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Table of contents
- 45 million of currently-living people in US will die of Alzheimer's unless something is done
- His first patient in 2012
- He had not seen a patient for 20 years, just mice
- Have identifed 35 different contirbutions to Alzheimer's
- amyloid itself is part of the innate immune system
- Alzheimer's disease is like a cytokine drizzle, not a cytokine storm
- Ancedotes published
- Getting backgrounds on patients
- Catch the fire before it gets out of control
- Keep away from molds, use HEPA filters
- News: !internal insulin not help Alzheimers
- Chance of Alzheimer's based on poor gene copies
- Mold, toxins
- Protocol is expense, but FAR lower cost than nursing home
- average person $350,000
- Keep on tuning the protocl, constantly learning
- 2,000 physicians in 10 countries have learned the protocol
- Laser stimulation and Alzheimer's
- Some of the symptoms showup very early
- Learn form the fads
0:00:00.0 Bredesen: It turns out it takes about 20 years from the beginning of the path of physiology to reach a diagnosis of Alzheimer's disease, you'll be surprised to see that in fact, your cognition will be improved and can be improved at any age. This is about improving, unlocking the SEATO-plastic side of the neuroplasticity, and to do that, you've gotta get at what's causing... We've had some amazing examples recently, people who did some of the right things, but we're still declining, and then it turned out that they had something that was unrecognized in one case, major organic toxin hadn't been picked up before, once that was addressed, the person started to improve again, in other cases, it'll be specific pathogens that haven't been recognized before, again, once they're addressed, people start to improve, and by the way, drug, one of the things that's come out really commonly that we did not understand previously how important it actually is, is a nocturnal oxygen saturation, and there was a wonderful study that showed that if you simply look at the mean spot, so the mean oxygen saturation while you are sleeping, that is directly proportional to the volume of specific nuclei in your brain, so as you begin to fall with your oxygenation and we see this all the time where people didn't realize they're falling below the 96 to 98% percent that you'd like to see...
0:01:31.5 Bredesen: Of course, we hear a lot about this with covid 19 about oxygen saturation, but many of us are dropping while we sleep without having covid 19, we're simply dropping because of sleep apnea or other reasons, the UAR is another big one, but for whatever reason, we drop that saturation, we see people dropping not only to the low 90s, but into the 80s, and we've even seen people into the low 70s, now, this is starving your brain during that time, so in fact, you need to increase that, and one of the things that people find is they do better when they actually address this reduction in oxygen saturation while they sleep, and usually they don't look for it, so critical to do that as part of the treatment for cognitive decline or risk for decline.
0:02:20.4 S2: Incredible, and I wanna go into some of those because you lay a lot of them out in the protocol inside the book and great detail for people to follow, but I wanna take a step back and you know people have all ages listening to this podcast, let's even start you share some of the stats, but give us a few more the global statistics and why it seems to be that when people talk about some of the scariest diseases, chronic diseases that are out there, why Alzheimer's often finds itself at the top of the list that's there, so what are the stats that we know, whether it's us or globally about Alzheimer's and cognitive decline.
0:02:57.7 Bredesen: So a really great point. So the loss of cognition has replaced cancer as the number one worry of people as we age, and of course we have an aging society, The Silver Tsunami is upon us, those of us who are baby boomers including myself, are all reaching an older age now, and this is a huge issue and is of course going to bankrupt Medicare within the next about 15 years, if we don't do something about it, so this is a huge issue, and as you indicated, the statistics we hear are horrible, and in fact that the reality is even worse than the statistics. Here's why There are about 56 million Americans who have a current diagnosis of Alzheimer's disease, but that is just the tip of the iceberg. My two daughters, for example, too young to know if they're gonna get Alzheimer's yet, so let's ask the question of the current... About 323 million living Americans. How many of us will die with Alzheimer's disease... Well, nothing has changed about 45 million of us currently living, Americans will die of Alzheimer's disease, this is a huge problem, this is a trillion dollar global pandemic. We've heard a lot about the pandemic covid-19, Alzheimer's is killing far, far, far more than that, and of course, the two are actually linked because in fact, many of the same features that give us risk for Alzheimer's also give us risk for poor outcomes in covid 19 it's just that covid-19 has taken the decades-long timeline of Alzheimer's and is compressed it into about two weeks, so yes.
0:04:43.7 Bredesen: With obesity, we are in crisis for both, yes. With poor immunity, we are at increased risk for both... Yes, with low vitamin D, We are at increased risk for both and on and on type 2 diabetes, another critical risk factor for both, and of course, one of the major things that's coming out of the covid 19 studies is that we all should be spending more time outdoors, as was pointed out in the Wuhan studies, they found that every case they looked at had transmission indoors except one, so when they had these sudden bursts, these were all from people getting together indoors, indoors is where the droplets are, it's where the duct work is the air conditioning, it's much different.
0:05:30.5 S2: Lower humidity factor, which is more likely to transmit the viruses through the air...
0:05:35.8 Bredesen: Exactly, You go outdoors now, things dissipate, and what's interesting is we see the same thing in Alzheimer's indoors is where the mycotoxins are... We build our homes out of old food, so we are at increased risk, but we spend more time indoors, of course, indoors is where the refrigerator is endorses, where the sedentary lifestyle is indoors, where the couch of the TV are all of these things that increase our risk so we wanna get out there, we wanna get more exercise, I wanna dissipate a potential for these various pathogens. So this is one of the things that's coming out of here. And again, these things are all critical, we understanding this disease and understanding it better and better will make it so that this is truly a rare, rare disease, just as it should be inside of those stats that you've shared. One of the things that your work has really put the spotlight on is... And understanding that.
0:06:37.9 S2: Just like you shared earlier, that Alzheimer's isn't caused one thing, so it's not gonna be one thing that helps unravel it, there's also this idea that even though you don't have a diagnosis yet for Alzheimer's, you could be on your way. And so there's factors that are going on in your 30s and 40s and 50s, well before most people would be diagnosed with Alzheimer's that can increase your risk of getting it. Talk to us a little bit more about that and how just 'cause you don't have a diagnosis doesn't mean... I think in the traditional public, people think like, you either have something or you don't have something, talk to us about how... Maybe that's not actually true.
0:07:16.0 Bredesen: This is so important because it used to be thought you either had diabetes or you didn't have diabetes, and now we understand there's pre-diabetes, we understand that even before that there's insulin resistance, etcetera, and the same thing is coming out here, and one of the points... One of the reasons that I wrote the second part was because people would say, Well, look, I'm not gonna worry about this all time to disease of your 60s, 70s, 80s, 90s. I'm 35, I'm 40 or 45. Well, it turns out, in fact that two things have happened since then, number one, It turns out it takes about 20 years from the beginning of the path of physiology to reach a diagnosis of Alzheimer's disease, so what we've thought of in the past as a disease of the 60s, 70s and 80s is really a disease of the 40s, 50s and 60s, it's just that this plays out, you get the manifestations later on, but the second thing is, just as we have seen, childhood obesity, child could type two diabetes like never before. We're seeing the same thing, there are people in their teens and 20s who are damaging their own ability to think, to do their best on various testing on their school, etcetera, because of the fact that they have ongoing inflammation, they have ongoing things that haven't been addressed or methylation, for example, that hasn't been addressed, unknown pathogens, chronic inflammation, the various toxic exposure, and again, we see these...
0:08:44.3 Bredesen: We make diagnoses including things like Parkinson's, from various toxins later in life, but when you're young, in fact, this can affect you, and therefore we are now, people should be looking into this early, if you've got a family history, especially... You'll be surprised to see that in fact, your cognition will be improved and can be improved at any age, we all recommend that everybody who's 45 years of age or older... Just as you know, when you turn 50, you get a colonoscopy. When you turn 45, or if you're older than 45, please get a Cognos copy is simple, and we go into the book or how to do that, but even people who are in their teens, 20s and 30s, we'll find that they do better with more energy, addressing the same sorts of things that are actually down the road going to increase their risk for Alzheimer's disease. Let's talk a little bit origin story, because I think the question that a lot of listeners have right now is that in the midst of all these stats, these overwhelming stats about Medicare going bankrupt, about the rate of cognitive decline increasing in society, the epidemic of Alzheimer's, it there is there.
0:09:56.8 S2: You've been in the field of anti-aging for a while, at what point in your story did you start to see the first glimpses that gave you hope that something else was possible.
0:10:08.3 Bredesen: Yeah, that's such a good point. So we were actually working... And again, with... With the old model that you're looking at, could we understand the fundamental nature of the neuro-degenerative process, and we worked on this for 30 years in the laboratory, looking at following cells that committed suicide cell death just as it happens in the brains of patients with Alzheimer's and other degenerate, this was at UCLA, this was at multiple places, this was at UCLA, this was at the Burnham Institute in San Diego, and then this was at The Buck Institute in Northern California. And so we looked specifically at the drivers of this, and what we found was very interesting, so there are many different things that impact on... An example app, so this is the thing that is at the heart of Alzheimer's disease, app is a protein called amyloid precursor protein, so it's actually the parent molecule of the AML that we associate with Alzheimer's disease, and what we found was that this thing actually is a molecular switch. So it actually responds to these many different processes and what happens, it's kind of amazing because it's a little bit like having the President of your country, and in the book I wrote about it is you're the president of my brain stem...
0:11:32.1 Bredesen: So when you've got things that are actually going Well, you have enough trophic support, you don't have invaders, whether it's invaders to your country or invaders to your brain, you don't have major problems with inflation, etcetera, and I like an inflation to insulin sensitivity versus resistance then... No surprise, you decide to grow and maintain, and that's what your brain is doing when things are good, and therefore your app is actually cut and this thing is sitting in the membranes of your neurons, it is to a lesser extent in other cells as well, and it is particularly rich at synapses, so this thing is sitting there and it's gauging these various inputs, so it responds interestingly to things like your estradiol level, your testosterone level, your vitamin D level, your status of inflammation, and on and on. When things are good, this molecule will be cut at a single site, which is just outside the membrane, and one peptide that results now signals others to say things are good, I'm gonna support Making and Keeping synapses, in other words, we can afford to make and keep New synapses, we can afford neuroplasticity. The other piece of it is inside is signaling to that cell to say, Yes, we're gonna support growth and maintenance, so again, very much like the head of a country saying, This is what we're going to do as a country.
0:13:08.3 Bredesen: On the other hand, when you now change that formula, you reduce your estradiol or your testosterone, your vitamin D, you have inflammation, you have now invasion, no surprise, you have a completely different response, now you actually have that same molecule that is cleared at three sites, Beta Gamma and cast-based sites and therefore produces four peptides to their external to that are internal, and now the message is completely different, the message is, We are being invaded or we don't have enough support to make new synapses, therefore the only way we're going to survive is to pull back, so it's literally saying, You have got to have a brain in retreat, we know that, Okay, we're gonna send out this amyloid, which is now going to kill the invading microbes, it actually binds some of the invading toxins, like for example, iron, high iron levels. The A-beta actually binds to a professor as Ashley, but showed many years ago, so these things are responding to insults and therefore actually protective, but in protecting their saying, We're gonna live with a smaller brain, we're gonna live with fewer synapses. Now I'm through, you can imagine what's gonna happen, you just keep the insult going, keep people exposed to the same thing, the doctor doesn't check the right things.
0:14:36.1 Bredesen: You get continued exposure. What do you think happens? You just keep going down down, you keep on pulling back polio, if you could identify what's doing that, you can get rid of that and you can now stop the process and begin the rebuilding. And so you really do have to look at what's driving this, because you can see fundamentally how this works with app being cleaved to go one direction or to go another direction, and that's what the research showed us. So the goal then was to take all of that research over those years and now translate that into a workable program, if you do it in a generic sense and just say, Well, everybody do this, this and this... Yes, it works sometimes, but many times you don't identify what's actually driving the problem, so you really do have to be a Sherlock Homes, you really have to get in there, just as of course, as Dr. Hyman and his colleagues do with looking at integrative medicine, and you wanna look at the things that are driving the process, this is a root cause analysis. The good news is the research shows us many of these root causes, we know the things that are driving this decline, and therefore for each person, we can tease these out and then have a program, so this is a personalized program that is going to be targeted...
0:15:58.0 Bredesen: This is precision medicine targeted toward the things that are actually driving the decline, or of course, the hope is targeting to the things that are giving you risk that there isn't decline there already, so that's what the research showed us over the years. By the way, it also showed us, but when you start to bare this out, you find that there are different subtypes of Alzheimer's, and that is very helpful in terms of addressing the underlying drivers. So
0:16:26.7 S2: Before we talk about the subtypes, which we'll get into in a second, when you did that initial culmination of that research that you continued at multiple places, ultimately that led to designing a protocol, a program that you would trial and air and put people on, and then that led to the publishing of the first case studies that are there, talk to us about that. What were some of the first case studies that you published and what was the goal of them, what did you show and what was the goal for the larger community to see what was possible in these case steps?
0:17:01.4 Bredesen: Yes, good point. So we actually started by looking, man, once we could see this balance, this molecular switch, we thought this was now back in 2007, we thought, Okay, great, let's develop a drug that changes that balance, and we kind of weren't looking at root cause at the time, we thought okay, if app can go either direction, let's simply develop a drug, it forces it in the good direction. Well, of course, it turns out that's an overly simplistic way to think about it. Back in 2007, we didn't realize that. So we screened thousands of drug candidates to look for things that would actually put you on the right side of that balance, and so we identified, if you actually identified some that had very good brain penetration that look like very good candidates for drugs. But as we got set to do the first clinical trial, this was now back in 2011, I realized, Well, wait a minute, we're gonna end up... These other things that cause this cleavage are simply going to go around our drug, that's kind of this idea of just hitting it at one point when you've got a very complex network of things going on, it became clear to me that that was an overly simplistic way to attack this network, it's a little bit like saying, Okay, we're going to see...
0:18:17.9 Bredesen: We're gonna try to change the entire culture of your company, we're gonna change one person who's doing reception in Cleveland or something like that, it's not that simple, you're gonna have to change key locations throughout, you're changing the culture of your entire company. Same idea here, we are changing network function for a very complex network of synapses within the brain, and therefore I thought, Okay, in this trial, we'll do the drug we discovered, but let's also target all the different things that are contributing to it, let's look at whether CAPP is activated as part of inflammation, let's look at whether there is insulin resistance, whether the hormones are too low, whether there are specific toxins, etcetera. So in 2011, then we proposed the first comprehensive trial in the history of Alzheimer's disease, and we were quickly turned down by the review boards because they said, Hey, you're trying to look at more than one variable, and so we said, Yeah, but this is a more than one variable disease, it's overly simplistic to say, Okay, we're just gonna hit it with one thing that does one hits one little piece and we're gonna expect everything to fall in line.
0:19:31.1 Bredesen: That's not the way the brain works, is that
0:19:33.5 S2: The way that life works and many aspects, that one thing that makes a relationship successful, and if people just did that one thing that every relationship would be successful... Well, unfortunately, it's not just one thing.
0:19:46.9 Bredesen: It's so true, and then we're hearing the same thing now with the agent, let's just take a drug and agent will go away. And again, that's not the way aging works. There are many contributors, and so we're looking at the same sort of thing for anti-aging as you mentioned earlier, and right now we're actually looking at patient zeros with other diseases, so we had our patient zero back in 2012. What happened was, when we got turned down in 2011, we started looking at how do we convince the review boards that we should in fact be doing a multi-variable trial because that's the way the disease works. And so at time, I got a call from a woman actually whose friend was about to commit suicide who live back on the East Coast, she already been told by her doctor, you have Alzheimer's disease. Her mother had died from Alzheimer's as well. She was told her, There's nothing you can do about it, you're gonna die from this disease, etcetera, and then he wrote in the chart, Alzheimer's disease, and then she was unable to get long-term insurance, which is common if someone writes memory problems in your chart or neuro degeneration or Alzheimer's disease, you're not gonna be able to purchase long-term care insurance, so she decided to commit suicide, she called her friend who happened to be on the West Coast, who said, Well, I've heard that there's some research going on at the Buck Institute.
0:21:06.3 Bredesen: Maybe you should come out here. So I got a call and I said, }}Look, I haven't seen a patient in 20 years, we've been working in a lab on this, I said, You know, if you're a mouse, I can probably help you, but as a human being, probably probably not, but I can tell you what our research is shown and what I can tell you what we were going to do for the clinical trial, so what we spent hours going over all these little pieces, and so of course, and I remember he was not good. She was writing all this stuff down and I said, Look, if you wanna take this back to your doctor on the East Coast, I talk to him about it, but that's all I really have to offer right now because we're not allowed to do the trial, so I was really shocked when three months later, I got a call in my home on a Saturday, and she said, I can't believe it, I'm back at work, my memory is better than it's been in 20 years. Things are great, and now she is over eight years from when she started this, and as you know, the natural history for cognitive decline is for nothing but decline, you may have a good day and a bad day here and there, but the natural history is for continued decline, so anyone who's having the problem she did eight years ago, we would be expected to be in the nursing home by now, she is now in her mid-70s, she's doing great.
0:22:17.8 Bredesen: In fact, she's working as a brain health coach, she still travels overseas and doing all sorts of things, doing very, very well, and interestingly, she actually went off the program for different times, as I mentioned in the book, and each time after about seven to 10 days, she began to experience some decline once again, the bottom line is you need to keep that signing going in the right direction, and as long as you do that, the great news is you've actually gotten at the contributors, the things that are driving the process, and so you can continue to do well, and we see people all the time who will improve and then stabilize and then add different features, attack something else, improve further and continue to do that. So that's another stab.
0:23:04.8 S2: During the work, it stops working...
0:23:07.1 Bredesen: Absolutely, and then that's what exactly what she's experienced, and so she's really stuck with it and done extremely well. Another big surprise has been that we talk of people about 36 holes in the roof because we have initially identified 36 different molecular mechanisms that all contribute to this process, and so we want to attack them all... Well, the good news is you don't have to attack every single one of them, just as others have shown in the past with cardiovascular disease, such as Dr. Dean or is, for example, you can see this once you get over the threshold, people begin to get on the correct side, they're actually improving things instead of getting worse, and we see the same thing with cognition. Once you get over that threshold, you don't have to address every single thing in her case, by the way, she addressed 12 out of 36, and for her, that was enough... That put her on the right side, she's improved, and now over eight years later, she's continuing to do very, very well, and we have a number of other people who started early on 2012, 2013, 2014, who years down the road are still doing extremely well.
0:24:17.3 S2: The power of that story for anybody who's listening here is not just the hope that through addressing some of these root factors, you can get better, but also while it's encouraged that people find, let's say, a practitioner that can support them, because some of these things like addressing micro-toxins or heavy metals or some of the deeper root issues require maybe a doctor or a functional Madsen doctor to support you on them, at least at the more advanced stage, but for the vast majority of the things that she did because you couldn't see her as a patient, she did them on her own in conjunction with their own doctor, and that's really telling of where medicine... Because it's highly personalized, and also so many of these interventions to address these insults are lifestyle-driven components, we can actually, in a way, start to become... It's always good to have a doctor, but we can start to become our own doctor in a way, and I really see that as the promise of your book, it's like, How can you start with these things here, and also laying out where you absolutely do need a doctor to be involved.
0:25:27.6 S2: But many of these things, you can start. Just in your own home.
0:25:31.7 Bredesen: Absolutely, I think that's a great point. And part of the second book addresses the things that came from the first book, so one of the things people said was, We want more details. Okay, we get it, you're telling us about all the signs that happened in the lab and how you could translate this into humans, but we want details what websites to go, what doctors to see all that, so that I can...
0:25:52.6 S2: I need exactly on the Keto flex diet. What's exactly the way to think about? Exercise or sleep?
0:25:59.4 Bredesen: Yeah, and what work-arounds, if we can't do this part... What can we do instead? So one of the things we did that I was really excited about is we would have a unique combination of three people, so I actually wrote is in the handbook part that gives all the details, we did this with a patient who is actually doing this extremely successfully herself, this is July Je who started the April E4 info. And with my wife, Dr. It Lachine reticent who is a clinician, and so we have a user who's doing very, very well and has gotten all the work around to doing the things and knows what has worked for her and what has worked less well for her, and she is a belief and she describes in the book and had significant decline and she's doing very, very well in scoring 98-99%ile and cognitive test repeatedly, and then my wife who is really... Who introduced me to integrative medicine years ago, and is very interested in this area, and then my stock part for the neurology and the molecular science of these together, we kinda have a triad here that can give you the best of all three worlds, so I was really excited to do that.
0:27:12.8 Bredesen: And then as you mentioned, to show people that love, you don't have to wait for decline, you can actually improve your current cognition and you can prevent the future decline from, as you know, over 80 million Americans have insulin resistance, so it's an incredibly common problem and so it actually contributes in multiple ways, so if you break down the science, what you find is the thing that actually triggers this change, so app, the amyloid precursor protein sits at the center of this and is essentially a master switch, so when things are good... Much like the president of our country, when things are good, it sends out signals that say, build new interactions, thing, it's a growth period, so your growth and support, and that's what allows you to make and keep memories. On the other hand, this is what it's about, neuroplasticity, on the other hand, that same master switch molecule app, which sits in your neurons, especially at synapses, and to a lesser extent in non-neuronal cells, this is sampling the environment and when things are bad, it's literally being cleaved, and it's now sending out a different set of signals that say pull back, and by the way, the analogy is direct to what happened with the pandemic, so we had an insult in that case, SARS COV 2, we were told, Okay, we got a shelter in place, we got a social distance, so things pull that we went into a protective mode, and what happened, we ended up with a recession.
0:28:50.0 Bredesen: The exact same thing is happening in your brain. When you have these various insults, then what happens is you change the signaling from one of growth and maintenance keeping and making memories to one of protection, you're now in a protective downsizing mode. You are losing synapses. Your brain is saying, I'm under assault, I can survive by being less of a brain, I'm gonna be a smaller brain, I'm gonna have fewer synapses, I'm not gonna be able to have the same degree of neuroplasticity, but I will be able to survive. And so it's now making the amyloid that is killing by the way, the bacteria and things like that, this was shown a number of years ago by professors Robert Mayer and Rudy tansy from Harvard, look at... So you look at this as a protective mode now, just as you said, as long as you keep the insult, you keep making that scab over and over, you keep... You keep having the insults, you're gonna downsize, so the insults come in four major groups, and you can literally trace the tracks that through the molecular pathways of app, so number one, anything with inflammation, so if you trigger an F-kapa, you are going to increase NFPA of course enters the nucleus, turns on hundreds of genes, and two of the ones that it turns on are the ones that make the A beta, the beta secret taste and the games Crete which cut the app to make more amyloid at saying out, I'm seeing inflammation, I'm gonna deal with these pathogens, so that's anything, inflammation, that could be metabolic syndrome, it can be poor dentition, it can be inflammation from chronic sinusitis, it can be any sort of exposure to different pathogens, leaky gut, all of the above.
0:30:40.8 Bredesen: So that's the first one, the second one.
0:30:42.6 S2: That's huge, because what you're saying is that all that inflammation in the body, wherever it's starting, and we've done a bunch of episodes on dental health and how that's related to body inflammation, all that inflammation will ultimately make its way, it's not just in the body, what you do to the body. You do to the brain.
0:30:58.1 Bredesen: Exactly, and I think one of the most important understandings is that the amyloid itself is part of the innate immune system, so when we talk about inflammation and we talk about things like Napa and cytokines and things like that, the amyloid is itself part of that response, so as long as you've got that ongoing inflammation, you're going to be making that amyloid, so just as people died from cytokine storm with covid 19, people are dying from cytokine drizzle, with Alzheimer's disease, it is creating over the years, this cytokine drizzle, it's a slower process. It's a more chronic process, but it's the same idea, and so yes, we've gotta balance that, we've got to remove the source of that, we got to first identify the source... What is this? Is this paging of ALICE from your dentition? Is this Lyme disease? Is this leaky gut? Is this chronic Sino? Is this mold in? Whatever it is, we gotta identify it, we've gotta remove it, that's the key and then... But absolutely, just as people looked at using things like Dexamethasone with covid 19, you have to think about how can we also quiet down, so we like to use resolving, for example, very helpful, but again, without removing the cause of it, you're gonna be in trouble down the road, so you've gotta look at both what's causing it and then how to deal with what's being produced that...
0:32:22.7 Bredesen: So that's the first group. The second group toxins, and they come in three, three different sub-groups, basically, number one, anything that is an inorganic things like mercury and things like air pollution, people who've been in the California fires, it's a big issue just being exposed to that smoke, the people who are exposed to the World Trade Center by the way, 14% of them developed cognitive decline by 15 years after that event, so it's a huge player in giving you increased risk for cognitive decline. It's incredible, very important. And then second group is the organics, so things like glyphosate and toluene and benzene, and from aldehyde and things like that, Aurelia exposure to fumes from cars and things like that as well.
0:33:08.4 S2: Centrale and things that are all over the place of fragrances that are there. Scary. Yeah, exactly. Very scary, we often don't even know the full extent the damage that those sense to, even though it feels like we wanna be surrounded by pleasurable sense, they're wreaking havoc on our body sometimes...
0:33:26.1 Bredesen: Please be careful. Yeah, over time. And then the third group is the bio-toxins, so things like mycotoxins, trio, the Sines, glean-aliphatic and things like that, Appleton and things like okra, toxin A, all of those can contribute, and the good news is many molds aren't making these toxins, but the classic ones, the stack e-Batra and Penicillium, Aspergillus, keto, Miu Walia, those are the big five to be concerned about, so it's inflammation, toxins, and then the other two are things that if you don't have enough of them, they're supportive things for your brain, and the first is energetics. So we have an equation in the denominator, the numerator are the toxins and the in-flames in the denominator, energetics and trophic support. So for energetics, the big four things there, cerebral blood flow, oxygenation, so people who have sleep apnea, huge problem, huge increase in risk, dropping your oxygenation is huge, and of course, you can check it easily on... You can check it on an iPhone or you can check it on a watch, or you can... So many different ways to check your oxygenation, get cheater and look at night, for example, the third part there is mitochondrial function that you guys of course talk so elegantly about frequently, and then the fourth one is the actual Bernal combustible substrate, which in this case ketones.
0:34:49.9 Bredesen: So as Steven Canaan taught us all a number of years ago, you've got a gap there, when you have Alzheimer's disease, you've got poor glucose utilization, that is the signature, the hallmark on a PET scan for Alzheimer's disease, and even for 10 years before a diagnosis is temporal and parietal reduced glucose utilization. Well, the good news is you can bridge that gap with ketones, so with the combination, and if you can develop metabolic flexibility so that you can now burn both the facts and the glucose, you're in the best shape. So we want to do both. And so you can see when someone has insulin resistance, they are causing their own cognitive decline by multiple mechanisms, they're creating inflammation because of the non-enzymatic location of hundreds of proteins, they're also causing a resistance too, so that you now have reduced trophic support from insulin when we would grow brain cells in a dish, which we did for 30 years in the lab, you'd always have to include some insulin there because you needed that to keep the cells alive. It is a very important neurotrophic activity, things like nerve growth factor, Brain-Derived Neurotrophic Factor and insulin are all critical for keeping neurons alive, so you're having this second mechanism as well, you're also having a metabolic component there, you're now lose...
0:36:17.4 Bredesen: You not only have the insulin sensitivity or insulin resistance loss, you're having the trophic problems also have a metabolic problem, a trophic problem, an inflammatory problem, you're really ticking most of the boxes to give yourself cognitive decline when you have insulin resistance. And then I should say the fourth piece of this, then just the third best being low energetics, the fourth part of this then is traffic support, and those come in three groups, so it is growth factors, as I just mentioned, things like insulin and things like ngf and BDNF, but secondly, it is hormones, so happy, this is why estradiol and the past was noted to be a critical support and a sudden loss of estradiol, as was shown by Mayo Clinic group years ago, if you have a sudden loss of estradiol at the age of 40 or younger, and you don't get HRT, then you are a doubling your risk for Alzheimer's, even though the Alzheimer's isn't coming till the future, you are increasing your risk starting at that time, and then the third of those three is nutrition, and so getting appropriate vitamin D in appropriate omega-3s and all these things.
0:37:25.5 Bredesen: Huge. So you look at those groups and you can add to that stress, which is another piece of us, it's really a part of the tropic and metabolic piece because of its effect on things like Cortisol and DHEA and pregnant alone and things like that. But those are the big groups, if you can optimize those four main groups, you are going to do a tremendous amount with preventing and reversing cognitive decline, and on the other hand, simply throwing a single drug at what you can see is quite a complex problem, really doesn't make any sense?
0:37:57.2 S2: Our diseases have gotten way more sophisticated as our modern world has gotten way more sophisticated, no longer is a single antibiotic or other intervention... Really the path forward, the path forward is a multi-faceted approach that deals at a root call, at a root cause level, that really is playing with systems biology. So let's make us personalized, we've teased a little bit that we were gonna get into some of these stories, so I'd love to pick one of these stories, and one of them that comes to mind is one of the women that was featured inside of the book, her name is Debra, and the interesting thing about Debra that I think is so relevant to this topic of Alzheimer's is that 20 years ago, you would ask people and talk about the conversation of Alzheimer's, and it was getting a lot more attention and awareness, but still for the most part, either a lot of clinicians would say, Well, don't worry about that, that's something that you really have to deal with in your late 70s or 80s, but tell us about Debra when she started experiencing some of the earliest signs, and I'd also love to expand in these quadrants that you just broke out, inflammation, toxins, all these different areas, what were some of her unique causes that led her to where she was...
0:39:15.7 Bredesen: Yeah, that's a great point. So when I was training years ago, we were taught that this is a disease all time is really a disease of your 60s, 70s, 80s and 90s, this is an old person disease, in fact, some people would call it old timers disease instead of Alzheimer's disease. But what we now know about the underlying pathophysiology is that it starts at least 20 years before that, so what we thought of as a disease of your 60s, 70s and 80s is really a disease of your 40s, 50s and 60s that just gets diagnosed later and in fact, people in the 30s sometimes have the beginnings of the path of physiology, you can show PET scan changes in some people who are able for positive even into their 20s. So in this case, Debra, and I agree with you, it was such a touching story for me just to hear what Debra went through, she's a very articulate attorney, and her description... She watched her grandmother die of Alzheimer's, she watched her father die of Alzheimer's disease, who in fact was a tremendous neurologist, and when he got lost and she had to literally drive the car and go find him out on the road somewhere, and she did finally manage to find him and get him home.
0:40:30.2 Bredesen: And she said, You know, you really need to have an evaluation. Well, he knew exactly what was going on, and he turned to her and said, There's nothing that anyone can help me with, which was a heartbreaking, yet so many families that are watching us now are people that are listening to this have been through that experience where somebody has no hope, especially people that are themselves in the medical field.
0:40:49.4 S2: Yeah.
0:40:50.2 Bredesen: And let me just stop and say something, which again is a bit blasphemous, but it's the truth, this is now an optional disease, people should not have to get this disease, if you simply get on appropriate prevention when you turn 45. And if it's in your family, you can even do it a couple of years younger than that, get yourself evaluated, get yourself on optimal prevention and continue with optimal prevention, you need not be exposed to this illness, and unfortunately, the current standard of care is the opposite, they wait and the longer than... Longer and longer, endeavors case, she began to notice the same sort of problems that she'd seen in her father when she was in her 40s, so you're absolutely right. A number of the people in the story is set to themselves... Wait a minute, no, this can be...
0:41:37.8 S2: I'm only in my 40s, but
0:41:39.2 Bredesen: Yes, this... The changes begin that early, and she's a very sharp woman, very smart, so she noticed something's not right, and as she described in the book, one of the things she went through, and she was going through with her car and trying to say that she was in a commuter Lane. And she called that conference call, she started saying things that weren't quite the right thing, she tried to call her dog and she... And she instead yelled out what she was making for dinner, she knew something wasn't quite right, She couldn't... Interesting that she couldn't help her kids with their homework anymore, and here's a very smart woman who graduated with high honors from Harvard, a very smart lady.
0:42:24.6 S2: And one of the anecdotes Adat in some cases, she couldn't tell people apart, right.
0:42:29.3 Bredesen: So she... One of the common things, because this is an area of the brain, the parietal lobe that is affected relatively early on, is that people will have this pro-SOP Agnosia, they'll have difficulty recognizing faces, and she had us and her father headed as well... She had this big time where she would go to some function and she had no idea people would be coming up to her and saying, Hey, should we talk about what we were talking about last week? Or whatever, she would not know who they were, she wouldn't know the name, she wouldn't know it, so she'd have to figure out things like, oh, if this person has an earring of this type on just on the left side or on both sides, or if they happen to wear a long red dress, a lot of... There happened to be with a certain dog, so that she'd have certain things he would do to try to remember these people, and as he then she went to... Actually went to a major university where they told her, yes, you're slipping, you're not doing particularly well in your scores, and so then she ended up...
0:43:30.4 Bredesen: It was her sister-in-law who had read about our studies and who then suggested that she get on the protocol, she got on it, and as most people do, it takes a few months as you start optimizing these various systems, and then interestingly, she started documenting her own improvement, he started noticing. And so one of the things that happened to her, after several months, she went to school for her kids, and then she said it was an incredible experience because she actually was able... She said not only did he know these people, but she knew that she knew them, so she knew right away that it was racist recognition, she knew the faces, she knew the names, so she could see such a huge change in her own ability to source her own ability to call into her into usefulness, the information that she needed, which is what happens when you're optimizing things.
0:44:21.9 S2: Tell me a little bit about whether it's her story or some of the other individuals at the first sign of hope, where they start to notice a shift, that not only are they no longer regressing, but they're actually getting back some of their brain function. Memory, one of the things that people deal with a lot is skepticism, right. Tell us a little bit about that and some of the stories that you have documented here, does anything come to mind about a person or the types of skepticism that people face from even their own providers that are trying to take care of them in terms of whether not, they're actually making progress.
0:44:58.7 Bredesen: It's a great point. There's always that question like, Wait, is this really true? And I wanna just go back quickly, and you had asked about her, some of her specifics, you... Yes, in her case, she had vascular issues with some lipid changes, she had hormonal issues, and she actually had some toxin-associated issues, so it is with many people, they often have this combination of things now, it may be that one is more important than the others, for many people, but the bottom line is most people have multiple contributors to their cognitive decline, so therefore, it's really important to identify these, but just as you said, as they begin to notice their improvement at first, they don't wanna trust it, and if they mention it, they're a doctor their doctoral say, nothing helps this disease, just... You know, you're fooling yourself, this is placebo effect. Something like that. So in her case, she finally, after about 10 months, went back to the same university that had not participated in any way in treatment, had it only participated in... Showing her that she was going downhill. And so she was retested and they said to her, What have you been doing, you're testing much better than you were before, and she said, Well, I've been doing this protocol, and of course, as many researchers do, they wanna know the one thing, so they say, Well, can you just now take away...
0:46:18.5 Bredesen: Take away one thing at a time, 'cause we wanna know what's giving you this effect, and so is it like this specific dosage or something, was it this drug that they included in, and many of your participants in your trial...
0:46:32.0 S2: No, first-hand, because part of this book is also showcasing the challenges, but doing a protocol, right, making progress and slipping back a little bit and the unique unique circumstances that are required to continue and maintain this life, if you wanna continue to get some of the benefits so many of them are trained to know it's not just one thing, it's the entire approach that makes the difference, and this is no different than saying, Hey, I had no one in the orchestra pit. Am I gonna add the timpani or am I gonna add the clarinets? What's gonna make it an orchestra? No, you have to add the orchestra, you have to have all the different instruments, and then the idea of.
0:47:12.1 Bredesen: Well, now let's take away to file in and see if it still sounds like an orchestra... No, it's no longer an orchestra.
0:47:17.7 S2: You have to have the whole thing to make it... Signor, try to find it. Fly a plane, let's get rid of the... Let's get to the left wing it, let's get rid of the right engine or something like that. Sure, you might be able to truck along for a little bit, but you're not gonna be able to continue, you ultimately gonna be able to crash, and I think that this is such a fundamental shift that's happening now in medicine that as diseases have gotten more complicated, there is more openness and awareness, it's slow, it's very slow. But as you mentioned, you really got rejected with your trial because it was multi-variant, how did you convince the powers to be to ultimately understand that this was a huge part of documenting any progress when it came to this chronic disease? How did you ultimately show them that you need to have a multi-variant approach? This is such a good point. So we were turned down in 2011, so we thought, Okay.
0:48:09.3 Bredesen: We need to have anecdotes, let's show a bunch of anecdotes, because we had nothing back then, so we published the first anecdotes, 10 people with nine of them improving in 2014. We had another 10 in 2016, we published a 100 anecdotes, all cases, we had documented improvement approval in 2018, so then after we had that, we thought, Okay, 100, they can't turn us down again, we went back in 2018, we got turned on again, because again, this is not the way people think about clinical trials, we need to now start giving the brain, it's due... It is a complicated organ, and we need to start thinking these as complex network insufficiency, these are Network inefficiencies, people are used to hearing about deficiency of vitamin D or a vitamin C. Those are simple insufficiency. We now need to come into the 21st century and realize that many of our illnesses are complex network insufficiency, and Alzheimer's is a great example, this is a complex network that has to do with your hormones and has to do with your traffic factors, so we finally... We went to a fourth different IRB that finally in 2019 said, Okay, we'll let you do a small proof of concept trial, which is what we just completed in December of 2020, and which is what we posted on med archive this year, and now we're just submitting for peer-reviewed publication, but it's already public now, so that you can read the whole thing in mid-archive.
0:49:37.5 S2: I think something very important about this, and again, if people are not in the world of research, and I'm not in it myself, but I get to talk to incredible people like yourself that are in it, is when people hear about your work, you know, I often hear about a couple of things, it's like, Okay, where is the big randomized controlled trial... You hear this all the time, even from peers, you have yours, legs of yours that are out there, that's like, Okay, I'll believe it when we have a randomized control... Big randomized control trial, but research happens in stages and there's different approval processes, and part of that is you have small showcases and proof of concept trials that then allow for the momentum to build up the approvals to come in and also funding because these trials are expensive to do... And you gradually build your way up if somebody's ready to hand and give you the approval of 100 million to be able to do a much, much bigger trial. Amazing, but this happens in stages, and that's why this whole idea of like, where is the big randomized control trial is really a lazy argument against the work...
0:50:40.2 S2: You know.
0:50:40.4 Bredesen: It's so interesting if people will try to sound intelligent by saying, Well, I don't believe it because there's not a ram big randomized controlled trial yet, but that's saying I haven't taken the time to look at what's available currently versus what's coming out of the studies you have published... And in fact, if you look at what's available, when there's nothing available, something is better than nothing, it's always easy to say, Oh, I wanna see a big... And once we finish publishing the randomized control trial, they'll say, We wanna have two randomized control or whatever, so we've gone from anecdotes to more anecdotes to proof of concept trial, and all of these have worked far better than anything else that's been published, and so... Yes, now we've gone to the next step, which is a randomized controlled trial, the thing that really takes us by surprise, I have to admit, is the toxin exposure when we started this work, we had no idea that this was a critical and incredibly common contributor to Alzheimer's so what happened was, we started back in 2012, we were really looking at what became Type 1, Type 5 and Type 2, improving the support, improving the trophic factors, improving hormones, reducing inflammation, improving insulin sensitivity.
0:51:58.9 Bredesen: We had a set of people that just didn't respond and we wanted to understand what was going on, and I actually started by calling some of the spouses and saying, Let's find out Where did this person grow up? What's going on with their life, what are the genetics... What's contributed to this problem, and they also look different, that's been the surprise, people who have toxins as part of their Alzheimer's often will present instead of amnesty with your typical, I can't learn new information, they'll often... I'm having trouble with organizing things on having trouble learning my new iPhone, I'm having trouble at my job, I'm having trouble with calculations, I'm having trouble with visual recognition, I'm having trouble with spatial orientation, all of these non-agnostic presentations, they often will have depression as one of the problems at the beginning, and these people turned out to have to three different types of toxins, so you've gotta look at the in organics, things like metals, and you know the story of air pollution that's turned out to be more and more common as a cause. So be careful out there on the free way and don't get too much of that air pollution into your lungs and ultimately to your brains, then second one, organics, things like formaldehyde in toluene and the Lhasa, all of these various organic toxins that we are exposed to, these are critical.
0:53:28.5 Bredesen: As an example, someone who had many, many years of exposure to parapan-burning and developed cognitive decline, so be careful about these organics, and we've seen these where they sneak up on people, they don't know about their exposure, they don't realize their glutathione has become low, trying to fight this stuff, they don't realize that they've got this stuff in depots in their body, and one of the things that that happens is as you approach menopause or Andre, pause, as you know, you're now changing the way you're dealing with your bone, you have a little more... On the osteo-clastic side, you're releasing this stuff back into the blood streams, and so many, many of these people are presenting late 40s to late 50s in that decade with beginning cognitive changes at that time, and they have various organics or the third group bio-toxins. I've been shocked to see how common it is for people to come in with cognitive decline, that turns out to have as a major contributor, toxins that are produced by mold species, and as you know, it's typically the big five, it's not all mold species, it's the stack Yatra, the Penicillium, the As for Julius hitomi and Alenia, those are the big five.
0:54:53.3 Bredesen: So if you've got those running around your basement around your house, if you've got black mold in your house or you haven't taken care that mold problem, please check to see first of all, check your amy score, that is your EPA relative mold index, or you can use another portal hurts me too, they're both fine, and they will look at whether in fact you've got mold, those mold species, especially within your home or place of work, and then look to see whether in fact you've got evidence of these mycotoxins, you can do this looking at your response is made in your blood looking at whether you've got these in your sinuses because they sometimes will actually brother, that molds themselves will grow in the sinuses, we have to inattention. Absolutely, and that's, as you know, that's another huge player, and looking at oral microbiome, another big one that wasn't clear years ago, becoming more and more clear, sign us microbiome and then of course, gut microbiome, all huge. And of course, the brain microbiome has turned out to be a surprise, that we were always taught that the brain should be a stair or an IT, but it's still controversial.
0:56:06.5 Bredesen: We don't know if that's the norm, but what we do know is if you look at the brains of patients with Alzheimer's disease, what do you see in there? You see oral, you see oral bacteria such as P-N, Gallant, Danica, you see mold species, you see fun fungal species, such as some of the candid species, you see things like Maria Spira kits, things like that, and you see viruses here, simplex hhv 6A being two of the most common ones, these are all critical things, and you're responding to this invasion by making the amyloid that we associate with Alzheimer's disease. So again, it comes back to supporting your immune system and things like that, so the big surprise, these three different groups of toxins, you're living in them, you don't know it, no one bothers to check, and then you come down with cognitive decline, and then typically people still don't chat, but if you bother to look, you will see that these are contributing backwards, so all of us can do better by checking these things when we're younger and minimizing them getting on basic detox is so huge, as you know.
0:57:18.3 S2: It's so true, and I think a huge part of it as you're really talking about is awareness, and more awareness that you have, the more likely it is that you can actually start to look in this direction, because we know from the World Health Organization, a lot of building surveys that are there. It's estimated that two-thirds of buildings in North America could have mold inside of them at some degree that's harmful for human health, but if we look at even the real estate game as a whole, all the mold inspectors are not really trained and incentivized to be looking for mold, in fact, they want to give simple enough checks, and a lot of the mold that's there is not viewable to the eye, to the naked eye, it's not black mold immediately that you can see... Sometimes it's the case, it's behind the dishwasher and there's a mold Colony that's there, that's been there since the last home owner had it, or if you're renting an apartment. I'm here in Santa Monica, a friend of mine just came back and said, How do I even see the level of mold that's in my house because I'm having memory issues, I'm having other stuff, I'm having sinus things, I eat healthy, I wear like a glucose monitor on doing all these things that are there, but I still feel like something is going on.
0:58:34.6 S2: And you mentioned the army test, it's an air test that people can get done and they can look up ermine in their area, but it's almost like... What I love about what you just shared is that you're giving people permission, encouragement to go and look for these items increasingly, since the Industrial Revolution, we are living in a more toxic world and these toxins are taking and wreaking major havoc on our health, even as you mentioned with covid-19, one of the primary correlates with covid 19 and many of these cities has been Air potion that they found people that are exposed to heavy amounts of air pollution that comes from not just cars, but indoor off-gassing. These are all factors that play a role, and the key is as overwhelming as it can be, 'cause sometimes it feels like a lot, there's this mold issue, there's this heavy metal on that, it's that we can get started somewhere and we can start with the basics and work our way up, not so that we address all these insults at once, but we can find the ones that are key to us... Actually, that's a great question to ask you.
0:59:48.5 S2: Part of the book, The End of Alzheimer's program, is helping people get clear on maybe where they can get started first for them, so how do people think about that when you're talking to people or about Tim bark program, how are they beginning to lay out the chips and at least even start where... At least decide where to get started.
1:00:12.4 Bredesen: Yeah, that's a great point. And you can think of this like you're sitting in your home, for example, and there's a fire out there, it's advancing toward you. Well, if you can put it out when it's out there and kinda push it back and then fact... It's less likely to come to your house. Once it gets to your house, you know you've got a lot of things to do, but you can get rid of it while it's out there, at least beat it back and really by yourself, decades, potentially. We should have people who are good cognition until they're 100. So you can get started in a number of ways, there's the basics, and then there are the things that are targeted on the basics, there is diet, exercise, sleep stress, brain training, basic detox, and some basic supplements, so those, what we think of as kind of seven core features, and we talk about this in the book as well. So just getting yourself into a plant-rich, mild Keto diet with some fasting, fasting has turned out to be so remarkably helpful for everything from hypertension to cognition to prevent, helping in the prevention of Alzheimer's disease, to improving vascular status, improving insulin sensitivity on and on and on.
1:01:23.8 Bredesen: So just doing basics like that, and we go into great detail in the book for specific things to buy, specific things for the so-called keto flex-123 diet than exercise. Just basic things with both strength training and aerobic training will sleep, as I mentioned, that may be the most overlooked, people don't bother to check to see if they have nocturnal hypoxia and it's incredibly common, and then that's the way to check that is through a sleep center. You can do it. Yeah, actually it's pretty easy. Now, you can actually do just get yourself in extent, and there are a number of good openers out there that can actually record for you in your oxygenation, so again, this is something more and more health we're seeing as quantify itself. Now, you can have your Apple watch and you can look at things, you can look at your heart rate, you can look at your oxygen saturation, and by the way, you can look at your office and saturation, what the moment's notice with your iPhone. That's simple to do, but if you wanna record it all night, you wanna have an operator, and yes, you can get this from your doctor, you can...
1:02:29.0 Bredesen: As you said, you can do a sleep study, but you can also do it more simply by just recording it with an operator and then see if you're dropping below that target of 96 to 98 10%, and then again, stress. Incredible, as you know, there are now spikes, and when they got an interesting email from a neurologist yesterday who's seeing a spike in her practice, looking at people with cognitive decline, everyone's anxious, everyone's stressed out, everyone's indoors, everybody is depressed and worried. There's so much going on in the world right now, and of course, this contribute to everything from hypertension to cognitive decline, so getting that just again, as a scientist, I never thought I would be talking about things like meditation. I thought This is not helpful, and yet I can't deny the statistics are there, the publications are there. Neuroplasticity is undoubtedly enhanced with forms of meditation like TM, like mindfulness, like things like that, so this is really important, and then brain training again, for each one of these things, isolated doesn't have a huge impact, but as part of an overall program, these are getting you over that hump, these are making it so that you are now on the right side of plasticity, so that you are able to lay down and keep new synapses and then some basic detox, and I'm learning this myself with detoxing myself with...
1:03:55.8 Bredesen: During the covid-19, one of the things I started doing was using chronometer a lot more. So I'm looking every day at what I'm doing right, what I'm doing wrong, how much fiber I have, how much protein I have, all these sorts of things, and critical to that is getting appropriate fiber, which turns out to be so helpful for detox, among other things, for improving your glycemic load from various foods and things like that, improving your insulin sensitivity and to improve in your limit numbers, so these things are all helpful, and then basic things like filtered water, sweating frequently, following up with anonymous soaps and things like that are non-toxic soaps. All of these things critical for keeping your talks and level low HEPA filters, I encourage people, especially if there's any question about molds, of course, you wanna have remediation, but also you wanna have a HEPA filter, improve the air where you are living. It will be helpful for... And you mentioned earlier, people get overwhelmed just to know, if you have water intrusion in your home, if you have a history of water damage, you're likely to have some mold issues if you've truly had from the very beginning, there's never been any water intrusion, which is relatively uncommon, most of us have had some of that.
1:05:18.1 Bredesen: Then you're probably in pretty good shape. But if you've ever had any water cage, we've have people, by the way, who will start to get better and then have a leak in their home, and literally they can tell their cognition will signal the leak in the home faster than the spouse will find it. So that they will actually go down hill within 24 hours and then they'll start looking, Oh yeah, here's new water intrusion that we were unaware of, so this is the surprising and important correlation. So these are some of the basic things that you can use to get started. And there are some basic supplements, I know Mark talks about these a lot, but even things that look at things like your insulin sensitivity, some basic detox, making sure that you have enough, and I would say one of the common ones that people leave out is calling males should have about 550 milligrams per day of collagen or more, females of 50 milligrams or more, and we talk about this in the book, and I find that just about every day... I am a little on the low side with Cole, we don't tend to get as much coin as we should.
1:06:28.8 S2: And I in that they're getting us through like
1:06:32.9 Bredesen: Eggs, occasionally some eggs, some liver, things like that. And so, yeah, we need to do a better job of that. And you can certainly support that, not only with things like Pastor digs and stuff, but also with things like cycling or with GPC calling, some easy ways to get yourself to make sure that you're getting that 550 milligrams or if you're a female, 450 Migos of US allowed of course, this is the precursor for acetylcholine, which is the most important neurotransmitter for story memory and making memory, so you need appropriate scaling, you also need appropriate glutamate for getting the appropriate memories, and there are other pieces to this as well, such as noradrenaline Ephron, which are key for... For a level of attention and a level of consciousness, and then things like dopamine, of course, are important for that reward feeling. So all of these work together, but as ETL college is the most important one, and of course, this is why people take arise, which inhibits breakdown of steel calling to give themselves at little boost when they have Alzheimer's disease, but of course it doesn't work by itself. Terribly well, so I encourage everybody, please make sure that you are not calling deficient, make sure that you are not vitamin D deficient on...
1:08:04.4 Bredesen: Make sure that you are not deficient in an important hormones and trophic factors that are critical for laying down and keeping memory storage, and then beyond that, you wanna do targeting, as we said earlier, looking at the key things that are driving this, if you've got toxins around that you're unaware of, which so many of us do, let's find out before the fire gets to your house, let's find out because this thing is growing, and by the way, the same thing is being recorded in Parkinson's disease, people who didn't realize that they had long-term exposure to things like TRI-claro, ethylene and glyphosate and agent orange, and on and on and on, things that are inhibitors of complex one, especially, these are things that increase your risk for Parkinson's disease, so these things are growing for years, and if we're aware of them before they actually make major impacts, we only get the symptoms late in the disease, and again, that's another part of 21st century medicine that's not emphasized enough. What we see as disease is the end stage of a chronic process that's been going on for decades, the good news is, and as Marc, as champion for years, we can now check these things, we can check these diseases before they strike us, symptomatic ally, so we should all be aware of the pre-symptomatic stages, are you in a pre-symptomatic stage of Parkinson's, are you in a pre-symptomatic stage of what will ultimately be Alzheimer's? Are you in a pre-symptomatic stage of heart disease and on on...
1:09:47.1 Bredesen: That's the good news on the chronic illnesses, we can see them coming, the bad news is that people have not been doing that, so that when they finally get a diagnosis, this is a fairly late stage, and we really have to work hard now, not only to get rid of the drivers, but then to rebuild, but I do think there are some great things coming with stem cells for helping us to rebuild these loss and asses, and I think that will be a part of the overall... We've had people already go on the program and then add stem cells and get an additional bump, so I think we're gonna see more and more of that using stem cells alone is a little bit like trying to rebuild the house as it's burning down, let's put out the fire first, then we try to rebuild the house as opposed to trying to do that as it's still on fire.
1:10:36.3 S2: Stem cells and some of these advanced therapies that are available to us now that really technology is making available. They're like icing on the cake, but we still don't need a foundational base that we wanna build on, which is all these dietary lifestyle recommendations that many individuals can get a chance to follow. So for somebody who's listening now, may have some history of cognitive decline in their family, some family members that have had Alzheimer's because it's so prevalent. And they're in there, let's say, 50s or 60s, and they're not seeing that. They're not maybe noticing or what they see is they're not sure if they're having cognitive decline or not, and they want to get the first step, which is sort of just assessing where they are, how bad or things have they just gotten used to their memory, falling a little bit here and there is actually something more serious going on, what would you recommend for them as the first step of options, is it doing that... Basically, I forgot the term, but the similar cognitive test that you said, that's similar to a colonoscopy.
1:11:50.1 Bredesen: Cognos, copy, exact, ask and you can actually get... You can now get this directly, so... Yeah, very good point. And I think if we're going to impact the global burden of dementia, if we're going to take these 45 million Americans who are going to get Alzheimer's and reduce that as close to zero as we can, we need to have everybody think about this and get on prevention and I would break these into two groups, and I think it's important to mention a group that's is rarely mentioned. So 95% of people who develop Alzheimer's have sporadic Alzheimer's, so in other words, it's not... In the genes that you're gonna have, yes, they may have increased risk with Arif, which is the common one, and there are dozens of genes that increase your risk, but April E4 is the common and striking one, if you have a single copy of April 4, it increases your risk from about 9% through your lifetime to 30%, you have two copies. It's well over 50%, so that's an important one for sure. And there are about about 75 million Americans who have a single copy, and again, none of these people should be getting Alzheimer's disease, and there are about 7 million who have two copies, and again, starting early, none of them, but I wanna mention the small segment, about 5%, just under 5% of the people who develop Alzheimer's have familial Alzheimers, and there has been nothing for these people in the past, and drug approaches have failed with this group, and so they just know if they have the gene, and this is typically three genes mutations in app, prison in 1 acres, in ill and 2.
1:13:32.0 Bredesen: So for those people, and they often will get symptoms in their 30s, 40s or 50s, very significant symptoms that comes on early, they know it'll hit the parents, half of the siblings will get it as a dominantly inherited team. I would encourage them, Please get on all the appropriate things for prevention, get evaluated, get on that in your 20s, because again, you may be getting symptoms in your 30s or 40s, so start as early as you can and really optimize everything. There is a real opportunity here, I think, for the first time to have impact... We'll see, there are some people who are already doing this. We'll see how it goes. Now, for people who are not in that group, which is the vast majority, then for them, I would encourage them to start when they're in their early 40s, so we usually say you 45, that's fine. If you've got a family history that starts in been a little earlier than that, and you want to know your status on the basics, do you have ongoing inflammation, do you have ongoing insulin resistance or Clio toxicity, do you have specific trophic factors, hormones or nutrients that are low...
1:14:47.3 Bredesen: Do you have specific toxins, do you have vascular component... We see a number of people where that's the major problem, and as you know, they get hypertension, they may have a little suggestion of a struggle or a TIA, they get thrown on statins, they have these low cholesterol, and there then over time, they're not confusing their brains the way they should, these are the people who actually will do well with things like eat exercise with oxygen therapy, helped perfume help you to do the right things and get that... You wanna get the oxygen, but you wanna get the blood flow as well, and then do you have histories of trauma? All of these things are critical, find out where you're staying on and then get on an optimal protocol to address those things, starting with the basics, and people will say, Oh, this is just about lifestyle... Well, no, it's about the things that are actually driving the decline, and of course you want to include a lifestyle... Why would you throw that out? That is an important contributor. The old idea from when I was in... Back in medical school years ago, was that, Oh, it's not that important, eat some food, get you get some protein, but it's not a big deal, it was mostly focused on weight loss of anything I would just keep your weight...
1:16:06.1 Bredesen: Not too high, it's all about prescribing the right drug, well, it turns out, of course, that getting at these upstream contributors is actually more important, the drugs are gonna be important, I believe that drugs for Alzheimer's will be helpful, but they should be used on the backbone of this foundation of the things that are driving the process, then you can target your drug, and there've been over 400 different trials for Alzheimer's that have failed Ventures made people's situation worse, is not just that the drugs aren't helping in some cases, they're actually hurting at least...
1:16:44.9 S2: So far, maybe ultimately, they'll add and will be figure out a way to integrate them more with protocols like yours that are there, but at least so far, it's either... Nothing or making the situation worse.
1:16:56.1 Bredesen: That's so true. And I should mention just in the last couple of days, yet another drug has failed, and that was in trnava insulin, so the idea was, Let's give you internal insulin, get it into your brain, the good news about internal delivery of things like nerve growth factor and things like that is that you can get them into the brain, bluff on another one, you can deliver... Deliver internally into the brain, so the idea was, Okay, your insulin signaling is not perfect, let's just add it, so now again, we recognize it's the insulin resistance, You don't overcome insulin resistance, like just giving more insulin, that is an overly simplistic way. We want to improve the insulin signaling, not just give up in a big pocket of insulin, and so this fail, unfortunately, did not show any improvement whatsoever in cognition, so yet another monotherapy that has failed and the drugs have been used the wrong way. I think when they're used appropriately with the backbone of getting at the drivers and then targeting the things that are still there, for example, targeting specific toxins, it may be there enhancing some of their cholinergic transmission. Fine, but doing that alone is not addressing the various pieces that are making this network dysfunction, so I think again, that there will be a place for these, but it will be on the backbone of looking at the drivers in these people, we typically find multiple contributing factors from just the thing, pathogens, as we talked about toxins, reductions in energetic support and reductions in Trophic support, and it's addressing those things, you're now pushing the people on to the correct side of the signal, you're literally changing neuro-chemical signaling from a SEATO-clastic signaling, which is pulling down, just as you think about osteoclasts, IC activity in osteoporosis, This is Senator SIS, that's what Alzheimer's is.
1:19:01.7 Bredesen: So you're now changing from SEATO-clastic signaling into SEATO-plasticine building up and maintaining those synapses, which is just what we wanna do.
1:19:13.4 S2: It's so key because as we are talking about this, I think that's an important point because, yes, you've done so many episodes on the importance of diet, we've sent so many episodes on the importance of sleep, but specifically the Alzheimer's, what you've shown through your research and work is that okay, there could be people that their diet is pretty... Is exactly where there could be people that their sleep is pretty good, but they have such deep environmental toxicity exposures, which they wouldn't have known of if they didn't go to one of the physicians that's in your network that's trained in the Bredesen protocol and the re-code protocol, and then found out their unique stressor, that's maybe one of the biggest ones for that... Right, it's definitely multi-faceted, but everybody has a big one or not big, just one, there's a big few that are there that the biggest pushes for them, were there any of the stories that are a good example of how... For one of those survivors, one of those key quadrants was a bigger pusher for them than for some of the others that were there... Is there anyone that comes to mind? Surety could share.
1:20:16.4 Bredesen: So Sally is a great example, and Sally was trained as a nursing professor and taught for years. One of the things that she taught people was that Alzheimer's is unreadable, there's nothing we can do about this illness, and unfortunately, she started to develop this herself, and it really also had her very first symptoms, probably in her early 50s, but really nothing enough to push her until she was in her late 60s and she started having trouble, she would forget to pick up her grandchildren, she had problems with executive function with your planning and carrying out specific tasks and things like that, and so she went in and she was told... So they actually did an amyloid PET scan and show... First of all, they found she was API positive, so she had the common Alzheimer-related gene risk factor that
- 75 million Americans have one copy, which she did, and about
- 7 million Americans have two copies, and unfortunately,
- if you've got zero copies, 9% lifetime risk, which is not too high, but it's not zero.
If you've got a single copy of April, it's about 30%... If you got two copies, it's well over 50%.
1:21:25.1 Bredesen: So she was in a high-risk group, she then had an amyloid scan that was positive, so they put her on a drug trial, and in fact, it was an anti-amyloid drugs, so they said, Let's remove the amyloid that's in your brain with each injection of the antibodies, she would get much worse, and we've seen this now in a number of people, again, if you understand that this is a protective response of your brain, as long as you've got the exposure, no surprise that when you get this reduced, you're going to do worse, fortunately for her, because we've seen other people that just kept on the trials and got worse and worse and worse, after this had happened to her four times, she said, I'm not doing this anymore, this is clearly making me worse, she then heard about the work that we're doing she started on the protocol, her MOCA score was 24, she then over time, is getting a perfect 30 repeatedly. She's done very, very well. It turned out in her particular case, the big contributor was mycotoxins, she had lived unfortunately, and so many of us do live in houses that are full of these molds that are making specific toxins.
1:22:34.2 Bredesen: Now, some people are lucky enough, if they happen to have mold in the house, that's not making micro... Taxes, in her case it was. And so now, just a... Just for context adding. It's already cut you off. Yeah, these micro-toxins are basically ways that molds protect and sort fight for their territory, so there are poisons that they excrete to fight for real estate, and that's part of their... They don't have classes, they don't have things, they don't have teeth. So these mycotoxins are poisons and they're part of their arson to get rid of other competing life forms to fight for real estate. That's a really good point. So what happens is, if you're a mold, you don't grow as quickly as the bacteria around you, so you're going to get squeezed out of your environment, if you don't find a way to fight off the bacteria that are trying to grow around you. Of course, that's why penicillin occurred. They're fighting off the bacteria around them, so unfortunately, some of these Mycotoxins, these toxins produced by the mold, they're volatile, they get in the air, that the spores get in the air, and often that'll actually even grow in our sinuses or in our GI tract, they're making these toxins, and the toxins unfortunately impact our brains, they impact our immune systems, they impact cancer, they increase our risk for cancer in some cases, they can damage our kidneys, so there are all sorts of problems, you get rashes, so your body now is trying to fight back, so you get this unfortunate Chronic Inflammatory Response Syndrome, first described, of course, by Dr.
1:24:10.8 Bredesen: Richard Shoemaker, and it is a chronic, I'd say, long-term inflammatory response to these toxins, and as he pointed out to many other things that occur in the water damage buildings that typically are the support systems for these molds, and so it's volatile organic compounds and little fragments of cell walls and all sorts of things that your body is now responding to, and unfortunately, just having a relatively poor immune system, not having good resilience, all of the things that happened to us because of our poor lifestyles and the processed food, all this sort of stuff. They set us up not only to have a poor outcome in covid 19, but to have a poor outcome when we are exposed to the mold and the mycotoxins, and so this is a very common problem, a very common contributor to cognitive decline and unfortunately, not even recognized by standard of care medicine. So if you say to someone, Oh, you're developing early Alzheimer's, you better see if you've got micro toxin exposure, you go to a standard Memory Center. They'll laugh you out of the room and just say, Well, we don't recognize that. As a contributor, well, you know, you better start recognizing it as a contributor 'cause it's unfortunately a relatively common contributor, and you do need to address that, and I published a paper a number of years ago say, this is really an unrecognized and treatable epidemic.
1:25:37.3 Bredesen: This is all over the place. And so that's what ended up happening to Sally. As she started to treat it, she started to get better, and as I mentioned, her scores are now perfect, she's doing great, she continues on the protocol, and it comes back to what you said earlier also, she's dealing with the issue of, What do I pay for? What is appropriate here? I don't wanna go over board, it is expensive, on the other hand, the alternative of a nursing home is many, many times more expensive, and of course, the alternative of this new drug at Ohel is also many, many times more expensive. And doesn't work nearly as well. So that's the unfortunate alternative.
1:26:18.2 S2: It's really... We think that this approach can sometimes be expensive, but as you said, we're here in Santa Monica at our studio recording, there's a very famous memory care center that's just right down the street from here, that I've been with a few friends to volunteer a few times, you go spend time with some of the patients that are there at the Memory Center, and it's well known because one of our past presidents, Ronald Reagan, was an individual who was staying there on 20 Tian, I remember as we were going on a tour, a few of my friends who went to go volunteer, they were like, Oh no, let's show you around, and we'll show you the room that Vonage was in when he was getting treated, and it's a nice place and were by the beach and everything like that. It's Santamaria California. Things are a little bit more expensive. And I remember walking into the room, and it was a very small room. Like a very, very modest room, nice, but extremely modest. And they told me the price at the time, rough range that somebody would be paying a... Most likely the president, probably former president, paid himself when he was there...
1:27:22.9 S2: These are astronomical numbers to have 24-hour care, to have a parent, a grandparent yourself at a memory care center, and not to mention that the drug add your home that's been in the news a little bit, the price tag that's been floating around that potentially could have bankrupted us in the economy was, I believe it was like $56,000 a year.
1:27:49.2 Bredesen: And that's just the beginning, 'cause you still have to pay for infusions, you still have to pay for PET scans, you have to pay for... For MRIs, you gotta have before and after MRIs, because of the fact that it causes bleeding into the brain, in about 17% of people, it causes side effects in about 40% to 50% of people, depending on whether you're able to... For negative or positive, so it really comes with some huge side effects, in effect, we'd like to do... In the upcoming trial, we'd like to use that as the control... Right, the problem is gonna be, will then have to be very careful about Are we actually hurting these people with giving them some cerebral hemorrhage and giving them some edema in the brain, is that fair to them to give them that sort of side effects as a control group, what we'd like to be able to do instead, and as you indicate, the costs are just astronomical, the average person is just the average person $350,000 before they pass away from Alzheimer's disease, much of which of course is spent with nursing homes, that can often be 100000 a year or more.
1:28:52.2 Bredesen: It's really unfortunate.
1:28:53.6 S2: So we'd like to be able to say is, Look, everybody, please get on appropriate prevention when you turn 45 or get inappropriate reversal when you have the earliest possible symptoms, and we can really make this an optional disease. I mean, this is the power of podcasts and books like yourself, is that really we're sounding to alarm that this is something that is both. Again, some people are gonna really have a challenge with the statement, but it's true, even though you have challenges with it, you're saying that this is an optional disease, now now that what we know, this is an optional disease, and that is the truth of the matter. And on top of that, we don't have to wait till you have an official diagnosis to start to make changes that are there.
1:29:38.3 Bredesen: Now, just going back to Sally story for example, help us understand a little bit and paint a picture for those that are listening, what was the process of actually her getting treated, who was she working with and interfacing with, and how did her traditional care fit into that model a great point. So she worked with a physician who was interested enough to read about this and to then begin to get her on an appropriate protocol. So what did she do? She went on to essentially the shoemaker protocol, in which she took specific binders so that she could actually remove the toxins that were within her, she also reduced her ongoing inflammation from these, she ultimately then had the internal VIP that was part of the shoemaker protocol. So he used basically a physician who learned this, who educated himself out so much, so often we talk about continuing medical education, and yet so many physicians are resistant to learning something new, they feel very comfortable with writing a prescription, then of course, unfortunately, many of them are told You don't have time to do more than just a quick evaluation and prescription, fortunately for in her case, the doctor was willing to learn this sort of approach to apply it to her, and then it is so important, continue to optimize a-ha.
1:30:59.6 Bredesen: This is one of the things that we don't think about enough. As people are beginning to treat these complex illnesses, you've gotta keep your finger on the pulse, did they do a little better, did they do a little worse, do we need to change something? Do we need to change a dose, do we need to now add something? Often, continuing to optimize is the most important thing, and this is of course where health coaches have been so helpful to help people to get on the right path and to keep optimizing, because again, it's not something simple, you're dealing with... This is a complex system, so you kinda have to wind your way through a labyrinthine sort of protocol to make sure that you're optimizing things for best outcomes, and they'll find that as they change one thing after another, they start seeing better and better results.
1:31:46.0 S2: And the physicians you work with, again, just expanding out and helping people understand a little bit of your world and all the things that you're involved with, this physician was trained in your protocol. Right, right. So talk a little bit about how many physicians are out there that are trained in this and what that process looks like, and how many of them, including some people that have been on the podcast before, contribute to the larger research and case studies that you're pulling together as an organization.
1:32:10.0 Bredesen: Yeah, that's such a good point. So we've had over 2000 physicians from 10 different countries and all over the US who have trained in the protocol, and we just actually had recently re-code 20 training. But what you said, I think is so important, as once you get an accurate model of what the disease is, instead of just saying, Okay, we're just gonna go after the amyloid or the towel, or what have you, and the next thing... There have been so many different theories, we're gonna just gonna go after the herpes, we're just gonna go after the pagan deals, we're just gonna go after the... What... Have you go in there? Fill in the blank. As you now have a model that actually is predictive, what happens is people start seeing a, when I change this or change that, I now got incremental improvements, and we're seeing this all the time. Do we need to address plasmids? As you know, Dr. Day and good now is a biochemist who's done such interesting work with plasmas and he's arguing that... Yeah, that's an important piece as well. Other things have come up, do we know what sorts of specific stimulation, it's turning out that things like violate or things like specific 40 her stimulation.
1:33:22.6 Bredesen: Lasers, for example, Dr. Robert Hodes done beautiful work on including specific laser stimulation has gotten excellent outcomes with his patients, so as we now see, okay. We're beginning to understand what Alzheimer's actually is. Now we can begin to make better and better, so we can do better and better with the idea, it's just like once you start realizing, we're not gonna fly a plane to the moon, we're gonna have to have a rocket, okay, now we're gonna get more and more sophisticated rockets, we're gonna get better at targeting them until, of course, we just heard recently that we've got people going up in space without the government here, so we get better and better and being able to do this, and now we've got probes going to distant parts of the solar system, so that's the same thing that's happening here is just as you said, practitioners are finding, Hey, here's an area that actually works better if we add this...
1:34:18.8 S2: I think the Rocket analogy is a great analogy because again, so many people poo-poo the X PRIZE, getting to space, private flight to space, the stuff that Richard Branson has been up to Elon Musk and some of the others. And we're seeing that that what costs NASA so many X times more, but the private industry is able to do at such a lower cost level, and it's actually we need a little bit of both because so many of the innovations that have happened in the private industry just as it's happening right now in Alzheimer's and the innovations that you guys are bringing to the table came from grants, building on top of the soldiers, but shoulders of what the government was able to get started. But we can't just stop there, we can't wait till we have this perfect intervention, because the truth is there somebody that's listening out there right now that who knows maybe one day there'll be a drug that makes a significant more difference than what is the low bar that's been set now, but it's not gonna do it if it doesn't get to the issues of it, but let's say it's a little bit better, what are you gonna wait another 10 years, 20 years, 30 years to get maybe a significant improvement...
1:35:28.5 S2: That's even just a little bit better than what we have now. We can't wait. We have to start with something, that's why we're spending the word about what you're up to. I got a question for you. I'm sorry, we...
1:35:39.5 Bredesen: I'm just gonna say one thing, 'cause you mentioned the xprize is such a good example. One of my favorite stories was from the engineer who designed the X PRIZE in what would eventually won the X price for space travel, and what he said was that they realized that there was no rocket avail, there was nothing in the current approach that would allow them to do what was needed for the XPRIZE, you had to go up a... Say had to go twice, within one week, you had to go up to it, originally it was 100 miles and they realized no one could do that, they changed it to surreptitiously kind of to 100 kilometers. You had to go up. You had to come down. Etcetera. So he realized that anything that they suggested that was an inside the box, this is what's already available, this is how we do it, he knew would fail. So he knew that whatever it was that was going to win the X PRIZE was going to sound crazy when the first person suggested it, and it turned out that what they needed was a rocket that had two different shapes, one going up and one coming down, and so when he first suggested that they were like, What are you talking about, two different shapes, so you actually had to change the shape of this while you were flying it, and so I think this is...
1:36:51.1 Bredesen: The same thing we're dealing with now, we're changing the idea of, Okay, it's just gonna be a single drug, just tell us which drug it's gonna be to no, let's go after the system, this is a deficiency of a sub-system, the drugs are gonna be critical for targeting specific things, but let's get larger data sets, let's look at root cause analysis and then less address all of these things for best outcomes. Now we have a very different view of the disease, and now we can begin to make incremental improvements.
1:37:22.2 S2: It's a fundamental shift in how you look at things, it's a fundamental shift. Let me ask you a personal level, as you were putting the stories together in writing this book, what were some of the themes or ideas that surprised you, was there anything that surprised you as you were starting to put this together and present these stories for the larger population to read.
1:37:45.9 Bredesen: Yeah, I was surprised initially by how young some of the symptoms started in the course, and I realize it again, this really brings back a fundamental scientific point, when you're dealing with something like a disease, there has to be internal consistency. In other words, when you see something on the clinical side, it has to fit what you see on the research side, it has to fit what you see on the epidemiological side, it has to fit what you see on the genetic side, these are all interlocking pieces and where there's been so much failure in Alzheimer's is that scientists wanted to run with one idea, Oh, I see Amelie under the microscope, let's get rid of the amyloid, wait a minute that doesn't fit what you see with the clinical data now, or they'll say, Oh, it's reactive oxygen species, let's go out, let's use an anti-oxidant to get rid of those reactive oxides and species... Well, that doesn't work for Alzheimer's disease, so you have to bring these things together. And so I realize, Okay, what we're seeing as these remarkably early symptoms, DeVries ribe changes in her early 40s, even though she probably wouldn't have been in a nursing home until her late 50s or even early 60s, she was clearly identifying things were that were very simple, similar to what happened to her father.
1:39:10.6 Bredesen: Now, she could see what happened to her father as he progressed into his 60s and really got severe Alzheimer's disease, she then looked backward and said A-ha... I remember the things he was saying and complaining about when he was practicing neurology way back in his 40s, she realized, Oh, these things that I saw as your minor changes and... Oh yeah, you're just getting a little older really were the harbinger of severe Alzheimer's, and so to hear these relatively young people talking about these changes and kind of... The doctor's just dismissing them, Oh yeah, you're in your 40s, you're no longer in your 20s or 30s, and really telling you this was pre-pre-pre-Alzheimer's, this was the beginning of these pathophysiology, Cal underpinnings. So that surprised me initially, but again, seeing the biochemistry, it all started to come together and started to make sense, the other thing that surprised me was how much it made a difference to stick with the critical pieces and how sticking with these and then continuing to optimize turned out to be so helpful. Some people will give up. They'll say, Look, I've done this for a couple of weeks.
1:40:24.2 Bredesen: I don't see any major changes, I'm gonna move on to the next fad. And so many of these fads, unfortunately, are not scientifically related, it's just take this, you'll take this, you hear it all the time, Take this supplement. And everything's gonna be great. The brain is not that simple, you really need to look more carefully at what's causing the problem... Sure. Supplements are an important part. Again, it's interesting, the opposite side is from the academicians who say, supplements can't be helpful. Well, wait a minute. Let's not throw the baby out with the bath water here. These things do help change your neuro chemistry, so we are looking at understanding the underlying neurochemistry and then going after that, going after those pieces and... Absolutely. Critical things can be helpful. You can't tell me that omega-3s don't change your neuro-chemistry, that's been shown again and again and again, you can't tell me that resolving? don't have impacts on your neuro chemistry, you can't tell me that things like whole coffee fruit extract that increases your BDNF. These things are not having impacts on your neuro-canter, and you can go down the list list, you're an ETL system, Al-Carrol, your backup, understanding how to use these and to target the right things in the right people, these are very powerful.
1:41:48.7 Bredesen: And you just have to know how to use them. So these sorts of things were all kind of eye-opening to me, but the most important thing to me by far was the happiness, the families, for example, with Debra, she knew watching her grandmother and her father, and then seeing what's happening with herself and knowing her own genetics, she turned around and looked at her children, of course. Oh my gosh. What's their future? And so now to be able to say for all future generations, they never have to deal with this again, that really makes me happy.
1:42:22.1 S2: Hey, YouTube, if you enjoyed what you just saw, keep washing for more great content on how to improve your brain and your life.
1:42:29.3 Bredesen: We can scan brains 20 years ahead of time and determine already when there is compromised brain... Energetics, the choices we make in our 30s, 40s, and 50s are very relevant.
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