The Dr. Hyman Show - How Inflammation Affects The Brain And How To Cool It

Episode Date: May 8, 2023

This episode is brought to you by Rupa Health, Bioptimizers, and Levels. Brain conditions, such as depression, anxiety, ADHD, autism, Alzheimer’s, and even schizophrenia, are fast becoming one of the largest categories of chronic health concerns. Instead of just relying on the traditional approach of looking at the brain in isolation as the means of healing these conditions, we are learning more and more that when you heal the body, you also heal the mind. In today’s episode, I talk with Dhru Purohit, Dr. Dale Bredesen, and Dr. Todd LePine about the one common factor behind all brain disorders: inflammation. We explore how inflammation may arise from our diets, toxins in our environment, stress, and more. Dhru Purohit is a podcast host, serial entrepreneur, and investor in the health and wellness industry. His podcast, The Dhru Purohit Podcast, is a top 50 global health podcast with over 30 million unique downloads. His interviews focus on the inner workings of the brain and the body and feature the brightest minds in wellness, medicine, and mindset. Dr. Dale Bredesen is internationally recognized as an expert in the mechanisms of neurodegenerative diseases such as Alzheimer's disease and the author of the New York Times bestsellers The End of Alzheimer's, The End of Alzheimer's Program, and his latest book, The First Survivors of Alzheimer's: How Patients Recovered Life and Hope in Their Own Words. Dr. Todd LePine graduated from Dartmouth Medical School and is board certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. This episode is brought to you by Rupa Health, Bioptimizers, and Levels.  Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 35 labs. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. BiOptimizers is offering my listeners 10% off Sleep Breakthrough. If you buy two or more you’ll get a free bottle of Magnesium Breakthrough. This is a limited-time offer. Go to sleepbreakthrough.com/hyman and use the code hyman10. Levels provides real-time feedback on how diet and lifestyle choices impact your metabolic health. Right now, Levels is offering an additional two free months of their annual membership. Learn more at levels.link/HYMAN. Full-length episodes of these interviews can be found here: Dhru Purohit Dr. Dale Bredesen Dr. Todd LePine

Coming up on this episode of The Doctor's Pharmacy. Anxiety, depression, neurodegenerative diseases like Alzheimer's, Parkinson's, these are all diseases of inflammation of the brain. Hi everyone, it's Dr. Mark. As a functional medicine doctor looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables, it helps me find the most effective path to health and healing for my patients. But such extensive testing can be very complicated and time-consuming for both the practitioner, somebody like me, and our patients. But lab ordering became very quick and painless

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Things like excessive screen time and environmental stressors can contribute to knocking your circadian rhythms out of whack. And this results in many of us dealing with sleep issues and not quite knowing where to turn. I've worked so hard to optimize my own sleep, and one of the most important tools in my sleep toolbox is Sleep Breakthrough by Bioptimizers. Sleep Breakthrough is a fully optimized, delicious sleep drink designed to help you fall asleep in minutes, experience deep, high-quality sleep,

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Hi, this is Lauren Feehan, one of the producers of The Doctor's Pharmacy. If you could name one thing behind most brain diseases, it would be inflammation. While also an important part of our body's repair system, inflammation can run wild, wreaking havoc on the brain and driving depression, anxiety, ADHD, Alzheimer's, and more. In today's episode, we feature three conversations from the doctor's pharmacy on why addressing inflammation in the body could be the key to healing the brain. Dr. Hyman speaks with Drew Pruitt about why brain disorders are at the root of an overall decline in the health of our population, with Dr. Dale Bredesen on the importance of early detection of brain inflammation,

and with Dr. Todd Lapine on patient cases where various underlying issues, including inflammation, are the cause of brain disease. Let's dive in. How big of a problem is poor brain health and inflammation of the brain, really? That is a very important question because a lot of the diseases that we see that are causing disability, loss of productivity, loss of quality of life, are brain disorders. Whether it's anxiety, depression, the opioid epidemic, neurodegenerative diseases like Alzheimer's, Parkinson's, and all the cognitive disorders like ADHD, autism, these are all diseases of inflammation of the brain and they're rampant. If you look, for example, just at

depression, our modern tools really suck at treating it. I mean, if you have severe depression, sometimes medications can help. But for most people, you look at the data, it may be 30% effective, not much more than a placebo. And the question is, what's driving that problem? It's all our inflammatory lifestyle, which we've talked about a lot on the podcast. And it's one of the most important things. One in four people have a severe episode of depression in their life in the world.

It accounts for the majority of the costs in our healthcare and all the collateral symptoms that we have from the externalities of depression, like loss of productivity. So there's a macroeconomic analysis looking at, over the next 30 years, what's it going to cost for chronic disease? It's $95 trillion with a T. That's a lot of dough. That's way more than the GDP of the top nations in the world combined, probably twice that of all the top six nations combined. That amount of money, the majority of that is for depression because of the loss of productivity, the effect on society and so forth. So these are rampant conditions. One in 10 kids

have ADD. Alzheimer's, we probably have Alzheimer's or pre-Alzheimer's in 40, 50 million Americans. Depression affects, you know, more than 60 million people. But throughout people's lifetime, it's super common. We're seeing rampant increases in autism and neurodegenerative diseases. So we have to grapple with this problem of brain health in a more focused way because it is the thing that we need to operate in our lives, to be happy, to have healthy relationships, to do the work we want to do in the world, to be a functioning member of society, to be engaged and not just be in a spiral of a near vegetative state sitting on the couch watching TV because you feel like crap.

So there is enormous opportunity to sort of pull the veil back and rethink our whole approach to brain health. Now, one of your first books was Ultra Mind Solution. And one of the core ideas in that book was what you do to the body, you do to the brain. Yeah. Can you expand on that? What did you mean by that? Well, the title of the book was The Ultra Mind Solution, How to Fix Your Broken Brain by Fixing Your Body First. Because unlike what we learned in medical school, which is that our head and brains are sort of this disembodied thing on the top of our shoulders and it doesn't connect with anything that's going on below there, we've learned that that's completely untrue. That we're learning that the brain responds to everything we do, what we think,

what we feel, exercise, sleep, our diet, environmental toxins, stresses, all these things influence our microbiome. Everything influences the brain. So we really have to sort of think about how do we sort of equilibrate to a different way of thinking about brain health based on all the things that we can do to fix the imbalances in the body that affect the brain, whether it's thyroid, whether it's your microbiome, whether it's toxins, whether it's low nutritional levels of certain vitamins and minerals like fish oil or omega-3s or vitamin D or the B vitamins.

So we know a lot about the things that make the brain healthy. We call these trophic factors. These are things that help the brain grow and improve and increase neuroplasticity and neuroconnectivity. There's so much that's exciting that we know about how to do that. And yet most of us are poisoning our brains and we think, oh, I know I have to exercise, I have to cut out saturated fat, I have to do all that and I can prevent heart disease. But most of us have no clue how to take care of our brain or live a brain healthy lifestyle. We just don't learn it.

What are a couple examples of things that people are doing today, separate from the topic of foods, that are some of the biggest contributors to poor brain function in their life overall? Well, the low-hanging fruit is lack of exercise. 8% of Americans get adequate exercise. That leaves 92% who needs some help. And the exercise is really extraordinary because when you do cardiovascular exercise, when you do strength training, when you do HIIT training and specific kinds of exercise, it increases these incredible molecules in your brain called BDNF.

BDNF stands for brain-derived neurotrophic factor. Think of it like miracle grow for your brain. So when you exercise, you're literally increasing the number of brain cells. You're increasing the connections between the brain cells. You're increasing your cognitive power. Exercise is super critical. So that alone can make a huge difference for so many people. The second thing is sleep.

If we don't sleep, our brains don't work. And I remember the study I read recently that looked at sharpshooters in the military, the snipers essentially, who are super accurate, like 99% accurate when they have eight hours sleep. When they get seven hours, drops off a little, maybe 90%. Less than six hours starts to go to like 60, 50%. Under six hours, it's like basically hit or miss. It's 50-50. And so we really don't understand how important sleep is to cleaning our brain, to repairing

our brain, to getting rid of the garbage. The garbage man comes at night when we're sleeping to clean out all the metabolic waste that our brain makes during the day. And if you don't have adequate sleep, you're not going to be able to do that. The third thing, in addition to exercise and sleep, is stress. We know that chronic stress, now we all have acute stresses, but the chronic unmitigated stress of our modern life, and whether it's coming from the world we live in and all the chaos, whether it's coming from inflammation and stress that our diet causes, because our diet literally causes us to build more adrenaline and cortisol in our body, like high-starch and sugar diets, whether it's our sedentary lifestyle.

All these things drive our brains to not function properly. And so the stress response is something we know how to deal with. We know how to actually reset the body by activating the part of your nervous system that is the relaxation response. We call that the parasympathetic system, as opposed to the fight or flight or freeze response.

It's playing possum, basically. And it's not just sitting on the couch, watching TV, drinking a beer. It's actually a very active thing. So it could be meditation. It could be yoga. It could be my favorite or more passive ones like massage, hot and cold plunges.

There's a lot of ways to access the nervous system to help reset it to create a deep sense of profound relaxation that's physiologic. And that helps repair your brain. Because if you have chronic stress, it literally shrinks your brain. It shrinks the hippocampus in your brain, which is the memory center. So we know that chronic stress causes dementia. So just that alone can have a huge impact, those three things. And then there's a huge long list that goes on and on. But Dale Bredesen, who, one of my favorite people, he's a credible neurologist who studied Alzheimer's and has used functional medicine to reverse, not just to stop or slow, but to reverse Alzheimer's

in patient after patient. And he talks about this idea called a cognoscopy, which is how do we, we get a colonoscopy, but how do we measure our brain function? Well, there are some really specific, simple online tests, neurocognitive tests you can do. There are ways of looking at brain imaging. There are certain lab tests and things you look at to see what are the threats to the brain. How do you, how do you assess the threats? And it's important because when you start to understand how the brain works, you can really play with it and see conditions reverse that you just never would see. I mean, I only wrote Ultra Mind Solution because I was treating

people's physical problems. And as a side effect, their brains would get better. And I'm like, what happened? Like Someone, for example, would be having panic attacks and anxiety and depression, and I would get their insulin under control and their microbiome under control. And they go, well, I don't have that anymore. I'm not depressed. I'm not anxious. Or they had bipolar disease, and I did this and this and this and got better. Or they'd have ADHD or autism or Alzheimer's, and they start to really improve or completely recover. I'm like, what's going on here?

This is not what I learned in medical school. And so I began to really through the inquiry of my own patients and their data and their experiences and applying functional medicine, was able to sort of map out how all this connects and all the things that affect the brain. And it's not just the obvious things, but there's a lot of things that we can dive into around infections and the microbiome and toxins and other things that affect brain health. So the fundamental things are easily accessible to everybody. And we all should think about not only how do we take care of our body and our weight and our heart risk, but also our brain health.

And there's some very specific things you can do to do that. Now, this topic is near and dear to you because you write in your book that not only were you focused on helping your patients, but you were trying to help yourself. Your own brain broke. So I'd love for you to take us down your story. And also, while you go through it, help us look at the whole topic of brain-related disorders and how conventional medicine might see disorders and how conventional medicine might see it and how functional medicine might see it.

First, I'll start with my story because it helped teach me so much about how the brain breaks and what to do to fix it. When I was in college, a student got in a medical school. School was easy for me. I barely studied and my brain was just like a steel trap. And I remembered everything, could focus, pay attention, was happy. I mean, my brain was good. I exercised, I ate healthy, I did all the right things. I did yoga. And then I went to China and got mercury poisoning,

which I didn't know at the time, came back and got some other insult that tripped my system into really being sick. And all of a sudden, I went from completely functional to completely dysfunctional. I couldn't sleep. Even though I was exhausted and had chronic fatigue syndrome, I couldn't focus. It was like I had ADHD. I couldn't remember anything. I got depressed. So it was like I had depression, ADD, and dementia all at once. And I would literally be reading my kids a story at bedtime, and I couldn't understand the sentence. If I read it out loud, I literally would not

be able to understand what I was saying. My brain didn't work. Or when I was talking to somebody, I would start a sentence, and I didn't really know where I was going. I couldn't finish the sentence. I was really damaged. And so through understanding my own biology and reverse engineering my way to health, I began to understand, you know, all the factors that affect brain health. And that's really why I wrote the Ultramind Solution because it's what I learned on myself, but it's also what I began to see on nearly thousands of patients. Talk to us about some of those root factors that were going on for you that might be beneficial for other people to hear. What was going on in your life that contributed you to being in that place in the first place? Well, I had a bunch of stuff. I mean,

I was in a crazy work schedule. I was working as a ER doctor after I came back from China, not sleeping. You know, I literally would, was doing 15 shifts a month, which doesn't sound like a lot, but it's a lot. And I was staying up all night, many, many nights. I would, I was taking care of my two kids. My ex-wife was an alcoholic and it was really a tough moment and a lot of stress and a lot of work and a lot of sleep deprivation. And then I would, you know, go to the emergency room and I would have an 11 o'clock to 7am shift at night night and I would drink a quadruple espresso, a giant chocolate chip cookie, and a half a pint of ice cream. And I'd get in the car and I'd drive to work and I'd last probably until five in the morning. Hopefully it was quiet enough I could take a nap. And I did

that for years. And so between that stress, between the difficult stress in my life in terms of my marriage and also this underlying mercury toxicity that then got tripped into full expression when I had a severe intestinal infection. That was sort of the straw that broke the camel's back and ended up just cascading into years and years of me trying to figure this out. And I got terrible diarrhea for years, SIBO, bacterial overgrowth. My muscles were getting damaged. My immune system was dysregulated. I started getting sores on my tongue, rash all over my body, autoimmune antibodies. My liver function went up. I mean, my whole lab tests looked terrible. And I was a mess. And doctor after doctor was like, well, you're depressed, take Prozac. Or you're anxious, take Xanax. Or you can't sleep, take Ambien. Or

you know, it was like, it was that. And I remember, and I started getting weird fasciculations and all kinds of weird symptoms and my muscles were twitching and my muscle enzymes were really high, which means my muscles were being damaged. And I remember going to Columbia and seeing these top neurologists who was an expert in this type of thing. And they ordered a test called the EMG, which is no fun. Essentially, essentially stick giant needles in your muscles and they then send electrical currents down them to see what's going on and This guy was his old British doctor there who was running the test and he said oh you have been benign fasciculations Which means your muscles twitch, but it's not serious. It's not ALS which because it could it could have been als and uh and the uh and he goes off the record this isn't normal like there's no such thing as benign fasciculations you don't have ls but it's something else you know so that and that

was even before i figured out the mercury thing i just i just didn't know what was going on i was searching and searching searching so it took a couple of years for me to actually figure out the mercury thing before i was able to get better what was going on. I was searching and searching and searching. So it took a couple of years for me to actually figure out the mercury thing before I was able to get better. What was part of that turnaround process, which also was the introduction for you into the world of functional medicine? Like how did you begin to look at things differently and then start to treat yourself? Well, I was always a little weird.

I mean, I always, you know, I studied nutrition in college and was a yoga teacher before I was a doctor, was interested in integrative health. I didn't even call it that then. And I was always exploring the edges, studied ancient healing systems, Chinese medicine. So I always had a different framework that I was coming from when I went to medical school. And then when I got a job at Canyon Ranch, it's right when I got sick. And I met a woman named Kathy Swift, who was a nutritionist there. And she's like, you got to come to this lecture from Jeffrey Bland. And I'm like, okay. And so I went to hear this guy speak.

And I listened to him. And I thought, this guy's a genius or he's a lunatic. And if what he's saying is true, it means that everything I learned needs to be reexamined, questioned, and reimagined. And I need to prove that to myself and my patients. So I said, I'm going to try it on. Because if he's right, it's a game changer. If he's wrong, he's just a nut who's promoting a lot of stuff that's kind of goofy. And it turned out he was right. And the rest is history. And that's when we really started diving into functional medicine at Kenya Ranch. We had a

great incubator where we could spend hours with patients. I could dig into all these things. I could learn everything. They were willing to do stuff. And so it was really a great incubator where we could spend hours with patients. I could dig into all these things. I could learn everything. They were willing to do stuff. And so it was really a great incubator. And then I just kept going down that rabbit hole and healed myself and started healing thousands and thousands of patients. So what was one of the first things, and we're going to touch on your story, but these are also things that people can walk away with when it comes to their own story too. So what was one of the first things that you did when it came to your diet? You're eating chocolate chip cookie, double espresso. You had all this

sugar in your diet. What was one of the first things you did when it came to your diet? Well, I literally had to do an elimination diet because the mercury not only affected my brain, it affected my gut, which by the way, they're totally connected, right? There's called your second brain. There's more neurotransmitters in your gut than in your brain. There's more nerve endings in your gut than your brain. It's really quite fascinating. And my gut was a mess. And so I developed leaky gut. I developed SIBO, which wasn't even a thing at the time, small intestinal bacterial overgrowth, fungal overgrowth. I would eat anything and my stomach would just blow up like a balloon. Like I had gas, it just wouldn't come out. And I felt like I was, you know, like a giant sort of tire inflator that just blow up like a balloon. Like I had gas, it just wouldn't come out. And I felt like I was,

had a, you know, like a, a giant sort of tire inflator that just blew up my intestines. And it was painful and difficult. And I had diarrhea and I just had food in my stool. It was just kind of a mess. So I literally had to dramatically change my diet to just be able to tolerate any food. So I used turkey, broccoli, and brown rice for like a year just to kind of calm my system down. It didn't really help get rid of all my symptoms, but it just helped them not be so bad. And until I got rid of the mercury, my gut couldn't heal. And it's not that you're necessarily recommending the turkey, brown rice diet to other folks. You're just talking about what you did. I'm just saying like my system was so dysregulated. I couldn't eat anything without causing a rash or my eyes like turning like a raccoon black or swollen tongue or my whole

system was just messed up. And in order for me to just reduce my diet to the most simple foods that were not going to be triggering reactions, I had to really simplify my diet. So that's what you did then. If you were your patient today, what would you do for that person in that same situation when it came to the topic of diet? If I had me as a doctor, when I first started this, I would have been better a lot faster. But like, I literally had to crawl my way through knowing. And by that, it was really tough, Drew, because not only was I i sick but it was very hard for my brain to work so i literally had to despite having my brain barely functional still try to learn and focus enough to try things and it was really tough it was really really tough it's like

kind of like trying to like um you know get out of a very deep hole and a black hole and it was tough because i didn't i didn't have the full capacity of my mind so i started to learn things and i started to incorporate things it was very slow and it took me a number of years before i even figured out that i had mercury poisoning uh and i ended up sort of being in a functional medicine conference and i met a guy on a plane who was a naturopath and he was he was like well come into my office because maybe I can help you I told him what's going on so he did this machine this electrodermal screening which sounds like total quackery but it's looking at the bioenergetics of different meridians and different electrodermal electromagnetic frequencies in your skin which

are there and he said well it seems like you have metal toxicity I'm like really okay and then I went to my friend Mark David I said I was just staying metal toxicity. I'm like, really? Okay. And then I went to my friend, Mark David. I was just staying at his house. I'm like, can you do my hair analysis and see what's up? And he took a little hair. We sent it off. It was really high. And then I did a challenge test.

And I found I had a level that's, you know, I've done, I've probably done 20,000 of these tests over the last 30 years. And it was probably in the top 10, 20 tests I've ever seen of the worst levels. And then that was when I started to detoxify, but it was really tough because I didn't have a roadmap. I was just sort of figuring things out. We didn't even understand what SIBO was back then. We didn't understand a lot of things that we know now, and we didn't have a lot of the tools we have now. So I would probably be a lot better, a lot faster. Hey everyone, it's Dr. Mark here. I've been

tracking my glucose with the help of levels for several years now, and it's Dr. Mark here. I've been tracking my glucose with the help of Levels for several years now, and it's become a crucial part of optimizing my health and my diet. One of the keys to an optimized diet is monitoring your glucose intake, otherwise known as sugar. Poor glucose control is tied to all kinds of issues like weight gain, fatigue, diabetes, Alzheimer's, heart disease, and stroke. But it can be hard to know exactly how much glucose you're getting in your diet. That's where Levels comes in. They show you how food affects your health in real time through continuous glucose monitors. In fact, I remember I was eating out with a friend once, and although we ordered a really healthy meal, I way over ate,

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levels.link forward slash hyman, Levels is offering an additional two months of their annual membership free. Now let's get back to this week's episode of The Doctor's Pharmacy. Inflammation is this common theme in all brain dysfunction whether it's depression or add or autism or alzheimer's or parkinson's or whatever it's inflammation in the brain so a lot of your work has really been in understanding what is driving that inflammation because the amyloid like you said is not the problem it's actually your body's attempt to fix the problem. It's the band-aid that the body uses to deal with the inflammation and the microbial factors, which often can come from gut and other factors. So talk to us about how we need to rethink this,

because I remember reading this article years ago in JAMA, which was called Shifting Thinking About Dementia. And there was a great line in there that says, we combine categorical misclassification with etiologic imprecision. And what that means in English is that we categorize people according to symptoms, not causes. And we are not really good at finding the etiology or the cause. So we're kind of just like throwing spaghetti at the wall, trying to see what works. And what you've done with the Bredesen Protocol and the End of Alzheimer's Program is to really map out systematically the ways in which you can

identify those factors that are harming your brain. You call them dementogens. And what are those factors that we need to provide the body to optimize and enhance brain function, right? Exactly. So, you know, what happens in COVID-19, again, is cytokines. And so, you know, cytokines are killing people, as you know. The cytokine storm is the problem. Well, part of the inflammatory cascade, part of your innate immune system activation is amyloid. So we have to quit thinking of amyloid as the cause of Alzheimer's.

Amyloid is just like cytokine storm, except it's longer. Of course, COVID-19 has compressed all the things that go wrong in Alzheimer's into two weeks instead of 20 years. But it's the same idea. As long as you have something that is saying, hey, something's wrong with your brain, you are going to continue to make that amyloid. That's part of the response. So you're absolutely right. You have to determine what these factors are. And it's often, there are often biotoxins or organic toxins or metallotoxins. Air pollution, of course, has turned out to be a big one. So all of these critical things, and then various pathogens. And there are several of these chronic pathogens from Babesia to Bartonella to Borrelia to various mold species to herpes simplex type 1 to HHV6A. These are all chronic pathogens. And typically, as you know, we don't know that we have them. So as you said, you know, this is interesting to me that we used to talk about people dying of fever. You know, in the 1600s, people died of fever all the time. And so now people talk about

people dying of Alzheimer's. It's no different than fever. You shouldn't have a period after fever and fever due to what? And you shouldn't put a period after Alzheimer's Alzheimer's due to what that's a critical piece and so the doctors have always put the peer they say you have Alzheimer's but we need to know why for each person and it's not one thing it's not like tuberculosis it's always the tubercle bacillus right all these different things so that's it is a systems disease. That's the point. Yeah, it's so true. You know, I think in, you know, in neurology, there's a famous joke that you see the doctor and it's basically diagnosed in adios. Here's the name for the condition you have. And there's not much we can do about it. Goodbye. Get your life in order. And that makes

me crazy because, you know, over 25 years of doing this and working with people's brains, I wrote about this 12 years ago, and I've seen more and more since then, of how we can really impact these patients. I mean, I saw a patient who had dementia. She had Lewy body dementia, which is sort of a combo of Alzheimer's and Parkinson's. She couldn't walk. She was in a wheelchair. She had real cognitive issues. She was trying to run her business. She couldn't walk. She was in a wheelchair. She had real cognitive issues. She was trying to run her business. She couldn't function anymore. And we essentially did this

detective work that you're talking about using the approach that's described in the end of Alzheimer's program in the Bredesen Protocol. And we found she had tremendous gut issues, tremendous overgrowth of bacteria and yeast in her gut, massive nutritional deficiency. She was diabetic, poorly controlled. Her thyroid wasn't working. She was post-menopausal and had all these various issues. And we simply corrected those things that we found. And she came back incredibly.

And her energy came back. Her cognitive function came back. She was able to be in her business again. She was able to, she was a relatively famous person who was able to record another album and write songs and write a book where she'd been totally dysfunctional and non-functional before and was able to even get up out of her wheelchair and start walking. So it's quite remarkable. And this was even over 80 years old. So no matter where you are in the spectrum, we see these remarkable changes that people just don't think are possible. And when you talk to traditional doctors about it, they kind of dismiss it. But, you know, there has been

research on this. You know, one of our colleagues, and you've published a number of papers looking at these case studies, but one of our colleagues, Richard Isaacson, did an incredible study that looked at similar kind of personalized interventions, not even the full protocol, and saw that he could not only stop, but he could slow it, and he could also reverse some of the symptoms of cognitive decline. So can you talk a little bit more about, you know, what kind of approaches you do to looking at the factors that are going on, and maybe sort of list some of the key factors that you're finding that are common among these patients? Yeah, and I think the best way to do that is to talk about the subtypes. So what we described back in 2015 is when you start to look at these, to do the very

evaluation that you just talked about, then in fact, what you find is that there are people, although there are multiple contributors, people tend to have specific subtypes. So type one, inflammatory. These are people who have exposure. They may have leaky gut. They may have periodontitis. They may have metabolic syndrome. Lots of reasons that they have inflammation. And that's the critical driver. And you can literally follow the molecular pathway from NF-kappa B activation, part of the inflammatory pathway, to where it's producing the amyloid, which, as I mentioned, is part of the inflammatory pathway. So that's the type one. And those people, you need to look for things like HSCRP, TNF-alpha, things like that. And then you need to use resolvins to improve these. And then you need to identify where this is coming from and attack that. So getting, again, upstream is

critical. Then there's type two, which is atrophic. And these are the people where they have low vitamin D, pregnenolone, progesterone, estradiol, testosterone, you know, on and on. The critical supports for this, nerve growth factor, brain derived neurotrophic factor, B12, all these things. It takes, as you know, it takes a lot to keep a brain functional. You have over 500 trillion synapses in your head. You've got an amazing supercomputer inside your skull. So you've got to keep that supported and prevent it from downsizing. Again, this is a disease of insufficiency. And by the way, one of the most common things we're seeing now, nocturnal hypoxia. People don't realize it.

The doctors don't check it. They say, oh, I don't snore. I don't need to look at this. And it turns out that when you actually look at it, you see that the oxygen has crept down during the night. Into the 80s, even into the 70s, we see people in the low 70s who don't realize that they have problems with oxygenation. So sleep apnea, you mean? Sleep apnea. It's often without sleep. That's the key. Sleep apnea is the tip of the iceberg. But there's upper airway resistance syndrome as another one of these. And there are people who just don't get enough oxygen at night, even though they don't have full-blown sleep apnea. So that's critical to check.

And then, of course, we talked about the ketones earlier. Then there's the type 1.5, which is glycotoxic. And this is the people where they've got both inflammatory changes because of glycation of hundreds of proteins. And they've also got the atrophic effect because they now have resistance to the insulin. So that's type 1.5 or glycotoxic. Those are the factors. You've got to look at their hemoglobin A1c, their HOMA-IR, stuff like that.

And glycotoxic means sugar being toxic to the brain, that it forms these crusts, sort of like a creme brulee on the top of your brain, so it can't really work properly. And that you talk about atrophic, which means lack of things to help the brain grow. Trophic factors are essentially the fuel or the food or the ingredients that the brain needs to function, including hormones and the right nutrients and vitamins and fish oil, all kinds of stuff that the brain actually needs to function, including hormones and the right nutrients and vitamins and fish oil, all kinds of stuff that the brain actually needs to function. So you talk about the way you identify this. And I thought this was brilliant the first time I heard about it. You know, everybody knows

they should get a colonoscopy to check their colon. But you come up with this term called a cognoscopy, which I love, which is essentially how do you do a deep dive into your brain and all the things that affect your brain that cause risk of cognitive issues. And by the way, all the things that you measure with a cognoscopy are all the things we measure for any chronic illness to look at. And some are more prevalent in different illnesses. But with Alzheimer's, you really come up with a model of a cognoscopy. So can you talk about what is a cognoscopy? What should we be looking for? How do we get it? Can we get it with a regular doctor? Or is this something that you really need specialized care for? Yeah, it's a great point. And people have told me don't use that

term cognoscopy. It sounds so horrible. I love it. But it's simple. It's easy to remember. And we all know we should get a colonoscopy when we turn 50. So we recommend everybody 45 or over get a cognoscopy. And as you said, it is things related to chronic illness. But the key is to prioritize. I mean, that's the key. The people who are getting the best results, as you know, are the ones who are prioritizing the things that are the most important drivers. It's different for each person.

For some person, you know, it's going to be getting at that Borrelia. For the other person, it's going to be getting at that mycotox. For the other person, it's going to be getting at that mycotoxin. And another person, it's going to be the glycotoxicity. So today, it's very simple to get a colonoscopy. One might be mold. One might be lime. One might be sugar. One might be mercury.

Might be mercury, right? And might be vascular. A common one is people just don't have the vascular support for their brain. And this is why they are downsizing. And so if we return that support, we return the oxygenation and the blood flow, they do better. So the way you can get a cognoscopy, it is three things. It is number one, a set of blood and urine tests, easy to do.

Number two, it is a simple online cognitive assessment. And if you're completely asymptomatic and doing great, and you're just in for prevention, you can stop there. Just those two things. If you have any symptoms or you're not scoring well on the cognitive tests, you want to include number three, which is an MRI with volumetrics. You want to know the volume of your hippocampus. You want to know the volumes of your frontal lobes and your parietal lobes and things like that. And hippocampus is that little memory center in the brain tends to shrink. Right. And I've heard you present some cases that when you've done these cognoscopies, you start these interventions that are in the end of Alzheimer's program, your new book, which everybody should get. And you map out the changes over time

when you implement the Bredesen protocol. And remember the story you told of the neurologist, the neuroradiologist who looked at the scans and was like, this was before and this is after. This doesn't make any sense. I've never seen this in my entire life to go from like 20% of what it should be to 70 or 80 or 90% of what it should be. Can you explain how that happens? Absolutely. And, you know, we see this again and again and again. We're actually just publishing another paper showing not only increase in hippocampal volume, but also improvement in PET scans, where you go from a PET scan that shows Alzheimer's to a PET scan that doesn't show Alzheimer's. We also see improvements in electrophysiology. So improvements in EEG, improvements in evoked responses,

and of course, improvements repeatedly in cognitive scoring and testing. So this is happening because you are putting the things in that actually support the brain. You're getting hormones and trophic factors that are critical. So the brain is now making the synapses once again. Now, we don't know yet, is it making more neurons? Is it making just more synapses? Is it changing in terms of its astrogliosis? We don't yet know what's happening at the cellular level, but we do know that that atrophy is improving in many of these people. So you said two things there that sort of struck me. One is that your brain can grow. You can rebuild brain tissue that's been damaged by the insults and literally

grow your memory center, which correlates with improved cognitive function on the brain cognitive testing. And second, you said you can do a brain scan that you can see Alzheimer's on. You can repeat the brain scan and the Alzheimer's markers on the brain scan are gone. That's like what? Stop presses, headline news. Why isn't this on the cover of New England Journal, JAMA, cover of New York Times, Wall Street Journal? What's going on here? Yeah. Well, partly because, of course, the standard is do a thousand people and then do the whole study. So at the beginning, you have to start somewhere. We're just getting the airplane off the ground. You've got to start somewhere. So we're looking, as you know, at the beginning, you have to start somewhere. You know, we're just getting the airplane off the ground. You've got to start somewhere.

So we're looking, as you said, at these various cases. We are in the midst, I should say, of the first trial in history in which we look at all the different contributors for each person and address all these different things. We'll be finished with that in December. So very enthusiastic about that trial. But yes, we do see in these anecdotes that we're now looking at, we see improvements in PET scanning and electrophysiology and hippocampal volume and all these things. When you are getting these people to improve and to do the right things,

you're literally just restoring a synaptoblastic neurochemistry. And what that means is you're creating a brain that likes to build new brain cells. That is capable. It's over almost 30 years ago, it was discovered. It was, of course, I was taught years and years ago that the brain doesn't make new neurons. You get the ones you have and that's it. And then about 30 years ago, it became clear that, hey, there are neural stem cells and you actually do make new neurons throughout life. And so it's a question of which ones do you keep and do you have them interact with other neurons? Do they become part of the functional network? So it turns out you do make

more of them. And if you do the right things, you can keep them and you can keep their interactions. Now, one of the big topics that you cover is the microbiome, leaky gut, inflammation, Alzheimer's. And so most neurologists aren't saying, well, let me look at your digestive system. Let me look at your gut and seeing if there's inflammation there. And how does that connect to the brain? And we talked to a colleague of ours, Rudy Tanzi, who's been pioneering some of the work around finding microbes in the brain. We thought the brain was sterile. We thought the brain had a blood-brain barrier that prevented anything bad from getting in. Well, it turns out

that barrier is only semi-permeable and that things can get in and they can be even microbes. So can you talk about this amazing research on the gut and the brain and the microbiome and how that impacts what we have to do with patients with Alzheimer's. And by the way, that patient that I had who had really had brain dysfunction, her main issue was her gut. And we fixed it up after decades of being constipated, needing enemas to go to the bathroom and laxatives and tons of bad bugs growing in there. It was just amazing what happened.

We fixed all of that. Absolutely. And I think that, you know, when a neurologist makes a diagnosis of Alzheimer's or pre-Alzheimer's, the best thing the neurologist can do is refer the patient to a functional medicine doctor to deal with all the things that are driving this problem. But of course, the neurologists have felt like, oh, this is our province. You know, we have to give the drug and watch you go downhill, which is really unfortunate. I think that's going to change. So absolutely, the gut is a driver. And I think one of the most interesting studies that was done in the last couple of years was a group, they were actually studying rodents, but what they were doing was

injecting candida. And they thought, they wanted to see how long does the blood-brain barrier keep the candida. They injected it into the blood vessels and asked, okay, what happens when it goes by the brain? How long can the brain keep it out? And the answer was it went in immediately. So there is, yeah, Canada, this is in a normal animal. So the fact of the matter is there is much more communication, just as you pointed out, and as Rudy has been pointing out, there is much more communication between the brain and the periphery than anyone thought possible. And what have the pathologists shown us? When they look in the brains of patients with Alzheimer's, what do they see? Herpes simplex in the brain. They see candida in the brain. They see Borrelia

in the brain. They see P. gingivalis from your dentition in the brain. Dr. Pompa- Gum disease. Dr. All these different gum disease. So the bottom line is our brains are communicating with the periphery much more than anyone thought before. And as you said, we actually probably have a normal brain. As much as that kind of blows my mind, we actually probably do have a normal brain microbiome and we're going to have to have probiotics for our brain at some point. Cognobiotics, right? Cognobiotics. Yeah, there we go.

Wow. That's incredible. Maybe we can just sort of share as a way of illustrating the power of addressing inflammation on the brain with some cases. I have a bunch of cases from autism and Alzheimer's, but it'd be good to get sort of a sense from your experience. What are the things that show up and how did you treat it and what happened? Well, you know, I've had a whole variety of cases. In fact, a couple of cases that we've had at the clinic where we had some patients who presented to psychiatric hospitals. And when it came out, you know, when somebody has psychosis or a breakdown, if you will, they call that, you know, a psychotic break or a manic break or whatever you want to

call that. And we've had a couple of recent cases where the patient's underlying trigger was Lyme disease, which is a spirochlea condition. And I always remember, this is something that I really like to emphasize to my patients, is that way back when doctors used to treat syphilis, we don't have a lot of syphilis in private practice today. It's just a condition which was readily treated and it's pretty much gone, although there's still some recurrences of it. But syphilis was caused by a, or is caused by a spirochetal bacteria. And that's the same thing as Lyme disease. And Lyme disease is the great mimicker. And it also can cause dementia and psychosis. So that's one of the conditions that trigger neuroinflammation. And then also there was a recent case of Bartonella also causing neuropsychiatric conditions and a diagnosis of schizophrenia. So it's really a fascinating field.

And the problem is that psychiatrists are not trained to think this way. And neurologists are not trained to step over into psychiatry. So they're like, they're two different fields, but they're really the same field. So it's neuropsychiatry. This is an area that is actually really, you know, quite fascinating to me. And I, you know, people always ask me, you know, what kind of doctor are you? And I have my own description. Yeah, how do you answer that question? Yeah, I'm a psychoneuroimmunoendogutologist. And basically looking at the whole connection between the brain, the gut, the immune system, and all of the body when it's all sort of interconnected.

And it's really, really fascinating. And it's really, really fascinating. And you can really help these people who are having significant conditions. So what happened? You said this patient with schizophrenia, right? And you found the tick infections. What happened then? We're able to get their symptoms down by treating the underlying cause, which is the underlying spirochetal infection. I also had another patient who had a mycoplasma infection, and it's actually known in the literature, mycoplasma is an atypical bacteria, and it's another infection which can cause the brain to be on fire. So it's a really fascinating thing. And one of the tests that you can do that can check for this, it's not a common test, and I don't know if you've done this, Mark, is the NMDA receptor antibody testing. This is looking at the parts of the brain that are

stimulatory. And this is something that any doctor who has a patient who has gone quote unquote crazy or had a psychotic break, they should have an NMDA receptor antibody test. Because if you have this, it tells you that there is some type of neuroinflammation that's driving their symptoms. Yeah, it's quite incredible. So I've had patients who have schizophrenia before or bipolar disease, and you think these problems are just so intractable and so difficult to treat, and they can be. But in fact, the whole field of functional medicine came out of the field of psychiatry with Abraham Hoffer's discovery that you could treat schizophrenia using nutrients and helping to improve the biochemistry of the brain. And then Linus Collingwood's seminal paper, Orthomolecular Psychiatry in Science Magazine in 1969, which

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

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

And so we have this potential to sort of rethink our whole approach to brain science. That's what's so exciting when we see the work of guys like Dale Bredesen or others and nutritional psychiatrists like those at Harvard and metabolic psychiatrists at Stanford. They're doing work in this field and understanding the connection between the brain and some of these systemic processes. Yeah, absolutely. And when you take a schizophrenic and you look at them with a PET scan, the positive emission tomography, what you'll see is their brain lights up. And that's because their microglia, which is their immune cells in the brain, are literally on fire. And unless you actually treat that, a schizophrenic is at high risk for developing dementia down the road because their fire is not being put out.

And this, Mark, I'm going to mention this because I actually have done some lectures for American Academy of Anti-Aging Medicine on neuroinflammation. And in the process of preparing for that, I came up against some really fascinating things. One is that when you look at the genetics of schizophrenia, they did this whole genome-wide association studies of saying, well, what gene or what genes are associated with schizophrenia? And they did what's called a Manhattan plot. And on chromosome six, it sort of stood out like the Empire State Building. And what they found out is that on chromosome six, chromosome six is highly involved with the immune system. So that

tells us that a lot of patients who have schizophrenia have an issue on chromosome six related to the immune system. And what I'm going to tell you next is absolutely positively fascinating. And this sort of blew me away. There were two case reports. And remember, case reports are just like a doctor observing, okay, this is interesting. Look what happened. You know, why did this happen? And the two case reports were this. And this tells you, you know, how the immune system is intimately involved in schizophrenia. One is a patient had refractory schizophrenia and developed some type of cancer and needed a bone marrow transplant. The refractory patient with schizophrenia got a bone marrow transplant. A bone marrow transplant is basically giving you a new immune system.

After he got the bone marrow transplant, guess what happened to his refractory schizophrenia? It was gone. What happened? Gone. Wow. It completely cleared up because it changed his immune response to whatever it was responding to. I don't know. But his refractory schizophrenia went away.

On the flip side, there was another gentleman who also needed a bone marrow transplant. He got his bone marrow from his brother who had schizophrenia. Guess what happened to him? He caught schizophrenia. He got schizophrenia. It goes both ways. Wow. That's pretty amazing. That's pretty amazing. Yeah. It is amazing. I was blown away by that. And I think that, you know, in people who are doing I'm a clinician, I'm seeing patients, but those those case reports are really, really seminal to change how we think about how we see these conditions. And the fact that that can happen. I also found it fascinating that, you know, we talk about the gut microbiome and how

that's so important related to the immune system is that when you do stool transplants, you know, we talk about the gut microbiome and how that's so important related to the immune system, is that when you do stool transplants, you can literally transplant or infect a person and make them skinny, or you can transplant stool and make them fat. We can go both ways. They're doing this with autism, Parkinson's, right? They're actually doing fecal transplants with autism and with Parkinson's and seeing real changes in the brain function. That blows my mind when you think about that. It does. It does blow my mind. And the thing about this is we are still in the nascent period of really understanding this because it's not like, you know, you take this one chemical or you take this one probiotic and everything's fixed.

It's a very, very complex array. And, you know, we have hundreds of different microbes and bacteria and viruses in the gut. So it's going to take us a while to figure this all out. But, you know, I think we're also in a approach these areas of understanding neuroinflammation and really difficult to treat conditions like ALS, like schizophrenia, like Parkinson's and such. And we're going to be able to biohack them and Alzheimer's. You're right, Alzheimer's. That's another thing, though. This is, you're bringing up one of my favorite things.

So for years, Mark, what did neurology focus on with Alzheimer's? It was what? It was amyloid plaque, right? All you got to do is get rid of the amyloid and you get rid of Alzheimer's. That's right. So you get rid of cholesterol and you get rid of heart disease. Right. So guess what? The plaque, the beta amyloid plaque that was found in the brain, guess what that actually is? That's an antimicrobial peptide. The brain is producing beta amyloid in response to some type of organism, be it a virus, a bacteria, or a fungus. So when we see that, those are the footprints of a organism that the body is trying to attack.

Yeah, absolutely. And I think, you know, we actually probably should have Rudy Tanzi on the podcast. He's a scientist at Harvard who specializes in Alzheimer's. And he has discovered the microbiome of the brain. So literally, there are viruses, yeast, bacteria in the brain, which we thought was sterile, that may be triggering this cascade of inflammation. And then the question is, where does this come from? And it seems like a lot of it may come from the gut, which is crazy. How does it get from your gut to your brain? But it does. And it triggers this sort of neuroinflammation that's driving things like

Alzheimer's. You know, I think we often get stuck on one thing though, right? In, in medicine, we stuck, it's stuck on it's this or it's that. And I think the important thing people remember is whatever your diagnosis is, it doesn't immediately tell you what the cause is. So you could have 10 people with Alzheimer's, they could have 10 different causes. And in one person, you could have three or four or five different causes, right? And I just remember one patient I had who was seven years old, really pretty significant. You know, Alzheimer's, not bedridden at this point, but pretty non-functional, also depression, and was struggling really badly. He was former CEO of his company, a family-run business, couldn't function anymore. Behavior was changing. His kids, grandkids, family didn't want to hang out with him anymore because he was acting inappropriate. And it turned out he had so many things going on. I mean,

the biggest thing he had was high mercury, which he lived in Pittsburgh and had exposed to all the steel plants and they use coal ash for fertilizing land and they put it on the streets in the winter instead of sort of salt for the icy roads. And he also had a mouthful of fillings. And he also had a terrible history of irritable bowel for 30 years. It was on stelazine, which is just like an antipsychotic. So it's like a relaxant for your gut, which is terrible. But he had terrible gut issues and bacterial overgrowth and leaky gut and gluten sensitivity. And he also had insulin resistance.

He had prediabetes. So essentially, he had all these problems, heavy metals, microbiome issues, and he had insulin resistance or prediabetes, which we know drives inflammation in the brain. They're calling Alzheimer's, you know, often type 3 diabetes. And he had all these other biochemical issues genetically, like methylation problems, which are the B vitamins. We're also driving inflammation in his brain because he wasn't able to produce antioxidants and glutathione and when we started to address all these things, we got the mercury out, we fixed his gut, we cleaned up his diet, we got rid of the sugar and starch, we optimized his B vitamins. He literally came back from the dead like Rip Van Winkle and was able to function, go back to work, be a

functioning member of his family again. This is someone who would have just been said, okay, you have Alzheimer's and you are going to be a nursing home and that's the end of that. And it was pretty miraculous to see that. It sort of woke me up to how by really being diligent with these patients, you can really help them either completely recover or dramatically recover. And I've seen the spectrum from the tough cases of autism, Alzheimer's, you know, it depends how much they've got going on, how far down the road they are, but you see amazing stuff.

But things like depression, bipolar disease, you know, mood disorders, it's often remarkable how quickly the brain responds, ADD. And it's something that we just, you know, unfortunately are not thinking about that well in traditional medicine. And that's really why we do what we do at the Ultra Wellness Center. And we've treated nearly thousands and thousands of patients in this way. And we now do stuff virtually too, which is kind of fun. So we can see people from all over. And we have a great team of physicians and nutritionists and practitioners who really help guide people through this space.

Because, you know, what kills me, Todd, and I'm sure it kills you, is you hear story after story. And I'm sure you get this all the time. Hey, could you help this one? Could you help that one? Or my mom or my dad or my sister or my friend? And people are just struggling to find answers. And, you know, when you hear the story, you go, oh, God, I know what's wrong with this person. But it's because we have a certain set of filters or lenses that we look at. And it's so gratifying. Can you think of any other cases that you want to share that sort of illustrate this? Yeah. I mean, I think I'd mentioned this. This is a fascinating case. I really can't 100% prove it, but I talked about

it when we talked about the oral systemic health connection is the connection with the mouth. And there's some really good evidence of the particular bacterium, which is a bad actor. And it's called Porphyromonous gingivalis. And I've seen this in a number of patients who have had early Alzheimer type symptoms. You can also see this oral bacteria in patients with rheumatoid arthritis. So looking for this with DNA of the mouth organisms. And again, you know, this is, this is to me is a really fascinating thing. You know, somebody says, well, Alzheimer's runs in our family. Well, poor Fremontis gingivalis may run in your family. You may be spreading the bacteria from person to person. And this, this bacteria, which is found in saliva, it stimulates

the immune system in genetically susceptible individuals and can really lead to profound neuroinflammation. And in one patient in particular who I saw, he had Lewy body dementia, which is another form of inflammation. Lewy bodies, because on anatomical examination of the brain they find these little things they call them louis bodies right it doesn't mean that they understand it it's just louis found it and that's it got named louis body after louis and and when i right and that's actually what uh that actually is what um robin williams had robin williams had louis body dementia with parkinson's you know so we call it we call it parkinson's we put in this neat little category and then we call it Parkinson's, we put it in this neat little category, and then we call it Alzheimer's, or we call it dementia, and we put it in this little category,

and then we call it Lewy body. And they're all sort of this interacting, overlapping kinds of things. And yeah, they can have different clinical presentations, but as you said, there can be many, many factors that go into the origin of this neuroinflammatory process. And diet plays a huge role. You know, if you don't have the right nutrients, you don't have the right fatty acids, you're going to be more prone to all of your cellular membranes have omega-3 fatty acids. If you're not able to make the compounds in the body, which are called pro-resolving mediators or SPMs, and actually have this as a supplement now, these are actually quite fascinating compounds. The SPMs, and I actually have this as a supplement now. These are actually quite fascinating

compounds. The SPMs are selective pro-resolving mediator compounds. They're basically turbocharged fish oil. And certain people, some people can't take their omega-3 fatty acids and turn them into these compounds. And clinically, I have found them, they either work really well or they don't work. I don't know about you, Mark, but these are other things that you can use as a nutraceutical to help turn off inflammation in someone who's got some chronic inflammation.

Not to say if you take it, it's gonna help with Alzheimer's per se, but it's one of the other tools that we can use to modulate the inflammatory response in the body. Yeah, so true. You know, we all fit in traditional medicine, don't know how to evaluate the brain properly because we're just looking at the brain, but we have to look systemically. And that's really what we do in functional medicine. And, you know, Dale Bredesen coined the term a cognoscopy, like a colonoscopy, but for your brain. And it's looking at all the things we've been talking about, looking at diet,

looking at nutrient levels, looking at hormones, looking at toxins, at the microbiome in the gut, looking at infections, looking at mold, looking at allergens, looking at the overall health of the person and seeing what of those things are driving adverse consequences for the brain and for brain function. And any individual, the same cause might cause different things. So one person might cause schizophrenia, another person might cause Alzheimer's, another person might cause depression. So we really have the tools to look at a true cognoscopy. And then the question is, how do we help the brain repair? How do we set up the conditions for the brain repair? So let's talk about how, from a traditional functional medicine

point of view, we actually treat these people. Because it's a pretty systematic approach that addresses diet and lifestyle and also some of these underlying causes. Yeah, I mean, so we, as you mentioned, Mark, we do a lot of the testing. So we'll do organic acid testing, which is checking for the nutrient metabolites that are found in the body. We'll also do gut microbiome testing, looking at all of the different bacteria, viruses, yeast, parasites potentially in the body. We'll look at markers for leaky gut. The other test that I do is a leaky brain. You know, just like you can have leaky gut, you can have a leaky brain.

There's actually a test for that. Cyrex Laboratories does the blood-brain barrier test. You can check also for neuro-autoimmune markers with the Cyrex brain barrier test. You can check also for neuro autoimmune markers with the Cyrex 7X test. Again, you can do gut microbiome testing. The one that I like to use is the GI map test because I think it's, it's quantitative PCR. So I find it to be very helpful. I think the whole GI realm area is an area that we're just learning. And there's going to, I think the whole GI realm area is an area that we're just learning. And I think as time goes on, these tests are going to get better and better. But I find that to be very, very helpful to distinguish what's going on inside the person that I have.

The other thing, which I think is also really, really critical, Mark, is sleep. And this is something that I really emphasize to people is that when our bodies sleep, our brains take out the garbage. Okay. And I'll guarantee you, when you have a patient who's got a neurodegenerative condition, one of the first things that you'll see is disruptions of their sleep. And what happens is during the day, you know, our brain only comprises 2% of our body weight, but it uses 20% of our body's energy, which means that there's a lot of metabolic activity. And what happens throughout the day is we get metabolic waste products that build up in the brain and our brain flushes them out during deep delta sleep. If we don't get that deep sleep, we can't flush

the brain and take the garbage out in the brain. And those toxins build up those things that metabolic byproducts, misfolded proteins, inflammatory molecules, amyloid, et cetera, build up in the brain and can affect how the person's cognition is, their memory, their mood, et cetera. It's amazing. Yeah, and I think, you know, the diet is such a huge role too in the brain. I mean, we see that the diet we're eating is a highly inflammatory diet in this country of processed foods, inflammation that are driven by sugar and starch, excess refined oils, all the lack of things that are

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

that they have sensitivity to certain foods. We treat the underlying infections if we find them directly with antibiotics if we need to, antivirals, or sometimes we'll use herbal therapies or things like ozone and other approaches to deal with infections. We'll fix the gut. Often that's a big issue. So we have a whole functional medicine approach to fixing the gut. We've talked about a lot on this podcast. And then we'll address whatever toxins that are there and help you eliminate the toxins through a really focused detoxification program. And so building on the framework of functional medicine, we can identify in each individual which of these things are the problem. And then we can start to map the right treatments for that person. And it's so gratifying when you see this. I hope you enjoyed today's episode. One of the best ways you can support this podcast

is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements, to gadgets, to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays, nothing else, I promise. And all you do is go to drhyman.com

forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search

their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.