trials, for example, in Alzheimer's, like the finger trial, the pointer trial, Richard Isaac's its work, where they're showing not just slowing down to the disease, but actually reversing it with intensive lifestyle therapy and

misfactor management. So do we see that in Parkinson's? Have you seen that in Parkinson's? You've guys like Delbridescent, who people think maybe a little bit off the rails, but honestly he's not reversing Alzheimer's. I just talked to one of my patients two days ago who I've been treating for two years and she was diagnosed with Alzheimer's and now she's better and back to work. Let's let's unpack a little bit. And let's just start with sort of, you know, a few P's. So we need to change the way that we practice when we interact with folks with Parkinson. You know, it needs to be practical, proactive, and preventative. Okay, we need to be thinking of those three P's when we're interacting. And I know. You might for that one. Personalized. Well, personal. We can keep going with P's too. And,

but, but absolutely, although I will say just, you know, like in general, you know how people make things a little too cliche. Sometimes people say personalized and that's going to cure everything. I say, well, what does that mean? Well, the reason I say that is, is because if you have a diagnosis of Parkinson's, it doesn't mean you know what's really wrong with you. Like I always say, if you know the name of the disease, it doesn't mean you know what's wrong with you. You don't know the cause. You know the name of the symptoms, which can have many causes. So Parkinson's disease, here's another myth. It's not Parkinson's disease. It's Parkinson's disease is, right? There are multiple causes. There are multiple syndromes. No two people look alike.

And I remember sitting next to Davis Finney and the White House having a nice discussion with him. And, you know, he said when you have Parkinson's, you got to make every day your best day. That always stuck with me. And then when I made my comments, you know, I said, you know, I think Parkinson's is probably the most complex disease in clinical medicine. And I just, I don't mean to insult other people in different diseases, but think about it. You know, you know, dozens and dozens of motor tremor, stiffness, slowness, non-motor symptoms, anxiety, depression, constipation, sleep, cognition, right? So you've got all of those things, right? Plus, you've got this miracle drug, dopamine. You give people dopamine, they wake up, right? And then, of course, there are fluctuations later. Then you've got, you know, as you mentioned, deep brain stimulation, you've got dozens of different medications. Oh, and by the way, it changes over time. People wear off. They get these dance-like movements. It is a super complex disease, okay? So when you take all of that, we need a different paradigm to care.

And so unpacking the first part of your question is we're doing it wrong, Mark. Like we're caring for people wrong. So when we have HIV, we're able to create navigators. We're able to check people as viral levels. We're able to get people, listen to this, mind blowing for people. We can get really expensive cocktails of drugs for people all over the world who have HIV. I get al-dopa for. And you can't get al-dopa for any.

pennies on the dollar. So we call for that as a bold action in the book. A hundred percent of people on this earth, on planet, if anybody's listening, you know, we need to have. And al-Dopa is the drug that's the main save for Parkinson's treatment that increases dopamine, which is what gets depleted in the brain when you have Parkinson's. And it's a game changer, right? And so super important to think about that. And cancer, we do better in the way that we bring together the right teams. So thinking about this, we proposed, we used to say the person with the disease or the is the sun and we revolve around the patient. I'm like the the broken record of saying this for 25 years at the institute I work at called the fixel. And now we've expanded that to be the Parkinson

universe. And let me just explain that for people listening a little bit. So of course the person with disease is the sun and we should all orbit around them. But what's the closest planet to the sun? Mercury is your caregiver. Gets a little hot being the caregiver on both sides because you're in between that and then all the other planets, which are all these different special. You might need, you know, a neurosurgeon, a neurologist, a psychiatrist, mental health is huge in this disease and a problem throughout the world, not just in the United States, all the rehabilitation specialists, PTO, speech, swallow, et cetera. So you need all of these people orbiting at different areas, and then you've got Mercury, the caregiver in the middle. Got to take care of the caregiver, okay? More men than women get Parkinson, but guess what?

When a woman gets Parkinson, they don't do as well as men. and the reason is the caregiver and the care partners. So we always should, we should be challenging men. I'm sorry, men, all the men that come to my clinic. I challenge all of you. Care better for your, you need to step up. The data says you need to step up, okay? And then Pluto is the almost planet.

That stigma, 25% of people hide their diagnosis with Parkinson disease, unacceptable. So, so and then what else, Mark? So the stars are all the support groups, right? And then all the satellites are the sensors. We have all these great sensors. I got some of them on. I think you've got sensors too and watches and rings and all these things, right, that can help us with sleep and exercise and making sure we're doing all those things.

Bringing telemedicine, Ray is an absolute pioneer in bringing care to the home for Parkinson. Well, I thought that was an interesting thing you said in your book because, you know, it annoys me at no end that, you know, the body doesn't change when you move from New Jersey to New York or from California to Nevada, but your license does and you can't treat a patient in another state, which is the most stupid thing. In Europe, if you're a doctor in any country, you can treat a doctor anywhere else. We uplifted those restrictions during COVID,

and then we put them back in, and it's crazy. And who loses? The medical boards. Yeah, but the patients lose, right? Patients lose, yeah. It's just a money graph, because every state has a licensing board, they're all making millions.

So we should make it so that any patient, any Medicare beneficiary, any patient can receive care from any clinician that they need to. Absolutely. So thank you for saying that out loud. Like, sometimes we think it, but we don't say it.

So thank you for saying it out loud. I'm working on a telehealth bill also in Congress, so we're on that. So maybe for the last, you know, two decades with Parkinson Foundation, we may have spent a lot of hours advocating so that your care is defined by where your physician or health care provider is, not where the person with disease is. It's a very simple concept that we just can't seem to get. And then we did a red card campaign in our last book, ending Parkinson. And we actually took over the White House and sent thousands and thousands, like 20,000 plus cards. One of the things we called for was just this, watch out the COVID restrictions on telemedicine were lifted. It's going to go away.

Pay attention. We need that. And so it was one of the three things that we asked for. So is there more because what you're talking about are sort of structural changes in the care delivery model. Yeah. What I'm really trying to get out here is like doctor-patient, like, What are the therapeutic interventions, other than just the social support and the structure and the care coordination, all the things you're talking about, you're really important. But, like, I'm trying to get to the granular level of, like, if someone's the same with Parkinson's or someone in their family is Parkinson's, like, what do I do?

Is there a way to slow this, stop it, reverse it? Yeah, so the practical. Now you're to the P of practical, right? Let's get practical, right? No, that's good, all right? So we think about practical, right? and the practical advice now that we should be giving that most people don't is, guess what, when you take dopamine? Dopamine, the most common drug for, you know, for Parkinson's, very important. Still the best drug we have. Ray likes to say, what a travesty that here we are 50 years after, and it's still our best drug in the armamentarium, right? That should be unacceptable, too. But having said that, dopamine depletes cofactors in your blood. And so your vitamin B6 may go down, your homocysteine may go up, you know, other things.

things that might put you at risk for dementia and other things. So guess what? From a very practical standpoint, you need to be on at least a general multivitamin. I call it like a centrum equivalent because most people I don't favor central over any other company. But don't take the blue pill. Right. I'm not, I'm not, but.

You don't want to take pills with dyes in them and titanium and you want to clean. No question about that. But, but, but, but. You're just adding more shit. But, but fundamentally, thank you for saying that. Again, you get to say the things. Talking to the expert here, man. I know.

I know. I know. Mark gets to say things. out loud that we can't. But from a practical standpoint, you send people to the shelf and say you want to look for a good multivitamin because this is going to be super important, right? And then when you're going to your general doctor, you want to have them check vitamin levels on you at your regular thing. They're checking, you know, we're so preventative in cardiology, Mark, why are we not in neurology, right? It's ridiculous, right? Vitamin E levels are low, you know, in Parkinson, right? Vitamin D levels are

low, right? And then it's a double-edged sword with vitamin D because we should be telling folks it's twice the risk. Did you know that? Twice the risk of melanoma and Parkinson's disease. You sweat different. You smell different. You know, Joy Milne was the famous UK person who could smell Parkinson's disease. And then they said, you know, you talked about quack. They said she's a quack. They put her to the test. Sure enough, there's a smell. Yeah. So you sweat differently. Remember, it's a full body disease. It's in the scan and everything. And you're not as well protected against the sun. And so we need to tell people about that. And of course, practically speaking, you can get suburbia and other things with skin, twice the risk of osteoporosis. Are you getting

regular bone scans? You know, like, I know this sounds like so, and we wrote the book 10 Secrets, you know, you think everybody knows this, but they don't, you know, two times the risk of that. So we need to pay attention to those things. And then in addition, as we're seeing folks kind of along the way, I know and Ray may want to talk about this, we need to shift our discussions with them to to sort of include the why, you know, figuring out what is your real history. And I was kind of jealous when you said in functional medicine, we always start the visit with the person. And Ray and I have taken care of thousands of people with Parkinson. We didn't always do this. You always start the visit from the beginning. You know, it's like, you know, Mel Brooks and history of the world. Don't

know, no, no, the beginning of time, right? You start from the beginning and you want to know what that story is. And I don't know if you want to comment on that. So I'm going to go to slow stop and reverse. So can we slow it? Yes. Can we stop it or reverse? Verset, no evidence that we can do that today. But let's talk about slow. I'll jump down on that. I know, we're going to... It's anecdotal, but I would say it's anecdot.

I always say it's anecdot. And so we're going to, uh, so slow, we told you to do 25 things. Stop getting exposure toxin. We got that. Next one is exercise. So exercise is probably this century, the biggest therapeutic advance. Sir William Gowers, when he described Parkinson's in the late 1800s, he said the life of someone with Parkinson's should be quiet and restful.

He was wrong. A hundred percent. If you have Parkinson's, you cannot be quiet. The boxing thing is a real thing that worships for a heart of my patient. You should be boxing. You should be knocking out, Dr. Hyman, in the ring with rock steady boxing. 7,000 steps a day. So we increasingly know that vigorous exercise, amount of exercise to make you sweat has enormous health benefits.

And it turns out it doesn't appear to be which exercise, whether you like to box, non-contact boxing. You're not hitting people in the head. Whether you like to swim, whether you like to jog, it's all beneficial. the pugilistic Parkinsonism. You don't want that. We don't talk about that, too. And so it turns out that exercise, as you know, releases brain growth for factors in the brain, and it likely protects the remaining nerve cells and protects them from dying all.

Our colleague, Dr. Boss Bloom, has even shown that, you know, you can see these changes on imaging. So now with imaging, you can actually see beneficial therapeutic effects of exercise. And then Michael and I both have had patients who have won either not taking medicine for many years because they were just so prominent on exercising two, three, four hours a day that they've delayed their need for medicine. And we have had patients who've been able to come, who've decided to come off medications and just treat their Parkinson's disease with exercise and other behavioral factors. Although we don't recommend that in general. In general. But it's something we have to have an open mind to. And you said, you know, Anna goes, so we see this. So now you want to say stop and

reverse. So you know what gets measured, gets managed. What gets measured, gets managed. And so And you've got an MBA, so you know that. That's, what's his name, Drucker? Peter Drucker. And so cholesterol, we came to the age where cholesterol was starting to be measured. We only got statins and everything like that because we started measuring cholesterol. Hemoglobin A1C, right? After we did our training that we're going to measure the glycolization of hemoglobin

as a measure of diabetes, and we do that. But are we measuring? I have never, in my entire life, I'm a neurologist, many pesticides are nerve toxins. I have never measured a pesticide level. Oh, I can help you with that. Okay. But if we're not measuring pesticide levels in people's bodies, how can we manage and see if we're taking steps to reduce it? When we did that with lead, when we measured lead in children, we got really, really serious about getting lead out of paint and lead out of gasoline. Problem is you need a fat biopsy to properly assess. Exactly. But there's other ways.

And so there are fat biopsy. So if we start to measure these chemicals in our bodies, whether that's in our blood, our urine, our fat, our hair, or stool, we can take better actions to be more informed. And if we can start measuring these chemicals in our environment, in our water, in our household dust, in our soil, in our air. You know, we have a thermostat in this room. There's actually body things you can now wear that. We'll register the PPMs or particulate matter in the air. So why don't we have a thing that's measuring particulate matter in our air?

Right. That's a more greater determination of our... Indoor air pollution is a big thing, yeah. greater determination of our health than the temperature, what gets measured, gets managed. We need to start measuring these chemicals in our bodies. We need to start measuring these chemicals in our environment so we can figure out what interventions,

which you're going to talk about in a second, can reduce these things in our bodies, in our environment so we can all live longer, healthier lives and perhaps slow, maybe get to the point that we can stop. So even you just said something like, you know, I never measured a pesticide. So in academic medicine,

other than maybe checking your blood, mercury, or lead, maybe our estuary. Like, doctors don't know what to do, don't know what labs to send things to, don't know how to test them, right? They're not widely commercially available. You can't just check them off, generally speaking, on a lab format.

I know, I know. Previously now, they are like, they are. But, you know, when we were in training, this would be like, you. But we need to start measuring these things. 100%. The body has an embedded system

for removal of toxins. Your, you know, sweat, your breath, your poop, your pee, your liver detox systems, you have enzymes. And I think, you know, as we're beginning to understand genetics, I think, and we're now, we went from a billion dollars. I think it's now 300 bucks to get your whole genome sequence.

Yeah. You know, you can actually start to see, oh, I have these detox pathways that may need a little help. Or my methylation pathways that help also with detox also need a little help. Or, you know, I have certain increased needs for X, Y, or Z nutrient, or one third of your genes code for enzymes. Enzymes require cofactors or coenzymes. All those are nutrients. It's like so, and we have huge variations, as Bruce Same says, in our meat for different nutrients at different doses. So we're all very soon going to be able to sort of create a roadmap of prevention and go, oh, here's your genetics, here's your potholes, here's what you need to do to fix those and prevent it.

And so, you know, one of the things I want to dive into is, is one, how do we detox? And two, how do we resuscitate our mitochondria? Because, you know, I don't know if you know Suzanne Goh. she's a pediatric neurologist Harvard trained, Oxford trained, published in the journal, you know, JAMA, and is basically discovered in autistic kids using very sophisticated MRI imaging,

functional MRI imaging, that their mitochondria aren't working. And she provides them mitochondrial cofactors, COQ10, carnitine, things like that. And they actually get better. Now, I'm wondering, I remember I read a study years ago where there was, they'd be used like 1,200 milligrams of CO210. Like, Some of them you take Okie 10, you take 50 milligrams or 100 milligrams. They're using 1,200 milligrams, and they found an improvement in their clinical outcomes. So is there any conversation among your colleagues and neurologists? Like, how do we put together a comprehensive mitochondrial rejuvenation program? And what does that look like? Yeah. So, you know, it's a great question. And I think part of it to, you know, Tony Lang is one of the leading neurologists in our field in Parkinson's disease. And when we were talking about him and doing an interview, you know, with him about the book, you talk about when something has dysfunction, so it's not

working properly or something's kind of dead or degenerating, you know, and like, where is it on that spectrum, right? And so I think one of the challenges for us is understanding which segments of ourselves, and we talk about the zenness, trying to get ourselves more zen, which segments of the Zen are still functioning and can we rescue them, which is what you're talking about, and could you rescue them with, let's say, higher dosages of K-Q-10 or something of else, and which are too far downstream? You know, like, they're already gone. They're too far downstream, or we need to look more upstream in, like, for the answer, right? So is the answer going to yeah, I mean, you're right. I'm going, how do you fix the mitochondria? I realize how do you fix the

toxins? Yeah. So let's go back to the toxin, but stay with the mitochondria for you. Yeah, so we know when it comes to toxins for Parkinson, we know that when you take, you know, you know, you know, no toxins. We have a very good friend. He was a mentor of mine at Emory named Tim Greenemeyer. Tim Greenemeyer studied a toxin called Rotenome, common herbicides in people's garages. You know, it was in that they used it in the creature from the, the dark lagoon. They put it into the water and make the fishes all die instantly come to the top. Great visual effect. Terrible if you're the creature, right, who's in the water. But he actually now has Parkinson himself. And he wrote an article and was interviewed.

went public with it in a very, I think, important magazine. I think it was in science, you know, which is, you know, very credible, you know, reputable magazine. You may be on the top levels, I think, talking about this and talking about the lack of protection. But the thing about rotonone that he studies is it's like MPTP, which is the other toxin that came from the designer drug, you know, where they were trying to make a drug called MPP Plus and they made MPTP instead. And people started to come down with Parkinson, the frozen addict.

if you ever watch the old PBS special, you know, and read the book by Bill Langston. Amazing story. And it was because of recreational drugs that we actually got our best early animal model. So people say, oh, well, maybe recreational drugs are bad. Maybe not. It spurred decades of research in Parkinson's and important research for my mentor, Malin DeLong, and others. But what do those toxins do, Mark? What does that do? Yes, complex one of the mitochondrial system. And in fact, it's non-selective for MPTP, which is, what we worked with when it was a memory. What was the tree name of that drug again? Like a crystal something?

Yeah, it's a form of heroin. Yeah, it's a methamphetamine. It's a methamphetamine and ecstasy, you know, sort of in that. It's in that category of drugs. But it was a designer drug maker trying to make a designer drug. He just got one little thing wrong on the end of that. So you take this complex one. And the one that Greenemeyer was working with, which was different than my mentor who worked

with MPTP, that one only does. brain cells, it only hits complex one in those dopamine cells. Okay. And the brain, it's very specific box into that. And then Greenemeyer himself ended up with Parkinson disease and talked about how he probably should have been more protective. And he's very open, you know, about his story. And I think that's a really, you know, great thing. And the question is, is, is access to. So let's say somebody in functional medicine wants to address mitochondrial dysfunction. Awesome idea okay and there are a lot of drugs out there that are addressing it you got to beat the the leaky brain so that's good right you got to beat the leaky brain you got to get and there's mitochondria

and other areas besides the brain too that may be affected as well and and then you've got to figure out you know how how far down the system is it gone what's the dose you know response on that and here we are spending like two cents at every dollar on prevention we're spending like zero on every dollar trying to figure out you know how we could actually try to resuscitate and improve the functioning, make those cells more zen. Well, this is really important what you're saying, because, you know, one of the failures of modern medicine came out of Louis Pasteur, which had a lot of benefits, discovered bacteria, but it was like, oh, there's a single cause for a single disease treated by a single drug.

You've got pneumococcal bacteria causing pneumococcal pneumonia, treated with penicillin, boom, end a story. And we've been chasing that false tiger for 100 plus years. for chronic disease, which it doesn't apply. And these conditions are all multifactorial, meaning there's multiple causes, and you need multimodal treatments, meaning you need a lot of different things. You mentioned exercise. You mentioned reducing your exposures. You mentioned mitochondrial therapies.

You mentioned L-dopamine. There's lots more things than you can't just do one thing. And people will say, well, you know, how do you do a randomized control trial? You don't know what works. Let's just try COQ10. Oh, no, let's just try lipoac acid. Or let's just try blah, blah, blah. And I'm like, no.

like it's like saying it's like saying we're going to create we want to win the NBA playoffs but we're only going to put Michael Jordan on the team and he's got no other players on the team he's going to lose every time yeah right so hey you know I think I think this is a fundamental flaw in research and I don't know how to answer that well let me just add like just add on to that and just pile on a little bit and just say we talk about in the book about combination therapies remember carbidopa leave it op is a combination therapy you need the two to get it to the brain right and to reduce the nausea again get it out of the blood and up into the brain, pest blood barrier, right? That leaky area, right? And HIV drugs. We talk about HIV drugs and heart therapy, which was, you know, where you take a bunch of these drugs together and combination and that was the winner, right? You talk about cancer chemotherapy. Malcolm Gladwell

loves talking about this telling the story. We tell a piece of that story, again, the most disagreeable guy at NIH ever that you wouldn't want to be in the same room because he's, you know, such a curmudgeon. It takes a guy like that to challenge the system to cure these kids with leukemia, put these combinations together.

Now we're so far down the road, and yet we're still not thinking in combinations. So I just wanted to add on to what you're saying. You know, like, well, what are we doing? Well, so I think I'm going to come back to the how do you remove toxins because that's like going upstream. But, you know, often, like, you can intervene with mitochondrial therapies and you can get pretty, you know, I would say, complex

because there's a lot of different pathways, a lot of other enzymes, a lot of the steps. So Kukuten, we've talked. talked about. We didn't talk about this, but NAD or NMN, which is a common longevity now supplement, but that actually plays a big role in mitochondrial function. Cretine, which has been shown to help you have been different neurological diseases. Help your thinking in some of these recent studies. Yeah. That's why I'm so smart this morning. I did my 10 grams of creatine. I had chronic fatigue syndrome as a result of mercury poisoning living in China. And I can tell you, my CPK, which is muscle

enzymes, were 600 for years. until I figured out how to fix my mitochondria. So, you know, then there's things that help like other antioxidants, like anacetalcysteine, things that boost glutathione, there's pitochemicals like resferatrol, curcumin, green tea extract, carnitine, all the B vitamins, Richard cofactors, particularly riboflavin, niacin, B2, B3, all the methylation vitamins, B6, B12, magnesium. And even there's interesting things like peptides, like S-S-31 and humanin and MOTC, which are kind of a little bit beyond the conversation we're having here,

but that our body's own biological way of regulating our mitochondrial function. Peptides are essentially the bodies like communication superhighway system, and we've been using them in medicine for years. Insulins of peptide, GLP ones are peptide. So, like, there are things that can help the body function better. So what I find is those things can be really great, but you have to first deal with the gut.

You have to first deal with reducing toxic load. And so that's where I think, you know, we really need to start funding these trials, on using these multifactorial assessments. Like, let's look at all the potential causes. Do you have mold? Do you have mercury? Do you have pesticides?

Do you have, you know, stuff from your household cleaning chemicals? Are you exposed to particularly air pollution? Like, what's your... And we have AI. We have the ability to now deal with multiple factor, right? Like, never before. Like today and the age that we're in, yet we don't study. We don't.

And then, you know, when you understand those, you start to kind of address all those systematically. and then you start to resuscitate and repair the body. So you take out the bats that put in the good stuff. That's what functional medicine is, really. And I think, you know, what I'm also wanted to ask you about before we get into the whole detox thing, because I think I don't want to just end because we're going on a long time. I can talk to you guys forever.

Recently, there's been some real advances in blood biomarkers for Alzheimer's like Ptow 217 and neurofeminine light chain and other biomarkers. Are there biomarkers for Parkinson's? Because it's a syndrome. What it means is a syndrome is that it's a clinical diagnosis. You go to an expert, you meet these criteria for these features, and you go, okay, you got Parkinson's. But it's not like, you know, you do like a blood test for blood sugar and you see have diabetes.

So is there now or will there be soon, blood biomarker? So Alzheimer's is just a little bit ahead of us. And, you know, and they have, you know, evolving. And people should understand these things are evolving because we get better and better and we should get better and better. It shouldn't be a static. you know, type of, type of deal. Where we started was by saying, oh, we just have the clinical examination. But if, you know, if you only train 40 or 50 docs or healthcare practitioners in the

United States alone, you know, and Medicare doesn't even cover those, they're covered by grants and philanthropy and things like that, we are going to, you know, have a public health crisis. We already have a public health crisis, all right? So we're going to need biomarkers both to tell we have the disease and also to tell how the disease is progressing over time. And so when we make measurements on all these things that you're interested in, we have a way to biologically measure them. So the things that we have so far, okay? So we've got a test called a dopamine transporter test. It's a one, two, three, it's a cocaine analog. Don't get scared. You don't get cocaine or don't get excited, you know, Mark, you know, like on any way or the other. But it's a test that you can tell

how the dopamine transporter is in the brain. Doesn't tell you if you have Parkinson or not, it tells you have a dopamine transporter. deficit. And it's an imaging test. It's an imaging, right? It's an MRI. Take a picture. It's like a nuclear medicine test. Nuclear medicine. Yeah. So we have that. We now have, you know, there was a 21 center study that was just signed by David Valancourt. I was part of that study from the University of Florida. He developed a free water imaging so we can tell the difference between Parkinson, PSP, and another mimic called MSA. So there are two other Parkinson common mimics. These are things that look like Parkinson but aren't exactly Parkinson. Progressive supernuclear palsy

Dudley Moore had, MSA, is multiple system match. If he has all those autonomic features, the lighter flight things associated. So in English, it's diseases that seem like Parkinson's but you can kind of test for? Exactly. And now we can do something the eyes can't see. It's really cool. The eyes can't see it, but the AI can. So they can take your MRI with this six-minute sequence

and tell the difference between these diseases. And then the latest evolution has been blood and skin tests. Yeah, blood, yeah. Okay. And so people are really interested in measuring the protein called alpha synuclion, okay? So you talk about Petal 217, which is really hot and really important for Alzheimer's disease. People have been talking about alpha sinuclion, which is that protein that gets deposited in something called the Louie body, again, named after the guy, Louis, who described it in the microscope,

right? So, but in any... Louie body is like a combo of Parkinson's and Alzheimer's. Yeah, so that, so... More Parkinson's, but like, it's like the it's like the amyloid plaque that you see in Alzheimer's disease, the pathological hallmark what you see under the microscope, and Parkinson's like a body garbage bag. I've had many patients of that actually. So we're interested, right, in measuring that. And that is huge, right? So when we can start to measure that and the fluid that bathes your brain in spinal cord called the suribospinal fluid. So you get to a spinal tap? Well, that's how

it started, you know, with spinal taps and looking at it. But now there are now evolving ways to look at this in the blood and in other areas and it's getting better and better. And then also skin. So skin biopsies. You should talk about fat biopsies, but skin biopsies. And then, you know, no, for sin nucleam. For looking for this protein, right? The misfolded protein is not just found the brain. It's not just found the gut. It's actually found the skin.

And just for people understanding, like, you know, genes make proteins. That's all they do. And one of the hallmarks of aging is proteostasis are just funky, merely misshapen and folding proteins that don't work properly. Yeah, so you fold the sheets. And, you know, if you have a regular sheet that's easy to fold and it's nice and neat. But trying to fold a fitted sheet is a really big pain in the behind. Right, exactly.

And so a fitted sheet, it's always misfolded. And so in Parkinson's disease and Alzheimer's disease and ALS and a lot of other brain diseases, the hallmark of the disease when you look on the microscope are misfolded proteins. But I don't know if this is true. I'm just hypothesizing because the genes make proteins and the proteins have functions and they're damaged because of environmental factors that change the gene expression or the what we call post-translational gene products, the protein that genes make, through proteomics, which is like a new way of actually testing

large numbers of proteins in the blood at very low cost. Are we seeing protein signatures of Parkinson's that can be identified? Yes, we are starting to see them, but as we get more data, we're overwhelmed by the data, where AI is helping us, but now you have imaging, you have blood, you have spit, you have skin, and the answer isn't going to be in one thing. You know, people like to go binary yes or no. Because it's like if you're making a difference, how do you know? Like I know, if I had 10 with Alzheimer's and I check their p-tow 217 and then I do 10 things and I check it again six months from now, it can go down. What gets measured gets managed. Right.

So is there anything like that coming? So that is right now, like right now, Mark, what so many people all over the world, multiple laboratories are working on because we're not quite there with the statistics to say it's good enough yet, but we're smashing these tests together. And my prediction is, and I think Ray feels the same way when we're writing the book is it's going to. to be a combination of these tests that are going to, are going to give us those markers. But what you said is so important, and I just want to reemphasize that, we have to be able to measure trajectory. It's not good enough to just diagnose. No.

We don't need a biomarker just for diagnosis. Like, you can see a lot of Parkinson, you know, it's a clinical diagnosis. Like you take a stat and your cholesterol goes down, right? Like you want to know what. Yeah, you have Parkinson. If you respond to the dopamine and everything, that's pretty doggone good. What we need to do is we need to be able to see how it changes over time. And then when we intervene, you know, do these things.

that we're given, because it might be some of the things we've tested actually did work, but we couldn't measure it, as Ray said. And so it's a problem. It's a challenge, let's say. Yeah. This is really great. I want to wrap up because, and I don't want to put you on this spot because you didn't learn this in medical school, and I spent the last 40 years studying this, which is how do you help someone detoxify? How do you measure toxins? How do you detoxify? So in functional medicine, we can do heavy metal challenge testing. We do blood testing for every metals. We can do blood testing for things like PFS, BPA, glyphosate. Also, urine testing. You can look at urine testing for a lot of the things like atrazine and all the things like the pesticides

and paraben. So we can actually look at all these things in the urine. And there's specialty labs that do that. It's typically not your average lab. And then being in a sense, okay, based on someone's history, based on their load, where are they at? And then then we design a detox program, which essentially, which uses all your bodies built in waste management systems, right? So sweat, saunas are a great way to mobilize toxins, making sure you drink a lot of water and pee and clear urine, simple, fiber, like make sure you're pooping and not constipated. You know, I had a patient once I said, I do a regular bowel movement. She goes, yeah, I said, how often do you go?

She goes, well, I go once a week. I'm like, what do you mean? That's not regular. She goes, yes, it's regular for me. I go every week, you know, but you want to go every day at least once or twice. These are just basic things. And then there's all the things you can do to upregulate your body's own built-in detox pathways. And that includes things to do with diet.

So you obviously reduce all the crap in your diet, all the sugar, all the processed food. That goes without saying. But there's certain foods that have the ability to boost your own detox enzymes like Lutothion, which actually you can use intravenously in Parkinson's and temporarily see reductions and tremors. So it's really, it's like one of the most important anti-inflammatory mitochondrial compounds. So we basically give them. broccoli and collards and kale and other things like garlic and onions that boost that and we give

them foods that help with B vitamins and methylation. And we do all these sort of dietary interventions and we've been talking about maybe keto diets that may be helpful. And then you kind of obviously can fix the gut and that's a whole other functional medicine domain. But in terms of the detoxification, you know, there's there's a chelation which can be used for heavy metals and that's been published, ADTeculation, DMSA chelation, these are things that are published in JAMA,

and in fact, in one study, they did it for kidney failure, and they found that people that had lead, they're more likely to progress to dialysis, and they did edatolation, and those who went through it didn't progress. So we have some data. We don't have enough, but we have some data.

So you can do chelation for every metals, and then, you know, for the dermatocondy rejuvenation and the cellular removal of toxins, it's a lot harder. And this is where things are kind of, I think, needs some funding to see what's going on here. Because clinically, I can tell you, when we do things like give intravenous glutathione or intravenous NAD,

or we give something we call the PK Protocol, which essentially is a cellular washout. It's like using high doses of the fat, phospholone, that your membranes are made out of. Where all the toxins are, it flushes them out. And then you also combine it with things like glutathione and the B vitamins. carnitine and you see people's mitochondria come back online. And I have a patient who's like

a rock star and that rock star couldn't play the guitar because they had Parkinson's and all of a sudden they did this protocol and boom, they're back on tour. So I think there's a whole bunch of things that aren't drugs that aren't anybody who's going to fund a billion dollar study unless it's the government or a philanthropist, but that I actually have real promise. And I would love to sort of hear your thoughts on how we start to take some of these things that are in the anecdotal or anic data stage and actually start to apply them and do clinical trials, sort of like Richard Isaacs are doing, because what all you guys are talking about in here is amazing and it's going to get people a lot of the way there. But there's a whole other level of thinking about

this. I'd love to just get your final two cents on. I think I love the term anecdote, right? And I think that's really important. And I'll just say it's, it's tricky because, you know, in the New England Journal, they tried to, there's a whole bunch of iron, as you know, in the brains of folks with Parkinson and everything. So they tried to use the standard, you know, chelation, you know, and for iron and that actually did work. Well, sure.

Sure, here's why. Here's why. It's a problem of thinking. If you give someone a drug for chelation and you don't make sure that that compound gets out of their body by peeing a lot, pooping a lot, making the liver enzymes work and binding them up in the gut and doing all these things, of course you're going to get worse.

And that happens also when you do treatment for heavy metals. If you just give the chelator without all the other support, then, of course, they're going to get... Yeah, and we're not, Ray and I are an expert on this, but I will say that I was so enthusiastic when the government was investing in that we had a Center for Alternative Medications where they were funding, starting to fund clinical trials. This was many years ago. One of my mentors, Maylindalong, was involved in some of those original discussions. And we just need to do more of it. I mean, this is super interesting, super important. And what excites me, and I'm interested to hear what Ray thinks,

what excites me about it is the why and looking upstream, like, right? So what you're talking about is looking for the root cause. And so when the guys... Cause or causes. Yeah, root cause is. And so when the guys that discovered helicobacter pylori, which was this, you know, infectious age... Are you guys the Barry Marshall of Neurology?

Yeah, well, we have the story in the... But please don't take the toxins. Yeah. So we have this, we drank a baker of bacteria and prove the unalcer. But don't drink a baker of toxins and then get Parkinson's trying to fix it. Yeah, so we have the story in the book about how nobody believed them, that this could be infectious causing all the peptic ulcers. And it turns out it was infectious. They ended up winning the Nobel Prize on this, you know, and it was really important and fundamental.

And people, what were they saying? Oh, you need to eat less spicy foods. You need to do all this. They didn't understand upstream what was going on. So, I don't know, what do you think? If you guys keep going, I want to beat your Nobel Prize ceremony because I think this is worthy of a Nobel Prize. Well, I think the credit really goes to Dr. Caroline Tanner. For 40 years, she's been detailing this and we haven't been paying enough attention to her.

You know, in my mind, she's a giant. In reality, she's like maybe five feet tall. She's over 70s. She looks like your prototypical grandmother, and she's been doing this for 40 years. She did studies in China as a woman in the 1980s looking at chemicals and Parkinson's disease. Just imagine that. we want to say yes we want to say right we want to say yes to everything that you're saying we just don't have the evidence and i think both michael and my minds have been open we did if you

had told us 15 years ago about chemicals we would have been poo-pooing or soft pedaling them and we know we just don't have the evidence we do know the Mediterranean diet for example high in fruits and vegetables low in animal products perhaps low in toxins that get magnified as they go up the food chain is beneficial for people with Parkinson's and might even prevent you from getting it. We know that vigorous exercise is helpful for people with Parkinson's and might reduce your risk

of ever getting Parkinson's. We know that these chemicals are likely causing the disease and we know that stopping exposure of these chemicals is potentially beneficial. We just don't have the data to answer to you here in 2020-25, you know, what complemented mitochondrial supplements

or other complementary medicines would make a big difference for people. But the NIH needs to focus on this, right? And then we're going to come back to your house, come back in five years, and we'll tell you what has been found because people like, you are constantly pushing the envelope. And you've been doing this for, you know, 30 years, right? Yeah. And you were, you know, not widely, you know. Respected.

Don't rein my Wikipedia pitch, please. And, you know, you and others have made us think about things in a more holistic manner. And you've told us that the power of prevention, you've told us that the roots of these chronic diseases, many of them lie in our environment. if we pay attention, more attention to the Mark Hyman's of the world, if we pay attention to the people who are out there on the front, Vanny Harry and others who are out there telling us that chemicals in our food, water, and air are fueling the rise of chronic diseases. We can prevent them, we can slow them, we can treat them,

and potentially we can even cure them once we know the cause. And I'm just going to say by, as an ad, my anecdote, I'm treating dozens of Parkinson's patients over 30 years or people with Louie Body Disease. I've had many of those as well, surprisingly, and I'm not a neurologist, but when people try everything and they can't get any help, they come to me.

And we treat them at the Elder Wellness Center. And I can tell you, I've had so many patients who we've slowed, stopped, or even reversed significantly their Parkinson's by using this kind of a systematic approach. And I think people should be hopeful out there, and I'm really hopeful that you guys are doing this because, you know, we need real scientists.

I'm just a science reader. I'm not like a, I mean, I published some papers, but I'm like, that's not my gig. But I read the science. And I'm like, I know that the smoke signals are there. And that it needs like to be a serious investment in this, in this field and in the kinds of therapies that can really improve people's lives, especially as we're seeing the acceleration in this whole thing.

So I want to just thank both of you for what you're doing. I think this is such an important book. It's the Parkinson's Plan, a path to prevention and treatment. You can get anywhere you get books. It's out. now, I would encourage you to get a copy and check it out. If you know anybody with Parkinson's, if you have it in your family. Or you don't want to get it. If you don't want to get it, which would pretty much be everybody. And the seeds of the disease are planted early. So

decades before. Decades as a child. Yeah, as a child. So it's never too early to start. Yeah. So I just honor you both for what you're doing and the courage you have to go against the grain to speak the truth, to, you know, honestly to be exposed to the potential. or ridicule of your colleagues. It's not easy, right? And yet here you are, and I'm just so impressed in having this conversation. And you guys are great. Let's keep talking. Let's revisit this. And when we have more blood biomarkers, when we have more treatments, if you want anybody to kind of give you my antics data from my decades of doing this to kind of guide some things that could be helpful if you want to get some research funder, if you have some philanthropists or if anybody's

listening out there who's a philanthropist who has any of this, like Louis Bodies or Parkinson's, like Please, we need help because the government's not doing it. Pharma for sure isn't doing it. And I think, you know, these guys are doing the work. So, so let's get some help for all the needless suffering out there. Thanks, Ray. Thanks for having. Really great conversation.

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