Brain Inflammation | Stop These Three Diseases Before They Start

Key Takeaway

Track your brain health like you track your fitness. Just as you wouldn't wait until you're severely out of shape to start exercising, don't wait for cognitive decline to protect your brain. Start monitoring biomarkers now—especially homocysteine, vitamin D, omega-3 levels, and for women, estrogen fluctuations. Consider getting the free Montreal Cognitive Assessment (MoCA) test online as a baseline. These simple, proactive steps today can dramatically reduce your risk of dementia decades from now.

Episode Overview

This compilation episode features leading brain health experts discussing the emerging science that challenges traditional views of neurological disease. The conversation reveals that conditions like Alzheimer's, depression, and Parkinson's are not purely brain disorders but whole-body diseases driven by modifiable factors including metabolism, inflammation, gut health, hormones, and environmental exposures. The experts emphasize that cognitive decline is not inevitable and can be prevented through personalized, multimodal lifestyle interventions.

Full Transcript

Transcript of Brain Inflammation | Stop These Three Diseases Before They Start from The Dr. Hyman Show. Auto-generated from episode audio; may contain minor errors.

The narrative needs to be there is something wrong with this person's brain or body or combination of the two that is causing dysfunction or dysregulation dysregulation dysregulation that can be fixed. The brain only has so many ways of saying ouch. When it's inflamed, you don't feel it. People who are depressed have inflamed brains. Autism has inflamed brains. Alzheimer's inflamed brain. If you look at multimodal lifestyle intervention that included exercise, nutrition, vitamins, supplements, uh, sleep, sleep, rest management, uh, keeping the brain engaged, learning something, yep, intensive lifestyle intervention of all the interventions that we tried, moved the needle the most, more than any of these billion dollar amaloid drug studies because coal was what they used to heat and do industry with, and that's full of mercury and lead.

And so we look in the brains of people with Parkinson disease, they have high levels of heavy metal. is there's a big myth about Parkinson and the myth is is that it's just a brain disease. Yeah. It's a whole body disease, Mark. disease, Mark. disease, Mark. For decades, we thought about conditions like Alzheimer's disease, depression, Parkinson's disease as disorders of the brain. But what if that's only part of the story? Emerging science is revealing that many of the factors driving cognitive decline, mental illness, and neurodeenerative disease may begin far outside the brain itself.

and our metabolism, our immune system, our gut microbiome, our hormones, and even the environment we're exposed to every single day. As part of our summer series, we're revisiting some of the most important conversations we have on the topic of brain health. In this special compilation episode, you'll hear from leading experts Dr. Richard Isacson, Dr. Chris Palmer and doctors Ray Dorsy and Michael Oaken as they explore the new science of brain health and what it means for preventing cognitive decline, supporting mental health, and protecting our brains as we age.

Now, what I find most encouraging about this research is that it challenges the idea that brain decline is simply an inevitable part of aging. Instead, it suggests that many of the biggest drivers of brain health are things we can influence through choices we make and the environments we create and the ways we care for our bodies long before symptoms ever appear. So, let's dive in. Let's talk about nutrition because there's a there's the mind diet which is Mediterranean and you know like the way I think about it is is is you know if food is medicine what's the drug what's the dose what's the duration right and I think yes the mind diet which is sort of a modified Mediterranean diet lots of omega-3 fats and anti-inflammatory foods great but it there's there's different levels that you can push on the gas pedal to get more effect I had a patient once who had MCI mild cog impairment She had a whole bunch of problems.

The 21 things and we fixed all her thyroid was off. She has heavy metals. She was pre-diabetic. She had u methylation issues and high homocyine. She had low omega-3 fats. I mean just the list went on and on and we fixed everything and her cognitive function dramatically improved. And then after like 3 or four years she started noticing a little bit of a dwindling. And I said, "Geez, why don't we try a ketogenic diet?" because I've been reading about ketogenic diets and changing the metabolism of the brain by cutting out all sugar and starch and carbohydrates pretty much and eating 75% fat and fat and fat and we did it and like the lights came back on and I was like holy cow.

So again, how do you approach diet uh with with all this? all this? all this? Yeah. Well, so you know, nutrition and and dietary patterns versus single or multiple nutrients. Like this is a this is a long topic and you and I both have written books about this and we could talk about this probably for an hour, but um to me um different diets, you know, we're not in the realm yet where precision nutrition is like um easy offtheshelf straightforward, but different people um I believe need to follow different dietary patterns.

and and I too back in I think 2007 was the first time that I put someone on a ketogenic diet um and and saw something that I just did not think was possible. Um but then I've had other people where I put on ketogenic diets and like things kind of went the wrong way. And and to me um you know it we're not we're going to get there very soon where one day we'll have you know whether it's a blood test or a genetic test or something um where we could put into a computer and the computer will spit out exactly what the person could eat.

until until we get to that time. I think you think about the big bucket. So, the Mediterranean style diet, fatty fish, brain healthy fats, omega-3 fatty acids, especially people with one or more copies of the ApoE4 gene. Um, like we have to have enough omega-3 brain healthy fats, otherwise people will have cognitive decline and the synaps because a lot of your brain is made up of DHA, which is 60% as far as I remember, which is and and DHA and EPA are the two most brain healthy fats.

And DHA is especially important for people with one or more copies of the APOE4 variant. So brainhealthy fats, um that's PUFAS, polyunsaturated fat. Then you have monounsaturated fats. Monounsaturated fats like if you want to drink olive oil like an ounce or two a day and your doctor says okay that's like anti-tow protein like that is good for but it's got to be good olive oil. It's got to be bitter and burn the back of your tongue otherwise it doesn't have the polyphenols. the polyphenols. the polyphenols.

Exactly. And 60% one study I read of the alcohol of the uh of the olive oil out there is corrupt. Exactly. So you know getting quality olive oil um like literally taking a shot of it one or two shots a day or pouring it on everything. Um you know I have olive oil stashed in different parts of the house and just pour it on whatever I can get pour it on whatever I can get it in cuz I I need and if it burns the mouth.

Yep. That's exactly the the proxy has a taste to it. So um avocados, olive oil, fatty fish, brain healthy fats are like so critical. um green leafy vegetables. So, you know, berries, you know, half a cup of strawberries or blueberries two to three times a week. Nurses health study published over a decade ago showed you could delay cognitive decline just by eating berries on a regular basis by two years just from one intervention. That's why I gave you a berry shake this morning. morning. morning. You did.

It was good with with goat milk, which was a first for me. So, I I appreciate it. Which is uh really nutritious and and actually tasted really good. Um so, you know, green leafy vegetables, high antioxidants. Um, people should be eating mostly plant-based. Um, you know, I would help plant rich. Yeah, plant rich. Plant rich. And, you know, there's totally different totally different totally different because plant-based is vegan. That might be problematic for people who want to build muscle. build muscle. build muscle. Mostly plant rich.

Okay. Yeah, that's a better and I wouldn't maybe maybe Yeah, I don't know the exact terminology, but you know, and then like meat is all not created equal like like red meat, grass-fed beef is totally different than other beef that isn't, you know, whatever. So, I think people need to eat, you know, where they feel comfortable with, whether ethically or or otherwise. They need to get protein levels whether it's through whey protein through goat or or whey protein through regular milk from cows. I think each person needs their own individual kind of um thing and some people may be more sensitive to one thing versus the other and there's lots of different and I saw you putting like cocoa polyphenols in your coffee this morning.

I travel I travel with dark cocoa powder which is completely ridiculous but I never leave home without my dark cocoa powder. Um, and yeah, I have I have coffee in the morning with dark cocoa powder because to me actually caffeinated coffee I think is brain healthy and has been shown to have better brain outcomes. Dark cocoa powder um again has to be like pure and not have the heavy metals in it and things like that. But um dark cocoa powder can help with insulin regulation, blood pressure control and has shown to be beneficial for for brain health too.

So Richard I starts morning with a mocha. mocha. mocha. I do. A mocha for a mocha for your memory in the morning. And it's funny because Mocha is actually one of the names for a test we use, the Montal cognitive assessment test, which is actually something you can actually do at home. It's something you download on the internet and it's a pretty good way of tracking your your brain health. Exactly. Yeah. We don't want people to do it too much at home because then they practice and the doctor see the doctor and they memorize a test.

But I I don't disagree. Yeah. Yeah. For sure. There are definitely ways to to track track. So fatty fatty foods, omega-3 fats, monocy fats, berries, leafy greens, you know, nut, nuts and seeds, antioxid balancing the omega 6 with omega-3s. Um there there's so much um nuance with nutrition, but I think that's it. Um also the elf diet. What's that? What's that? What's that? Oh my Oh my Oh my eating moss in the art. I I just Dr. Mark Heyman on a dietary pattern that he's never heard of.

Wow. This is this is a great day. I'm never going to forget this day. The elf diet. that eat less food. Oh, eat less food. Yeah. Yeah. Like Michael Pollen, they eat food not too much, mostly plants, right? Yeah. So, just less like people just eat so much in excess. Like it's it's crazy. And you know, there was a study out of Mayo that showed that people that ate like I think the cut off was like 2100 calories a day less than 2100 or more um have you know delayed cognitive decline.

And and again this is like imprecise. So the Okinawa principle, right? Harihachibu, which is eat% full percent. Exactly. Harihachibu. That's exactly it. So, the takehome here is though, if you're trying to gain muscle, well, you better eat sufficient protein and and and calories because you need both carbs and protein to build muscle and you don't want to like just, you know, starve yourself. And there's good carbs and bad carbs and know the difference. Um, that's really key. Berries and leafy greens are carbs, right? right? right?

Exactly. Yeah. And, you know, some whole grains in moderation, I think, are okay, but but not if a person's not active, you know. So, so anyway, uh, yeah, nutrition's, you know, tricky. um you know vitamins we we talked about um you know omega-3 fatty acids but vitamin D especially people with one or more copies of the APOE4 variant um we check vitamin D and just like you mentioned earlier we don't just tell everyone to take vitamin D but I think the statistic in Miami as a as an example 60% of the people in Miami even with sun exposure are deficient in vitamin D so we check vitamin D and we have to be naked between 10 and 2 in the in the morning 2 in the afternoon for 20 minutes and if you're not you're not going to get enough vitamin D if If you're if you're if you're a lifeguard, you will, but otherwise, forget it.

Exactly. People wear sunscreen now. People are indoors. And yeah, you know, I usually tell people you need 15 minutes of of 12 to 15 minutes between the hours of 11 and 1 to try to split the difference. I don't want to, you know, it's it's hard to know for sure, but um you know, we we check vitamin D and and and supplement if needed. Um we also talk a lot about B complex vitamins and B complex vitamins again are not something that's one sizefits everyone. Um the Vitito study which was published over a decade ago showed that when people had a marker in their blood called homocyine homocyine is high the people that took B complex vitamins B12 folic acid and a tiny little bit of B6 those people not only um did they um have slightly improved memory function on cognitive testing but those people actually also had slower shrinkage of the memory of of the sorry of the of the of the total shrinkage of the total brain size.

So I mean there was a paper published a number of years ago in JAMMA New England journal I read where if your homoyine was over 14 you're 50% more likely to get Alzheimer's or dementia and that's again something we test at function health and also methylonic acid which is a marker of B12 function and I I remember a patient who came to me who was you know very successful business woman was on multiple boards she was in her early 80s and she's like I got diagnosed with MCI mild cog impairment early dementia and she was pretty upset and I'm like well I don't know let's what we find and she had extremely high homocyine and high methylonic acid which is a marker of B12 which are better probably better than measuring folate and B12 in the blood probably had a double MTHFR she did she had the genetics that made her having trouble with pathways yeah and she was older and probably not absorbing B12 which is common as you get older you get less stomach acid and so on and so forth there are people taking acid blockers they don't get I mean that's that made me crazy I mean there's the third most leading um prescribed drugs after statins and psychiatric drugs is the acid blocking drugs which are now over the counter and they they're they're dangerous to take long term.

Fine short term but long term and so I I I said I found this and I gave her uh B12 shots and I gave her high dose of methylolate and some B6 some of these methylating nutrients and completely cured her MCI. Now it's not that everybody with MCI or predment has that problem. It's just that she had that problem. And then a number of years later, probably five years later, I got a call from her and I thought, "Oh, she's probably going downhill and I'm a little worried about her." And I saw her on my schedule and I'm like, "What's going on?" She says, "Well, I'm going for a trek in Bhutan.

She's 85 and I want to know what I should be doing to prepare and take and blah blah blah." I'm like, "Okay, great. Amazing." Yeah. What else supplements? What other supplements? Vitamin D, fish oil, the B vitamins. Yeah. I mean turmeric um I think um you know kurcumin the active ingredient curry um I think in certain people especially with um elevated um amaloid levels um in the blood you know we usually we we we sometimes use this and I think in terms of like the the big picture those are like the one size fits many ones but I mean the list just I mean list is really long so I mean there's there's definitely other things people can do um but but the take-home here is um you know um we check it in the blood we do the history and then we personalize the plant for So I think nutrition is is really nutrition and exercise are like critical critical levers.

Um and you know in our research study that we uh presented data um that I can talk about because we presented this at the uh 2025 Alzheimer's Association International Conference in July 2025 and we showed that when you looked at and I'll talk about different interventions in a moment but if you look at multimodal lifestyle intervention that included exercise, nutrition, vitamins, supplements, you know, uh sleep, sleep modification, stress management, uh keeping the brain engaged, learning something new. Yep. seeing a doctor on a regular basis to make sure their blood pressure, cholesterol, uh you know, blood sugar is all modified and in in in a in an optimal range for specifically for them.

when you when you put all those together but no um drugs if you look at the the groupings of of the the categories of the people we followed. So intensive lifestyle intervention lifestyle intervention lifestyle intervention intensive lifestyle intervention of all the interventions that we tried moved the needle the most more than any of these billion dollar amaloid drug studies in in our in our study that we've and this hasn't been fully published but I can talk about it because we presented abstract form there are people that for example took GLP-1 drugs and GLP-1 drugs are tricky because you know I believe that too high a dose if you're not eating right and doing the right thing you can you know lose muscle and have all the things lower dose you know I'm more of like the micro dose crew when it comes to GLP1 ones GLP-1s positive effect on biomarkers you know in my opinion based on the our results you know impressive results when used in the right person at the right dose for the right duration of time people ask me all the time what supplements I take personally I'm constantly evaluating new research new compounds and new products and the truth is there aren't many that make the cut one that does is timeline powered by mopure if you follow my work you've heard me talk about mitochondrial health now mitochondria are responsible for producing about 90% % of the energy in your body.

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It's backed symptoms. for asking what do the underlying systems need to actually function and one of the tools I keep coming back to in my own routine is my sunlight and sauna infrared therapy is one of the most underrated recovery inputs out there and I say input intentionally the same way I talk about sleep or nutrition not a luxury it's a condition your body can use what separates sunlight specifically is their pulse IQ technology it delivers red light plus near mid and far infrared wavelengths independently so you're not just getting blended wavelengths plus heat you're a targeted personalized session.

Now, if you're already dialed in on food and exercise, this is the piece most people are missing. Go to sunlight.com and use the code high menu, you'll save up to $2,100, plus get free shipping. Well, they improve metabolic health, which and there's many roads to Rome to do that, right? If you radically improve your diet. I mean, I mean, before GLP1s were on the market, I was reversing diabetes, getting people to lose 200 lb, 100 lb, 150 lbs. You you can do it. It's just it just and I think my guess is that they would do a head-to-head comparison of GLOP ones and the same diet that you would eat if you were on GLOP ones, there would be no difference in any of the biology.

That's my feeling. my feeling. my feeling. So, while multimodal treatments, you know, I would say worked the best, the other categories that worked exceptionally well, that meaning exceptionally well to me means statistically significant improvements in a variety of pathologic proteins that are associated with neurodeenerative disease. So, disease. So, disease. So, so you're testing, not guessing. We test everything. Let me try these 20 things and let's cross our fingers and maybe do a like a a sort of semi semi-ubjective objective test which is a bunch of questions.

You're actually looking at blood tests show changes. show changes. show changes. Try one thing, we repeat it. We don't try 10 things. Well, for multimodal interventions, we try a group and then if we're going to try a drug, we're going to recheck the 150 biomarker proteins. We check the proteins on different machines in duplicates. Every blood test we do, we run twice. This is not normal. This is not cost-effective. we do it anyway because we care about quality, not about anything else. Um, but and and and we just try to do things as as as rigorous as as humanly possible.

Um, and what we show is that when we do these tests, we call these NF1 studies, we'll try a GLP1 and we'll check we'll try hormone replacement therapy like hormone replacement therapy, bioididentical hormones for women during the permenopause trans transition in the right woman at the right dose. the the women in our in our little hormone replacement therapy group, uh, believe it or not, the age ranges from 42 to 67. We have multiple women that have actually started on hormone replacement therapy with approval and agreement by the gyn and the primary care doctor and our and our team.

Um, we've had, uh, I'll just say what I feel like I should say, amazing success with using hormone replacement therapy. And, and when that rapid drop of estrogen comes in a genetically susceptible woman, you know, we did this whole women's uh, brain imaging study at at Cornell and spent, you know, millions and millions of dollars on this. Women that had, you know, hormone replacement therapy on board had better brain volumes and less amaloid. But it had never really been proven in a in a study that you could use H hormone replacement therapy.

Um and then there was this that women's health study that used like synthetic hormones and horse urine derived whatever like when you use a bio identical patch and you use progesterone and we talked to the gyn and we talked to the doctors hormone replacement therapy during the parametransition has helped improve brain biomarkers associated with Alzheimer's and neurogenerative disease risk. It's been striking. So, so this is more than just what has been done before which is population based studies which can't really directly look at cause and effect.

You're actually looking at blood biomarkers that change that improve the the blood biomarkers that are associated with neurogen disease. That's a big deal. And the other thing I want to just say is that the consensus most of that I've heard is that it's it's important to start right away after your menopausal transition. But what I hear you saying is that you can actually start it later. Well, end early. I I want to start anytime. Yes, start early. Does that mean every woman should be on hormone replacement therapy?

Like what what are the implications here? Yeah, this is these are these are really it you know and by the way, why hasn't this been better studied? Why are we the only group to my knowledge like we have misogynistic research infrastructure. research infrastructure. research infrastructure. Like it's it's just so it's demoralizing. It's just so wrong that women are taught that like oh you're having night sweats. Oh, oh, you don't feel good. Oh, you're having brain fog. Oh, okay. Sorry. You know, we'll see you back in 6 months.

P menopause is a neurological disease. Like, you're just going to have a woman suffer. These are these are symptoms that are treated. Oh, go change the temperature in your room and maybe you'll sweat less or maybe change your sheets, get better sheets, like like no, this is a medical condition like really or get like you know the cooling thing like okay or a weighted like fine okay treat the problem. And what we've shown is that, you know, through ridiculous amounts of time, effort, money spent, and research, which needs to be quadrupled or or probably increased even much more than that, we've shown that when we use hormone replacement therapy in the right woman at the right dose, at the right duration in collaboration with a multi-disiplinary team, when we start seeing the estrogen drop, even if the symptoms are very mild, you get the estrogen back up, the towel starts coming Now, even though the towel wasn't elevated to a degree where we're like, uh-oh, sky is falling, but the towel is higher than it should be in that woman who's 47 years old.

And this whole concept of like, you know, uh, it's normal. Well, no. Optimal is where we want a brain protein. Normal, a little borderline, a little high, like, no. In order to have the most benefit, we need to make these incremental changes. And hormone replacement therapy during the parameopause transition to me is one of the most impactful tools that we can use to reduce the risk of cognitive decline, dementia, and Alzheimer's disease in women. And and I think, you know, it's tricky. I think there's risks and benefits with every one of these decisions, but um you know, I've just seen too many women suffer and it's just not fair.

So, they're symptomatic or if you if you do evaluations and you have a higher risk based on your Alzheimer's risk score, which you developed, then maybe it's a good idea. But even even if you're not you're not you're not symptomatic, symptomatic, symptomatic, well, I think if you're symptomatic, it's it's like how like how could you not? I think it's like, you know, it's unethical not to try to figure out how to in our cohort, we track estrogen, estradiol levels, and other hormone levels. Um, you know, I mean, women 21 and above, we also, this is crazy, but like, you know, this hasn't been done before to my knowledge.

We do multiple blood draws through the menstrual cycle to try to figure out like as estrogen and progesterone change during the cycle. Guess what? Pile 217 changes and these other markers change too. How has this never been done before? So we have women, we have like Thank you. Thank you. I'm not going to say their their code numbers in in our research study. They get six blood draws on day one, on day three, on day seven. Like we get six blood draws during the menstrual cycle.

We're just trying to figure out like what should the PTA be at what depending on what day the blood was drawn. We need to correct for what the tow level should be based on where the estrogen and progesterone is. Like these are things that just haven't been figured out yet. And these are the types of questions we're asking and these are the types of things that need to be figured out. And when you take this approach, precision, personalized, individualized approach, um, we've seen women in their early 40s, like 42 is the earliest we've started, where we've seen the estrogen going down and we've seen the amaloid going up.

Well, maybe they're a little symptomatic, but it's not really bothering them. But we're going to start on lowdose hormone replacement therapy if everyone is in agreement. And guess what? She feels better. her cholesterol comes down. That's interesting. interesting. interesting. Her amaloid is improving even though it wasn't abnormal. And this is really the key like we have to personalize these therapies and we have to you know you also just monitor for a change. We've been monitoring these women for so long. We see the change and then you intervene.

And so so to me it's if symptomatic like please talk to your doctor and and if your doctor says tough it out like go to another doctor. If you're preymptomatic you're preymptomatic you're preymptomatic um follow it closely. I think women pre-menopause pre-menopause pre-menopause should should probably get checked every 6 to 12 months for these brain biomarkers and hormones. Um, so essentially what you're saying is if you're symptomatic, don't suffer. And if you're not symptomatic and you have a lot of risk factors and some of these blood biomarkers that were emerging are abnormal, then it's better to get on early even if you're not symptomatic.

I believe that specifically in people that are at the high women that are in the highest risk category which are APOE4 positive especially women with two copies of the APOE4 variant. Some of the most striking improvements actually one one woman is actually lives in Austin, one woman is in California. I mean I know these cases like you know the back of my my my my mind like I you just start and you see everything improve. This this is honestly Richard why we co-ounded function and and I I don't mean to kind of oversell it here but these tests are not things that your doctor likes to order or often will order and for a very low cost.

We've dramatically reduce the cost. You can get all these biomarkers including AP4 and some of these brain biomarkers and then you can kind of start to decide what to do and and take control of your own health. The narrative needs to be there is something wrong with this person's brain or body or combination of the two that is causing dysfunction or dysregulation dysregulation dysregulation that can be fixed if we can ask the question what might be causing the problem and we can systematically look for causes.

So what do we know now about those causes and what are the mechanisms that are going on that are causing this brain dysfunction? Because it's things like insulin resistance, inflammation, oxidative stress, mitochondrial dysfunction, all these fundamental concepts that are root rooted in functional medicine thinking that we've been talking about for decades. It's happening in the brain and we know what's causing it and and yet we're not treating it. So can you talk about what are those causes and in a little bit more depth and and how do we start to begin to think about fixing those and even diagnosing them?

So the the part of the field that I really want to embrace which has been around for you know 50 60 years is this concept of biocschosocial biological psychological and social those are the root causes and we know it. So adverse childhood experiences if they occur early enough in life they increase risk for all of the mental disorders even autism spectrum. If if you if a if an infant is severely neglected or abused, that infant is at much higher risk of developing autism because they that infant will never learn appropriate social skills.

But every label in DSM5 TR is increased. Um you're increased risk from adverse childhood experience. What else do adverse childhood experiences increase risk for? obesity, type two diabetes, cardiovascular disease, autoimmune disorders, all sorts of other physical metabolic health conditions. Yeah. Anybody listening, you should go online and look up the ACE questionnaire, ACE, it's adverse childhood events, and get your score and it'll tell you what your score is. And the higher your score, the more likely you are to have your health issues driven by what happened to you.

Because it's what happens to you is not just a emotional thing. It actually gets written in your epiggenome and written in your biology in a way that changes everything and drives inflammation. So when you have adverse events happening to you, it literally turns on different genes that drive different metabolic pathways that drive inflammation and oxidative stress and even things like insulin resistance. We we know the biology of this and interestingly can change your gut microbiome. M microbiome. M microbiome. M so we just had a paper out research study out in last year showing that amygdala activation so this is your threat system in the brain the amygdala actually activates a c specific pathway in the vagus nerve which then lands on something called bruner's glands in your digestive tract that secrete an enzyme that changes the acidity of your gastrointestinal tract that within an power changes your gut microbiome.

And so stress and trauma impact your gut microbiome, which can then impact whole body health, mental health, all of it. But as you might know, what you eat also impacts your gut microbiome. And so we need to put it together. So even if stress or trauma is causing changes in your gut microbiome that then increase your risk for a disorder, we can use diet and nutrition to treat those changes in your gut microbiome to restore a healthier gut microbiome, which will then reduce your risk for disease or improve your health.

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And that becomes part of the root dysfunction in the brain that you fix with the changes that you do with diet and other therapies. Right. Yes. That's the way I think about it. So I I think there's many roads to Rome and there's many things that can drive it. But the brain only has so many ways of saying ouch. And so when it when it's inflamed, you don't feel it. But when you look at the science, people who are depressed have inflamed brains. Autism has inflamed brains.

Alzheimer's inflamed brain. All the psychiatric illnesses, their brains are in literally inflamed on fire, but we we don't feel it except as as psychiatric symptoms and we think of it as something that is like you said genetic or because of it's in our head as opposed to it's in our body and there's something we can do to find the root cause and fix it. I think about inflammation. I mean, the way that I think about it, it really is that there are a series of pathways that are all connected, like a series of dominoes that are connected.

And so, inflammation is one of those dominoes. It is not the only domino because all of us get inflamed when we get a cold. And that includes brain inflammation. And yet, most people don't become psychiatrically ill from a cold. Some do, but not most don't. And on and on. COVID infection caused severe neuroinflammation. neuroinflammation. neuroinflammation. I mean, I remember when I had CO, I got severely depressed afterwards. And I could feel my brain and I'm like, "Wow, I've never felt this before." And I felt suicidal and I actually took exoomes and it was gone like literally in a day.

So the sui the the depression part is common and and a lot of people don't think about that but researchers have been talking about this for decades. High levels of inflammation cause behavioral behavioral behavioral motivational changes in most animals. So if you get the flu you have a decrease in energy. You have a decrease in confidence. You are less likely to take risks. And what does that do? That drives you to want to go to your bedroom, get under the covers, and hide from the world and stay away from the world.

You are less interested in reproduction. Less interested in sex. Even if the opportunity is right there, you're like, "Get the hell away from me. Leave me alone. I'm sick. I don't feel well. Leave me alone. Let me recover." And in in my mind, those are all adaptive responses. adaptive responses. adaptive responses. The that that your body is hardwired to have this response. And the response is conservation of energy because your body is expending tremendous amounts of energy on your immune system right now. It is waging war on this thing that is infecting you and trying to take your life.

life. life. It is waging war and it is spending every ounce of energy possible to create new immune cells, antibodies, cytoines, other things that are all trying to defend your life. And it is telling you as an organism, do not spend an ounce of energy that is unnecessary. Get into bed. Go into that cave and hide from the world. Don't challenge anyone right now. Don't go out and get into a fight where you have to fight or flee. Don't do anything. Stay away. Hide from the world.

The suicidal. So that part is actually really common with infections and high levels of inflammation. The suicidality part is not. And that's where I think about the brain becoming disregulated from the neuroinflammation. Yes. Yes. Yes. And and people getting all of the constellation of symptoms. Well, you talk about, you know, the genetic vulnerabilities, but then there's a lot of inputs that can drive the same final common pathway of energy dysregulation in your brain cells, right? Diet, sugar, and refined carbs, which you know affects everybody. I mean, 93% of Americans are metabolically healthy at some level.

You know, I would say most of those have some degree of insulin resistance. We figured out tests for at function health, the company I started with a bunch of folks, we actually can measure insulin resistance and we can see the degree. is probably over 90% of people who we test have some degree of insulin resistance. It's it's pretty striking. You know, chronic stress and trauma. So, psychological traumas can be transmuted into biological signals. Sleep deprivation, substance use, toxins, we talk about microplastics in a minute, uh not exercising or being sedentary drives inflammation and anything like infections or allergens, microbiome changes, all those kind of lead to this final dysfunction which you you kind of think is is at the root of it.

And when you look at things like Alzheimer's or autism, which are not psychiatric particularly diseases, the same phenomena is going on. Suzanne Go who's been on the podcast talks about mitochondrial dysfunction, autism, and treating kids by treating their mitochondria and helping them with autism. And you're doing the same thing with mental illness. So can you talk about this kind of final common pathway of energy dysregulation and how it ties everything together because there's a lot of ways to grow on this, but it the final dysfunction is very similar and the therapies can be cross disease is very effective.

So whether you have fibromyalgia, whether you have, you know, alcohol use disorder or eating disorder, whether you have Alzheimer's, autism, depression, bipolar, schizophrenia, anxiety, PTSD, these can be impacted by changing your diet. The way that I think about it, cuz some people think, oh, you know, Chris Palmer, you're being too reductionistic. You're saying everything's mitochondrial dysfunction. And so I really like I'm struggling. How can I explain this so people understand what I'm really trying to say? Yeah. So what I'm really trying to say we're on the edge of our seat is that bio biological like wide range of biological whether it's infections or you know hormones like all sorts of things gut microbiome diet biological psychological social and environmental in particular environmental toxins.

All of those four buckets are the root causes of chronic disease. Those four buckets. So there are lots of things that go into those four buckets, but they all converge at this central pathway called metabolism. Mitochondria. Mitochondria are regulating and controlling metabolism because they are they are really mitochondria. Give us a 60 second like when you say metabolism people I have a slow metabolism. You're not talking about that. about that. about that. I'm not talking about that. Talk about what you mean by metabolism because it's important for people to understand this.

understand this. understand this. So most people think of metabolism as burning calories and yes it is burning calories. Most people think of it as well. It's metabolic syndrome. It's high blood pressure, high glucose, insulin resistance. That's metabolism. Yes, those things are tiny parts of metabolism. But metabolism in fact is a fundamental definition of a living organism. organism. organism. The ability to take food and turn it into energy or building blocks is a fundamental definition of a living organism. Viruses organism. Viruses organism. Viruses cannot do that independently.

And so many biological authorities will say viruses are not independent living organisms. They are not a life form unto themselves. themselves. themselves. They so life a living organism whether it's a bacterium to a human being and everything in between has to be able to take food take food take food oxygen oxygen oxygen nutrients and turn that into energy or building blocks to maintain life. And in fact the absence of metabolism the sessation of metabolism is the definition of death. There are zero exceptions. There is no cause of death that does not involve the sessation of metabolism.

metabolism. metabolism. Suffocate somebody, you're depriving them of oxygen, which stops metabolism, starvation, starvation, starvation, toxins. toxins. toxins. You will not find any toxin that can kill a human being that does not disrupt metabolism. Cyanide. That's what it does. Boom. You're dead in seconds because it interrupted. It is a mitochondrial toxin. Arsenic, a mitochondrial toxin. Tylenol overdose, mitochondrial toxin. Alcohol poisoning, mitochondrial toxin. mitochondrial toxin. mitochondrial toxin. You can go on and on. And the reason is not it's not, you know, when I first started doing this work, I was initially like shocked by what I'm saying.

And I was a little bit in disbelief. I'm like, it can't be that simple. It is that simple. And why is it that simple? Because metabolism is a fundamental law. Like we don't really have laws like they do in physics. They have laws. And this is a law of biology. Metabolism is fundamental to life. The absence of metabolism is the definition of death. of death. of death. Disregulation of metabolism. This is what I am proposing. Disregulation of metabolism leads to chronic disease. chronic disease. chronic disease.

Yeah. Yeah. Yeah. Dysfunction of mitochondria broadly leads to chronic disease. Ray Michael just sort of talking to me about, you know, Parkinson's. What is it? Uh give us a little background on on the biology of it and then the the increasing incidence of it and and what you think are the major reasons why we're seeing this this increasing dramatic increasing incidence. It's like orders of magnitude. It's not just like a 10 or 20% increase. Uh Parkinson's the first major description of the disease was by Dr.

James Parkinson in 1817 in London. So he's 61. He's a a surgeon actually and he's actually even a geologist. And he sees something new on the streets of London. Something so new that at 61 he bothers to write a case. He basically writes this case on six people. Uh five at least five of whom are men. They're all older and they have tremor which has long since been described. But they have this stoop posture, this hunched uh posture and this tendency to walk faster and faster and to fall forward.

And he said in 1817 this has not been described in the medical literature. Really 1817. Really 1817. Really 1817. So in 1817 Dr. Parkinson says that park disease that became known as Parkinson's has not been described in the medical literature. Airgo I'm describing something new. something new. something new. And this was the beginning of the industrial revolution. industrial revolution. industrial revolution. And it's the beginning industrial revolution. And where is it? It's in London. London. London. Yeah. And air quality in 1800 London is equivalent to what is in uh Delhi, India today.

It's equivalent to what was over New York City with the Canadian wildfires. Remember two or three summers ago, ago, ago, the skies turned orange. That was every day 1800 London. Yeah. Yeah. Yeah. So I think Dr. Parkinson is describing the effects of chronic exposure to high levels of air pollution. And so Parkinson we think as as and by the way it was coal. coal because coal was what they used to heat and do industry with and that's full of mercury and lead. One thing I've learned over the years is that healthy eating gets a lot easier when you have better options available before you're starving.

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And so we look in the brains of people with Parkinson disease, they have high levels of heavy metal. And so when you look at smog in LA, for example, you're seeing little pieces of dirt and soot that are suspend the air. The fancy term is particulate matter. Most of them we cough out or sneeze out. But some are so small, less than 1/30th the width of our hair, they penetrate the nerve that hangs down. They're responsible for smell that hangs down in our nasal passages. And hitchhiking on those pieces of dirt and soot are toxic metals.

metals. metals. Wow. So it's a super highway from your nose to your brain. Exactly. It's a front door to your brain. brain. brain. Wow. Wow. Wow. And it's the blood brain barrier. You remember from medical school, right? Doesn't let let things in. Well, it kind of does. But this a little But it kind of does. But this a little leaky, leaky, leaky, but this this is the front door. This is doesn't go through the bloodb brain barrier. It's just going through the oldactory nerve. This the nerve responsive smell that's hanging it and it's hitchhiking are these metals.

Lead from gasoline, iron from brakes, platinum from catalytic converters. And so people with Parkinson's and Alzheimer's both have high levels of metals in their brain. No one's really been able to explain why, but I think one of the reasons why is air pollution, which is one of the toxicants that are inhaled that lead to Parkinson. Yeah, we're supposed to I mean, listen, we're exposed to mercury and the fish we eat. lead is, you know, in their food and you know, if you eat a lot of kale, it's grown in urban environments, it just picks up all the lead.

You know, what what what you said was so interesting to me about the leaky brain because, you know, when I was in in sort of my early years of practicing, we were talking about a leaky gut and I used to get laughed at all the time by traditional doctors because they're like, "Oh, that's nonsense. It's just, you know, you're quack." For a long time, I've also basically been saying that there's a leaky brain. Well, you, Michael, you you sort of just sort of brought this to attention because I think people don't really understand what that is.

I mean, leaky gut is when the barrier breaks down and food and poop leak in and affect your immune system and then start to cause all kinds of havoc, you know, and and as you mentioned, Michael, Michael, that you basically have this barrier, this bloodb brain barrier, but it becomes permeable and then all of a sudden things get in from the outside. So, it's not like a like completely impenetrable barrier. And I think we're seeing increasingly things that cause a leaky brain like stress and many other things like toxins.

So, maybe you could talk a little bit about this leaky brain phenomena because it's really how the toxins get into the brain that are causing all these problems when you do biopsies and you're fighting toxins and heavy metals in the brains like what's happening. happening. happening. Yeah. And you're absolutely, you know, spot on when you talk about leaky gut too. And it turns out the gut is also a a a pathway, you know, where you can hitchhike in and potentially cause Parkinson as well. We talk about now brain first Parkinson and gut first Parkinson.

And uh and so this leakiness, you know, this permeability to, you know, to stress and and other factors that can get across is really important. So if you think about the brain as having like a force field, if you're a Star Wars fan, you know, it's kind of got like a force field. And we've always kind of taught all the medical students, we've taught everybody in medicine that this is this impenetrable force field. Nothing's going to get through this force field. It's actually not correct. Not only is it not right, but as we develop, you know, treatments and as we develop, you know, different, you know, therapies, we're actually able to defeat the bloodb brain barrier is what we call it or the BBB.

We're able to defeat that. And and it's so super important for us to remember that things can get through it. We can use that for therapeutics. We can also need to be thinking about that for cause and getting to the root cause of Parkinson. And one of the treatment and even treatment, but one of the thing I just wanted to bring into the discussion and and I'm so glad that you mentioned the gut is there's a big myth about Parkinson. And the myth is is that it's just a brain disease.

It's a whole body disease, Mark. and and and we see it in the gut, you know, we see the proteins in the gut, we see it in the skin, we see it in multiple systems. And so proteins that are expressed in the body in Parkinson. in Parkinson. in Parkinson. Absolutely. And so misfolded. Yeah. And misfolded. I mean, we have twice the risk of of malignant skin cancer, you know, melanoma and Parkinson disease, twice the risk of osteoporosis in Parkinson disease. This is a whole body disease.

And as we think about it, and I love, you know, kind of how you describe yourself as someone that that, you know, thinks of everyone, thinks of the whole, we have to start thinking about Parkinson in a different way. It's not just a brain disease, and it's not just a disease of dopamine. There are certainly multiple circuits in the brain. And then, you know, this barrier that we, you know, have, you know, invested so much in in all of our textbooks, we've got to rewrite them.

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