Reversing Cognitive Decline: A New Approach - Episode 282

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Welcome everybody to this edition of the Gladden Longevity Podcast.

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I'm your host, Dr.

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Jeffrey Gladden.

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And today I'm here with Heather Sanderson and Heather's doing some remarkable work, really
kind of a work that's been needed for a long time.

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And she's taken a completely different approach, I would say really to the whole space of
cognitive decline, dementia, families involved, the whole concept of, um, you know,

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caring for people, right?

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So there are these centers associated with, you know, cognitive care.

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um And yet in my estimation, they're really just custodial places, right?

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So memory care is really is what they're called, but there's nothing really going on
except watching people's memories decline.

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So you've really taken a different approach to all this.

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So, Heather, welcome to welcome to the show.

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Thank you for having me.

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It's a privilege to be here.

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Yeah.

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So tell us a little bit about how you got into uh this whole space.

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I'm sure when you were five or six years old, you had it predetermined.

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You know, I'm going to change the world when it comes to dementia.

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yeah.

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And what was I went to naturopathic school and learned a lot about functional medicine.

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Other people have sort of termed it that, but how to think about health and instead of
disease, right, how to think about optimizing a complex system, the human body and the

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human brain.

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And yet I was still told that there was nothing you could do to support someone with
Alzheimer's or dementia.

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And so I took that as gospel.

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I got out of school and really didn't think that...

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I would ever see an Alzheimer's patient.

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just thought there was nothing I could do for them, right?

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And then I saw my mentor, Dr.

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Dale Bredesen speak at a conference.

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And he said the opposite.

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He actually said, this can be reversed.

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There are things that we can do to optimize cognitive decline for patients who have, are
at any age at any stage of the disease process.

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There's something we can do to intervene.

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And what he was presenting was essentially naturopathic medicine, functional medicine as
applied

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to neurology and cognitive function.

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And when I heard him speak and he was talking about these different components and how if
we stacked all of functional medicine on top of itself and we applied each of these things

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in a precise way for that individual, if they change their lifestyle, their diet, their
exercise habits, their sleep habits, their stress management, we could see outcomes.

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And although I was very skeptical when I heard this, because again, I had taken this
gospel that there was nothing we could do,

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I was intrigued because it made sense.

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was common sense.

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Just no one was practicing it this way.

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And so then Dr.

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Bredesen published his book in 2017, The End of Alzheimer's.

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And I was on the list of providers who'd been trained by him because I was so intrigued.

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I signed up for training and realized these were things I had learned to do in school,
right?

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It was the detox.

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was the hormone balancing.

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It was the lifestyle medicine.

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And so after,

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getting his training and starting to see patients, I was no longer a skeptic.

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I watched miracles happen in my clinic, not just once, but over and over again.

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People with even severe cognitive function, severely declined cognitive function were
improving.

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People with diagnosed Alzheimer's were getting better.

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Now, of course, it's easier when they're younger, it's easier when they have mild
cognitive impairment or even those early signs, but I saw them getting better over and

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over again.

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And then I got the call.

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Hey, my uncle has Alzheimer's, where do I send him?

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I don't have the bandwidth to cook all of his meals, to get him to exercise, to do all
this stuff, but I want him getting the benefit of this approach.

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So where does he go?

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And as you mentioned, Memory Care is a place no one wants to go.

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No one has any interest in ending up.

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You end up there when you have no other option and it's expensive and essentially they
park you in front of a TV.

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and help take care of your activities of daily living while you await demise.

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And it is heartbreaking and torturous.

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And so the alternative is, again, it's common sense, just not common practice.

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It's how do we create a space?

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It's just putting the best of what we know in memory support, in cognitive optimization,
into the place where people with memory issues live.

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It's just combining two things that already exist.

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Yeah, exactly.

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So did you actually start a facility then that where people can go that's kind of an
alternative to memory care?

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Is that what we understand here?

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Yeah, exactly.

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So in 2020, we started Marama.

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And it is an immersive experience in Dr.

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Brutison's approach where all it's done for you, right?

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The meals are organic and mildly ketogenic.

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They're high, full of veggies so that you get that high polyphenol rich foods, lots of
cruciferous veggies for detox support.

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We're just that we're using food as medicine.

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We also get the social engagement in a non-toxic environment.

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So by default, you're forced to have meals with people, converse with people, engage with
people, garden with people, exercise with other people.

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We heal together.

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We're a social species.

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We don't heal in isolation.

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Getting people back together is part of what's happening.

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We also have a non-toxic environment.

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We're hypervigilant about mold.

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We use organic mattresses, and bedding, and food, and non-toxic cleaning products so that
we're not getting any inputs that are going to

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increase our risk, right?

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We're not getting neuroinflammatory chemicals that we're inhaling.

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We're really careful about that.

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And then our staff, uh we have basically four pillars.

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It's diet, it's the environment.

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Our staff expect improvement, right?

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And so you treat someone really differently if you expect them to improve versus if you
expect them to just decline.

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You engage in a completely different manner.

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And our staff are also very familiar with the supplements and medications that are most
common on a Bredesen protocol.

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And then the fourth piece is engaging in the exercises, the brain jam, the mental and
emotional engagement that keeps things compelling so that we're looking forward to a

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bright future.

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Right.

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No, that's a wonderful approach.

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You he really, when I first read his book, you know, the 36 holes in the roof, I think is
what it is.

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Right.

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So it's basically breaking down all the different contributing factors because it's never
just one thing.

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And then, you know, beneath that, there are a couple of things going on.

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uh One is genetic predisposition.

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So everybody knows that there's genetic predisposition.

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The second is

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the aging process itself, which can have a big impact on hormones and estrogen and thyroid
and things like that, which also can play a major role.

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Um, and so, you know, in our world, when we think, when we see somebody that's suffering
with cognitive decline, the first thing that we end up doing is our genetic, uh, test to

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kind of figure out, okay, what genes do they have?

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Because there are many different gene sets that can predispose somebody to dementia, if
you will.

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Some of them are.

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you know, more slated towards Alzheimer's, APOE4, APOC1, TOM40.

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But there are many others that can actually impair cognitive abilities as go forward as
well.

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uh we found that to be kind of really helpful.

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And then we've also found real issues with thyroid.

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So the DIO2 gene is a big one, right?

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People don't basically convert inactive to active thyroid in the brain efficiently.

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And uh if you give them T3, even if they're technically normal thyroid, my gosh, their
brains wake up.

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We've seen this many times, right?

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uh So there's many nuances to this as well, right?

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um And I think it's a really interesting field because I think a lot of people feel
relatively hopeless in this space.

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And yet I think there's a tremendous amount that can be done based on

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kind of what you're doing.

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And then it sounds like maybe some things that support that as well, right?

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So are you involved with any of the, any of the research trials around things like TB 006
or any of those kinds of things, antigallectin three, is that something that you're having

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an eye on or thoughts about that?

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Yeah.

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Yeah, I haven't seen that many people improve on it, although I do have a new patient that
I saw recently who's been doing that.

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And when she doesn't get her TB 0.006, she does not do as well.

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So I know that it is helpful for some people.

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I think it's interesting that they're not testing Galectin 3 levels.

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I don't know if there's some explanation for why you wouldn't test Galectin 3 before to
see it, to evaluate if that was going to be beneficial.

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For me, I find it helpful.

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to create some structure and a framework for how you would think through this, because I
think there is a lot of overwhelm.

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And for good reason, Dr.

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Bredesen and his group at Apollo, Julie Gregory, they say that there's sort of this false
hopelessness that comes out of conventional community, that there's not reason to be

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excited about improvement, potential improvement.

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And yet when we look at it, there's...

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an overwhelming amount of things that you could do to optimize cognitive function,
including looking at genetics, considering TB 006, including, you know, potentially

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looking at antibody therapies, the amyloid antibody therapies, those are not appropriate
for everyone, especially people who are ABUE 4, 4 positive or 3, 4 positive, but there are

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lots of things to consider.

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And so how do we create structure so that we can systematically go through that list of
options?

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And what's important for me as an individual, these, as you mentioned, 36 holes in the
roof, it's probably more like 7,000 potential holes in the roof, right?

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How do we approach this?

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So I think of the six components of brain health, toxins, nutrients, structure, stressors,
signaling, and infections.

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So under structure would be our molecular structure or our genetic risk, right?

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You mentioned APOE, there's also APP, PSEN, the...

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piece in one and two, which are associated with early onset Alzheimer's versus our later
stage after post 65.

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so there's genetic structure can put us at risk, but then it's going to be those
environmental factors, those lifestyle factors that pull the trigger.

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So we can talk through all of those if that's helpful to kind of get a sense of what do we
prioritize?

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Where do we focus?

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And how do we make sure that we're not chasing something that maybe isn't?

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necessary for us personally, but we're looking at things that have good data behind them,
good support that are relatively low risk, high reward.

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Yeah, I think that's right.

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think, um you know, our approach over here, and I think yours is very similar, is that we
like to, whenever we see somebody, we like to deconstruct the problem before we actually

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start recommending solutions, because it's really easy to say, well, we could do this and
this and this, but it may not be the right thing for that individual, right?

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So deconstructing in terms of, you know, their gut biome and their...

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their mold toxicities and the infections they carry and the inflammation in the brain,
right?

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And the genetics that they carry with those predispositions are insulin resistance, right?

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Cardiovascular health.

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um All these things kind of get broken down to actually understand, okay, these are
contributing factors.

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Then you can sort of formulate a plan where to your point, you can actually reverse uh
cognitive decline or the flip side of the coin is you can actually enhance cognitive

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function, right?

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So yeah, super exciting stuff.

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Yeah.

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One of the things that I've gotten into recently is uh optimizing ATP levels in the brain.

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So I think part of the issue is that as people age, the amount of ATP they have in the
brain goes down.

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m And so even when we get everything set up properly, they still don't have the energy, if
you will, to kind of heal.

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So we've been impressed with

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using a product called Vitality, which is basically think of it as an NAD precursor
combining it with, you know, Apigen, which basically blocks an enzyme that breaks down

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NAD.

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As we age, we build up this enzyme called CD38 and it breaks down our NAD.

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So we end up tired and old, so to speak.

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Right.

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So uh anyway, you block that, you boost the NAD production, but then you go jump in an
ozone sauna.

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So ozone sauna basically oxidizes NADH back to NAD.

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And my gosh, I mean, it's like you're on another planet, right?

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For two or three days.

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It'd be interesting to see if you had an ozone sauna in one of your facilities, what that
might do in a situation like this, because ah there's so many, there's so many little

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twists here, right?

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Little peptides, things that we use, other stuff, right?

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That become really fascinating.

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I think it's, the point is I think when we combine these approaches in a, in a thoughtful
way, not just, you know,

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throwing everything at everybody, but in a thoughtful way, it's really possible to reverse
Alzheimer's, quite honestly.

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yeah.

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Have you spent any time looking at Dan Goodenow's work at all?

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Dan Goodenow?

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Mm hmm.

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Yeah.

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So he's doing some pretty remarkable work also with regards to dementia, even ALS, things
like that.

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He's starting to show a reversal of...

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And I know he's really big on functional MRI scans to actually outline what the brain is
doing, things like that.

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um And then he also has sort of a dietary plan, things like that.

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But it just feels like the field is kind of um bringing forward enough complimentary
technologies that people that are listening to this should understand, you know, if you're

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suffering with cognitive decline, you know, just raise your hand because there's help out
there.

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There really is help out there.

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So what are some of the um common things that you see that seem to work the best for
people?

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Yeah, again, the thing that I think does the most heavy lifting is getting into ketosis.

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Now, not everybody can do that, but our brains and our bodies are just absolutely
miraculous to me.

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think it's so fascinating and impressive that we're like hybrid engines.

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We can go back and forth from burning sugar for fuel versus burning fat for fuel.

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And many people, when I encounter them, have never burned fat for fuel.

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They've never been in ketosis.

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And as you mentioned, ATP is harder to make as we age.

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So regardless of our diabetes status, as we age, we're less insulin resistant and we're
less sensitive.

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We're no less capable of turning glucose into ATP efficiently in the brain.

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So switching the fuel source to ketones, beta hydroxybutyrate through either exogenous
ketone supplementation or through a diet that restricts carbohydrates can be a fantastic

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way to do that.

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And I have seen really profound improvements in cognition where a patient will

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not remember their grandchildren's name one day and three days later after they're in
metabolic ketosis, they're remembering the names of their grandchildren.

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mean, real profound impacts from this.

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And so it's something that's free.

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00:15:45,954 --> 00:15:48,274
It doesn't cost a lot of money.

214
00:15:48,274 --> 00:15:50,769
It is very safe to do.

215
00:15:50,769 --> 00:15:52,231
I mean, work with a provider.

216
00:15:52,231 --> 00:15:54,473
For many people, we worry about frailty as they age.

217
00:15:54,473 --> 00:15:56,895
And so we want to make sure they're not losing too much weight.

218
00:15:56,895 --> 00:16:01,390
Now, if you want to lose weight or if you have diabetes, you mentioned metabolic.

219
00:16:01,390 --> 00:16:06,043
uh syndrome or having metabolic issues around, again, turning glucose into fuel.

220
00:16:06,043 --> 00:16:10,817
And then getting uh into ketosis is actually very, very helpful.

221
00:16:10,817 --> 00:16:21,215
You need to watch blood pressure and watch if you're, certainly if you're taking insulin
or even metformin or other diabetes medications, you want to watch and be able to monitor

222
00:16:21,215 --> 00:16:23,466
those and adjust the medication doses.

223
00:16:23,466 --> 00:16:28,768
Because what we see is that people, their mood improves, their sleep improves, their blood
pressure improves, and of course,

224
00:16:28,768 --> 00:16:33,422
their A1Cs and their blood sugar control improves on an organic ketogenic diet.

225
00:16:33,422 --> 00:16:36,014
So we get the toxins out and the fuel up.

226
00:16:36,014 --> 00:16:39,478
The brain is a very resource intensive organ, right?

227
00:16:39,478 --> 00:16:43,531
It's 2 % of body weight, 20 % of energy expenditure each day.

228
00:16:43,531 --> 00:16:46,274
And so we need to make sure we're getting enough fuel there.

229
00:16:46,274 --> 00:16:47,635
We use IV NAD.

230
00:16:47,635 --> 00:16:51,798
em You mentioned getting NAD levels up.

231
00:16:51,899 --> 00:16:56,142
We do a lot of NAD precursor support, ATP support, of course.

232
00:16:56,314 --> 00:16:58,776
But really what we're looking at is an energetic issue.

233
00:16:58,776 --> 00:17:00,027
You mentioned imaging.

234
00:17:00,027 --> 00:17:01,238
We look at ASLs.

235
00:17:01,238 --> 00:17:04,560
So this arterial spin labeling, it's MRIs of the brain that looks at perfusion.

236
00:17:04,560 --> 00:17:06,682
So we look at atrophy rates.

237
00:17:06,682 --> 00:17:12,416
So we're looking at volumetrics, brain MRIs and volumetrics so that we see is the
hippocampus aging at an accelerated rate?

238
00:17:12,416 --> 00:17:14,888
Is the amygdala aging at an accelerated rate?

239
00:17:14,888 --> 00:17:18,290
What about the precuneus, the temporal regions, prefrontal?

240
00:17:18,290 --> 00:17:24,206
Where is this affecting this person in terms of the size of the different areas of their
brain?

241
00:17:24,206 --> 00:17:28,606
That can give us some insights, but what's even more insightful is looking at perfusion.

242
00:17:28,606 --> 00:17:32,446
This seems to be a leading indicator of where atrophy is going to go.

243
00:17:32,446 --> 00:17:42,186
So if we aren't getting enough blood flow into areas of the brain, then of course we're
gonna end up with atrophy and potentially cognitive impairment associated with that.

244
00:17:42,186 --> 00:17:44,826
And so that's been the most helpful thing for me.

245
00:17:44,826 --> 00:17:47,700
We can also see, you know, is there a risk of microbleed?

246
00:17:47,700 --> 00:17:48,972
like the AIM and spec scan?

247
00:17:48,972 --> 00:17:51,745
The MRI, yeah, OK.

248
00:17:52,293 --> 00:17:53,054
ASLs.

249
00:17:53,054 --> 00:17:53,324
Yeah.

250
00:17:53,324 --> 00:18:03,074
And then we work, I feel very, very fortunate to be partnered with the group at Pacific
Neuroscience Institute, including David Merrill, Dale Bredesen, Karen Miller, and Cyrus

251
00:18:03,074 --> 00:18:06,908
Raji is the neuroradiologist who we collaborate most closely with.

252
00:18:06,908 --> 00:18:08,870
He's at Washington University in St.

253
00:18:08,870 --> 00:18:09,322
Louis.

254
00:18:09,322 --> 00:18:10,303
Cool.

255
00:18:11,343 --> 00:18:12,263
Very cool.

256
00:18:12,263 --> 00:18:13,463
Yeah, very cool.

257
00:18:13,943 --> 00:18:22,243
So, yeah, so to the point there, you're really kind of deconstructing an individual to
understand where they are in the process, where the issues are, what's happening, what's

258
00:18:22,243 --> 00:18:23,103
contributing.

259
00:18:23,283 --> 00:18:28,276
And then do you end up taking different strategies based on what you find?

260
00:18:28,276 --> 00:18:29,167
Absolutely.

261
00:18:29,167 --> 00:18:31,248
Yes, that's the whole point of looking for them.

262
00:18:31,248 --> 00:18:40,986
I would never suggest a test for a patient if it wasn't going to change the outcome of the
test, the results of the test, we're not going to change the treatment plan.

263
00:18:40,986 --> 00:18:44,467
Now I have a couple of exceptions, A MOCA score, Montreal Cognitive Assessment.

264
00:18:44,467 --> 00:18:47,381
We want to understand, it's a yardstick, right?

265
00:18:47,381 --> 00:18:50,046
It's saying where are we on this spectrum of decline?

266
00:18:50,046 --> 00:18:54,746
And that outcome is, that number isn't going to potentially...

267
00:18:55,126 --> 00:18:59,766
I mean, I say this, I'm starting to say this out loud and they're like, well, it can
change my treatment.

268
00:18:59,766 --> 00:19:03,398
It will change how much I emphasize how fast we need to go.

269
00:19:03,398 --> 00:19:03,588
Right?

270
00:19:03,588 --> 00:19:12,391
If we're in more of a mild, mild cognitive impairment, you know, we say mild, even though
this is affecting people's lives often at this stage, there's nothing mild about it.

271
00:19:12,731 --> 00:19:21,013
But if we have a higher MOCA score than maybe we had anticipated, then maybe we're not as
rushed to do everything yesterday.

272
00:19:21,453 --> 00:19:23,974
But if we have a lower MOCA score, then

273
00:19:24,014 --> 00:19:27,994
It changes how we talk about our expectations.

274
00:19:28,194 --> 00:19:32,014
We see that people with MOCA scores of 18 and above, 30 is perfect.

275
00:19:32,014 --> 00:19:36,254
So this is a one-page PDF worksheet, the Montreal Cognitive Assessment.

276
00:19:36,254 --> 00:19:41,154
draw a clock, copy a cube, identify zoo animals, identify where you are in time and space.

277
00:19:41,154 --> 00:19:43,034
26 and above is normal.

278
00:19:43,054 --> 00:19:48,234
And then as we go towards zero, that is representing more severe cognitive impairment.

279
00:19:48,234 --> 00:19:52,294
And we see that right around 16, 17, 18, there's sort of this

280
00:19:52,622 --> 00:20:01,085
spot where we have real high confidence above that, that if people put in the work, do
what they need to do, take the supplements, do the hormone replacement, they get the

281
00:20:01,085 --> 00:20:08,346
toxins out and the infections dealt with and the blood pressure under control and they get
their hearing aids and they do everything, they treat their sleep apnea, we see

282
00:20:08,346 --> 00:20:11,027
improvement the vast majority of the time.

283
00:20:11,227 --> 00:20:14,769
Now when they're below that level, we see improvement.

284
00:20:14,769 --> 00:20:20,268
It takes more effort, takes more investment of a caregiver, a care partner's time.

285
00:20:20,268 --> 00:20:22,438
and it requires more resources.

286
00:20:22,438 --> 00:20:26,349
I mean, it just takes more work and our confidence is not as high.

287
00:20:26,349 --> 00:20:28,420
It's not guaranteed, right?

288
00:20:28,681 --> 00:20:34,692
And so that is, it's a test that I do where we're assessing where someone is.

289
00:20:34,692 --> 00:20:47,123
The PTAO levels, PTAO-217 is another blood test that we use to assess where someone is on
a spectrum of neurocognitive, neuropathology, neurodegenerative pathology.

290
00:20:47,123 --> 00:20:48,466
And that's another test.

291
00:20:48,466 --> 00:20:54,150
Like I'm not going to change my treatment plan based on this, but it gives us a yardstick,
a measuring stick for where we are.

292
00:20:54,150 --> 00:20:56,937
Are we getting better or are we going downhill?

293
00:20:56,937 --> 00:20:57,447
Sure.

294
00:20:57,447 --> 00:21:03,331
So I mean, but those tests are useful to your point to give you an idea where somebody's
at, right?

295
00:21:04,232 --> 00:21:15,400
And I think to your other point, I think the other tests do give you clues as to where to
intervene or how quickly to intervene or how to collaborate with different modalities or

296
00:21:15,940 --> 00:21:18,983
weave together different modalities to get the best effect.

297
00:21:18,983 --> 00:21:24,796
It's interesting that the ketosis is kind of sounds like that's really kind of a rock, ah
right?

298
00:21:24,796 --> 00:21:25,663
A base rock.

299
00:21:25,663 --> 00:21:29,306
uh foundational piece for you in this whole process.

300
00:21:29,306 --> 00:21:31,367
And I know Bredesen talks about that as well.

301
00:21:31,367 --> 00:21:35,451
um Is there anybody in which you don't do that apart?

302
00:21:35,451 --> 00:21:46,122
In other words, let's say they don't have a medical contraindication, but um is there
anybody in whom you don't see that be a positive uh contributing factor to their outcome?

303
00:21:46,122 --> 00:21:49,365
Yeah, there's definitely patients who are an exception to that.

304
00:21:49,365 --> 00:21:52,818
uh I've had South Asian patients who are vegetarian.

305
00:21:52,818 --> 00:21:58,293
It gets very challenging to be on a ketogenic diet if you're not doing animal protein, and
particularly if you're vegan.

306
00:21:58,293 --> 00:22:08,192
Now, interestingly, Dean Ornish published in June of 2024 the first randomized control
trial showing that people with mild cognitive impairment and uh dementia due to early

307
00:22:08,192 --> 00:22:12,526
Alzheimer's improved in an intervention group compared to the control.

308
00:22:12,874 --> 00:22:18,197
on a vegan diet with some supplementation, with support groups, and with exercise.

309
00:22:18,197 --> 00:22:20,927
there are other dietary interventions.

310
00:22:20,927 --> 00:22:29,702
I suspect that over time, hopefully the science will play out and we'll have even better
data to suggest the best diet for brain health.

311
00:22:30,102 --> 00:22:38,046
But I suspect it will be going back and forth between a ketogenic diet, a ketogenic state,
and potentially a plant-based diet.

312
00:22:38,342 --> 00:22:45,868
high polyphenol rich, again, lots of veggies, lots of fiber, no matter what diet you're
in, and eliminating the highly processed foods.

313
00:22:45,868 --> 00:22:48,331
I think that that's going to be one of the most important pieces.

314
00:22:48,331 --> 00:22:51,113
But metabolic ketosis, there's a magic about it.

315
00:22:51,113 --> 00:22:56,858
I recommend that most people experiment with it, see what it feels like to be in ketosis.

316
00:22:56,858 --> 00:23:00,240
I personally feel brighter.

317
00:23:00,380 --> 00:23:01,531
My mood regulates.

318
00:23:01,531 --> 00:23:03,412
I get off the blood sugar roller coaster.

319
00:23:03,412 --> 00:23:04,434
I have less anxiety.

320
00:23:04,434 --> 00:23:05,505
I get better sleep.

321
00:23:05,505 --> 00:23:06,665
I get more efficient sleep.

322
00:23:06,665 --> 00:23:07,806
I wake up at

323
00:23:08,174 --> 00:23:08,885
5 a.m.

324
00:23:08,885 --> 00:23:18,422
ready to get out of bed rather than kind of dragging myself out of bed between 6 and 6 30
I get an hour to an hour and half back in my day when I'm in ketosis so I can speak from

325
00:23:18,422 --> 00:23:27,058
personal experience I don't I hope I don't have dementia but I don't have cognitive
impairment at this stage but there's an optimization that happens and my blood sugar is

326
00:23:27,058 --> 00:23:34,707
much better managed and I think people at any age can get that benefit but particularly
people who are noticing cognitive impairment

327
00:23:34,707 --> 00:23:35,325
Mm-hmm.

328
00:23:35,325 --> 00:23:41,417
a lot on the table if we don't at least try and see an experiment with getting into
ketosis.

329
00:23:41,417 --> 00:23:46,059
So when you talk about going into ketosis for the audience here, they're listening to
this.

330
00:23:46,059 --> 00:23:47,719
are different ways to go about that, right?

331
00:23:47,719 --> 00:23:49,670
I mean, you can just go on a water fast.

332
00:23:49,670 --> 00:23:51,891
You can do a five day fast mimicking diet.

333
00:23:51,891 --> 00:23:56,783
You can ah just cut out all the carbs and sugar in your life or whatever.

334
00:23:56,783 --> 00:24:03,790
So how would you instruct them to think about this um if they're sitting at home listening
to this and they want to try something?

335
00:24:03,790 --> 00:24:05,981
Yeah, and you mentioned medical contraindications.

336
00:24:05,981 --> 00:24:08,952
like, work with a provider, right?

337
00:24:08,952 --> 00:24:15,275
If you've ever had an eating disorder of any type, I don't recommend restriction, right?

338
00:24:15,275 --> 00:24:24,039
If you have gallbladder issues, if you have hyperglypidemia, if you're on medications,
especially for high cholesterol, you've been managing cholesterol, this is controversial,

339
00:24:24,039 --> 00:24:29,625
but we see a lot of people improve their lipid outcomes when they get into the right type
of ketogenic diet, right?

340
00:24:29,625 --> 00:24:31,714
This is not a bacon and cheese diet.

341
00:24:31,714 --> 00:24:36,485
This is lots of plants, lots of fiber, and you're burning lipids, right?

342
00:24:36,485 --> 00:24:38,756
So those numbers actually go down over time.

343
00:24:38,756 --> 00:24:42,507
But you want to work with a provider and see what happens to my lipids.

344
00:24:42,507 --> 00:24:44,318
Am I increasing cardiovascular risk?

345
00:24:44,318 --> 00:24:49,319
I think you can decrease cardiovascular risk with the right type of ketogenic diet.

346
00:24:49,659 --> 00:24:58,382
And then with gallbladder issues, with kidney issues, you just want to make sure you're
working with a provider.

347
00:24:58,914 --> 00:25:04,497
The first step is to get the carbohydrates out and increase plants.

348
00:25:04,797 --> 00:25:14,782
most of my patients are not getting enough good green veggies, lawn starchy veggies,
increasing that, increasing uh good high quality proteins.

349
00:25:15,062 --> 00:25:16,324
I am not afraid of dairy.

350
00:25:16,324 --> 00:25:19,745
I know some people feel that that's very inflammatory.

351
00:25:20,006 --> 00:25:28,140
As long as you're not lactose intolerant, I find that to be a great source of protein and
fat that can help feel very satisfying.

352
00:25:28,172 --> 00:25:31,584
And then we're big fans of fat bombs.

353
00:25:31,584 --> 00:25:42,788
getting whatever you need for that sugar craving that's undoubtedly going to pop up as
you're trying to get into metabolic ketosis and having some sort of coconut oil, cacao,

354
00:25:42,788 --> 00:25:51,072
maybe there's a uh sweetener that won't, a monk fruit or a alulose sweetener with some nut
butter.

355
00:25:51,072 --> 00:25:53,613
There are these fabulous fat bombs.

356
00:25:53,613 --> 00:25:55,374
If you Google fat bombs, there's a thousand.

357
00:25:55,374 --> 00:25:56,406
uh

358
00:25:56,406 --> 00:26:05,654
I'm sure there's well over a thousand recipes for delicious fat bombs that can be great to
have in the freezer or in the fridge for when you're having that hankering for something

359
00:26:05,654 --> 00:26:06,552
sweet.

360
00:26:06,552 --> 00:26:07,173
Nice.

361
00:26:07,173 --> 00:26:07,763
Okay.

362
00:26:07,763 --> 00:26:09,024
That's good advice for people.

363
00:26:09,024 --> 00:26:18,081
Yeah, I think, you know, it seems like dementia is really um on the rise, right?

364
00:26:18,402 --> 00:26:29,731
It seems like, I don't know if we're just diagnosing it better or people are living longer
and we're seeing more dementia or we're just living in a more toxic environment, but it

365
00:26:29,731 --> 00:26:33,334
seems like more people are struggling with cognitive decline.

366
00:26:34,943 --> 00:26:45,907
Do you have uh recommendations for how people kind of architect their homes and
environments to kind of, uh you know, minimize the toxins?

367
00:26:46,316 --> 00:26:47,356
Yeah, absolutely.

368
00:26:47,356 --> 00:26:53,580
So the demographic shifts, I think, are what are primarily contributing to this rise in
dementia.

369
00:26:53,580 --> 00:26:56,112
Everyone knows someone who's been affected.

370
00:26:56,112 --> 00:27:03,036
And that's because such a huge chunk of our population, the baby boomers, are approaching
that age where they're at the highest risk.

371
00:27:03,036 --> 00:27:08,739
So we can't change the risk associated with age, but we can change our biological age.

372
00:27:08,739 --> 00:27:12,481
We can't change the day we were born, but we can change how we age.

373
00:27:12,481 --> 00:27:15,102
And I think environment plays a huge role in that.

374
00:27:15,190 --> 00:27:22,356
Another demographic change that we see is how young people are when they're diagnosed with
Alzheimer's and dementias.

375
00:27:22,356 --> 00:27:26,339
And these are not genetically associated necessarily, right?

376
00:27:26,339 --> 00:27:33,630
There might be an APOE 3-3 person who's in their 50s or late 40s who's experiencing
cognitive impairment.

377
00:27:33,630 --> 00:27:36,107
And I think there are multiple things at play here.

378
00:27:36,107 --> 00:27:44,113
One, you mentioned toxic environments, and two, screen time and stress, the stress of
modern society.

379
00:27:45,122 --> 00:27:55,982
The group, the generation that is approaching this higher risk age category has spent a
lot more time in front of screens than any generation that has ever preceded us.

380
00:27:55,982 --> 00:27:59,860
And I think that really is having an impact on cognitive function.

381
00:28:00,765 --> 00:28:01,956
Tell us about that a little bit.

382
00:28:01,956 --> 00:28:13,187
you think it's a blue light phenomenon or do you think it's ah just a passive consumption
of information or what's your take on that exactly when you're talking?

383
00:28:13,695 --> 00:28:15,406
stress, sleep.

384
00:28:15,406 --> 00:28:17,616
It keeps people from sleeping.

385
00:28:18,117 --> 00:28:20,257
Yes, I think there's a blue light.

386
00:28:20,838 --> 00:28:30,262
I'm not an expert in this and I haven't, you know, but I do think that there's something
there in terms of what are the differences between this generation versus the ones that

387
00:28:30,262 --> 00:28:31,142
came before us.

388
00:28:31,142 --> 00:28:32,903
And toxins are the other big one.

389
00:28:32,903 --> 00:28:35,794
Now, environment, your question was about environment.

390
00:28:35,794 --> 00:28:39,026
How can we set up our environments to reduce our risk?

391
00:28:40,118 --> 00:28:41,339
Where do you put the TV?

392
00:28:41,339 --> 00:28:42,250
Where do you put your phone?

393
00:28:42,250 --> 00:28:43,480
Where do you charge your phone?

394
00:28:43,480 --> 00:28:48,404
Are you tempted to be on your phone or on your computer or on a screen all day long?

395
00:28:48,404 --> 00:28:52,927
And is your house set up so that it's easy to go from looking at one screen to looking at
the next screen?

396
00:28:53,247 --> 00:28:58,641
Just thinking through that, I've lived in places where we hide the TV from ourselves.

397
00:28:58,641 --> 00:28:59,672
We put it in a closet.

398
00:28:59,672 --> 00:29:02,724
We only bring it out if that's what we really wanna do.

399
00:29:02,724 --> 00:29:08,918
We put our phones in a box at the door and we drop them there and we eat dinner with our
phones in a different room.

400
00:29:08,934 --> 00:29:23,338
So really intentionally getting the screens out from in front of your face, And then, so
we can talk about how behavior is impacted by our environment all day long, right?

401
00:29:23,338 --> 00:29:25,124
There's lots of things we can do.

402
00:29:25,244 --> 00:29:32,909
What it comes down to is like a James Clear atomic habits kind of perspective is how do we
put in front of us so that we see it?

403
00:29:32,909 --> 00:29:35,212
How do we make it easy to do the things that are?

404
00:29:35,212 --> 00:29:38,725
beneficial for our brain health, like getting exercise, eating the right foods.

405
00:29:38,725 --> 00:29:46,571
So this is just like organizing your refrigerator so that what's right in front of you is
not the sweets and the treats and the processed food, but all the veggies.

406
00:29:46,812 --> 00:29:53,687
Then how do we optimize our environment to make it harder to do the things that aren't as
good for us, right?

407
00:29:53,687 --> 00:29:57,761
This is putting the TV in the closet or putting it in a cabinet that closes.

408
00:29:57,761 --> 00:30:04,002
Just that one little extra bit of effort to open the cabinet or to go find the remote.

409
00:30:04,002 --> 00:30:14,602
or to get up and change the channel, get rid of the remote, those things can create enough
friction that we don't do it, we don't engage in those things that aren't as good for us.

410
00:30:14,602 --> 00:30:17,426
So intentionally taking the time to think through that.

411
00:30:17,765 --> 00:30:20,286
I think this uh is brilliant, really.

412
00:30:20,286 --> 00:30:26,939
think the way we think about it from the longevity perspective is that we all live in four
environments for the most part.

413
00:30:26,939 --> 00:30:32,941
We live at home, we live at the office or work, and we live on business travel and we live
on vacation travel.

414
00:30:32,941 --> 00:30:41,855
So it's important to intentionally architect each of those environments to actually
support the mission so that otherwise the wheels come off.

415
00:30:41,855 --> 00:30:47,007
I was doing great, then somebody went to Italy for two weeks and everything flew apart.

416
00:30:47,505 --> 00:30:54,958
If you're listening to this, just think about how you would, I mean, you would just take
30 minutes and intentionally architect your home, right?

417
00:30:54,958 --> 00:31:01,300
The way that Heather's talking about here to, you know, keep the screens away.

418
00:31:01,401 --> 00:31:09,224
And the other thing is to understand that willpower is, you know, very, very high in the
morning and at 0 % at eight o'clock at night.

419
00:31:09,224 --> 00:31:09,594
Right.

420
00:31:09,594 --> 00:31:11,495
So willpower runs out.

421
00:31:11,495 --> 00:31:16,767
So if you, if you don't architect the environment to keep the ice cream out of the
freezer, you know, if it's there.

422
00:31:16,895 --> 00:31:18,057
I don't have perfect willpower.

423
00:31:18,057 --> 00:31:20,699
it's there, I would eat it, but I just don't put it there.

424
00:31:20,960 --> 00:31:22,191
that way I avoid it, right?

425
00:31:22,191 --> 00:31:29,159
So you have to really understand that you oh can never really count on your willpower to
get this done.

426
00:31:29,159 --> 00:31:31,773
You really have to architect the environment to support you.

427
00:31:31,773 --> 00:31:33,600
That's how I think about it.

428
00:31:33,600 --> 00:31:36,012
Yeah, I love that idea about vacations, right?

429
00:31:36,012 --> 00:31:40,455
I want people to go enjoy their Italian vacation, but can you make it about cycling?

430
00:31:40,455 --> 00:31:45,049
Can you make it about hiking so that you are doing it in a way that's active?

431
00:31:45,049 --> 00:31:50,583
Yeah, that's such a great point of all these four environments.

432
00:31:50,583 --> 00:31:53,966
The other piece about environment is toxicity, right?

433
00:31:54,306 --> 00:32:01,469
We're hypervigilant around mold and moisture and environments because we have seen
mycotoxins play a big, well, we know that they are carcinogenic.

434
00:32:01,469 --> 00:32:04,160
We know that they are immunosuppressive.

435
00:32:04,160 --> 00:32:05,951
We know that they are neurotoxic.

436
00:32:05,951 --> 00:32:09,532
This is not controversial, right?

437
00:32:09,553 --> 00:32:15,275
We see that in the animal husbandry industry, there's a trillion dollar investment in
getting mycotoxins out.

438
00:32:15,275 --> 00:32:22,348
This is a trillion dollar industry with huge amounts of investment going into getting
mycotoxins out of sheep and cows and.

439
00:32:22,518 --> 00:32:27,920
rabbits and horses and any mammal that is used uh to make money.

440
00:32:27,920 --> 00:32:34,363
And yet landlords have a very different financial incentive than a potentially sick
tenant.

441
00:32:34,363 --> 00:32:42,806
uh HOAs and apartment buildings have a very different incentive than the potentially sick
person that's living in them.

442
00:32:43,662 --> 00:32:51,985
Understanding that there's a little friction between the interests at play can help us
understand that there's really different types of mold inspectors, different types of mold

443
00:32:51,985 --> 00:33:00,749
testing, and uh each of them sort of support the interests from the group that typically
pays that way.

444
00:33:01,369 --> 00:33:03,955
So being careful about that.

445
00:33:03,955 --> 00:33:07,697
I've had clients that were deathly ill from mold.

446
00:33:07,697 --> 00:33:13,682
uh Had the inspector come in, looked through everything in their office, whatever, found
nothing.

447
00:33:13,682 --> 00:33:14,923
Were still deathly ill.

448
00:33:14,923 --> 00:33:16,584
Had to actually quit work.

449
00:33:16,584 --> 00:33:20,487
An attorney actually had to leave work, uh was disabled.

450
00:33:20,728 --> 00:33:24,851
Then somebody came in and actually took apart the ceiling and they found all kinds of mold
in it, right?

451
00:33:24,851 --> 00:33:25,501
So

452
00:33:25,501 --> 00:33:28,993
The point is there's mold inspection and there's mold inspection.

453
00:33:28,993 --> 00:33:31,234
And I think the same is true for water.

454
00:33:31,234 --> 00:33:32,915
I think the same is true for air.

455
00:33:32,915 --> 00:33:40,039
um think we really need to be vigilant because to your point, the landlord will never be
vigilant on this front.

456
00:33:40,039 --> 00:33:41,960
They simply want to rent the space, right?

457
00:33:41,960 --> 00:33:43,961
And they don't want to have to pay for any renovations.

458
00:33:43,961 --> 00:33:46,272
So they're simply there to rent the space.

459
00:33:46,272 --> 00:33:50,715
So if you smell anything that's funny, I would run the other way, quite honestly.

460
00:33:50,715 --> 00:33:52,556
I mean, that's your first cue.

461
00:33:52,556 --> 00:33:55,247
It's not the only cue, but yeah.

462
00:33:55,712 --> 00:34:03,358
Yeah, so this is a whole, there's a big can of worms, but we see that it directly impacts
cognitive function, even in people without dementia.

463
00:34:03,358 --> 00:34:06,831
But of course, it's contributing in those who do have Alzheimer's or dementia.

464
00:34:06,831 --> 00:34:08,773
So we want to get that out.

465
00:34:08,773 --> 00:34:18,341
And if we have control of our environment, right, if we are the landlord, if we are the
owner, then doing what we need to do to make sure that we're not being exposed at work or

466
00:34:18,341 --> 00:34:18,711
at home.

467
00:34:18,711 --> 00:34:20,012
And then

468
00:34:20,014 --> 00:34:26,596
uh Just opening doors and windows can be really helpful or using an air filter can be
really helpful.

469
00:34:26,596 --> 00:34:33,318
The kitchen is a place where we could talk about plastic, you know, and uh nonstick pans.

470
00:34:33,318 --> 00:34:36,619
We want to get as much plastic out of the kitchen as possible.

471
00:34:36,619 --> 00:34:39,954
Nonstick pans, want to break up with those.

472
00:34:39,954 --> 00:34:41,590
Be patient when you cook.

473
00:34:41,590 --> 00:34:48,282
Cook on medium and use good coconut oil and butter to grease your pans.

474
00:34:48,290 --> 00:34:58,778
But use stainless or cast iron cookware because that's how we can prevent those toxic
chemicals from getting into our system through our food.

475
00:34:58,778 --> 00:35:08,625
uh Tell me what would be of value to your audience because there's so much we could talk
about in this environment uh conversation that could be.

476
00:35:08,625 --> 00:35:20,088
Yeah, I was just thinking too about the aging process itself and menopause and andropause
and the impact that changing hormone levels has on cognitive function.

477
00:35:20,088 --> 00:35:20,418
Right.

478
00:35:20,418 --> 00:35:29,071
So a lot of uh individuals, male and female, will complain, you know, my memory is shot
now or whatever.

479
00:35:29,071 --> 00:35:29,521
Right.

480
00:35:29,521 --> 00:35:34,282
And it can be in a perimenopausal or peri-andropausal state as well.

481
00:35:34,282 --> 00:35:37,311
So I think I think it's very important.

482
00:35:37,311 --> 00:35:47,496
from our perspective that people, unless there again, there's some contraindication that
they be hormonally optimized for longevity and for the health of their brain.

483
00:35:47,496 --> 00:35:50,728
uh Super important, quite honestly, and estrogen becomes super important.

484
00:35:50,728 --> 00:36:01,853
Many men will get testosterone, um go to a testosterone clinic, get testosterone, then get
put on anastrozole, which basically blocks the conversion of testosterone to estrogen.

485
00:36:01,991 --> 00:36:07,153
And it really does them a massive disservice because men need estrogen, just like women
need testosterone.

486
00:36:07,153 --> 00:36:14,106
And so you really want to make sure that if you are doing well, if you're ignoring hormone
replacement, certainly think about it.

487
00:36:14,106 --> 00:36:15,617
Now, there are reasons not to do it.

488
00:36:15,617 --> 00:36:18,958
And we won't go into all those, but work with a provider to do that.

489
00:36:19,018 --> 00:36:28,452
But but if you if you are going to go forward and be healthy and have a healthy brain, I
think having some hormone optimization becomes important and then doing it safely.

490
00:36:28,452 --> 00:36:28,722
Right.

491
00:36:28,722 --> 00:36:31,705
So you're looking at metabolites and how you're metabolizing your.

492
00:36:31,705 --> 00:36:40,420
and making sure it's done well on your screen to make sure that you don't have cancer and
prostate cancer, breast cancer, endometrial cancer, whatever it may be.

493
00:36:40,420 --> 00:36:47,363
But I do think that, um you know, having estrogen is very, very helpful for both men and
women.

494
00:36:47,363 --> 00:36:48,184
So I don't know.

495
00:36:48,184 --> 00:36:51,796
You probably have a similar uh view of that, I suspect.

496
00:36:51,796 --> 00:36:53,336
But but I don't know.

497
00:36:53,336 --> 00:36:54,386
Yeah, no, absolutely.

498
00:36:54,386 --> 00:36:56,337
So this is under signaling for us.

499
00:36:56,337 --> 00:36:59,419
So what are the signals going to our brain?

500
00:36:59,419 --> 00:37:07,132
And if we think back to when we're in our late teens and 20s, and we don't necessarily
have to go back to hormone levels that high, but that's that stage where we're making

501
00:37:07,132 --> 00:37:08,192
these social connections.

502
00:37:08,192 --> 00:37:09,333
We're learning new skills.

503
00:37:09,333 --> 00:37:10,793
We're maybe in college.

504
00:37:10,793 --> 00:37:13,834
Our brains are ripe for all that synaptogenesis.

505
00:37:13,834 --> 00:37:16,516
We're making connections between neurons.

506
00:37:16,516 --> 00:37:21,097
And what we want to do is approximate that, get the benefit of those signals.

507
00:37:21,097 --> 00:37:22,818
So what are those signals?

508
00:37:23,118 --> 00:37:25,438
And not just sex hormones, but I couldn't agree more.

509
00:37:25,438 --> 00:37:32,518
Estrogen, progesterone, testosterone, DHEA, prognanolone, all of these are worth
considering and talking to a provider about.

510
00:37:32,518 --> 00:37:35,038
I think the conversation around that has really changed.

511
00:37:35,038 --> 00:37:47,118
Just in the last 12 months, there was a study published about 12 months ago on 10 million
women over the age of 65, so Medicare eligible women comparing 9 million of them who were

512
00:37:47,118 --> 00:37:50,734
not on hormone replacement therapy to another million who were.

513
00:37:50,734 --> 00:37:54,874
They saw a reduction in the risk of all-cause mortality by 19%.

514
00:37:54,874 --> 00:37:58,374
You get a reduction on your risk of dying by nearly 20%.

515
00:37:58,374 --> 00:38:04,974
Reduction in risk of cancer, heart disease, dementia, and then of course you get the bone
benefits.

516
00:38:05,514 --> 00:38:08,054
So this matches what I've seen clinically.

517
00:38:08,054 --> 00:38:13,054
People who are on hormone therapy, they tend to look and act and feel younger.

518
00:38:13,934 --> 00:38:20,258
So definitely worth considering making sure that that's done appropriately and with risk
mitigation and working with the provider, as you mentioned.

519
00:38:20,258 --> 00:38:26,930
But not forgetting about thyroid, you mentioned T3, we're huge fans of Cytomel, I think,
but you know, I've seen it work for sleep, right?

520
00:38:26,930 --> 00:38:28,918
It's not even supposed to work for that, it's supposed to give you energy.

521
00:38:28,918 --> 00:38:33,425
And I've seen people get better sleep, of course, weight management, energy, mood, so many
things.

522
00:38:33,425 --> 00:38:38,548
And most doctors leave out T3 from thyroid supplementation, they just use T4.

523
00:38:38,548 --> 00:38:46,812
looking uh with a functional medicine doctor at what your full thyroid health looks like,
looking for Hashimoto's, all of those pieces.

524
00:38:46,812 --> 00:38:49,898
Vitamin D em is another,

525
00:38:49,898 --> 00:38:58,605
important hormone, a signaling hormone that vitamin D and D3 and K2 are both important for
the brain.

526
00:38:58,827 --> 00:39:06,694
BDNF, brain dry and no trophic factor and all of the other nerve growth factors that
signal to our brain to make those connections.

527
00:39:06,694 --> 00:39:13,841
We want those signals going to our brain, not the microglial activation that says protect
and defend in flame.

528
00:39:13,841 --> 00:39:15,424
We want to switch.

529
00:39:15,424 --> 00:39:18,627
are signaling to synaptogenesis, neurogenesis.

530
00:39:18,627 --> 00:39:23,631
We don't get a lot of new neurons, but we get new connections between neurons, even as we
get older.

531
00:39:23,631 --> 00:39:31,749
And then other pieces in signaling, I'm sure you probably use a lot of these, but you
mentioned peptides, exosomes, stem cells.

532
00:39:31,749 --> 00:39:42,505
How can we really turn up the signaling that tells our brain that we are healthy and
regenerating and in a repair state so that we can make those new connections?

533
00:39:42,505 --> 00:39:46,887
Yeah, we use all those quite honestly, ah all of those and the peptides as well.

534
00:39:46,887 --> 00:39:57,402
know, things like dihexyl will boost BDNF and C max and C length and, you know, cerebral
lice and there's lots of different things that can actually help improve brain function.

535
00:39:57,402 --> 00:40:01,143
But to me, they're, they're kind of a little bit of the icing on the cake.

536
00:40:01,143 --> 00:40:04,345
It's, it's kind of like the cake is building.

537
00:40:04,345 --> 00:40:08,947
Um, for me, the cake is actually understanding your genetic predispositions, right?

538
00:40:08,947 --> 00:40:09,937
And then building.

539
00:40:09,937 --> 00:40:12,949
on top of that with understanding where are you in the aging process, right?

540
00:40:12,949 --> 00:40:13,699
What's your thyroid?

541
00:40:13,699 --> 00:40:15,190
What's your resting metabolic rate?

542
00:40:15,190 --> 00:40:17,291
What's your DIO2 genes?

543
00:40:17,291 --> 00:40:20,683
What genes do you have that may predispose you towards one thing or another?

544
00:40:20,683 --> 00:40:28,737
Then taking action there, then basically looking at, you know, your environment that you
reside in, which has to do with how much exercise you're getting and what kind of area of

545
00:40:28,737 --> 00:40:36,802
breathing, toxins, infections, and then kind of working your way up into, okay, if we fix
all those things, are we where we want to be?

546
00:40:36,802 --> 00:40:39,657
If not, then let's look at, you know, peptides like...

547
00:40:39,657 --> 00:40:42,069
look at stem cells, let's look at some other things, right?

548
00:40:42,069 --> 00:40:44,610
And then doing the diagnostic tests that you've talked about.

549
00:40:44,610 --> 00:40:56,968
oh So I think it's a really exciting time because it used to be, to your point when you
graduated, it's like, no, there's just nothing I can do for you into, my gosh, I think the

550
00:40:56,968 --> 00:40:59,839
Basvenjorda people can be significantly helped.

551
00:41:00,340 --> 00:41:05,297
In your work, you also talk about helping the caregiver.

552
00:41:05,297 --> 00:41:05,617
Right.

553
00:41:05,617 --> 00:41:14,858
So someone that's living with someone that's suffering with cognitive decline, we know
that for them, it becomes a diagnosis as well.

554
00:41:14,858 --> 00:41:15,248
Right.

555
00:41:15,248 --> 00:41:19,763
I mean, their health is impaired, their life expectancy is impaired as well.

556
00:41:19,763 --> 00:41:27,116
And so do you want to talk a little bit about the, uh you know, the work that you do to
kind of help the caregiver in this regard?

557
00:41:27,116 --> 00:41:28,046
Yeah, absolutely.

558
00:41:28,046 --> 00:41:31,801
So what we see, we put this kind of in that stress category.

559
00:41:31,801 --> 00:41:40,240
And when we're talking about anything, toxins, nutrients, stressors, structure, signaling,
and infections, too much, too little, in the wrong place, at the wrong time.

560
00:41:40,240 --> 00:41:41,482
That's what we're trying to identify.

561
00:41:41,482 --> 00:41:45,667
Where is the imbalance that's affecting this particular individual?

562
00:41:45,667 --> 00:41:48,909
And we see that caregivers with stress

563
00:41:48,990 --> 00:41:50,791
We want enough exercise.

564
00:41:50,791 --> 00:41:52,803
We want enough stimuli.

565
00:41:52,803 --> 00:41:58,257
We want enough stress that people are engaged in purposeful and meaningful experiences day
to day.

566
00:41:58,257 --> 00:42:02,060
But the scales get tipped for many caregivers.

567
00:42:02,060 --> 00:42:12,118
It is so much stress that we see in the literature that it can, being a caregiver, serving
as a caregiver for someone with dementia increases your risk of a dementia diagnosis

568
00:42:12,118 --> 00:42:14,814
anywhere from two and a half to six X.

569
00:42:14,814 --> 00:42:15,116
Right.

570
00:42:15,116 --> 00:42:20,330
So this and its highest for male spouses of a female partner with dementia.

571
00:42:20,330 --> 00:42:28,097
And so when a patient comes into my office and they come with a partner with a caregiver,
the caregiver becomes a patient too, right?

572
00:42:28,097 --> 00:42:34,012
This is not about my wife who has dementia getting on the ketogenic diet and I don't need
to.

573
00:42:34,012 --> 00:42:37,134
It's not about my wife getting the sleep study and I don't need one.

574
00:42:37,134 --> 00:42:41,068
It's not about her cholesterol and not mine and her A1C and not mine.

575
00:42:41,068 --> 00:42:44,172
This is about how do we change the lifestyle and get

576
00:42:44,172 --> 00:42:54,310
both of you optimize so that we address your risk while we're in this luxurious position
of prevention and we address her risk and turn on her signaling so that we get back into

577
00:42:54,310 --> 00:42:55,470
that repair mode.

578
00:42:55,470 --> 00:43:02,466
So it's about both and, it's thinking of both the care partner and this dyad, right?

579
00:43:02,466 --> 00:43:09,110
We're part of a complex, you know, we call them dyads.

580
00:43:09,110 --> 00:43:11,192
It's just not as simple as.

581
00:43:11,192 --> 00:43:14,604
there's this one patient and they're responsible for everything and they're going to do it
all.

582
00:43:14,604 --> 00:43:23,689
The caregiver is just as inherently important because we really depend on their
involvement, particularly when people are more progressed.

583
00:43:23,689 --> 00:43:32,434
But even in early stages, we depend on everybody being on board so that they're not
creating an environment where there's cake and cookies on the counter.

584
00:43:32,434 --> 00:43:38,337
And they're not saying, hey, instead of going to that exercise class, why don't we go out
to dinner and get a couple of cocktails?

585
00:43:38,337 --> 00:43:39,017
Right?

586
00:43:39,017 --> 00:43:40,686
We really need that.

587
00:43:40,686 --> 00:43:46,081
whole system to be in alignment, rowing in the same direction to get the best outcomes.

588
00:43:46,099 --> 00:43:48,472
Yeah, no, I think it's think it's true.

589
00:43:48,472 --> 00:43:52,167
It is a massive stress um on the caregivers.

590
00:43:52,167 --> 00:43:55,831
And I think it's kind of overlooked for the most part.

591
00:43:55,831 --> 00:44:03,711
So it's really it's really quite wonderful that you actually are treating the dyad and not
just the, you know, the patient, quote unquote, patient.

592
00:44:03,711 --> 00:44:04,562
Right.

593
00:44:04,663 --> 00:44:05,528
And then

594
00:44:05,528 --> 00:44:10,530
groups are really, really beneficial and particularly in-person support groups.

595
00:44:10,530 --> 00:44:21,135
Of course there are online support groups, but whenever you can meet with other diads, or
even just with other caregivers, we prefer to have both people come and then sometimes

596
00:44:21,135 --> 00:44:28,798
we'll pull the caregivers apart and do something specific for them and have the patients
with dementia do something specific.

597
00:44:28,798 --> 00:44:34,188
But we really like having everyone there in the same room, having those conversations, it
just sparks

598
00:44:34,188 --> 00:44:42,244
so much and people feel like they're not alone, can be very lonely to be a caregiver
because your entire life is wrapped up in dementia.

599
00:44:42,244 --> 00:44:51,753
If there are any caregivers listening or if you care for a caregiver, the one piece of
advice that I want you to walk away with is that I believe caregivers should have eight

600
00:44:51,753 --> 00:44:57,288
hours a week, eight consecutive hours hopefully, to themselves where they are not
caregiving, right?

601
00:44:57,288 --> 00:44:58,779
They don't go take care of grandkids.

602
00:44:58,779 --> 00:45:02,306
They don't go pick up the teenage grandkids from school.

603
00:45:02,306 --> 00:45:07,648
They don't go do other things that are caring for another person.

604
00:45:07,648 --> 00:45:09,349
They care for themselves.

605
00:45:09,349 --> 00:45:11,110
They focus on their hobbies.

606
00:45:11,110 --> 00:45:12,120
They see their friends.

607
00:45:12,120 --> 00:45:14,932
They don't talk about dementia unless they need to vent.

608
00:45:14,932 --> 00:45:19,644
But they really focus on creating an identity outside of being a caregiver.

609
00:45:19,644 --> 00:45:29,855
And this is important for mental health after that role resolves one way or another, but
also for sustainability of the caregiving role and quality of the care that you provide.

610
00:45:29,855 --> 00:45:30,915
Yeah.

611
00:45:30,995 --> 00:45:40,295
No, I think there's so much wisdom in that because it's easy with any 24-7 tasks to
literally burn out, right?

612
00:45:40,295 --> 00:45:49,755
And then it's very difficult when you're burned out to really have the compassion and
empathy that you even want to have, love towards the individual that you're there to care

613
00:45:49,755 --> 00:45:50,535
for.

614
00:45:50,775 --> 00:45:54,434
So taking time away is critical for any caregiver, right?

615
00:45:54,434 --> 00:46:01,188
We also see families really forced into a corner when something unexpected comes up for
the caregiver.

616
00:46:01,188 --> 00:46:04,494
They break a femur bone and they can't walk anymore.

617
00:46:04,494 --> 00:46:13,079
They, you know, from a slip and fall or the daughter who's across the country needs help
because something comes up and they've got, they need to go.

618
00:46:13,079 --> 00:46:16,466
They have another priority that supersedes their caregiving role.

619
00:46:16,466 --> 00:46:20,519
And now they're just looking for a warm body to keep their loved one alive.

620
00:46:20,519 --> 00:46:21,009
Right.

621
00:46:21,009 --> 00:46:23,390
And it's not, it's not a great fit.

622
00:46:23,414 --> 00:46:33,743
And so if we can get help before we think we need it, then we have the time and we can put
in the effort of finding the right fit, someone who's really gonna understand and know our

623
00:46:33,743 --> 00:46:40,989
loved one, get along well with them, inspire them to eat well and get the exercise and get
to bed on time and do all those things versus.

624
00:46:42,040 --> 00:46:57,927
Yeah, do you ever find dyads that come together and sort of tag team in a sense of, know,
one caregiver will act will look after two or three uh patients while the other two

625
00:46:57,927 --> 00:47:00,138
caregivers get a break or that kind of thing.

626
00:47:00,138 --> 00:47:07,520
you ever see that happen either organically or or under your tutelage?

627
00:47:07,520 --> 00:47:11,313
Less than I would like to, I think it's a good idea, right?

628
00:47:11,313 --> 00:47:17,677
And I think maybe as communities are designed with aging in mind, we'll maybe see more of
that.

629
00:47:17,677 --> 00:47:26,503
uh But I think people feel like they have a lot on their plate to begin with and get
overwhelmed very easily.

630
00:47:26,503 --> 00:47:31,986
uh So I haven't seen much of that actually manifest yet, but I love that idea.

631
00:47:32,037 --> 00:47:32,668
Mm-hmm.

632
00:47:32,668 --> 00:47:39,677
Yeah, it just seems like there's more of a communal element to it and you you might make
some friends with some other caregivers as well, right?

633
00:47:39,677 --> 00:47:40,418
So.

634
00:47:40,418 --> 00:47:52,745
We see senior centers being a great resource for people, I can get my loved one to go play
bingo and play cards and be engaged with arts and crafts for even just four hours during

635
00:47:52,745 --> 00:47:53,145
the day.

636
00:47:53,145 --> 00:47:55,046
And then I can come back and pick them up.

637
00:47:55,046 --> 00:47:56,347
That makes it more sustainable.

638
00:47:56,347 --> 00:48:01,940
Cause now I can check off a list of things I need to do, or I can go get my exercise, that
kind of thing.

639
00:48:02,205 --> 00:48:04,196
Right, Perfect.

640
00:48:04,416 --> 00:48:04,926
Awesome.

641
00:48:04,926 --> 00:48:10,208
So um just to kind of finish up here, what's kind of on the cutting edge for you?

642
00:48:10,208 --> 00:48:14,180
What are you looking forward to that you're not doing currently?

643
00:48:14,180 --> 00:48:15,840
there some things that you're thinking about?

644
00:48:15,840 --> 00:48:20,662
Gosh, I wish we could do that or this or I'm waiting for something else to happen or how
are you feeling about that?

645
00:48:20,662 --> 00:48:21,973
Or you feel like you're pretty complete?

646
00:48:21,973 --> 00:48:22,863
I don't know.

647
00:48:23,459 --> 00:48:26,141
Yeah, I there's a lot we're looking forward to and excited about.

648
00:48:26,141 --> 00:48:35,219
em My book, Reversing Alzheimer's, came out last year and through that we've had a lot of
really exciting collaborations and partnerships and we're expanding Murama through

649
00:48:35,219 --> 00:48:35,899
partnerships.

650
00:48:35,899 --> 00:48:47,520
So we are working and collaborating with a handful of groups across the country uh to
deploy essentially a Murama model in these existing senior living communities.

651
00:48:47,520 --> 00:48:50,356
And that is what I'm really, really excited by.

652
00:48:50,356 --> 00:48:58,140
I had my hand at operating and owning a facility and I realized there's a reason why
people spend entire careers doing that.

653
00:48:58,140 --> 00:49:03,353
And I really appreciate the expertise and wisdom that our collaborators have.

654
00:49:03,353 --> 00:49:13,632
And so I really want to focus on the part that I'm good at, which is the immersive
experience of diet, exercise, programming, and environment and helping people.

655
00:49:13,632 --> 00:49:16,874
apply that in these communities and making that accessible.

656
00:49:16,874 --> 00:49:19,145
So I think that'll have a really big impact.

657
00:49:19,145 --> 00:49:21,227
I'm really, really excited about that.

658
00:49:21,227 --> 00:49:22,517
The other piece is research.

659
00:49:22,517 --> 00:49:22,778
Dr.

660
00:49:22,778 --> 00:49:32,262
Rettison is in the uh middle of collecting data for a controlled trial, and they'll finish
that up in the fall and then hopefully be publishing pretty quickly after.

661
00:49:32,262 --> 00:49:40,138
And we, through Pacific Neuroscience Institute, uh I am working with that group to also
fundraise for another clinical trial.

662
00:49:40,822 --> 00:49:43,827
We're looking forward to contributing, continuing to contribute to the research.

663
00:49:43,827 --> 00:49:44,149
Yeah.

664
00:49:44,149 --> 00:49:46,808
What will the next clinical trial be?

665
00:49:46,808 --> 00:49:48,773
What question will it be asking?

666
00:49:49,698 --> 00:49:53,731
Essentially, the question I want to ask is how do we get this reimbursed?

667
00:49:53,731 --> 00:49:59,084
How do we get more access to more people will come through making it financially
affordable?

668
00:49:59,084 --> 00:50:06,328
And so if we can show that we can do this in an institutional kind of setting, then I
think that we'll be a little closer to that.

669
00:50:06,328 --> 00:50:09,880
And it will in some ways replicate the control trial that Dr.

670
00:50:09,880 --> 00:50:13,312
Bredesen is doing now to show that we can do it in multiple settings.

671
00:50:13,312 --> 00:50:14,893
There are six clinical trial sites.

672
00:50:14,893 --> 00:50:17,080
So I think that they're establishing that.

673
00:50:17,080 --> 00:50:25,671
but I think we can show hopefully not just in a small functional medicine practice, you
can do this, but hopefully also in a larger institutional setting.

674
00:50:25,671 --> 00:50:26,492
Yeah, beautiful.

675
00:50:26,492 --> 00:50:27,192
Beautiful.

676
00:50:27,192 --> 00:50:32,675
Well, I really congratulate you on the work you're doing ah and the passion that you have
for this.

677
00:50:32,916 --> 00:50:44,704
You know, I think what's exciting is that you continue to kind of push forward into it,
innovate, find new solutions, and then find ways to actually democratize, if you will, ah

678
00:50:44,704 --> 00:50:46,875
the things that you've learned to impact more people.

679
00:50:46,875 --> 00:50:47,135
Right.

680
00:50:47,135 --> 00:50:53,350
So that's, that's a beautiful thing when you can step outside of your own practice, so to
speak, and actually start to expand this.

681
00:50:53,350 --> 00:50:54,861
So that's really, really fun to see.

682
00:50:54,861 --> 00:50:55,420
Yeah.

683
00:50:55,420 --> 00:51:05,703
so inspired by the patients, you know, who are the pioneers in this space, really putting
their faith in us, doing the hard work and looking, just looking for the options, not

684
00:51:05,703 --> 00:51:09,654
taking no for an answer from the neurologist and being willing to do the work.

685
00:51:09,654 --> 00:51:14,096
I wake up every day because I know how hard people are working.

686
00:51:14,096 --> 00:51:23,112
And also when I get to hear someone say, I got my mom back or I got my dad back, just is,
it makes every bit of work worth it.

687
00:51:23,112 --> 00:51:23,762
absolutely.

688
00:51:23,762 --> 00:51:25,183
Yeah, that's the best thing, right?

689
00:51:25,183 --> 00:51:30,455
mean, um yeah, hearing that, I got my dad back, my mom back.

690
00:51:30,556 --> 00:51:32,477
I mean, it almost makes you cheer up, right?

691
00:51:32,477 --> 00:51:33,858
Quite honestly, seriously.

692
00:51:33,858 --> 00:51:37,099
I mean, it's so emotionally rooted in what you do.

693
00:51:37,099 --> 00:51:38,450
I know this feeling.

694
00:51:38,450 --> 00:51:41,041
yeah, congratulations to you on all that.

695
00:51:41,041 --> 00:51:41,602
Beautiful.

696
00:51:41,602 --> 00:51:44,523
Well, thanks so much for joining us.

697
00:51:44,824 --> 00:51:45,821
Such a pleasure to be here.

698
00:51:45,821 --> 00:51:47,120
Thank you for having me.

699
00:51:47,120 --> 00:51:48,580
Oh, my pleasure.