Alzheimers: What the experts are getting wrong | Ep185

[Music] [Music] welcome to the dr gundry podcast it's now the sixth leading cause of death for all adults in the united states and over 90 million americans are genetically predisposed to get it yes i'm talking about alzheimer's disease and unfortunately most so-called experts will tell you that there's nothing you can do about it but i've got news my guest today says that that line of thinking is completely bogus in fact he believes that not only can this dreaded disease be prevented and i certainly agree with him but it can be reversed i'm joined again by dr dale bredesen new york times best-selling author and professor of molecular and medical pharmacology at ucla dr bredesen has a new book out called the first survivors of alzheimer's how patients recovered life and hope in their own words after a quick break he's going to give you an exclusive look into his new book including what most people get wrong about the evaluation prevention and treatment of alzheimer's disease we'll also share how you can support a healthy brain and mental clarity no matter your age or health that's right dr bredesen says there is hope for everyone out there and your journey starts today so stay tuned this episode could save a life we'll be right back okay all right dr bredesen dale great to have you back stephen so great to see you always enjoy talking to you so last time you were on the dr gundry podcast was for episode 108 and you shared some amazing news regarding cognitive health and i still love that episode but today you're back with even more life-saving information but first things first for listeners who might not know what is alzheimer's disease what's going on with the brain great point so dementia by definition is global reduction in cognition so you begin to lose memory you begin to lose the ability to analyze things to plan things to calculate to recognize faces to speak all these sorts of things most commonly as you know memory starts to go first when you look at dementia the most common cause of dementia by far is alzheimer's disease as you indicated it is the sixth leading cause of death in the united states and actually professor christine yaffi from ucsf a couple of years ago published an interesting paper where they just did serial autopsies and showed that if you look at all the cases it's now actually the third leading cause of death so what however you slice it it is a very common cause this is a trillion dollar global problem it is costing the u.s as you know stephen over 300 billion dollars per year big problem so it really dwarfs as bad as the covet 19 pandemic has been it actually dwarfs the size of that pandemic so you know there's a lot of different information out there and i even heard it again this week with a relatively new patient regarding the causes of alzheimer's and you know some say oh it's free radicals in the body others say no it's the build up of proteins in around the brain cells what say you straighten it out for me please this is a great point stephen you know this is what my laboratory colleagues and i spent 30 years looking at what is the nature of this illness because it's not something simple like covet 19 where you've got it's a virus we've got sequence we know about variants and all that so as you said people say it's due to herpes no it's type 3 diabetes no it's free radicals no it's amyloid no it's tau no it's prions just go on and on and on none none of those theories has ever led to a successful trial where you can actually improve things so as we just uh actually posted recently a successful clinical trial so our view of this is quite different that this is fundamentally an insufficiency in a network of neuroplasticity so your brain has as you know a whole set of things just as you describe with cardiovascular disease there's a set of things you need that blood flow you need the oxygenation you need the patent arteries you need all of these things to get yourself the best working heart well same thing as you've pointed out same thing true for your brain you need the mitochondrial function you need the support and what happens is you've got a supply and you've got a demand and for people with cognitive decline the supply is being exceeded by the demand chronically and it can be for four different reasons it's because either you don't have enough energetic support and that's mitochondrial function oxygenation blood flow ketones glucose that or it can be because you don't have enough trophic support and that is estradiol testosterone you know and all that sort of stuff nerve growth factor all the things that are supportive or it can be because the demand is too high because of inflammation all sorts of pathogens or because there is toxicity you've gotten exposed to biotoxins or inorganic toxins or organic toxins so for those four groups if you put you on the wrong side of the supply and demand then no big surprise your brain starts to involute i think one of the things i love about you is that you've really broken down in your previous books and now particularly in this book there are different types of alzheimer's just like you've alluded to and the idea that this is a one-size-fits-all which is still what's out there in the world uh there are different things you should do for all of these different factors right absolutely so um this one you know let me let me let's stay on this topic what are some of the indicators that i should be looking for families should be looking for of pre-alzheimer's or alzheimer's i mean can you spot it a mile away are there tests now to help us you know look at who's at risk let's start there yeah stephen i am so glad you brought that up because this has been one of the biggest reasons that this is such a common disease that has been so untreatable we hear all the time the term mild cognitive impairment and that's unfortunately a damaging term that is the third of four stages so there are four stages that you go through pre-symptomatic at which point you're only seeing it with a pet scan or spinal fluid and that can last several years then sci subjective cognitive impairment where you know things aren't what they were and you're still scoring in the normal range on your testing but you can notice that there are slip ups and they're often things like having trouble uh navigating that's a common one uh having trouble remembering a phone number where before you remember phone numbers or before you remember numbers having trouble calculating a tip having trouble recognizing faces those are all early signs that's when you want to get this if you don't get on prevention please get in as early as possible sci lasts on average 10 years so what that means is we have a tremendous window of opportunity to make it so that nobody goes on to get full-on alzheimer's virtually everybody with sci responds beautifully to appropriate evaluation and treatment now if you don't do anything during those 10 years you go on to typically go on to mci mild cognitive impairment and this is like telling someone don't worry you only have mildly metastatic cancer it is a late stage of this thing that ends up as alzheimer's so it's like saying we're not going to diagnose diabetes until you have ketoacidosis it just makes no sense so mci is mild cognitive impairment and we still get good results 84 of the people in our trial who had mci or early alzheimer's improve their scores but it's clearly easier with sci than it is with mci and with mci each year of mci five to ten percent of the people convert to full-on alzheimer's and by definition that's the fourth stage by definition that means you've begun to lose the activities of daily living so this is why the idea of let's see what alzheimer's isn't treated is such a problem we should be looking much much earlier than that and again it's as if in your practice as a cardiac surgeon you know you only looked at people after they've had a large mi um it just doesn't make sense you want to get into people earlier and earlier so that's been the big problem and those are the sorts of things to look for and then as you said yeah then you want to go get appropriate labs you want to look at your inflammatory status you want to look at your glycotoxicity status what's your homa ir and or do you have other toxins do you have vascular disease these are all critical so many times i've noticed that it's the um spouse in one way or another that that first recognizes this and often the the other spouse is maybe unaware or certainly doesn't want to address it uh my problem is that these people may go to their well-meaning physician they may even see a neurologist but the neurologist says oh gosh you know this is just you're getting old and of course you're going to forget these things yeah how do you see that we should be intervening at this early stage what what what can people listening to this podcast do either by themselves buy your book obviously but how do they get through this oh there's nothing you can do about that's normal this is a great point and so you should have a cognoscope i mean we all know that when we turn 50 what do we do we get a colonoscopy it's so helpful to make sure we're not going to get colorectal cancer or that we catch it early same thing for a cognoscopy for anyone who's 45 years of age or older please get a cognoscopy and that's three simple things it's a series of blood tests that are looking at these various parameters so just as we all know what our blood pressure and our cholesterol are we should also know what our risk factors for cognitive decline are we should know things like what is our do we have insulin resistance what is our homa ir we should know what is our hscrp do we in fact have any evidence of systemic inflammation one of the important things oral microbiome you probably saw just this past week that the company cortisone reported that they there now they've developed a treatment is supposed to be for alzheimer's which actually addresses one bacterium in your mouth which is p gingivalis which has been found in the brains of patients with alzheimer's this inhibits a protease now unfortunately the trial failed but they're on the right track with the fact that this is one of the contributors and so absolutely your oral microbiome important so for a cognoscopy it's some blood tests it's uh a it's a simple online cognitive assessment and then only if you've got symptoms you or you're scoring poorly on the cognitive assessment please also include an mri with volumetrics that's optional if you're just there for prevention and your scores are good but if everybody would simply do that cognoscopy we could really lower the global burden of dementia last week i had a patient who uh had some memory issues and got an mri from a neurologist and the neurologist uh said oh you got nothing to worry about this is normal brain shrinkage with age uh what say you yes that's a great point the so if you look at mris across the period then on average you lose about uh if you have if you're a quote normal person you lose about one percent of the gray matter volume per year and you lose about three to three and a half percent if you have alzheimer's or pre-alzheimer's mci in the trial that we just did we took people with mci or with early alzheimer's and interestingly their gray matter actually grew it actually got larger even though they had the conditions that's associated with more shrinkage so this has been the problem because we as physicians have not in the past had anything to offer these people we've developed this whole way of speaking it's not that bad yet it's normal aging you're getting a little older don't worry about it this is because we've had nothing to offer we've got to change that approach just as you've been doing for years now we've got to get in there early we've got to say to people yes there's a tremendous amount you can do about it and let's make sure that you do that so that you don't go on to get full-on alzheimer's disease so again i think this idea of just telling people yeah it's normal brain shrinkage um this is an old-fashioned approach so what what what do you think are the biggest threats out there and you know i we we have become friends and i greatly respect your work so um i want to put you on the spot what are the biggest threats to brain health that that you see out there that that we can do something about if we recognize them yeah this is a great point you know and you and i have discussed you know there are dozens of things that contribute but you're right there are a few things that are really a problem and part of it is just the attitude of the physicians just saying that hey don't worry about it because there's there's nothing to be done at this point but one of the common things that people a couple of things that are critical that people don't recognize one of them is dropping your oxygen saturation as you sleep and it's easy to check you can get an oximeter you can get itself an apple watch however you want to do it get a sleep study if you want but it's important to know and in fact there was a beautiful study a few years ago where they simply looked at the average oxygen saturation during sleeping versus the size of various nuclei within your brain including by the way the hippocampus and in fact there was a direct correlation if you're running around if you're sleeping every night and you're averaging down at 91 or 90 or 89 or 88 for your oxygen saturation you have a smaller brain on average if you're up where you should be in the 96 to 98 percent you're going to have on average a larger healthier brain so that's a big one the second thing is the oral microbiome you know we're realizing more and more i mentioned the p-gingivalis but there are others t-denticola f-nucleotim a number of these as you know getting the appropriate gut microbiome is so important and getting the appropriate oral and sinus microbiome turns out to be important as well the big surprise has been you find those same organisms inside the brains of patients with alzheimer's and guess what the amyloid is it's there to fight those organisms and again same sorts of things that's been found in the plaques of the arteries you've got these bacteria as you call them your gut buddies and things like that these bacteria are finding their way to your blood vessels to your brain they're actually involved sometimes with tumor formation so it's amazing how these things get around your body and your holobiome is so critical uh and then the third thing i would say is people don't realize unfortunately the toxins they're exposed to please everybody get evaluated make sure that you don't have a house full of mold related toxins again and again and again these things come up and i have to say i was never trained to look for those we didn't think in my neurology residency or fellowship that mold toxins had anything to do with cognitive decline so i learned the hard way seeing people several people who turned out that that was their biggest problem and until you address those you're not going to get people to be much better so for optimal outcomes make sure to include that and then of course the fourth one is what you preach about a lot things related to your diet and so many people about something like 80 million americans are insulin resistant it may be more than that and this is a such a common problem with cardiovascular disease and with dementia yeah it's uh it's shocking how metabolically inflexible the vast majority of americans are and for those of you who don't know what that means it simply means your mitochondria your energy producing organelles should be able to shift on a dime between using glucose as a fuel to make energy or using free fatty acids or ketones to make energy and in my upcoming book unlocking the keto code it turns out that if you're overweight overweight people 98 of overweight people are metabolically inflexible and 99.9 of obese people are metabolically inflexible so it's actually worse than any of us including me even even realize and it to your point it's no wonder that this is happening to us um okay so let's suppose uh before we move on let's suppose you're diagnosed with alzheimer's someone tells you or your loved one that's what you got uh what what now in your opinion should be the standard of care yeah that's a great point and so that's what you know we have now that we've published the one trial we're now putting together a larger randomized controlled trial that will start early next year uh and in that one we have one arm that is doing the optimal care as we in our hypothesis of the optimal care which has worked for many people and then we've got another group which is standard of care and so standard of care as you know has not worked well you don't see people turn around you don't see people get better and so the optimal care is to address those things so you have to kind of flip the script because we've had nothing to offer as physicians over the years everything just as it has been as you've pointed out in your books for cardiovascular disease everything is backward starting with the doctor saying delay it's not that bad yet come back later this is normal aging to then saying okay get on a drug and then you wait all these things and then the other thing is they say we're going to treat everybody the same we'll give them everybody the same drug so what we want to do is flip that around and say for each person we're going to discover what are the contributors to your cognitive decline in some people it is more about their metabolism in some people it's more about exposure to mycotoxins in some people it's more about exposure to air pollution that's been a common one that people look at in some as we talked about it's related to their oral microbiome herpes is another association so what you really want to do is for each person identify the various contributors and then address each of those contributors and even addressing a few of them people will begin to feel better and begin to score better on their testing begin to do better overall and as you address one after the other they typically do better and better and we've had the longest people now have been on for nine and a half years and are still doing well started in 2012 so there is a tremendous amount that can be done starting with a serious evaluation and then getting these and there are there are some core things for sure getting people as you indicated insulin sensitive so important getting them into mild ketosis as you indicated it's that metabolic flexibility normally you can go back and forth when things are good between ketones and glucose with people with cognitive decline they've lost both of those they've lost the glucose because of their insulin resistance they've lost the ketosis because the insulin having a high insulin prevents you from getting into ketosis among other things so they have the worst of both worlds so let's let's talk about um let's talk about the recode protocol and it's not a magic pill or a quick fix so when people say i want the bredison recode protocol you know where what pill do i take that's not what you're talking about and as you and i both know it takes serious dedication and for most people it means making some major lifestyle changes so tell our listeners and viewers what is this protocol and why is it called recode anyhow right so recode is for reversal of cognitive decline so when we first saw people reverse their cognitive decline i'm actually one of my co-workers suggested well why don't you call it recode for reversal of cognitive okay well that's that's a good name for it so uh the idea then is you look at what's driving it you're going to improve these things and yes it's helpful to work with a health coach because what you're really doing is we are changing your fundamental neurochemistry this came straight out of our 30 years in the lab looking with transgenic mice what we called alzheimer's looking at fruit flies what we call alzheimer's looking at cell models all this stuff and then translating that to what can you do with a human being and so yes it begins with the basics diet a ketogenic diet mildly ketogenic plant rich diet which is high in things like choline and getting you the appropriate neurotransmitter precursors that you need and things like that high in fiber having appropriate time for fasting we call this keto flex 12 3 because it gets you into mild ketosis and because it is flexitarian and you've got the time of 12-3 for fasting and then exercise and interestingly there's more and more that we understand about exercise and how it can be helpful people using things like katsu bands and exercise with oxygen therapy that to enhance what you're actually getting from the exercise and you're getting insulin sensitivity and you're getting better blood flow you're getting better oxygenation and then sleep one of the huge issues that's not looked at carefully enough in many people and then stress reduction you want to shrink someone's brain put them under stress for a while their brain will shrink so that we want to optimize that as well and then basics brain training detoxification and targeted supplements all part of the protocol and i do believe these various drugs will be much more successful when they are used on the backbone of an optimal personalized protocol so this is nothing more than we're addressing and optimizing the neurochemistry because it's the neurochemistry that's been out of whack to give you this cognitive decline to begin with uh not surprisingly you and i have very similar views on how food choices as well as time restricted eating play a huge role in both the prevention and the reversal of alzheimer's would you would you give our listeners just a little snapshot of what what the timed eating is in your plan i know we we do this together so tell tell people what you're talking about yeah great point uh so what we recommend is that you want to have a period that helps you in a number of ways to get you into some autophagy so you want to have a period of fasting fasting turns out to be very important for many things um including your including your immune system including your lipid status including your your ability to clear toxic lipids and proteins and damaged mitochondria and things like that from your brain so you want to have a minimum of 12 hours we usually recommend if someone is apoe4 negative and that's three quarters of the population 12 to 14 hours if you're apoe4 positive and that's about a quarter of the population you want to have 14 to 16 hours and some people go longer so for example my wife and i like to do typically 8 to 10 hours of eating and then the rest of the day so we're ending up with you know so uh you know a 16 14 to 16 hour fast before you're eating again then so you have that gives you time for a couple of meals uh and you know you can have appropriate fasting while you're sleeping it's very helpful and we're doing for everybody in this upcoming trial everybody will have continuous glucose monitoring cgm so that gives you a couple of weeks and people are so surprised as you know stephen you see people spike their glucose and equally as bad you see people have it drop into a trough so they go to bed at night because they've had a higher carb diet and suddenly their glucose is 45 and they're waking up in the middle of the night feeling horrible and so you want to avoid both of those you want to avoid the spikes you want to avoid the valleys and get a much smoother glucose curve so that so what we want to do is that 12 to 16 hour fast and then three hours before you go to bed at night because you certainly don't want to go to bed with a high insulin yeah i think that's so so critically important and i've been trying my best to get folks to please stop eating three three hours or even more before you go to bed it absolutely makes a huge difference in outcome uh your protocol also includes taking a variety of supplements bless your heart can you share a couple of the most important ones with listeners yeah and again this is all coming from mechanistics and so let's just talk for 30 seconds about the immune system this is critical as you know if you look at this has been very instructive with covet 19. what happens with cobit 19 your innate system is on fire you've got those cytokines pouring out your adaptive system has not cleared the virus and so you die from cytokine storm in alzheimer's very much the same thing your innate system is ongoing for years and your adaptive system hasn't cleared the various things that you've been exposed to so you don't die of cytokine storm but you die of cytokine drizzle and guess what part of the innate immune system is amyloid beta so it actually makes perfect sense your body is responding to these various insults so therefore we want to improve your adaptive system we want to reduce your inflammation now sometimes that means using things like low-dose naltrexone other times it simply means supporting things with zinc vitamin d kind of the standard sorts of immune support that we think about uh when we look at covid19 uh and you know and acetylcysteine things like that so yes there are many different uh many different supplements that can be used and what's amazing to me is we've always been told that the arsenal for alzheimer's is zero there's nothing you can do to prevent it reverse it or slow it and in fact the opposite is true it's a huge arsenal and you the in the you know the physicians who are excellent can pick out here the most important ones for each person here are the high priorities here the low priorities now some of the ones i happen to love um i like whole coffee fruit extract because it increases brain-derived neurotrophic factor again it some people this is going to be more helpful than others you can actually measure your bdnf in your blood if you like magnesium-3 and eight is another uh good one i happen to like resolving um the with magnesium three and then of course guosong lu from mit did some very nice work showing that that's helpful for many people with their car for cognitive benefit i like resolvence professor charles sirhan at harvard has done some nice work on resolving the issue there with inflammation again it's more complicated than we often hear number one you want to resolve it it's not just about an anti-inflammatory you want to resolve what's there you want to prevent the further and most important of all you want to remove the source and if that is poor dentition okay so be it remove that source you can use all sorts of things like dental cyto you can use things like revit and toothpaste that are probiotic toothpaste now so you can restore a good oral microbiome one of the things that the people in the new trial are also getting is these cone beam analyses because so many people will turn out to have unknown deep abscesses that haven't been picked up and there is another source of infection another source of inflammation another inducer of cognitive decline so getting that optimal is critical and then of course the classics i do think things like s acetyl glutathione so many people are not doing so well with their detox and having appropriate glutathione probiotics and prebiotics as you've talked about of course your gut buddies as you've said these are so important um and i certainly you know i'm religious about taking uh prebiotics myself i think these are are critical and by the way uh without going into any uh glory detail i'll just say that i followed some of your suggestions and the various the the exact things that you describe in your book happened um my gut has done much much better since i've done the right things whereas when i was in medical school things were not as good and so just say thank you dr gundry you know i think we're all on the same page with probiotics and prebiotics and then making sure that there's plenty of fiber i think fiber is undersold because we think of fiber as being like like your grandfather's oldsmobile you know so what big deal but you know very very important for your lipids for your glycemic load for your detox i mean it's just amazing how important of course for gut healing so all of those i think are helpful ones and of course omega-3s and aspartial cysteine these are all things that can be quite helpful you know it's interesting um there's this uh current little uh baby aspirin controversy and one of the things a lot of people don't know is that long-chain omega-3 fats are converted into resolvins by low-dose salicylic acid which happens to be aspirin so for the last 20 odd years i've been asking my patients to take a baby aspirin several times a week not to prevent heart disease but to activate their omega-3s into resolvins and in fact there was a very famous paper a few years ago saying omega-3s don't help with inflammation but when you read between lines they gave them nothing to activate their omega-3s into resolving so i had a good chuckle when i saw that very interesting yeah i think you know the human organism is complicated and medicine has changed fundamentally since we were training in the 20th century from a discipline in which doctors couldn't begin to look at all the different pieces of how the human organism work and so therefore they would focus on this prescription or that prescription because you know that's what we could do for the last few thousands of years but now it's a new era 21st century medicine is fundamentally different and now we're beginning to be able to say here's how this very very complex machine works now there's a lot we don't know granted but there are so many of these points just like the one you just made where we're beginning to understand what it actually takes to make the biochemistry work functionally and this is exactly what we're doing with the neurochemistry and i believe that this can now be adapted to all of the different major degenerative diseases lewy body disease frontal temporal dementia als all of these things and we're actually starting with the project we've got the first patients with uh with um macular degeneration where again you evaluate the things that are actually driving the macular degeneration and then you go after those and we'll see we'll see how it goes but this is the way that we should be able to approach all of these complex chronic illnesses well that brings me to the next point um does this program work for everyone and if it doesn't why not yeah this is such a good good point so thank you for asking it so there are several varieties of course it doesn't work for 100 of people in our trial 84 of the people improved so the ones that didn't you could see why they were not improving as an example one person uh we've had we could see this person had very high levels of mycotoxins in their home and person said i don't want to remediate it i don't want to leave the home i'm going to stay right here so okay continued exposure continued decline continued problems uh although to be fair even just fixing the metabolism is a good start so that's the first thing so it depends on when you start the program if we can get everybody to start when they either as prevention or sci you could pretty much eradicate this disease we unfortunately are dealing with everybody at the other end mci and alzheimer's disease so how late you start is one of the critical determinants to how easy it is to get better the second one is how compliant for people that are really getting themselves into ketosis doing all the right things they almost always get better and that's exactly what the trial showed 84 of people you know we had an optimal situation with health coaches etc one of the big questions from the trial is can we now make it much more practical much easier for people well okay that's the way we're headed but you had to start somewhere first is can we turn it around and the answer is in most people yes especially if you don't wait too long then the third issue is for people who have severe toxic exposure and have lost a tremendous number of synapses no question it is tougher and so for the ones that where we detect high levels of toxins you really do have to stick with it as you know the detox physicians like dr joe pizorno for example they talk about the fact it takes years to get rid of these dr neil nathan as well they talk about the fact that it does take years to get rid of some of these toxins so i'm always happy when i see someone who's mostly got issues with insulin resistance and inflammation metabolic syndrome we can fix those people fairly quickly and fairly completely it's the tougher ones that have the severe toxicity so those are the those are three big parameters that determine and then the other thing is that people give up early because they don't yet understand they don't realize that yes this is something you've got to stick with and their doctors will tell them well you know just take a pill so we know we have to get people to come in early and to stick with it because this remember this is a disease where you don't get a diagnosis typically for about 20 years after the pathophysiology starts so kind of circling all the way back um what type of test would you advise listeners to ask their doctor in order to learn more about their risk and what do you do if your doctor laughs you off when you request these tests which quite frankly happens a ton in the people who end up seeing me you know that's so important stephen um yeah i usually tell people when the doctor laughs them off i say if you've got something better please let me know you know here are some published papers and a couple of books that show results if you've got something better i'd love to hear about it if not then please suppress the laughter because there are some stuff going on out there there's getting better results than you are so you know it's great we all like our doctors to be up up on the latest one doctor said uh doctors are too busy to read that that horrified me oh dear doctors aren't too busy to read but the other thing is what we want people to know are those very things and they are very much relevant to the things you've talked about with cardiovascular disease we'd like them to know what is their ongoing inflammatory status so at least in hscrp you may also want to look into a couple other things like your albumin uh to globulin ratio uh maybe your tnf maybe your il1 so some basics like that but really you just mainly need hscrp and steven i don't know if you like to use other things said rates or you know other cytokines that you look at or not yeah i i i don't look at said rates very much i think they're just too um too inaccurate for a long term look at things and the same way i feel about fibrinogen i do like aisle 16 recently i've got a paper coming up at the american heart association in a couple weeks looking at that as a risk factor for cardiovascular disease and we can now measure that so that's another thing i look at um but you're you're right um people really i have third-year family practice residents rotate through my clinic and i can tell you that not one of them has ever been taught about a fasting insulin level seriously they they go what's that and none of them have ever seen a homa ir or know what it is right this is ir stands for insulin resistance and um yeah and you and i you know think about this every day and we go well of course that's standard of care these are about to go into practice in family medicine i mean very talented individuals but they've not been exposed to the basics yes it's true and it is because there is a fundamental schism in medicine right now there is 20th century medicine which is about what is it make the diagnosis write the prescription or do the surgery and there is 21st century medicine which is about why is it what are all the things this is systems medicine this is functional medicine this is precision medicine going after the things that are actually changing the pathophysiology and as you indicated you want to know your homa ir you're fasting insulin your hemoglobin a1c you're fasting glucose all of those things because they together give you a picture of what's going on you have continuous glucose monitoring very helpful for people you see what spikes and what are the valleys and all those sorts of things and then we want to know your hormones and growth factors and nutrients things like vitamin d and things like your progesterone pregnenolone estradiol testosterone all these sorts of things because they are all playing on your synapses to tell you whether you are in this synaptoblastic state the ability to make and keep synapses or you're in a synaptoclastic state where you're pulling back literally your brain is simply saying i'm gonna have to protect myself it's going into a downsizing protective mode and in so doing it is impacting the very mitochondria you were talking about a a few minutes ago and so those are the sorts of things you want you also want to know if there's vascular damage your specialty so things like your triglyceride to hdl ratio and your ldl particle number and as you often talk about your sdldl all these things critical for understanding whether you are having a high risk or a lower risk all right i want to jump to your new book the the first survivors of alzheimer's now it features uh stories of seven unique patients who committed to the recode protocol can you tell us a few of those stories and why you decided to feature them in the book because they're they're really moving stories they're fantastic they are and i have to say you know when we were uh when we talked to some of these people i mean they became tearful um it's it's their amazing story so back in 2012 the very first patient that i called patient zero in there uh called me up after three months and said oh my gosh you know my memory's so much better i'm doing so much better and i thought wow yeah this is this is amazing our the research that we had done over the years um at that point only about 20 a little over 20 years now over 30 years where we were looking at these things we said okay this is driving us in the right direction following the app signaling following what actually is driving your synapses to continue or pull back is helping to drive us in the right direction so as we began to hear being one person after the other started to do this the stories are such beautiful stories and i thought that they could do a couple of things number one they can inspire people not to give up to say hey look i did it it really changed my family the other thing i thought was they can give them their protocols and say look this is what i did this is what i tweaked this is how i optimize it for myself and the third thing is their wonderful stories about how they impacted the families because the first couple of books were a lot about the science and then the clinical translation but this is the human nature part of it this is people saying you know a great example you know julie very well yeah and she talks about uh of course she is at 4 4 and highest risk and she talked about when she first was diagnosed and talking to her son who started crying and said mom i don't i don't want to lose you and then about how she got better and then ended up going to her son's wedding so it's just a beautiful story and my hope is this is the beginning as i said in the second part of the book toward a world of survivors we really need to make it so that we reduce the global burden of dementia and imagine that we could stop half the people in the world there are over 30 million people in the world right now with alzheimer's over 6 million in the us alone about 45 million of the currently living americans will die from alzheimer's which is a horrible horrible problem as you know horrible way to go and so giving people the inspiration and the know-how to make a big difference was just wonderful it was really a labor of love just going through these stories and then the last half of the book is about okay what are the updates for the protocol what have we learned in our nine years since we had the first patient back in 2012. yeah they they really are are great stories how in how long just in general does it take people to see a difference or is there a general rule no that's a really good point and you have to remember you know they've been doing this it's typically the pathophysiology has been there for years sci alone averages about 10 years so typically when we see them it's been years and it typically takes i always tell people give it three to six months now that's three to six months after you do the right things so if you don't do the right things it's not going to happen in three to six months but get yourself into ketosis make sure that your sleep is okay make sure that your oxygenation is optimal make sure that your gut is healed make sure that your lipids are looking good you know make sure that you are insulin sensitive and you are now uh you know and you've now metabolically flexible once you've done those things give it three to six months and most people will do well now we've had we had one person as early as four days because this person had massive mycotoxin exposure just getting out of there four days later she was already starting to improve but that's the exception most people you've got to fix a number of things and so we usually tell three to six months but some people are still doing better and they'll what will happen is they'll plateau and then we find that oh there's something else that's been missed now they go to a higher plateau and then maybe they'll add one more thing there's another pathogen or they'll add low-dose naltrexone improve their immune system and then they'll get a higher plateau so we want to keep people getting higher and higher plateaus and of course that means for a quote normal cognition people tend to get better than their normal cognition as you well know by doing the right things now this is not a one and done once you get these results you don't go okay i'm fine i can go back to doing exactly what i did before no that's yeah exactly right i'm so glad you brought that up because you want to keep optimizing you want and you want to stick with it now to be fair there are people who will have you know once a week go out of ketosis and they'll cycle in and out which is you know which is not such a bad thing cycling out once a week especially for the people who um are who have low bmis and really need that calorics you got to be careful because some of the people at the low end of the bmis can hurt themselves by jumping into too much uh fasting at the beginning you've gotta again you have to remember this is a disease of insufficiency interestingly even though it's born of excess typically excess sugar and things like that so you've got to kind of walk that midline where you're not taking things away too much but yeah absolutely fine to get off occasionally but as you indicated you want to continue this for your life because it will continue to it will continue to signal to your brain yes i want to be able to make and keep synapses it'll keep your memory sharper it'll keep your cognitive abilities better overall for many years to come so our goal is to get everyone to be sharp to a hundred well sounds good i just one of my 97 year old patients from l.a drove out to see me this week as sharp as a tack yeah and he's a 3-4 and he still runs his business and i've been taking care of him now for 15 years because his family brought him to me and said you know he's so important we got to keep him around he's 97 and he's thriving so you're right i think people people need to understand not only there is hope thanks to you but that this is you know there if you if you have these signs you know jump in dive in it's worth it and the payoff is you know a great brain and life for a very long time absolutely and i think it's something we're not used to people keep saying oh you're 45 now you you can't expect to be as sharp as you were oh my gosh as you said people should be as sharp as attack until they're 100. so you know this guy's 97 he's doing very very well and you know this is the new era of medicine this this is for you know this is functional medicine and we can all stay well and stay functional well into our late 90s or beyond yeah uh i know i'm interested time i know you got to go what's next for you in the recode protocol you've kind of filled us in on where you're going but anything on the horizon new and exciting absolutely yeah thanks for asking so three things so number one we're doing this larger trial now we had very exciting results and i should have mentioned you know that both the gray matter and the hippocampal volume in this trial did better than normals so very exciting to see that so we've got a larger trial now that will be a randomized controlled trial starting early in the year second thing is that we are adapting this for other neurodegenerative diseases starting with macular degeneration and we've had good results already with lewy body but you know what about als what about frontotemporal dementia and things like that and then the third thing is called the sarah trial and that's not started yet but that's down the line severe alzheimer's reversal attempt sarah and the idea is what about the people because we looked at people with mochas of 19 to 30. now that's mci and early alzheimer's what about the people with mocha scores of zero late end stage alzheimer's we've had some anecdotes where we've gotten some improvements we've never seen him go from zero to thirty but we've seen him go from not dressing to dressing from not talking to talking tremendous subjective improvements so we need to ask what do we need to include to get people who are very severely involved to bring them as close back to normal as we can does that take stem cell addition does it take intranasal peptides does it take in hospitalization what does it actually take to do that so that's the third piece of this going forward and that's those are the directions we're going all right well i know you got to go you got to go to a conference and lecture and i really appreciate you tearing yourself away uh because this is you know as you know this is really important and exciting information that uh this is not the end of the world as everybody expects when they're given this diagnosis so much that can be done and again please encourage everyone when people are really late i tell them please bring in all the children let's make sure that you end this problem with this generation and that's something that we can all do so great to talk to you stephen i really appreciate it always love talking to you you're always doing exciting stuff and i look forward to your upcoming book as you know my wife and i are huge fans of all of your books so thank you well it's a mutual admiration society i assure you so uh and thanks for all your great work and i know we'll be talking off camera soon thank you very much please stay safe uh watch out for those mudslides and uh and stay away from covet 19. okay i plan to all right thank you thanks bye-bye bye all right it's time for the audience question this question comes from oaks oksana hernandez on youtube who says dear dr gundry you are simply amazing and very inspiring well thank you love your work i've done my diet transformation now struggling to find a lectin-free substitute for wheat flour to use for bread and pancake making i can't achieve the same consistency and viscosity with coconut flour and almond meal i'll try millet and sorgen flour please advise well the good news is that i just so happen at gundry md to have a really fabulous bread mix and also pancake mix and chocolate pancake and waffle mixes that we at the gundry household have fooled so many of our guests into thinking that they are actually having pancakes and waffles and they are shocked when i actually show them the box and the next thing i know they're ordering it there's all sorts of ways around just coconut almond flour and don't get me wrong they're very useful but a lot of times we found that psyllium fiber is one of the real tricks tapioca fiber is one of the real tricks cassava and play with it there's lots of great recipes online we have recipes in our books on how to do this so don't despair you can actually get the mouth feel that you're looking for uh either from our mixes or by going online and looking at that and again thank you so much for you know writing me about how how well you're doing and my work i really appreciate it time for the review of the week this week's review comes from cheryl h on youtube who watched my interview with katherine arnstein she said thank you thank you for this interview dr gundry i learned so much that i didn't know about spirulina and chlorella despite hearing people praise them for at least 40 years and now i know about a brand that i feel i can trust as well which has been the main thing holding me back all these years now i can't wait to introduce these superfoods to not only my diet but my daughters and granddaughters as well so once again you have profoundly improved the direction of my health just as you did when you introduced me to the concept and effect of lectins which i've since found to be the primary cause of most of the arthritis i have suffered with for the past 10 years you and dr jason fung have been godsons in my life and i could not appreciate you more thank you thank you thank you again and again well thank you cheryl for sharing um just almost every day i hear people with arthritis shocked that when they get these troublemaking foods lectin-contained foods out of their life their arthritis resolves and often resolves quickly and dramatically so thank you for writing in i appreciate it spirulina and chlorella are really great uh algaes and uh aquatic organisms to get into your life and i'm glad you liked that show it was it was fun i'm doing this for you guys and keep writing in because we'll read about it and uh we'll see you next week because i'm dr gundry and i'm always looking out for you before you go i just wanted to remind you that you can find the show on itunes google play stitcher or wherever you get your podcast because i'm dr gundry and i'm always looking out for you [Music] you

Channel: The Dr. Gundry Podcast

Views: 116,545

Keywords: dr gundry, dr. gundry, steven gundry, gundry md, gundry, plant paradox, the plant paradox, plant paradox diet, diet, cookbook, lectins, lectin free, the dr gundry podcast, podcast, interview, longevity, nutrition, Alzhiemer’z, Dale Bredesen, The First Survivors of Alhiemer’z, cognitive decline, brain health, leaky gut, gut health, autoimmune disease, microbiome, leaky gut syndrome, dr. dale bredesen, akkermansia muciniphila, bacteria, inspiration, metabolic flexibility, mthfr gene, gut

Id: hGtCxRy0OSc

Length: 57min 31sec (3451 seconds)

Published: Tue Dec 07 2021