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Mind that Americans are affected by

2:36

neurogenesis. These are like Alzheimer's dementia,

2:38

a lesson, Parkinson's and more. But

2:40

the good news is it there

2:42

some simple steps that we can

2:45

take every single day to protect

2:47

your brains and reduce the risk

2:49

for and even reverse the symptoms

2:51

of corgan decline and neurodegenerative diseases.

2:53

I can see. Episode will feature

2:55

three different conversations from the doctors

2:57

pharmacy about why it's so important

2:59

to take care of our brains

3:01

com or young and what to

3:03

do. If we're experience or

3:05

brain conditions I speak with Doctor Marlins the

3:07

buy about the role of eight but we

3:10

forging He was ahead of the Memories Clinic

3:12

at Cleveland Clinic. I also speak

3:14

with Doctor Rich Isaacs, one of the

3:16

pioneers in understanding how to reverse Alzheimer's

3:18

disease for life some modifications, it's quite

3:21

amazing and with Doctor Jay Lombard about

3:23

bacteria as the cause of neurogenesis. So

3:25

let's dive in. We're.

3:28

Now seeing now a big push

3:30

to move the calculus beyond the

3:32

time of symptoms too much earlier

3:34

and tried to find people who

3:36

identify people at risk along the

3:39

way. Submit my most that research

3:41

has been focused on drug interventions

3:43

to prevent the or bread don't

3:45

prevent delay or of forestall the

3:47

onset of symptoms but along the

3:49

way of course if I'm gonna

3:52

implement my seventies I know my

3:54

disease started my thirties or forties.

3:56

We can change. Beyond

3:58

drugs weekend change to say lifestyle

4:00

interventions have benefits and there's now

4:03

a whole new Arab research exercise

4:05

has really emerged as one of

4:07

the areas that has for as

4:09

grown and with real biological evidence

4:11

that it can prevent and improve

4:13

brain function, brain health or and

4:15

beyond the that it we see

4:17

now. People. Are looking things

4:19

like diet and supplements in other ways to

4:21

manage those disease and so I think this

4:24

is an area as is. Granted you

4:26

know relatively new but very exciting can be.

4:28

There was a recent study called the

4:30

finger study A finger studies one the one

4:32

which can suck ass and was at I

4:34

was about yeah I know and and this

4:37

study was done in Europe and it was

4:39

a very large study where they didn't intervention

4:41

with diet and exercise and stress and

4:43

and caught during aiming. Gag.

4:45

Addressing cardiovascular risk factors and tell

4:48

us about the study was a

4:50

fine guess. So why is this

4:52

study is done at the Karolinska

4:55

Institutet of Geriatrician? name is me

4:57

a Kyiv upheld to a really

4:59

really sharp very for a very

5:01

thoughtful physician scientists and she said

5:04

we're going to create a multi

5:06

modal intervention including diet changes, manager

5:08

managing Ah Idea health conditions are

5:11

improving A of exercise improving all

5:13

their parameters and one group was

5:15

randomized. To the intervention, one group was

5:17

randomized to just kind of passive intervention

5:19

and an objective way fall for over

5:21

two years with aggressive intervention. The Treaty

5:23

group did much much better over the

5:25

two years. Now do they not get

5:28

a decline? The actually got better while

5:30

and so and is of people not

5:32

young. They're starting their late sixties into

5:34

their seventy so these are people. The

5:36

middle allies there's tons of in the

5:38

senior is running into the sea rage

5:40

and actually got better and this has

5:42

been published in the journal Lancet so

5:44

it's a very respected. You

5:46

know, peer reviewed scientific journal. Hope this

5:48

is really remarkable when a pause here

5:50

because what you just said. Is

5:52

pretty radical. Now. Like. I

5:55

said we send billions of dollars on hundreds of

5:57

studies and none of them so this will have

5:59

slowed it's. or reverse, now

6:01

you're saying just by eating better,

6:03

exercising, optimizing your health, we

6:06

literally can slow and even start to reverse

6:08

the disease. That is correct. In fact, the

6:10

US is taking the finger study and in

6:12

2019, 2020, there will

6:15

be the US version of it

6:17

called the pointer study, which is

6:19

being rolled out in about six

6:21

sites in the United States this year. And

6:24

the government has to pay for it because

6:26

there's no drug involved. The government, well, to

6:28

be very clear, the pointer study so far

6:30

as I know is being funded by the

6:32

Alzheimer's Association. I don't know if there will

6:34

be federal dollars behind it. But

6:36

the fundamental issue is- But it's not a drug

6:38

company. It is not a drug company. But the

6:40

fundamental issue is we want to answer an important

6:42

question. Do these things objectively work? The signal, the

6:45

way the evidence suggests the answer is yes. And

6:47

so having more evidence, because

6:50

I have to tell you, you and I are

6:52

both physicians, part of our day job is taking care

6:54

of people with disease. Right. So

6:56

here we are saying, let's step back

6:59

from that. Let's say instead of treating

7:01

disease, let's treat health. Yeah. And- Wait,

7:04

did you take the course in medical school called Creating Health 101? I did

7:06

not. No, I didn't either. I did

7:08

not take that course. Yeah. We didn't learn

7:10

that. We did not. But

7:12

the advantage of that is that

7:14

it's not prescriptive, then you can

7:17

help recommendations that come up from

7:20

consensus panels and then it can

7:22

have effect change at

7:24

a larger level. This is actually easier

7:26

to roll out if we can prove there's

7:28

a signal than it is by just writing

7:30

a prescription. It's unbelievable. Yeah, I think what

7:33

you said is really remarkable that we need

7:35

to focus on how do we create health

7:38

rather than just treat disease or symptoms or

7:40

pathways or some pathology. That's

7:42

correct. And that's essentially what functional medicine is.

7:44

It's asking the question, how do you create

7:46

a healthy human being? Right. What

7:48

are the factors that knock you off that path

7:51

and what are the things that actually help create

7:53

health? And in those studies, the finger study, the

7:55

point study are looking at those factors and there

7:57

are more, right? There are more. And I think

7:59

that's the exciting. Thing is that. I.

8:02

Think you know I I have to be

8:04

tell you I've been involved in all these

8:06

clinical trials every time there's a failure if

8:09

breaks everybody's heart. yeah is there is no

8:11

there is no ego involved as not like

8:13

a high she told you so because I

8:15

will say to you whether the drugs work

8:17

or not I'm going click tomorrow or the

8:19

new updates and I still go look These

8:22

people know I and say you know something

8:24

good is coming We just kind of hope

8:26

that it's coming soon. Ah and so I

8:28

see the to because if I can see

8:30

a path forward whether it's a drug. A

8:33

device. A lifestyle

8:35

interventions anyway for to help my

8:37

patience either prevent, postpone or delay.

8:39

Let's talk about the disease little

8:42

more in a medical way because

8:44

the. The. Understanding was from

8:46

my training. Was it the brain seem

8:48

to be disconnected from the rest of

8:50

the body? We learned about this right

8:53

is. Barrier. Called the blood

8:55

brain barrier Worth nothing except your

8:57

some nutrients got. An industry was

8:59

like this. Thing. Yes

9:01

to disconnected our head from the rest

9:04

of this. Turns out that our body

9:06

is one system and their brains are

9:08

connected. Everything else is happening in our

9:10

gut, microbiome, race in infections, what we

9:12

eat, our everything is is actually influencing

9:15

our brain function. So can you share

9:17

a little bit about how this understanding

9:19

as chains where we think about the

9:21

brain and and how some of these

9:23

factors that are driving inflammation? Price? Are.

9:26

Actually causing this disease because it's a

9:28

disease. A brain inflammation it is. So

9:31

the So They kind of. The conventional

9:33

wisdom there were trying to look at

9:35

is that inflammation isn't It is a

9:37

response to an injury or or is

9:39

it the injury itself as at the

9:42

end of the day. you know lot

9:44

of people think that there's an amulet

9:46

triggered event and then the inflammatory events

9:48

occur because of the production the I'm

9:50

in Am I just stick to do

9:53

we started comes up your brain that

9:55

is correct and as importantly. ah

9:57

but when a week to think as you said

9:59

there was North of the

10:01

neck and south of the neck, right? And that everything

10:03

in Alzheimer's was north of the neck and nothing south

10:05

of the neck was related to it. When

10:08

in fact now we know that things

10:10

like gut microbiome can alter your immune

10:13

system and having a healthy

10:15

microbiome can keep you healthy and

10:17

by the innate and you can

10:19

boost your innate immunity which might

10:21

reduce inflammation across the body including

10:23

the brain. Yeah, and exercise helps

10:25

reduce inflammation. And BDNF. And exercise,

10:27

I have to tell you I

10:29

hated running but I've taken

10:32

up running because of BDNF.

10:34

So what is that? It's

10:36

brain derived neurotropic factor because...

10:38

It's like miracle growth for the brain, right? It's miracle

10:41

growth for the brain and the funny part about it

10:43

is almost neuroscientists are

10:45

runners. They don't do anything but run.

10:47

Okay, they have to have something to do with it. It's

10:49

the fastest way to raise your BDNF with this. Which

10:51

is basically this growth factor

10:54

that connects your brain cells together so

10:56

it calls neuroplasticity which increases connections and

10:58

helps neurogenesis which is the development of

11:00

new brain cells. That is correct. So

11:03

we never thought that was possible. We never thought it

11:05

was possible. We said once you're born with your neurons

11:07

you're going to get it but we now know that

11:09

the brain is making neurons throughout their life. Yeah, I

11:12

mean I read a study where they studied terminal cancer

11:14

patients and they gave them this dye that only goes

11:16

to dividing brain cells and they found even at the

11:18

point of death they're making new brain cells. That's correct.

11:21

We did a... when I was in Sun City, Arizona at

11:23

the Banner Sun Health Research Institute we

11:25

had a brain and body donation program

11:27

and we had scientists that could take

11:29

brains of patients who had just expired

11:31

and culture out, bring out stem

11:34

cells that were still

11:36

left alive in dead brain. That's

11:38

unbelievable. That's pretty cool stuff. So

11:40

these things like diet and exercise

11:43

and optimizing your gut microbiome and

11:46

stress reduction they all in a

11:48

sense work by regulating this inflammatory

11:50

product? That's correct. That

11:52

is correct. Inflammation of course is

11:55

the unifying common pathway that we

11:57

can manage And you know, the end

11:59

of the day? That's. We wanna do is that

12:01

is getting and on ever really work. They

12:03

tried it. Promo: Cotton hitters have not worked

12:05

as so Then the questions are scientifically as

12:08

it is it that pathway of information. People

12:10

are now looking at different pathways of information

12:12

you know, now looking at dirty and I

12:15

thought I was a tuna courses alpha. They're

12:17

looking at the fact a tin of top

12:19

of my trigger enzymes relays Alzheimer's com base

12:21

so we think that there's a links to

12:24

that. Inflammation is not just a broad category

12:26

but their specific segments the seem to work

12:28

and others that we've tried. Like you said,

12:30

we try to anti inflammatories for years to

12:32

treats to treat or prevent. Alzheimer's did more

12:35

for the non right? Well that sort of

12:37

goes back to the thinking in front of

12:39

medicine which is what's causing it in the

12:41

first place right? So to standing on attack

12:43

takes a lot of aspirin make you feel

12:45

better frontal attack outside so it's not visited

12:48

us logic but it's is something that we

12:50

have to sort of begin to wonder about.

12:52

I I had talking to one of your

12:54

colleagues really tense from Harvard her who who

12:56

said to me that they've done studies of

12:58

patients who had brains for. This amyloid but

13:00

they had the gene Somehow they didn't let

13:03

them create information and they were calgary intact.

13:05

They didn't have dementia right? That's amazing things

13:07

that you can go to your grave with

13:09

a brain for. Lemley not developed dementia and

13:11

we want to study those people because there's

13:13

some he's protecting them via against the development

13:15

of symptoms and of course they may have

13:17

just lest inflammation. As you commented, Rudy tend

13:19

to be the gotta figure that out. The

13:21

A: He talks about the microbiome of them

13:23

brain. I ain't no, I don't think they're

13:26

still trying to figure it out. were finding

13:28

microbes in the brain right? We thought. It

13:30

was sterile up there but turns are

13:32

we not may not be assessed. Eliminated

13:34

is a new one that you pray

13:36

have A and just hearing about there's

13:38

a company out of the barrier that

13:41

sound. There's a at oral My ah

13:43

bacteria called a P Ginger of Alice

13:45

which creates a protein called Ginger Pain

13:47

which may be a neurotoxin and neuro

13:49

trigger of neuron inflammation and so they're

13:51

looking at a drugs to stop that.

13:53

maybe brushing your teeth lacing, getting clean

13:55

as a good idea for Nasa not

13:58

it is good for the hard. Green

14:00

eyed where I am eager them by Know

14:02

that? but one of the biggest triggers for

14:04

heart disease is that somebody threats caresses. So

14:06

so sad about the genetics here for minute.

14:08

So glum, you know? Mostly. When

14:11

you get your genes are fixed. Your.

14:13

Your fey to see of does not as you

14:15

can do. Red Sox have genes work know you

14:18

can modify these genes expression which ones get turned

14:20

on off and how they work and I remember

14:22

have his pace and years ago was nine year

14:24

old woman she was a dentist she had a

14:26

po he double for meaning no way she had

14:29

to. Have the worst teams you

14:31

could have that are triggers or. Maybe.

14:33

Presupposing Alzheimer's and she was nine years old,

14:35

she was still working and who's completely time

14:37

we intact and she was a health not

14:39

her whole life. She ate a perfect diet

14:42

exercise. He never smokes, never tracksuit sticker vitamins.

14:44

I'm he was. It was remarkable. Does I

14:46

see that? Yeah, some friends and in this

14:48

way you talk about in his book with

14:50

this woman steamy she came you because she

14:52

had a family history of Alzheimer's yeah and

14:55

you checked your jeans and see had that

14:57

dreaded tape We for Gene see as many

14:59

people are afraid to test because they feel

15:01

like insisted. Why? Why? why bother

15:03

Emily you've talked about? Why bother

15:05

right? Cellos? Why bother? So idea

15:07

of out to l as the

15:09

Y button a second. but Jamie

15:11

is like your dentist step patient.

15:13

She's a for-for. She found

15:16

her story. Of course she found out

15:18

for genetic was by accident. Now you

15:20

nine know that if you are a

15:22

full two copies of the a Pee

15:24

for jeans your lifetime risk is ninety

15:27

one percent that you're going in developing.

15:29

It's almost a matter of when not

15:31

yes yes. Ah and and the problems

15:33

with is dead. Fortunately,

15:35

there's only two percent the publishing their have

15:37

or double copy twenty percent of populations a

15:40

single copy the buoy for but people now

15:42

finding out because this commercial genetic testing box

15:44

and twenty three and me twenty three me

15:46

rights and and then they got a doctor

15:48

google it's me my friend doctor google yeah

15:51

man that as and they're like well what

15:53

does this mean and then they go on

15:55

dates and so the jamie's of the world

15:57

are finding out day in and day out

16:00

by accident and they're trying to figure out what

16:02

does this all mean. So the story is on

16:04

her half is how she found out by accident

16:06

and how it affected her. My half of the

16:08

book is, is it a good

16:10

idea to be tested? What are the consequences of being

16:13

tested? What does it mean? And

16:15

so that's what my half of the book,

16:17

it's been a nice convergence of two

16:19

storylines that help people to become informed because

16:22

this is happening every day of the week.

16:24

Anyway, but what your book Fighting

16:26

for My Life suggests is that

16:29

by knowing that it can motivate people

16:31

to take control of their life

16:33

and their lifestyle and address the modifiable

16:36

risk factors. That is exactly right. And I

16:38

want everybody who reads the book to be

16:40

like your dentist patient, right? Yeah. She

16:43

was amazing. I have to say to you, I had one

16:45

other. I'm not sure I would go to her at 90

16:47

years old to clean my teeth. But she got to 90.

16:49

She was. Right? Yeah.

16:52

And working. And working. And

16:55

I think that's where my other elderly person get

16:57

to late 80s, 90s, a four,

16:59

four who was unaffected. In

17:01

my career, if I've almost

17:03

said that if you have that genetic profile,

17:06

it's almost a foregone conclusion you're going to

17:08

get Alzheimer's dementia eventually. But there

17:10

was one exception to that. So we want everybody to

17:12

be the exception, not the rule. Now, you

17:14

know, one of the things we haven't really talked about yet is the

17:17

role of sugar in the brain. Yes. And

17:20

many people may remember Ronald Reagan's favorite food was jelly

17:22

beans. Yes. And Alzheimer's now, maybe

17:24

there's a correlation, but it

17:26

turns out that diabetics have four times

17:28

the risk of getting dementia. That is

17:31

correct. And that we sometimes talk about

17:33

Alzheimer's as type 3 diabetes. Yes. This

17:35

is Susan Delamante from University of Rhode Island. Brown.

17:38

Yeah. Brown. Yes.

17:41

And the truth is that we all have control over whether or not we get diabetes. This

17:43

is almost 100% preventable and reversible disease

17:46

by changing our diet. Right.

17:48

So we know that insulin resistance, of course,

17:51

is the hallmark of type 2 diabetes and

17:53

that we can see insulin resistance in

17:56

the brain. And that's what the type 3 diabetes, even

17:58

if you're not having insulin resistance, and the

18:00

rest of your body. And we think, of

18:02

course, and I strongly believe, like you, that

18:04

that's a modifiable risk factor, that we can

18:06

alter that. We can alter it,

18:09

of course, the epigenomes, which

18:11

we're gonna talk about, I hope we're gonna

18:13

talk about epigenetics, but the diet and reducing

18:15

the sugar intake and the diabetes risk is

18:17

something we can alter and have a positive

18:19

effect on. So we all learned, I mean,

18:21

I learned in medical school that your brain

18:23

uses 25% of your glucose and it needs

18:26

sugar to run. Yes, it does.

18:28

And the PET scans show that

18:30

you need sugar to make your brain light up. So

18:32

the rule of thumb on a PET scan is, you

18:34

want your, south of the neck, you wanna be dark.

18:37

North of the neck, you wanna be bright on

18:39

sugar PET. Because if it's dark below, you got

18:41

cancer. If it's bright below, you got cancer. If

18:43

it's dark below, that's why you wanna put it,

18:46

in the brain, you want it to be nice

18:48

and bright. You want that brain to light up

18:50

because it consumes much of the sugar metabolism is

18:52

in the brain. But you also say in your

18:54

book, in patients who have Alzheimer's, that people are

18:56

exploring the role of ketogenic diets, which

18:59

means no sugar and loss of fat

19:01

and the brain running on ketones

19:03

instead of glucose. And the issue

19:06

that people are trying to decide

19:08

is, can you bypass insulin pathway

19:10

mechanism? So if you're relying on

19:12

insulin and pathosolated insulin to

19:15

nourish your brain and you have

19:17

insulin resistance, either you can

19:19

pharmacologically improve that or you can dietarily

19:21

improve that. I

19:30

mean, you know, I remember this patient I had at

19:32

the Ultra Wellness Center, my practice in Lennox, and she

19:35

came in, she was about 78, and she started having

19:37

what we'll call MCI, or myocardial cognitive impairment. And she

19:39

had a whole bunch of things wrong with her fibrosis,

19:41

bad, she had gut issues, she had low

19:44

vitamin B12, she had heavy

19:46

metals and mercury. But she

19:50

was able to fix a lot of these things and

19:52

do a lot better for many years. And then she

19:54

started to climb, and I'm like, well, let's try a

19:56

ketogenic diet. And we got someone to work with her

19:58

and cook for her. And it was like the

20:01

lights went on again. It was pretty dramatic. And

20:03

I think there's some preliminary studies that are showing

20:05

that. And people have

20:07

been looking at it. So the ketogenic diet

20:10

all starts with the whole coconut oil conversation,

20:12

which is coconut oil is controversial by itself.

20:14

But the story behind ketogenic

20:17

diets is that we do understand there's insulin

20:19

resistance. The NIH actually funded a study looking

20:21

at the ketogenic diets. So I think the

20:23

science is there. It's just a matter of

20:25

being able to prove it, and

20:28

more importantly, to adhere to it. Ketogenic

20:31

diets is not easy. It's

20:35

not new to neurology. We've been using ketogenic

20:37

diets to treat childhood epilepsy for 30 plus

20:39

years. So it's new

20:42

to Alzheimer's, but it's not new to brain disease.

20:44

It's been used to treat other brain diseases for

20:46

a long, long time. But

20:49

fundamentally, it's really hard to diet to stick to.

20:52

We're finding more and more people are doing it.

20:54

It's one of the hottest diet trends out there.

20:57

If you look at all the best-selling books, it's not mine. It's

20:59

the keto book. And we're seeing much

21:01

more interest. And we're running keto programs at

21:03

Cleveland Clinic. They're our most popular programs, which

21:05

is pretty amazing. So people seem to be

21:07

willing to try it. I know you had

21:09

Dan Perlmutter on a few weeks ago. And

21:12

Dan and I have. David Perlmutter. David Perlmutter.

21:14

He and I have had

21:16

an internet debate about this. And

21:21

I will say to you that I think it's

21:23

more nuanced. I think that ketogenic diets that

21:26

are insulin-sparing make more sense in

21:28

the symptomatic phase of the disease.

21:30

And I have to tell you,

21:32

I look at Alzheimer's disease

21:35

in a dichotomous way. There's

21:37

the pre-symptomatic. And then there's

21:39

the symptomatic. Symptomatic disease means

21:41

mild cod, repairing, and dementia. And I think

21:43

there is some logic to a ketogenic diet

21:45

in the dementia phase. I agree. I think

21:48

an ounce of prevention is where the pound

21:50

of cure is Benjamin Franklin. Correct. And I

21:52

think the ketogenic diet is a pound of cure.

21:54

It's a pound of cure. But I would

21:57

not necessarily Advocate for it in

21:59

the mild case. The priests symptomatic days

22:01

are more advocating for the. For.

22:03

The. It's Mediterranean

22:05

diet. yeah, and the presumed innocent Getting

22:08

your book or you talk about how

22:10

to create resilience and for health so

22:12

you don't need the pound of cure.

22:14

Correct has tricked her poppers. Life isn't

22:16

to be restricted in restricted, it's actually

22:18

be more resilient. Correct. Healthy for

22:20

you actually are resistant to these zealots.

22:22

Correct right? such as actually exactly the

22:24

right idea. Stare are so many things

22:27

that we can do to put the

22:29

ball back and are court said said

22:31

to to write the script and tell

22:33

our own story on you know. Ten.

22:36

You definitively one hundred percent prevent Alzheimer's in

22:38

every case. Will know. I mean, there are

22:41

certain. Pretty. Rare genetic

22:43

causes were. Basically. Just

22:45

about anything you're gonna do, you're gonna

22:47

get Alzheimer's and gonna probably start early.

22:49

And that's unfortunate, but that is an

22:51

exceptionally rare number of cases most cases

22:53

of Alzheimer's you can do something about

22:56

the based on this Twenty Twenty Lancet

22:58

commission. New.

23:00

Maison State based on twelve

23:03

modifiable risk factors weekend. To.

23:05

Person makes brain healthy choices. Prevent.

23:08

For out of every ten cases of

23:10

Alzheimer's disease. Wow, like we didn't learn

23:12

Adam Med School. Of Medicine Medical

23:14

Student Now aren't learning that? A medical school.

23:17

It takes ten, fifteen, twenty years for something

23:19

to be learned in medical science to be

23:21

translated into clinical practice. And I think it's

23:23

important for this podcast and and people like

23:25

us that to to share this news because

23:27

there are so many things a person can

23:29

do. So you ask me, what can for

23:32

a person do I want? I want them

23:34

to know there's so many Thanks Are merely

23:36

twelve or at least one up so you

23:38

know on our study? I think there's more.

23:40

What is Elise well at least about you

23:42

know in our study is we recommended. On

23:44

average, twenty one different things that a person

23:47

can do on those were individualized per person.

23:49

In our whole universe of our study were

23:51

recommended. Almost fifty things that a person can

23:53

do I'm Susie. Things that that was a

23:56

brand new by going to fight. The

23:58

Up: And. it's some beer This

24:00

isn't radical, this isn't rocket science, this isn't

24:02

like, you know, I'm a simple

24:04

man, I did not graduate first in my med

24:06

school class, I did pretty good and I worked

24:09

pretty hard, but you know, I

24:11

try to just see things from the

24:13

patient's perspective, and there are

24:16

so many things that are evidence-based and safe. The

24:18

two categories I would start with, just

24:20

to kind of set the stage, are

24:23

pharmacologic and non-pharmacologic, and I wanna

24:25

get granular because the word pharmacologic

24:27

doesn't just mean drugs and prescription

24:30

drugs. It also means- Food

24:32

is medicine? Well,

24:34

food is definitely medicine, although

24:36

that got sidetracked to non-pharmacological,

24:38

but like vitamins are medicine?

24:40

Oh, vitamins. I

24:43

actually would challenge you, Richard, because I think that

24:46

food is actually real medicine.

24:48

The phytochemicals, compounds in food

24:51

are biological response modifies,

24:54

or single transduction transchanges,

24:56

and they have a similar effect as

24:58

drugs. In fact, many drugs come from

25:00

the phytochemicals in plants. So

25:02

I would just kind of, well, make us

25:04

think about that a little bit. Well, actually,

25:07

so I'm glad you brought that up. I

25:09

would say that, traditionally speaking, and let's talk

25:11

through this, this is a great opportunity. So

25:13

traditionally speaking, I've always framed it, and I'm

25:15

open-minded, so this is great. As

25:18

pharmacologic individuals- I'm just teasing, right? No,

25:20

this is great. This

25:22

is exactly why we're doing this. This is exactly

25:24

a meeting of the mind, gloves

25:27

are off, let's go. So

25:30

drugs, vitamins, supplements, and

25:32

medical foods are the classic things

25:34

that I personally have categorized in

25:37

the pharmacologic session. And then in

25:39

the non-farm section, I've included diet,

25:41

exercise, sleep, stress, a

25:43

whole bunch of things, learning new things. But

25:46

what you bring up is important, and I

25:48

have a colleague named Dr. Robert Krekorian, and

25:50

he's an amazing guy, he's a neuropsychologist, and

25:52

he's fought the good fight, kind

25:54

of like us. Yeah,

25:56

In some ways that contrarian views, because he's

25:58

tried to do randomized- That using nutrition

26:00

he's done studies on the key to generate

26:03

diet and all timers and Parkinson's in is

26:05

done to you know stays on blueberries and

26:07

and omega threes and see what he's done

26:09

is is taken the food and he said

26:11

okay it's not just about the blueberries with

26:13

the the study and wild blueberries are better

26:16

will why because of this is called Panthers

26:18

Cyan and and then it gets down open

26:20

to it So I completely agree that food

26:22

is Madison Hundred percent agree. I completely agree

26:24

that the specific. Chemicals

26:26

nutrient compounds can be isolated but I think

26:29

it's if it's to reduction is to

26:31

just say let's just put a pill of

26:33

answer cyan and and and prescribed out

26:35

of Russia because it's it's the mill you

26:37

it's rights it's like we had happened

26:39

he did Coffee is good for brain health.

26:42

Will. Is that the caffeine is the

26:44

coffee? will know they. They think it's

26:46

like some substance X during the brute

26:48

brewing process. Rights? So so either the

26:50

depending on which way you look at

26:52

the science, I would prefer that food

26:54

is medicine. Or just

26:57

some time I murderer. I understand the buckets that I'm

26:59

I'm just gonna play with you but I I love

27:01

and I think. We

27:03

when it when I or I put a patient

27:05

for on accuser guy with alzheimer's. A

27:07

may wake up in their brain, becomes alert and

27:10

they remember their. Son. And their

27:12

daughter and a Michael How's. That.

27:15

Less. A drug run some

27:17

other drugs or there are using

27:19

where they are separate. Him is

27:21

impressive. Yeah no I mean I

27:23

I just I just feel like

27:25

all of the different paths like

27:27

you know some people call like

27:29

nutrition. I. Don't

27:31

know, I'm. Not. Mainstream

27:34

medicine like that. To me as a

27:36

western doctor that doesn't make any sense

27:38

to me. Nutrition is I got. I

27:41

got very little nutrition education medical school

27:43

and I think that's a terrible thing.

27:45

I learned a ton. and

27:47

i had to hum of my

27:50

better half has a master degree

27:52

nutrition from colombian she's taught me

27:54

bomb or a lot i think

27:56

russell simmons memories i regard to

27:58

better have seen the less

28:00

enlightened one. So,

28:04

you know, I guess what I'm trying to say

28:06

is nutrition is

28:08

the cornerstone of how we

28:10

practice. Physical

28:12

exercise and precision exercise, precision

28:15

nutrition, these are all the

28:17

things that are

28:19

developing and really become

28:21

the cornerstone of our care. So

28:23

you're talking about the 12 and then the 21 and

28:26

then the 50, maybe there's gonna be 100.

28:31

Tell us more about the granularity on

28:33

that. You were using these, you know,

28:35

and I just wanna sort of frame it for people. You

28:37

did a study that you published, I

28:40

think in 2019, which surprised even

28:42

you, where using this approach,

28:45

looking at a personalized assessment of

28:47

these biological factors that

28:49

could be modified and then

28:51

individualizing the treatment, that

28:53

you not only slowed the decline,

28:56

you not only stopped the decline,

28:59

but you reversed the

29:01

decline, which is

29:03

something that has never really been seen

29:06

except in a couple of trials like

29:08

the finger trial and I think there's

29:10

anyone coming out the pointer trial. So

29:12

those are also lifestyle trials. And

29:15

so you really have sort of cracked

29:17

the egg and published

29:20

something that should have been on

29:22

the front page of every major newspaper, the

29:24

lead story in every evening news. And yet

29:27

it was like crickets. Yeah,

29:29

well, I mean, we got the Wall Street

29:32

Journal and CNN and the Smothers, so I'm

29:34

okay. But for

29:36

me, it was like, it should have been

29:38

like the NIH should have gone, oh, Richard,

29:40

here's $10 billion to get going

29:42

on it. Like that's what it should have. I

29:45

have to be careful, but you know, the NIH

29:47

doesn't really fund what we do and that's been,

29:49

it's very hard. And listen, the NIH, I've engaged

29:51

with the NIH over the last year or two

29:53

and there's definitely been more

29:55

interest, but I talk

29:58

about crickets years ago, a decade ago when I was a kid. started

30:00

this whole thing. 15 years ago, there

30:02

was nothing. There was no funding for

30:04

any of this. So, you know, what

30:06

I would say is, what

30:09

our work shows is that when you individualize care

30:11

and you give people a

30:13

plan, and I know you've asked me at

30:15

least three times now, what should people do?

30:18

What I'm trying, why I'm delaying

30:20

things is because it really truly needs

30:23

to be individualized. And what we use

30:25

is a term called the ABCs of

30:27

Alzheimer's Prevention Management. Based on

30:29

the data, we get data on A's,

30:32

the B's, and the C's. A stands

30:34

for anthropometrics. Anthropometrics is basically a fancy

30:36

A word for body composition. What

30:39

is your body fat? What is your waist circumference? What

30:41

is your muscle mass? Depending on these

30:43

factors, we're going to change the recommendations

30:45

we give. The B stands for blood-based

30:47

biomarkers. We're going to look at markers

30:49

of lipids, cholesterol

30:51

markers, also advanced markers that preventative

30:54

cardiologists use, for example, that most

30:57

neurologists honestly don't really pay attention to.

30:59

We look at metabolic markers,

31:01

insulin resistance. We look at inflammatory

31:03

markers. We look at nutrition markers.

31:05

You know, instead of saying,

31:07

okay, well, go eat fish. It's good for you. We're

31:09

going to look at the markers in the blood. We're

31:12

then going to tell you based on your blood and

31:14

based on your genetics, how much fish you should be

31:16

eating, what types of fish. So, the

31:18

take-home point is we're going to get granular

31:20

with every patient. The other thing we do is

31:22

in the blood-based biomarkers, we look at genetics. We

31:25

look at the ApoE4 variant. It's the most common

31:27

risk gene. It doesn't mean you're going to

31:29

get Alzheimer's if you have the variant, but

31:32

it increases your risk. Well, if

31:34

I know that you have the ApoE4 variant,

31:36

they check for this in 23andMe and millions

31:38

of people have gotten this checked, I'm

31:41

going to personalize your care differently. If you have the

31:43

variant, I'm going to give you plan A, B, and

31:45

C. If you don't have the variant, I'm going to

31:47

give you a little bit modified plan X, Y, and

31:49

Z. If you have two copies of the variant, you

31:51

have a different plan altogether. That's only 1% of the

31:53

population. So, the take-home is

31:56

we take all these markers and then the

31:59

C is cognitive function. function. And

32:01

we understand a person's cognitive baseline.

32:03

We look at memory function,

32:06

language abilities, learning abilities, speed

32:09

of processing attention and executive function, which

32:11

is higher order processing, we take all

32:13

of this and the patient's medical history,

32:15

we learn about the patient, we learn

32:17

everything we can about them, about their

32:19

family, and then we personalize a plan.

32:21

So those 21 different things

32:23

are based on that person individually. And you know,

32:25

there's a lot of overlap if you if you

32:28

want me to say, okay, what are the core

32:30

things? Well, exercise on a regular basis. Okay,

32:33

well, exercise on a regular basis is good.

32:35

But every person gets a different plan. If

32:38

we're putting someone on a plan for body fat loss,

32:41

we're going to give them a different plan.

32:43

Steady state cardio, for example, some people would

32:45

call that zone two training. Steady

32:48

state cardio at 60 to 65% of your heart

32:51

rate, there's different ways to do this through lactate

32:53

testing through a variety of things that we do,

32:55

you know, more precisely in our clinic. But we

32:57

put people on these steady state cardio plans, fasted

33:00

in the morning as long as they can

33:02

tolerate it because that way it jumpstarts body

33:04

fat loss. We have

33:07

people that don't do any muscle strength training

33:09

because they don't like it, we educate them

33:11

to say, I don't like it

33:13

either. I'm not I'm not, you know,

33:15

Mr. Big muscles over here, but I

33:17

have to do strength training once or

33:19

twice a week minimum. Because if you

33:21

don't have muscles, you can't boost metabolism.

33:23

So we put people on these very

33:25

specific plans, high intensity interval training, I

33:27

really believe that high intensity interval training

33:30

is almost necessary for people with

33:32

at least one copy of the APOE4

33:34

variant. And this is what has been

33:36

studied down in a couple of studies.

33:38

And yes, we need more, we need

33:40

more research and studies out of Norway,

33:42

we're good. But we, we need to

33:44

personalize an exercise plan. We

33:47

need to personalize a nutrition plan, we need

33:49

to personalize a vitamin and supplement plan. In

33:51

some people, we do use drugs, it's, you

33:53

know, drugs are actually not commonly used at

33:55

all in our in our research, although we

33:58

do use them on occasion. We'll

34:00

use a variety of drugs, usually at

34:02

much lower doses than maybe

34:05

the regular community uses. But

34:07

when it comes to management,

34:10

unequal opportunity. If there's

34:12

data and it's relatively

34:14

safe, I'll entertain it.

34:16

So we recommend cognitive

34:19

activities that will have a spillover effect,

34:21

learning something new, learning how to play

34:23

a musical instrument, learning a new language.

34:25

These are things that may have a

34:27

protective effect, build backup pathways. Believe

34:29

it or not, even learning how to

34:32

play a musical instrument in midlife has

34:34

protective effects on cognitive outcomes in late

34:36

life. And that's just hope for me

34:38

yet. There's hope for me yet. I

34:40

got my bass guitar over there. I got blisters in my fingers.

34:42

I'm sorry I didn't learn to play the guitar. But

34:47

my big problem is I don't know how to tune

34:49

it. And I am so musically inept that I probably

34:52

there are good apps and things to do

34:54

it. There's a website.

34:56

It's called, you got a pen. It's called YouTube.

34:59

YouTube. You may have heard of it. Almost

35:03

as many people watch YouTube as listen to your

35:05

podcast. So you can learn how to play guitar

35:07

on YouTube. I think you can do

35:09

it. Okay. For sure.

35:11

That's my December. And

35:14

the January and February mark. So the

35:16

take on point is engage your brain.

35:19

Treat your brain with respect. Love

35:22

your brain. Make a plan for your brain. What

35:24

does that mean? Make a plan for sleep. If

35:27

you exercise and exercise and exercise, some people

35:29

say colloquially that that loosens the amyloid, the

35:31

bad protein that gets build up in the

35:33

brain of a person with Alzheimer's. But

35:35

if you're burning the candle at both ends and

35:38

you're not sleeping during sleep, especially deep sleep, that's

35:40

when a person has the trash come. The

35:42

trash man comes, they pick up the garbage

35:44

and they take it out and they take

35:46

it to the trash heap. That

35:48

is the restorative part of sleep. And if someone

35:51

isn't sleeping, you know, at least seven, seven and

35:53

a half, eight hours of sleep is usually the

35:55

goal as we get older. It's, you know, harder

35:57

to sleep that much. But

35:59

making a plan. for sleep, prioritizing sleep. You

36:01

know, we have people that track their sleep,

36:03

that track their exercise. I'm wearing a wrist

36:06

device here, I have nothing to disclose but

36:08

we've done you know, several research using this

36:10

device. I track people on my phone. I

36:12

have my phone right here and I can

36:15

check how much exercise they've

36:17

been doing, how they're asleep, how much deep

36:19

sleep. I can see their blood sugar control.

36:21

I can see all these different things on

36:23

my phone because my patients share

36:26

their data with me. And when I

36:28

talk about data sharing, it's not just

36:30

about tracking sleep, it's not just about

36:33

doing exercise, it's about tracking it,

36:37

determining the response, talking to your physician about

36:39

it. Granted, it's hard to find physicians that

36:41

will take the time to talk to you

36:43

about this kind of stuff. Tracking

36:45

your blood sugar, there's you know, at

36:48

home devices called continuous glucose monitors. In

36:50

our program, we take a very, very

36:52

deep dive and we learn about all

36:54

of these different metrics and we refine

36:56

or fine tune the plan that we

36:58

give them based on their

37:00

real time measurements. So you

37:02

know, I can keep going, there's

37:04

stress modification, you know,

37:07

transcendental meditation. Bob Ross taught me a ton

37:09

about this. What about mindfulness

37:11

based stress reduction? You can take a course

37:13

online. Mindfulness based stress reduction has amazing outcomes

37:15

when it comes to brain health. The list

37:18

goes on and on. There's no one magic

37:20

pill or one magic cure, but there are

37:22

a variety of, I was

37:25

going to say pharmacological and non-pharmacological, but you're

37:27

reevaluating how I say this now. There are

37:29

a variety of interventions that are evidence based

37:31

and safe that I think all of us

37:33

need to learn about. You know, whether we

37:36

talk about fasting and I like

37:38

the term time restricted eating better meaning

37:40

not eating for 12, 14, 16

37:42

hours overnight, at least four or five days a week.

37:45

I use the term fasting for a more

37:47

prolonged fast, you know, 24 hours or more

37:49

and that's a different discussion. There's

37:52

the ketogenic diet, there's a Mediterranean

37:54

style diet, there's the mind diet,

37:56

there's components of each diet, green

37:58

leafy vegetables, wild wild salmon,

38:01

grass fed beef better than non grass fed

38:03

beef because of the Omega 3's. There's

38:06

so many devil's in the details. Half a

38:08

couple blueberries and strawberries two to three times

38:10

a week, leads

38:13

to better brain health outcomes and cognitive

38:15

outcomes in the nurses health study many

38:17

years later on. There's

38:19

dark cocoa powder. There's so many things that

38:21

I can drop in as key things. But

38:24

the take home point is all of these things need to

38:26

be individualized. So let me

38:28

ask you this because I mean, you know, first

38:31

I want to just kind of feedback

38:33

because what I'm listening to you thinking,

38:35

you're a neurologist, it's also an immunologist,

38:38

the cardiologist and an chronologist, the gastro

38:40

neurologist and nutritionist. You're

38:43

breaking down the paradigm of medicine. We should

38:45

stay in our lane, focus on our organ

38:47

and leave the rest to everybody else. And

38:50

your insight here is that the body is

38:52

a system, that everything's

38:54

connected to everything. You can't just

38:57

pick out one thing and work on that like

38:59

amyloid or tau or whatever and

39:01

get to the problem. And

39:04

you know, it's sort of like trying

39:06

to bail

39:09

the boat while there's holes in it. You got

39:11

to fix the holes. And

39:13

essentially the holes that you're talking about are all these

39:16

ways in which our brain gets injured by

39:18

our lifestyle and by our environment. And you

39:20

didn't mention toxins, but that also plays a

39:22

large role. And so all of

39:24

a sudden we have to sort of rethink

39:26

our whole approach, which has really been a

39:29

reductionist approach, single disease, single drug

39:32

with a single outcome. And

39:34

there was an article in JAMA a number of years

39:36

ago called Shifting Thinking in Dementia. You

39:38

probably saw it. And

39:41

they said in that article that

39:43

we combine categorical misclassification with

39:46

etiologic and precision. And

39:48

in English for those listening, that means we

39:51

categorize dementia according to symptoms, not

39:54

the causes. And

39:57

we are not very focused on the etiology or

39:59

the causes. From the symptoms and

40:01

will will you can remember this and

40:03

you fit the profile on your New

40:05

York Iger testing. You had Alzheimer's. You

40:07

have this kind of dementia are lewy

40:09

body, Obama block and the reality is

40:11

that you can add ten people with

40:13

Alzheimer's only ten different treatments. And.

40:16

That's exactly what you're talking about.

40:18

That's heresy. Richard, Mets heresy and

40:20

medicine. Honestly, because we we really

40:22

have have a very, very restricted

40:24

to Texas view of disease, it

40:26

doesn't let us. At. Least even

40:28

study these things. And I'm I'm literally had

40:31

arguments with Hop. A leading researchers

40:33

like has a research of major

40:35

institutions say these are all the

40:37

factors that affect the brain. We.

40:40

Want to study them together? Is

40:42

owner it's to say one thing at

40:44

a time and then see how that

40:46

works and when the study exercise missing

40:48

nutrition the same I am indeed and

40:50

studies to Charlotte am I now see

40:52

as a house things actually work her

40:54

life since I guess you have to

40:56

use it out the whole picture as

40:59

be realising I wanted to sort of

41:01

a touchdown was that you. Use.

41:04

Of introducing. A concept

41:06

of. The. Personalization which again

41:08

is is very different Medicine.

41:11

As. That one size fits all and it,

41:13

and you're talking about. Very. Sophisticated

41:15

personalization based on a whole set

41:17

of biomarkers and tests the things

41:19

that are easily accessible. But. That

41:21

that aren't normally looked at and that

41:24

are normally tested. Name is typical Panel

41:26

your thyroid, your B twelve. You

41:28

get your spinal fluid time you get your i'm

41:30

riding Okay. you got Alzheimer's how I is it.

41:32

A. Little. Bit more healthier than that,

41:34

but it's it's. really. A

41:36

fairly narrow window of. Biomarkers.

41:39

Metrics. And there's. Brazilians, Up.

41:42

And and I think we're just to the touching

41:44

hatching that the for the tip of the iceberg

41:46

on this and I've i've seen in my patients

41:48

When you start to apply these. Concepts

41:50

of personalized. Care. Around

41:53

food around exercise around sleep

41:56

around stress around. Supplements.

41:58

Around everything. That. You really

42:00

begin to see dramatic changes in brain function. Yeah,

42:04

I'm. You. Know

42:06

I. I. I often joke that I'm

42:08

like a one Third Neurologists but a

42:11

preventative neurologist at that. I'm a one

42:13

third of Make believe I will. Full

42:15

disclosure: I'm not a preventive cardiologist, but

42:17

I may make believe preventative cardiologists i

42:20

us one third primary care doctor and

42:22

make believe prevented endocrinologists. I don't even

42:24

know any preventative endocrinologist or if you

42:27

find one, introduce them to me and.

42:30

Why? I was trained in an environment

42:32

in which was six your medical Program where I

42:34

was in med school from day one, Universe in

42:36

Missouri, Kansas City or newer ones. Be a doctor

42:38

and I was alive after seventeen years old were

42:40

my white coat and I did so much internal

42:42

medicine during med school I had like an extra

42:44

year of medicine because that's where training was an

42:46

attorney for. Was that or I'm not sure exactly

42:48

what it was, but. All.

42:51

Timers Diseases a medical disease. Yeah,

42:54

full stop that sisters this thing called the

42:56

skull and it's a hard yeah thing that

42:58

you affects you and you fall. but it's

43:00

just like it's it's it's like when you

43:02

have medical conditions you can affect your kidneys.

43:04

When you have medical conditions it can affect

43:06

your eyes. It can affect your heart's the

43:08

same thing. it can affect your brain and

43:11

I couldn't agree with you more. People can

43:13

take different roads to all timers. And.

43:15

You have to figure out what were their on. And.

43:18

Get the get them the heck off

43:20

that wrote women for example or unfortunately,

43:23

Many times in the fast lane to Alzheimer's

43:25

women to out of every three brains affected

43:27

by Alzheimer's or women's brains and by ten

43:29

years ago up I would sadden know why

43:32

and. Now. I think I

43:34

can answer that question. It's related to

43:36

pre menopause transitions really a specific life

43:38

sectors. It's related to women being maybe

43:40

a little bit more at risk if

43:42

they have the if we for variants

43:44

to the tic. On pointers: if you

43:46

understand a person's individual risk factors, whether

43:49

it's biological sex, whether it's medical conditions,

43:51

whether it's what's floating around in their

43:53

blood, whether it's what is their cognitive

43:55

function at baseline. Yet.

43:57

to figure these things out and then you have the target

43:59

that and personalize that plan. And I

44:02

mean Alzheimer's disease and

44:04

brain health needs to be treated in

44:06

a medical way because if

44:08

it's not, if you're just targeting amyloid,

44:12

you're missing the boat. You know, amyloid is

44:14

a marker and I think hopefully one day

44:16

we're going to have just like we treat

44:18

diabetes with lifestyle interventions and exercise

44:21

as well as certain targeted drugs that honestly

44:23

some of them actually do tend to work

44:25

pretty well. I'm not the biggest fan of

44:27

insulin like that doesn't, that's maybe band dating

44:29

to me. That's probably too late. I mean,

44:31

I'm not the best whatever, but some of

44:33

these new, you know, new

44:36

things that are pretty interesting. I won't get into

44:38

specifics, but I hope that one day

44:40

we treat Alzheimer's disease and

44:42

cognitive decline like any other chronic

44:44

disease of aging where we hit

44:46

things with a multimodal evidence-based and

44:48

safe approach that requires

44:50

a medical intervention. So essentially

44:53

you're saying that to paraphrase is that Alzheimer's

44:55

is not a brain disease. Correct.

44:57

It's a systemic disease that affects the brain. Yeah,

45:00

I really believe that. I have to

45:02

be careful saying that. Is this being recorded? Oh

45:06

no. That is going to be broadcast to billions of

45:08

people around the world. Great. Great. My

45:10

field. I was just trying to, I was just gaining

45:12

some, some, some fans in my field and

45:16

now it's all a decade of work. Oh, God.

45:18

What are you going to do? You are, you

45:20

were at the forefront of a paradigm shift that's

45:22

happening throughout medicine, which is the breakdown of the

45:25

old concepts of disease from simply

45:27

introductionist, organ-based, symptom-based model to

45:29

systems thinking and network medicine.

45:31

And that's really all you're

45:33

talking about. There's very strong,

45:36

compelling evidence at this point

45:38

that bacteria are the cause of

45:40

neurodegenerative diseases. Not my... Yeah.

45:43

Rudy, we talked about Rudy Tanzi who's

45:45

a Harvard scientist, one of the discoveries

45:47

of some of the pre-synchron genes, which

45:49

are the genes that show that people

45:51

are at risk for early Alzheimer's. He actually

45:54

said they were discovering all these

45:56

microbes in the brain, which we

45:58

thought was... It was impossible

46:00

and that we had this blood brain barrier

46:02

that protects us and you're

46:05

saying and he's saying that that barrier

46:07

is not always 100% and that stuff

46:09

can leak through. Not only can you have a

46:11

leaky gut but you can have a leaky brain.

46:13

Look bacteria, not to scare people, bacteria love the

46:15

brain. Why? 25%

46:17

of the body's glucose is used by the brain. They

46:19

know where to eat. They

46:22

go into you know Le Pen or

46:24

the fancy restaurant is downtown. Like everyone else

46:26

is eating downtown. They're getting you know

46:28

our brains. Can bacteria live

46:31

on ketones? 100%

46:33

but not but not wait that's very important.

46:35

They prefer simple sugars. Why?

46:39

Because they're lazy right? They want you know

46:41

they want instant gratification. So

46:43

they like sugar better than ketones.

46:45

But ketones and ketotic diets work

46:48

for some of these neurodegener diseases like Alzheimer's

46:50

and even LS and brain cancer. That's

46:53

right. That's right. One

46:55

of the mechanisms to be honest

46:57

with you is that ketones actually

47:00

improve firstly improve mitochondrial function but

47:02

they're not a good substrate for

47:04

bacteria. They're a great substrate for us.

47:07

Bacteria don't like them

47:09

because they like eating fast food basically. Yeah.

47:11

So eat them sugar and we eat fat.

47:14

That's right. Okay so this

47:17

is just a breakthrough idea and

47:19

this isn't just an idea. You've

47:22

actually treated patients using this approach.

47:24

You've seen some really extraordinary things.

47:27

So can you share with us you know a

47:29

little bit about this case you were sharing with

47:32

me earlier about ALS which is a horrible

47:34

condition. Stephen Hawking had it. It was called

47:37

Lou Gehrig's disease after the baseball player. Essentially

47:39

it's where your nervous

47:42

system is affected by the

47:45

killing of the neurons in your spinal cord

47:47

which makes you basically paralyzed. You

47:49

got fasciculation which is twitching. You

47:52

eventually can move your arms and legs. You're in

47:54

a wheelchair. You can't breathe. You need a respirator.

47:56

You wouldn't worship on your worst enemy. You would

47:58

not worship. It's a horrible thing. like a

48:00

slowly getting paralyzed. Yep, that's

48:02

right. And never

48:04

has there been a treatment that

48:06

has stopped or reversed it. Right.

48:09

And you're saying that you've seen patients where

48:11

this has actually happened. So,

48:15

well, we are in the

48:17

process of validating that

48:20

sort of, that data,

48:22

yes. So, yes, we need

48:24

more studies. Yes, we need to do research

48:26

on multiple patients. But even

48:29

if there's one patient where you've seen

48:31

a change, it raises the question.

48:34

By the way, it's made me go crazy, by

48:36

the way, because I am so, I'm finally glad

48:38

to be a neurologist. Being a neurologist

48:40

is like being a nihilist or a masochist. Diagnose

48:42

and adios, right? Well, it's worse than that. It's

48:44

like diagnosed and let me not tell

48:46

the patient that they have ALS. Let me treat them

48:48

for a CIDP picture because

48:53

they don't want to actually make that diagnosis for people.

48:55

It's the hardest diagnosis you could make for a patient

48:58

because everyone knows ALS is incurable

49:00

disease, right? I mean, it's 100%. Even

49:03

pancreatic cancer is better. Well, you have a

49:05

5% chance of living in pancreatic cancer. You

49:07

have zero chance of living through this disease,

49:09

zero. So, basically your hypothesis

49:11

is infectious. Yes. Because that

49:13

plays a big role. That's not, is the main role. Right.

49:17

I personally shared on this podcast that I

49:19

went to a place in Mexico called Santa

49:21

Viva where I and my

49:24

wife both went through this treatment

49:26

called hyperthermia, which essentially is where they

49:28

heat you up to 107 degrees,

49:30

which sounds crazy and is

49:32

scary. But actually we

49:35

did both fine and it killed

49:37

a lot of infections that we had.

49:39

Your image is amazing. Like Lyme, my

49:42

wife, her viral loads of very tough

49:44

to treat infection called CMB came

49:47

plummeting down. She felt

49:49

much better. I felt much better. And

49:52

so this is a therapy that is not much used in

49:55

the United States, but is used

49:58

widely in Europe, is used in Mexico. in

50:00

other countries is a therapy for some

50:02

of these types of infectious diseases and

50:04

even cancer. Right. So

50:07

how does the theory work behind this

50:09

with something like ALS? Well,

50:14

the idea is that fever

50:17

is the way of actually denaturing

50:20

spores. So that's a big sentence.

50:22

Can you unpack that? Sure.

50:24

So human cells have

50:27

their proteins that either

50:29

fold properly or not fold properly at

50:31

a certain temperature. Right. Bacteria

50:34

have their own temperature zone like

50:36

their ideal climate and spores have

50:38

another ideal climate. Right. Meaning

50:41

that to kill a spore. A spore is

50:43

like a baby bacteria. A spore is a

50:45

baby bacteria. And that's what I believe personally

50:47

is the reason that patients

50:49

have amyloid accumulation. That

50:51

the spores are creating

50:53

this protective cover against

50:55

antibiotics that actually is

50:57

in fact the amyloid being produced.

51:00

So the amyloid is like the armor for the

51:02

bacteria. Yes. They're like

51:04

the bomb shelter.

51:07

The biofilm is the bomb shelter for

51:09

these little baby bacteria. Yep. And

51:12

so how does hypothermia work

51:14

to disrupt that? Oh. And

51:16

what is that procedure? Well, so it

51:18

works. Hypothermia works by

51:21

it's a very narrow window

51:24

of temperature. Meaning if you give too much

51:26

temperature you can actually hurt normal

51:29

cells as much as you

51:31

know bacterial cells. If you don't give enough

51:33

temperature you've done nothing. So it's like Goldilocks.

51:35

It's like Goldilocks. You got it just right.

51:38

You have to get it exactly right. Okay.

51:41

And that's part of the

51:44

way that the hypothermia technology

51:47

has been developed is by really

51:49

understanding that the brain itself

51:52

can provide feedback on

51:55

the tolerability for human cells because

51:57

brain cells against hell the brain.

52:00

hey free hot near your fry your

52:02

brain. I t turn the thermostat off

52:04

now so deposits for the device actually

52:06

as to. To. Get his brain

52:08

temperature. Or back into the

52:10

feedback system where it's self regulating

52:12

so that you never reach a

52:15

point where the temperature is harmful

52:17

to your own cells. And

52:20

and so you have the often.

52:22

In. Places where they do this a they'll

52:25

give at the peak of a temperature they'll

52:27

give antibiotics or any virus. right?

52:30

Does. That make sense to get anti virus

52:32

or it yeah to give anti microbial treatments

52:34

to patients when they're the peak of a

52:36

fever because ideas it it's sort of size

52:38

after it for yes for cute reception yes

52:40

I would I would argue that I more

52:42

while Islam is a cute certainly I mean

52:45

I think that said I I mean I

52:47

think he had these weary of the of

52:49

the issue that by in I use robbing

52:51

Peter to pay Paul for instance let's let's

52:53

say that see the if is let's say

52:55

well as far as I say this is

52:58

a poly microbial disease okay as opposed to.

53:00

A like lots of different bucks, less

53:02

of a box as opposed to just

53:04

one ringleader. Ever else is falling attacking

53:06

so Lombard believes it's it's that that

53:08

see if is the ringleader okay and

53:10

all these other guys lime Hsv they

53:12

just bit tagging arrived as it's such

53:14

a great killer that's like okay great

53:16

move will take the leftovers no problem

53:19

here. Will. Take the leftovers. So

53:21

my concern is clinically that if we

53:23

saw tree impatience you know with in

53:25

a bacterial. Drugs like

53:27

recession? Whatever it is for

53:30

chronic Lyme. Yes, you're dressing

53:32

chronic Lyme. The New Seabiscuit

53:34

Scorsese. Yes, Exactly Here exactly.

53:36

Who. So the heat alone is enough to

53:38

disrupt the see This. It's.

53:41

Well, we haven't demonstrated that.

53:43

Yes, be quite frank. Biden

53:45

what What's been demonstrated His

53:47

dad by applying. Hypothermia,

53:50

That. were able to actually see improvement in

53:52

clinical symptoms of patience with a lot of

53:54

people's muscle strength as is a progressive disease

53:56

so getting worse and worse and worse every

53:58

visit their worse You're seeing patients,

54:01

it stops or it gets better, which

54:03

never happened. Correct. So this is a

54:05

major breakthrough. I think so. Major

54:07

breakthrough and this is not

54:09

something new. It's been around for a long time.

54:12

So where in the world is

54:14

most of the research being done on hypothermia? ALS?

54:17

Period. I mean it's

54:19

– So most of the research

54:21

on hypothermia actually is cancer

54:24

research. So they call it

54:26

chemothermia, chemohypethermia. So people can look up a

54:28

lot of data on how

54:30

hypothermia affects cancer. But as far as I

54:32

know, there's zero data until now applying

54:35

hypothermia for ALS. We will be the first

54:37

people to actually talk about applying hypothermia for

54:39

treatment of ALS. What about things

54:41

like Alzheimer's or Parkinson's or MS? Well, the

54:43

difference in those diseases are that in

54:48

Alzheimer's, right, it's very difficult

54:50

to induce hypothermia in a

54:52

patient with Alzheimer's disease. Why?

54:54

Because you need to be compliant. The

54:56

treatment itself is – it's fairly rigorous

54:58

as you know from your experience. They put

55:01

me to sleep. They put you to sleep, right. We don't

55:03

want to put them to sleep though, right, because we're concerned

55:05

about protecting their brain. So, you

55:07

have a patient who's got end-staged

55:09

Alzheimer's disease for instance. I

55:11

don't see how this is going to be held for them. Early.

55:14

Early 100%. Early. Early.

55:17

In fact, I will talk later, not about the case now

55:19

because we're really just in the beginnings of this case. But

55:23

yeah, I think it's applicable for Alzheimer's disease as

55:25

well. Have you seen any patients? No. Reported

55:28

or in literature or anywhere? No, definitely not. But you

55:30

serve as a theory. Yes, still a theory. An MS?

55:32

What about MS? MS,

55:34

there's data on actually

55:37

the opposite, right, which is

55:39

how do you induce hypothermia, right,

55:41

because an MS, it's an inflammatory

55:44

disease obviously, right, which

55:47

by the way, I also believe is caused

55:49

by clostridium but not C. diff, which is

55:51

especially important to actually identify at that

55:54

stage that this is bacterial. So

55:57

there, I don't know what their... Yeah,

56:00

so what what what is

56:02

the idea with MS that you you wouldn't want

56:04

to use hyperthermia that you wouldn't want to use

56:06

heat Because it makes it worse. Well because remember

56:08

when you heat up a patient with MS what

56:10

happens? They usually get worse. So

56:13

the trick is but maybe not enough,

56:15

right? Well, it's not enough. That's right

56:17

Maybe you haven't reached the threshold to

56:20

actually, you know use the body's fever

56:22

mechanisms against because there's links

56:24

to MS and epsilon virus and

56:26

other infections is links to Alzheimer's

56:28

and herpes virus infections. Right, right.

56:30

So yes, the whole principle is

56:32

applicable for all those diseases But

56:34

we don't know yet if it

56:37

is applicable yet until we clinically demonstrate that

56:39

right but Yeah,

56:43

I think that this is going to be a treatment

56:45

that's going to be very important for a lot of

56:47

different diseases mark So there's this whole theory that the

56:50

body has a mechanism for dealing with this and

56:52

it has these own Proteins that

56:54

are produced in response to heat and there

56:57

are things we learned about in medical school.

56:59

They're called heat shock proteins I

57:01

learned something very important about heat shock proteins from

57:04

dr. Lesler Because remember

57:06

that you know people looking at how to

57:08

induce hypothermia, right? So there's all sorts of

57:10

research It's actually even a drug in clinic

57:12

for ALS That

57:14

is the the mechanism

57:16

of action is based upon increasing heat

57:19

shock protein through a pharmaceutical agent So

57:22

I was at this lecture and I you

57:24

know I thought I knew everything basically and

57:26

I learned that and actually you can induce

57:28

it You thought MD stood for medical deity.

57:30

Is that it medical theory? Yes. Yes, exactly.

57:32

We all got that training Yeah, the truth

57:35

is we know close to nothing. That's why

57:37

I said the beginning of this talk I

57:39

you know, like thanks for inviting me, but

57:41

I really know nothing Just

57:44

disclaimer, but anyway, so yes

57:46

actually in MS The

57:48

the goal is to induce heat shock protein

57:50

through hypothermia hypothermia. So

57:52

you get people cold not people

57:55

The brain the brain right? How do we do

57:58

that? Chill the brain kill the brain? Then.

58:00

How. Do you do that? The ice

58:02

blocks around the had no, no. Ah,

58:05

Well that you up and you could you

58:08

could see for yourself with that looks like

58:10

arrive sooner. Had no sort of nope Nope.

58:12

Nope. No. The Bus: Okay, so

58:14

we have to be in mystery here,

58:17

but a mystery about what the device

58:19

looks like? Him: Yes, it's it's It's

58:21

basically the same concept as building a

58:23

Hyper thermae device, except remember now it's

58:25

technology itself. Is. Was.

58:27

Developed basic as his urologists who's

58:29

as well to yell. By.

58:32

Doctor A Brave who's the the

58:34

person who actually discovered. A.

58:36

Way of measuring brain temperature. Who

58:38

object of li. Externally.

58:41

A case that that's kind of where

58:43

this whole thing started from be. Ah,

58:45

yes, and we want us to collect.

58:47

Showing your brain, you can really map

58:50

it up. From the outset, you can

58:52

map enough mail size, cel deep. The

58:54

billie to do that now allows a

58:57

clinician to not only you know, heap

58:59

the the body to create hypothermic states,

59:01

but through other types of modalities to

59:03

actually cool the brain safely at certainly

59:06

with the same distance in the same

59:08

way. Mean that you can actually

59:10

apply. Ah, a small device.

59:13

Ah, To a region of

59:15

the of the skins perry orbital

59:17

location and you could actually change

59:19

temperature. The brain. Through this

59:21

was called the Brain Thermal Tunnel. Thanks

59:26

for listening to that! If you love this

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