Dr. Gundry:
Welcome to The Dr. Gundry Podcast. Now, what if Alzheimer’s wasn’t inevitable but optional? For decades, we’ve been told that memory loss is just a part of aging. That cognitive decline is genetic, irreversible, and out of our hands. But today I’m welcoming back Dr. Dale Bredesen, my good friend, a leading expert, the leading expert in neurodegenerative disease, and the author of the new book, The Ageless Brain: How to Sharpen and Protect Your Mind for a Lifetime. We’ll unpack the new science that offers real hope, including how gut health and chronic inflammation may be the missing pieces in protecting your brain, and most importantly, what you can do about it. So stick around, we’ll be right back, and you don’t want to miss this one. I’m so excited. Dale, it’s great to have you back.
Dr. Dale Bredesen:
Great to be back, Steven. Thanks so much for having me.
Dr. Gundry:
All right, I want to dive in because we got a lot to cover, and you and I could talk for hours and hours we do on the phone anyhow. So let’s get right into your new book. You open it with a bold statement that Alzheimer’s may now be optional. Come on. What gives you that kind of confidence?
Dr. Dale Bredesen:
Yeah, it’s just a great point. And we are in the middle, Steven, of a randomized controlled trial at six sites. The interim analysis is striking, strikingly different between the control group and the treatment group, and the control is the standard of care for Alzheimer’s. And what we’re seeing now is the armamentarium has increased, as you know, gut health, sleep apnea, red light therapy. You just go there are hundreds of various items, various supplements, things that you have supported, for example, and we understand this, there are new blood tests. So now we can look earlier than before, we can evaluate, we now know a lot more about the pathophysiology. In fact, you may have seen the article that just came out a couple of days ago showing that people in their twenties you could already pick up changes on these biomarkers. So we’re in a new era, we can pick it up earlier.
We know we can see it coming, just like when hemoglobin A1C came out about, what was it, 50 years ago or so. And we could now look at pre-diabetes and say, “You don’t have to get diabetes because we can see it beforehand.” We’re in the same place now with Alzheimer’s disease. We can see it coming very early on. We can do something about it. We’ve already seen it. We know the phases it goes through, from the asymptomatic to SCI to NCI to dementia. We can pick it up at these early stages, and virtually everybody at these early stages who is treated appropriately and optimally, as you well know, they do well. We see improvements, and we just published recently the first examples of sustained improvement for over a decade. So if you put all that together, you come to the obvious conclusion. This is now an optional disease for most people.
Dr. Gundry:
So you and I were talking off camera and you and I both run into this in our practice where we’ll have a new patient who has beginning dementia or is deep into dementia and their well-meaning physician and/or neurologist has them on one or two or three Alzheimer drugs and things are getting worse and worse. They always do, and yet they’ll say there’s absolutely no use in doing some draconian Dale Bredesen ReCODE program or some draconian Dr. Gundry Plant Paradox program because it’s not worth it. Help people understand how that’s still happening.
Dr. Dale Bredesen:
Yeah, it is hard to believe at times. I understand, as you said, they’re well-meaning people are saying, “We don’t want to create false hope.” I understand that, but please don’t create false hopelessness. That’s Julie G’s term. And of course, at one time, she was told that it was hopeless when she was in her late forties as an APOE44, and she’s done spectacularly well. She’s now in her sixties and is brilliant as she was before she had cognitive changes. And so I would just encourage people, if you’re going to say that there’s nothing, please first read the published studies, look at the protocol, maybe talk to a few of the patients who have gotten better. Maybe look at the ones that were described in the first survivors of Alzheimer’s. These people got better. What are you missing here? So I think we are in a new era, and I think people need to recognize that this is a new era.
Dr. Gundry:
You’re very vocal about the amount of money that’s been spent on pharmaceutical research for the treatment of amyloid plaque and tau proteins. What has all that money gotten us so far?
Dr. Dale Bredesen:
About $40 billion. Hard to believe. $40 billion or so have been spent on the development of pharmaceuticals, and yet there is nothing. There is no golden bullet, there’s no silver bullet, no perfect way to do this. And as you well know, when you’re dealing with a network insufficiency, which ultimately this is, then you need to have silver buckshot, not a silver bullet. You need to actually look and see what is causing the problem. And if you look at Charles Piller’s recent book, which I think is very helpful, which is called Doctored, which is all about fraud, arrogance in the attempting to cure Alzheimer’s, people are kind of gotten off on the wrong side. And so the problem is once you’ve put that many billions of dollars into this, you’re not going to give up easily and you’re going to try to convince the FDA, you’re going to try to convince the various payers like Medicare to pay for these things even while knowing that it doesn’t work.
And I have to tell you one quick example here because there’s a separate analysis that’s been published showing that people who are APOE44 actually did worse than control. So, in other words, if you gave them nothing to treat, they did better than if you gave them a specific drug, an anti-amyloid antibody. And yet knowing this, having it published, I’ve had people go to major medical centers, the top medical centers in the world, and they will be diagnosed and say, “You got to go on this drug.” And they’ll say, “But I’m an APOE44, this is already… “No, this is what we have to offer.” So when you have that kind of money and influence, unfortunately, you can deny the truth, and that’s sad.
Dr. Gundry:
Why are these plaques occurring in the brain? And I have my answer, but I want to hear your answer because I think it’s the same as mine, but where are these plaques coming from?
Dr. Dale Bredesen:
This is such a great point because I’ve been working on a unifying theory for all these diseases. And what’s interesting is, as you well know, you have an adaptive immune system, which it is specific. That’s the last thing to be activated. You’ve got the innate system, which precedes that. That’s where your inflammation’s coming from. It’s less specific, it’s older evolutionarily, but what’s interesting, you also have a barrier system which precedes the innate immune system, your skin, your cerumen, things like that, gut lining. The first places to go, things that you’ve written about extensively, of course. What we now see is that amyloid is a barrier function. So it’s really fascinating because, as we already know, you can go for decades with amyloid in your brain and not have cognitive compromise, but at some point, you start developing the compromise. When is that?
So, what we now believe is that this is an intracerebral version, essentially like cerumen. It is a barrier. We know that it oligomerizes it and then polymerizes, just like putting an insect in amber, it surrounds pathogens. And as long as you have a low burden of pathogens, you can prevent the activation of the innate system for decades. However, as the pathologists have told us for years, once you get that innate system going, the microglial activation, the cytokines going all this, that’s when you start having major loss of synapses and major problems. So having some amyloid around and as long as you’ve got this low burden, which is why we want to lower the toxins and lower the burden and improve the oral microbiome and fix the sleep apnea and all the things that you do, gut probably being the most important of all these people can do well for years and we believe that that is what the amyloid is all about.
Dr. Gundry:
Yeah. I like to use the example after 9/11, all of a sudden we had concrete barriers erected around all our federal buildings, around our airports, because we didn’t want a terrorist coming with a truck attacking. And I just have my patients visualize that these plaques are barrier defenses against something that’s coming. And you’re right, that’s a pain in the neck go through security. But if they visualize, hey, you’re putting down barriers because something’s coming from our mouth or from our gut, and it’s a barrier function.
Dr. Dale Bredesen:
Exactly right. And that way, it allows you the luxury of going for years without a lot of inflammation. As long as you can avoid that and just keep that barrier function. You’ve got a small number of pathogens, but it’s when that is overwhelmed, you’ve got to bring in that next line, that’s when things go south.
Dr. Gundry:
Yeah, you’re exactly right. The troops down in our gut can’t hold the hoard back any longer.
Dr. Dale Bredesen:
Exactly.
Dr. Gundry:
And as you and I know, they send signals to the microglial saying, “Oh my gosh, we can’t hold them back any longer. They’re on the way. They’re climbing the vagus nerve.” Yeah, and you’re right.
Dr. Dale Bredesen:
And can you imagine now that you spend years developing a drug to remove the barriers?
Dr. Gundry:
Exactly.
Dr. Dale Bredesen:
Like, oh yeah, just take those barriers out. Everything’s going to be fine. Wait a minute, there’s more to this.
Dr. Gundry:
Yeah. I want to talk about the things that you tell people to avoid. One of the things that’s interesting as a heart surgeon, we always told some of our older patients with Parkinson’s or with mild cognitive impairment that after heart surgery, they’re going to backtrack in terms of their Parkinson’s, in terms of their memory. And it would take them, I guarantee it, that it would take them a year to maybe recover. And we thought it was the heart surgery being on a heart-lung machine. And eventually, when we developed beating heart surgery where we didn’t use heart-lung machine, the same thing happened, and we started seeing it in general surgery or from a hip replacement, and we realized it was actually the toxicity of the anesthetic itself. So, what are these toxins that are potentially modifiable preventable?
Dr. Dale Bredesen:
Yeah, this is such a good point because one of the things that when you look at the big three that create cognitive decline, they are reduction in energetics, blood flow, oxygenation, all that mitochondrial function, inflammation, as we were just talking about, and then toxicity. And we didn’t know about this at the beginning, with the first couple of patients, we didn’t realize how important these toxins are. And as you know, they come in three groups. It’s the inorganics, the California fires, the air pollution, all that stuff, the mercury. It’s the organics, things like anesthetic agents, and now microplastics are emerging as a big concern. Toluene, benzene, all these things that you’ve got to deal with, and then it is the biotoxins, things like trichothecenes and ochratoxin A. But what’s been fascinating is that these organics, when you look at what happens as you know as a surgeon better than anyone, you have a combination.
Unfortunately, it’s like a perfect storm. So you may get some hypoxia during your, especially if it’s a long procedure, you may get some hypotension. And usually the anesthesiologist is like, yeah, great, no problem. The blood pressure is low, but you’re not perfusing the tissue that needs to be perfused. So these are things you can discuss with the anesthesiologist ahead of time, wrote about it in the book, the various books in the past as well. And then, as you said, you also are adding to your toxic burden a significant amount of an organic toxin, which you’ve now got to excrete. And especially if, as my wife Aida says, “If your tub is full already with other toxins, you’re now adding to that and you’re overflowing.” Also, you are going to lower your glutathione level, you’re going to deal with your detox issues, all of your various detox, your methylation pathways, all these are going to be challenged during this time.
So it really is a multiple type whammy here to your system. And so as you said, so many people will after this, or they’ll say, “My mother was doing well, then she had a procedure she was under for three hours or something, and she just really hasn’t been the same since, and she seems to be going downhill now.” So we tell people, “Look, prepare ahead of time. Make sure you optimize your glutathione level. Make sure you’re essentially on the protocol before you start. You’re dealing with your toxins. Then right afterwards, bump up your glutathione again, help yourself to detox, make sure that your gut is in good shape, and you’re doing all the right things.” So, absolutely, toxin exposure is one of the common things, and the other interesting thing is we often see with a very toxin-related cognitive decline, a very different pattern than your typical metabolic and inflammatory decline.
Dr. Gundry:
Now, one of the things that impressed me when was writing Gut Check was if you look at these super centenarians, their microbiome is really good at eating xenobiotics, eating plastics, eating these toxins. And people are, “Oh, come on, bugs can’t eat plastic.” Well, they’re carbon atoms, and we know that we can clean up oil spills with bacteria that eat carbon atoms. It was an aha moment for me was if we actually had a decent microbiome, we could handle mold toxins. As we know, fungi and bacteria hate each other, and they both have defense mechanisms against each other. Most antibiotics, of course, are the mold defense system against bacteria.
Dr. Dale Bredesen:
Exactly.
Dr. Gundry:
So yeah, I think the good news with your protocol and mine is if we can maximize these guys and our defenses against these environmental toxins, we’re hopefully way ahead of everybody else.
Dr. Dale Bredesen:
It’s a great point, and especially in this day of looking at how much microplastic we are getting exposed to, the claim is it’s about five grams a week, of basically one credit card worth per week-
Dr. Gundry:
Yeah. Per week.
Dr. Dale Bredesen:
Per week. And what’s interesting is now comparing what’s in your brain, what’s in your kidney, what’s in your liver, it’s clear that it is actually concentrated in your brain more than the kidney, more than the liver. And further, the concentration in the brain is associated with your risk for cognitive decline. Now that doesn’t necessarily say it’s causal. We don’t know that yet, but there’s certainly a concern if you see more microplastic in the brain, you are at greater risk for cognitive decline. So as you said, we got to get those bacteria optimized. You got to get your gut microbiome optimized, and there are recent studies showing dramatic reductions about a 70% reduction in microplastics with plasma exchange. So, plasmapheresis is coming as a more and more common way to help people detox. Almost like a spa. You can go through a couple of months of it and then be okay for a while. Good way to knock down these various toxins you’re exposed to.
Dr. Gundry:
So, should we throw away our plastic water bottles?
Dr. Dale Bredesen:
It’s a great point. We probably should. And we probably should be having it right here in glass. I think-
Dr. Gundry:
In glass.
Dr. Dale Bredesen:
… that’s a really good way to go. And there’s no question we’re exposed in the air exposed, we’re exposed through our gut, we’re exposed through skin, on and on and on. Very interesting graph I saw just a couple of days ago, Dr. Heather Sandison showing who’s done a great job with people and is the one who started Marama, a wonderful assisted living facility that has improved people’s cognition and what she showed was the toxin profile before and after hair coloring in one patient and it was strikingly different. So I think that cosmetics, we got to be careful about these and getting less toxic cosmetics. We got to stay away from the California fires, we got to get some HEPA filters.
Dr. Gundry:
We have to move.
Dr. Dale Bredesen:
We just got to be careful about being around these things. These are things are definitely harming us, and we got to then. I think the old idea of spas and reducing your toxic burden at times, especially, it was a great one.
Dr. Gundry:
And you mentioned when we first started hemoglobin A1C, and people now know that term because it’s on TV every night. I got my A1C down. Interesting. I have third-year family practice residents who rotate through my clinic for a month, and these are physicians who are about to go into practice, and not a one of them has ever heard of insulin resistance, a HOMA-IR.
Dr. Dale Bredesen:
Wow.
Dr. Gundry:
Not one of them. And none of them have ever measured a fasting insulin level.
Dr. Dale Bredesen:
I’m so glad that they’re allowing them to rotate through your service. I mean, that is fantastic. So they’re getting a good look at what’s coming. I do think as you and I were talking about before we started here, that there has never been such a huge gap between what is being practiced and what is available and where there is knowledge and not just research, but actually things that are working that you’re doing all the time, for example. And I think that we need to look at how to close that gap so that people can get better outcomes. I think part of this is from the third-party payer system, when you have a fixed amount that you are bringing in, you don’t want to offer more. It doesn’t fit the business model. So I think that we have to re-gauge, recalibrate what is available because many people can do much better than they’re doing. And so as you mentioned, HOMA-IR very important to know, very important to know whether someone has insulin resistance. And it’s one of the common contributors to cognitive decline.
Dr. Gundry:
Yeah. In fact, particularly with my APOE4 patients. And for those of you hopefully know about the APOE4 gene, 25 to 30% of Americans carry one or both copies of the APOE4 gene and Dr. Bredesen, my hero is really one of the forefront researchers on the APOE4 gene and its effect, I got interested in it because of its effect on heart disease and that’s how we got to know each other but it’s really important. I always show them their fasting insulin level and their HOMA-IR, and if those are in the yellow or God forbid, the red, I said, you have just virtually guaranteed cognitive decline. And they go, “What? But my hemoglobin A1C is 5.5.” I said, “Yeah, but your insulin is 15 and your HOMA-IR is three.” And they go, “What?” And I said, “This is modifiable and we got to get going here.” Is that your experience as well, that insulin resistance is a big piece of driving cognitive decline?
Dr. Dale Bredesen:
Absolutely. And in fact, when we used to grow brain cells in the dish, doing our experiments, looking at what happens if you do this or do that, we would have to include insulin in the Petri dish, otherwise the neurons wouldn’t survive. So insulin is a very important, not just for metabolism, but also a trophic factor for neurons. And there is an intimate relationship between insulin and metabolism, and Alzheimer’s disease. And as an example, the amyloid beta itself, this barrier that we were talking about previously, one of its numerous effects is to interact with the insulin receptor and inhibit it, so it creates a state of relative insulin resistance in the brain.
And there was some nice work from UCSF several years ago looking at insulin resistance just within the brain by using neural exosomes, which they could pick up in the blood, and you can actually see what’s going on in the brain. What they showed was that virtually everyone who was getting cognitive decline had insulin resistance, whether they had it peripherally or not, they had it in the brain. It’s very striking studies. So no question. This is so important for its numerous effects, and it is one of the big players in reducing support for the brain and increasing risk for decline.
Dr. Gundry:
So you outline in most of your books, and I do too, what steps can our viewers and listeners do? I mean, are there action items that we can do every day?
Dr. Dale Bredesen:
Absolutely. And the most important thing I would say is for people to know where you stand. So now we have new tests, which now you don’t have to go and get an expensive PET scan. You don’t have to go get a spinal tap, and who wants to go for spinal taps? I don’t want to have a spinal tap unless I have encephalitis or something. So you can avoid that now. So there are blood tests that you can do. So you want to know your P-tau217, your GFAP, and your NfL. There’s something called brain scan that will give those to you. And I actually had it done at my kitchen table a few weeks ago to check mine, like, okay, good. If you know your cholesterol, you know your blood pressure, you should know what your P-tau217 is, and there’s a new one coming called super P-tau217 that’s even more sensitive.
So this can tell us even before you are symptomatic where your brain stands. Are you synaptoblastic? You’re making synapses, or are you synaptoclastic? One of the surprising things we found is that you literally just like sleep and wakefulness, your brain has two modes, connection, protection, and so when you’re in connection, the blood flows differently. Your trophic support is on, you have oxidative phosphorylation, you’re using oxygen, all this sort of stuff. When you then switch to the protection mode, you’re making amyloid. You’ve got that barrier, you’re changing your metabolism, your cytokines are going, all these sorts of things. So you have literally a switch. So we want to look at this, and as far as what to do on a day-to-day basis, we think of the seven basics and the two specifics. So the seven basics, which you’ve talked about as well, plant-rich, mildly ketogenic diet, which has worked very, very well for metabolism.
You want to have, most importantly, metabolic flexibility as you write about and then exercise. And it looks like HIIT is actually probably the most helpful for people in terms of rate reduction, but aerobic exercise and strength training are very much synergistic because they give you by different mechanisms, they improve that. Of course, the strength training improves your insulin sensitivity. So these things are very helpful. And then sleep. You want to have seven hours, at least an hour and a half of REM. I encourage everyone, have a wearable. You can see, make sure your oxygen saturation is at least 94% at night. The claim is 80% of sleep apnea in the United States goes undiagnosed. People don’t look for it, and it’s a common contributor, and then stress, of course, is a big one. And then brain training or brain stimulation, detox, and some targeted supplements like Dr. Gundry’s supplements.
Dr. Gundry:
Bless you.
Dr. Dale Bredesen:
Yeah, no question, these are going to help you… By the way, we had in the trial one of the patients who, a couple actually of the patients who finished the trial, stopped all their supplements. This is from Dr. Kat Toups, who’s done a fabulous job. I really appreciate her fantastic work. She’s an outstanding psychiatrist and has been involved in over a hundred clinical trials. She gets great results. But a couple of people, when they finished the trial, they stopped them, and she said they just went right down. So you can see, yes, these things were doing something. So these things are all these the kind of the seven critical pieces that we can all do each day to reverse decline and to prevent decline.
Dr. Gundry:
I have the same thing. Taking supplements is often a pain in the neck and take a lot and you take a lot and my patients sometimes get tired of it and they do a self-experiment in between visits and they’ll go, “Hey, I want to tell you I stopped my supplements for two months before I did the blood test because I want to show you that they’re a waste of time,” and it’s striking what the changes you actually see. And they go, “Oh my gosh.” Say, “They don’t make expensive urine like I used to think.”
Dr. Dale Bredesen:
Right. And having optimal supplements is important. I often hear as a neurologist, “Oh, supplements aren’t a cure for Alzheimer’s.” Of course they’re not. We’re not claiming they are. What we’re saying is that when you have that silver buckshot and when you’re optimizing your cognition, they are part of an overall optimal protocol.
Of course, some people will need certain ones and others won’t, but you can get an idea. Obviously, we have a better than ever ability to look between the advanced imaging things like arterial spin labeling, and there’s new AI around looking at volumetrics in the brain that can predict who is headed for cognitive decline. Dr. Cyrus Raji, a professor at WASHU who we work with has done a fabulous job. He’s able to show who’s headed for what. We can get an idea, as I mentioned, from the biomarkers, things like P-tau217, and then we get an overall idea of all the contributors from homocysteine to hsCRP to your gut. And I think if you look at the things that are missed the most, it’s gut health, as you talk about, it’s oral microbiome, it’s sleep apnea. These are the things that are being missed repeatedly that are critical for optimal cognition.
Dr. Gundry:
You and I we have patient stories in all of our books, and I think it gives a lot of hope to people. Got any new ones that you’d like to share with people?
Dr. Dale Bredesen:
Sure. So here’s a guy, very successful businessman, was tapped to come out to California and lead a youth group. Within a few weeks of arriving here, started having some vertigo, and within a few months started having some problems with his thinking. And he said, “What is this all about?” This guy’s 53 years old, so he goes to one of the nation’s leading centers, and they tell him, “Oh, you’ve got Alzheimer’s disease. There’s nothing to do. You’re going to die.” And he said it was such a profound statement that he just thought, “Oh my gosh. I mean, I’m at a center that everyone wants to come here because it’s such a famous place, and they’re the ultimate word, and they’re telling me I’m going to die, and like I’m 53. What the heck? A few months ago, I was fine.”
And he then found one of the physicians I had trained, Dr. Jeralyn Brossfield, who’s fantastic out in Palm Springs, out in your neck of the woods. He saw her. He has recovered; he has done very well. He’s not back to perfect yet, but he’s far better than he was, and he no longer has the prognosis that he was given. And he said, “How can it be that a leading medical center would be telling me this sort of thing? Why don’t more people know about this?” It turned out that when he moved out to this place, he was exposed to massive mycotoxins in an old house, and he wasn’t aware of it.
And he’s actually APOE4 negative. When we see young people who are APOE4 negative and who are having rapid decline, you got to look at biotoxins, and that’s exactly what he had. And so he’s getting treated for these. He is detoxing, he is getting things back. He got to the point he couldn’t even use a keyboard. So you would say he was at that fourth stage dementia. He’s now able to use his keyboard able to use his computer, doing much, much better. So there’s a story. We don’t want to see people die needlessly.
Dr. Gundry:
That brings up the point, I would bet you that he was recommended to take one or two pharmaceutical drugs to help him out. What should our listeners hear from you about that?
Dr. Dale Bredesen:
Yeah, this is such a good point because everything is about best outcomes. Look, if it takes 10 drugs and three injections, only two things happen when you have cognitive decline: either you get treated successfully, or you go on and die, unfortunately, it is a terminal problem. So let’s do everything we can to get people better. But here are the data. Dr. Lon Schneider from USC has done a nice job publishing the long-term outcomes and showing that people who went on Aricept or Namenda in the long run did worse than people unfortunately. Now, he pointed out it may not be causal, it may be an association that’s possible, but the bottom line is these, if you go on them, it may give you a little bump up, but it’s not a long-term solution because you’re not dealing with what’s actually causing the problem. You’re just kicking it down the road, and you’re saying, “Well…”
It’s a little bit like saying, “Look, I can take Adderall and get a little bit of a bump. That’s fine. I can eat a chocolate bar and get a few minutes of boom, but that’s not going to help me.” That doesn’t help your brain. And in fact, it can hurt your brain in the long run. The new anti-amyloid drugs we know have very significant side effects, micro hemorrhage, death in some cases, swelling of the brain, and at best, they don’t make you better. The best thing they do in the right patients is to slow the cognitive decline by about 27% or so. In women, it’s only 11%. So it’s almost imperceptible, and yet it’s a lot of risk. In APOE44s, as I mentioned, it’s worse than nothing.
So if you’re a four, I wouldn’t even consider those. But for others, if you want that minimal effect, fine. Of course, people are coming out with GLP-1 and saying, “This might be helpful.” Well, but again, it’s a non-physiological way. They have their own side effects. So what we recommend is, look, if you’re really interested in those and you’re truly overweight, you’ve got some lipid to burn and you want to bump up your endogenous insulin, which could just create more insulin resistance, but be careful about that and you’re willing to undergo the possibility to risk the fact that you might have gastroparesis and things like that then give it a try for three or six months, get your weight done. That’ll help you to be more insulin sensitive and then get yourself off them because we don’t know the long-term effects of these drugs. The fact of the matter is, we can do so much better with the protocol we have with the sort of thing you’re using, with the sort of thing we’re using right now, than you can with these drugs. So they can be supplementary if you want, but be careful.
Dr. Gundry:
I keep telling all my patients there has yet to be a safe long-term weight loss drug ever.
Dr. Dale Bredesen:
And well, there’s a safe, long-term weight loss approach, which is what you take.
Dr. Gundry:
That’s right. That’s right. Yeah. But yeah, we just have to be careful, and actually, it’s interesting. I don’t use these drugs, but my patients who get them, their insulins do go up, and their insulin resistance goes up because they’re losing muscle mass. We’ll see.
Dr. Dale Bredesen:
[inaudible 00:34:13], so let me ask you a question if I could.
Dr. Gundry:
Sure.
Dr. Dale Bredesen:
Because one of the common things I hear is people will say, “Well, I understand you want me to be more insulin sensitive. You want me to be more metabolically flexible, all this sort of stuff. But when I come home and I’m under stress, I want a candy bar. So how do I take that next step to say, ‘Okay, what can I do to feel better to address that, which often is coming with stress and things like that?'” What does Dr. Gundry say to people to get them to optimize their metabolic status?
Dr. Gundry:
Well, a lot of it is actually in my new book, the Gut-Brain Paradox, where these cravings, interestingly enough, are driven by certain gut bacteria, and we’re being able now to measure them how many of them there are. And usually, interestingly enough, most of my patients with these cravings make very little short-chain fatty acids in their gut. They don’t make much butyrate at all. Even people who are taking [inaudible 00:35:18], eosinophil, it’s not growing in them, which is really interesting. And you and I shared in my last book, Gut Check, the APOE4s actually, that gene actually fights against the short-chain fatty acid-producing bacteria colonizing their guts. And so all of my patients, certainly with the APOE4, they’re all on these short-chain fatty acid producing bacteria, and they just have to chronically take them because that gene prevents the seeding of them.
Dr. Dale Bredesen:
Interesting. Interesting.
Dr. Gundry:
So that’s one of my new prescriptions for everybody.
Dr. Dale Bredesen:
Yeah. And that may be very helpful for people who have those cravings. That’s great.
Dr. Gundry:
Yeah. Yeah.
Dr. Dale Bredesen:
Okay. I think that’s a great learning point. Thank you.
Dr. Gundry:
And it turns out that extra dark chocolate should not be viewed as a guilty pleasure because it actually manipulates the gut microbiome in a very positive way, and you and I know it actually manipulates the brain, but not milk chocolate.
Dr. Dale Bredesen:
Right. Yeah.
Dr. Gundry:
Yeah, sorry.
Dr. Dale Bredesen:
Absolutely.
Dr. Gundry:
Probably obvious to everybody, where can they get the Ageless Brain? Where do we find out more about you and ReCODE?
Dr. Dale Bredesen:
Yeah. So the Ageless Brain now is available wherever books are sold, Amazon, Barnes and Noble, whatever your local bookstore. The whole point of this is to save synapses. It’s to make it so that everybody, not just people with Alzheimer’s, everybody. What’s happened in this country, unfortunately, is that our lifespan is not equaled by our brain span. And so many people spend the last years of their lives in nursing homes, in memory care facilities, et cetera, and this does not have to happen. So the whole point of this is let’s make our brain spans equal to our lifespans. I often ask people with all the anti-aging who wants to live to 120 or 140, and a bunch of people will put their hands up, and I say, “And spend half of that time in a nursing home with dementia,” and of course, the hands go back down.
So we want to make sure that our brain spans are equal to our lifespans. You can measure; you don’t have to wait till late to do that. You can look at this as time goes on. There are now epigenetic tests for looking at brain aging, and we can do, as you know, lots of things to reduce that biological aging for the body and for the brain. So there’s so much that can be done, and that’s the point of this book. And you can learn more on Facebook, Dr. Dale Bredesen, on Instagram, on X, on Blue Sky, all of the above, because this is a time of great progress. There’s so much that we didn’t know even five or 10 years ago with the new blood tests and the new approaches, the new protocols. Really, as you started with, this is becoming an optional problem to have cognitive decline as we age.
Dr. Gundry:
Wonderful. What do you say to all these 30-year-olds who they know their brain isn’t working right? Brain fog, it’s attributed to mommy brain, it’s attributed to perimenopause, the 40 or 50-year-old woman, is that just mommy brain, or is this a warning sign? Oh my gosh. There’s something already happening.
Dr. Dale Bredesen:
As you know, the paper that just came out and showed twenty-somethings. You’re already seeing changes, as I mentioned before. And so what it really shows is that it’s not that your brain function is normal than dementia. That’s not the way it works. We all know you stay up all night, you’re not quite the same the next day. So you have this plasticity change, and you are always rejiggering and reconnecting and thinking, am I more on the connection side? Do I have to be on the protection side today? Do I have a little gut leak? Did I stay up all night? Did I drink too much? These things are all changing, and as you mentioned, hormonal changes. So now these things are, and brain fog that you mentioned, I think, is one of the most important and underappreciated issues. It was really shown in relief because of COVID-19.
People were getting brain fog left and right. And by the way, if you had COVID, you are at increased risk for cognitive decline, that’s been published because you are inducing that inflammation. Once again, you’re going past that barrier function now to that next stage of inflammation. And so we should address the cognitive decline, this cognitive change, this brain fog. You may have brain fog because of inflammation, because of poor sleep, because of hormonal change. And I mentioned in the book, we talked about brain fog in the book, as you know, although people will say, “Oh, but that’s not Alzheimer’s. It’s just brain fog.” But it’s the same sorts of biochemical processes.
When you’re young, you tend to be able to get past it and so it doesn’t become a degenerative problem. It just becomes a synaptic function rather than a synaptic anatomy loss, but it is the same sort of thing. And if you don’t do something about it, you are at increased risk for actually having that anatomical change that is ultimately neurodegenerative. So I really appreciate your mentioning that because I do think brain fog is something so many people deal with, and doctors in general are not saying, “Hey, you got to pay attention to this.” It may be that you get vascular issues. Let’s get you on nattokinase or nitric oxide or artericil or things like that. Let’s see what’s going on here. We can look at these things like never before, and we can help people so that they don’t have to live with that.
Dr. Gundry:
All right, I warned you that there’s going to be an audience question. So this is from @NaperTandy3579 on YouTube. Is it true there is a link between eyesight deterioration and Alzheimer’s? I read somewhere there was. Many, many thanks for all your hard work.
Dr. Dale Bredesen:
Great point. And as we talked about it earlier, brain stimulation, it’s one of the basic seven, and that it comes in the form of brain training and doing new things and learning new things and photobiomodulation, all these things, and it includes stimulation from your senses. In fact, I was just at a meeting yesterday about cochlear implants, and the surgeon was talking about how much it helps your cognition. If you’ve got blurry vision, you’re not getting the right stimulation. If you’ve got what she called blurry hearing, then you’ve got issues. And this is why they believe cochlear implants have done so well, helped people. And of course, eyesight is the same. And there are specific data on glaucoma, macular degeneration, and Alzheimer’s. Now, what’s interesting, glaucoma actually turns out to correlate more with Alzheimer’s than other eye changes.
But anything that reduces that stimulation is an issue. And we’re particularly interested in macular degeneration because it has a number of the same sorts of inputs like sleep apnea that increases your risk for both for cognitive decline and for macular degeneration. So the bottom line is, yes, there is an intimate relationship, different mechanistics for different things, whether you’re talking about cataracts or macular degeneration or glaucoma or what have you, but these are all important.
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