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Hormone

WITH DR. KYRIN DUNSTON

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How To Protect Your Brain And Prevent And Reverse Dementia


Do you have a loved one suffering from dementia? Are you worried about your own cognitive health as you age? If so, this episode of The Hormone Prescription Podcast is for you!

Our guest, Dr. Heather Sandison, the founder of Solcere Health Clinic, and Marama, the first residential care facility for the elderly of its kind, and a leading expert in the field of integrative medicine, shares her insights on how to protect your brain and prevent or reverse dementia.

In this episode you will learn:

  • The role that hormones play in brain health

  • The benefits of lifestyle changes, including diet and exercise, for cognitive health

  • The genetic determinism of Alzheimer's disease and what you can do to mitigate your risk

  • The tests and treatments available to prevent and treat dementia

  • The complex system science approach versus the reduction approach to brain health

  • And much more!

If you are interested in learning more about how to protect your brain and prevent or reverse dementia, this episode is a must-listen!

(00:00): Do you think that dementia is a done deal and that once you get it, you'll always have it. Well, you need to listen up because that's actually a lie.

(00:12): So the big question is how do women over 40, like us, keep weight off, have great energy balance. Our hormones in our moods feel sexy and confident and master midlife. If you're like most of us, you are not getting the answers you need and remain confused and pretty hopeless to ever feel like yourself. Again. As an OB GYN, I had to discover for myself the truth about what creates a rock, solid metabolism, lasting weight loss, and supercharged energy. After 40 in order to lose a hundred pounds and fix my fatigue. Now I'm on a mission. This podcast is designed to share the natural tools you need for impactful results. And to give you clarity on the answers to your midlife metabolism challenges, join me for tangible natural strategies to crush the hormone imbalances you are facing and help you get unstuck from the sidelines of life. My name is Dr. Kyrin Dunston welcome to the hormone prescription podcast.

(01:05): Hi, everybody. Welcome back to another episode of the hormone prescription with Dr. Kyrin. Thank you so much for joining me today. If you believe that dementia is a done deal in that, once you have it, you will always have it. It will progress and get worse. Then you need to listen up because that is just not true anymore. The truth is that you can prevent and reverse cognitive decline and Alzheimer's and other types of dementia. When you take a root cause all systems approach. And my guest today is an expert on this. She is going to break it down for you. She's also hosting a wonderful summit that is coming up on Alzheimer's and cognitive functioning and dementia and how to prevent and reverse it. So I definitely want you to attend that. We'll have the link in the show notes, because this is for everyone.

(02:00): You know, don't hear this title and think, oh, uh, my brain is fine, right? It takes decades to develop cognitive decline and dementia. And so if you have a brain, and you're a human, and you're getting older, which is just about every one of us, then you need to listen up, cuz you need to be doing things, taking steps to protect your precious brain, your mainframe computer. Now. So we'll dive into talking to Heather. She gave a masterclass today about all the things that you need to be doing for your brain. Don't be overwhelmed though, because in her summit she's going to go into with experts like me, way more detail. And of course I'm the hormone expert and hormones. You definitely need a prescription for hormones. If you want to protect your brain, you cannot have optimized brain function without it. So we'll dive into that, but I'll tell you a little bit about Dr.

(02:56): Heather and we'll get started. She's really rather remarkable. Dr. Heather Sandison is the founder of SOCE health clinic and MIMA the first residential care facility for the elderly of its kind at SOCE Dr. Sandison and her team of doctors and health coaches focused primarily on supporting patients, looking to optimize cognitive function, prevent mental decline and reverse dementia by addressing root causes of imbalance in the brain and body. This is something all of you should be doing. She was awarded a grant to study an individualized integrative approach to reversing dementia and is a primary investigator on the it H N C L R clinical trial at Marama. Dr. Sandison has created an immersive residential experience in the lifestyle proven to best support brain health. She understands that changing her diet, adding nutrients, creating community and optimizing a healing environment are all challenging. Even for those with full cognitive capacity at Marama, she's done the work for you, all you or your loved one need to do is show up. She is also the host of the reverse Alzheimer's summit and collective insights podcast, where she works to share what is possible for those suffering with dementia. Welcome Dr. Heather Sandison.

(04:23): Thanks. It's so exciting to be here with you.

(04:25): Yeah, I am so excited about your summit coming up. Many of my listeners know that my mom suffers with advanced Alzheimer's and I really I'm so passionate about helping others to know how to prevent and reverse cognitive decline. Cuz personally, I think it is the most devastating disease someone could be diagnosed with. How did you come to be so passionate about preserving cognitive capacity and preventing and reversing Alzheimer's?

(04:59): Well, as you know, it's an absolutely torturous disease, not only for the person experiencing it, but for all of their loved ones who have to watch this slow painful demise. And the reason I became so passionate was because there's a bit of injustice in this, right? I was told that there was nothing you could do for dementia by very well meaning very well educated instructors when I was in school just 10, 12 years ago, right? Like this is very recent history I was told. There's nothing you could do to suggest otherwise is to give someone false hope and that's just cruel. Right? So don't do that. And then fast forward a few years I saw Dr. Bison speak at a conference and I was really intrigued because his approach, he was saying, you could reverse dementia. You could reverse cognitive decline. And his approach made a lot of common sense.

(05:54): It just wasn't common practice to kind of put all of functional medicine together and apply it to someone with dementia. So what he was describing was BA essentially complex system science approach, the opposite of the reductionistic approach that conventional medicine has been taking for decades, where they try to create one pill or one IV formula that's gonna cure Alzheimer's right. And then everybody's gonna get on it and nobody's gonna have it again. Well, this is really a false premise. It doesn't work because it's based on this idea that beta amyloid plaques or tell proteins these pathological or, or histological really physiological changes. They're almost like scar tissue in the brain that they are the ones that cause dementia or, or Alzheimer's when in fact it's what causes that scar tissue is what causes dementia. And so what I saw after seeing Dr Bison speak was that I was intrigued, right.

(06:55): I, I was skeptical, but I was curious. And so like when I had and did his training, I came back to my office still skeptical, but my first patient Linda came into my office after I was on Dr. Bison's website. Right. I was on the list of people who had been trained by him. And so I had patients showing up asking, uh, because there weren't other people in San Diego who had been trained by him at that point. And so Linda came in with her husband, very enthusiastic, totally committed to doing everything she could. Now for your listeners who aren't familiar with a mocha score, this is the Montreal cognitive assessment. And it's a score out of 30. So 30 is perfect. We really wanna get over 26, especially as we're aging. And when we start to be able to measure cognitive decline. So this can be sometimes you hear this called mild cognitive impairment.

(07:46): And I won't go on the tangent about how I feel about that use of language <laugh>. But as you get down into the teens, lower teens, this is Alzheimer's disease. This is relatively severe dementia, where you're having trouble taking, having a conversation. Maybe you get lost in familiar places. You aren't nonverbal. Like you can still have a conversation, but often you're repeating yourself. Unable to work is very typical at this stage. Now, by the time you get to a two, a three, a four, this person is, is answering with yes or no statements, right? They're they can't hold complex concepts in their mind. They can't hold questions for very long. And this is where Linda was. Linda was at a two out of 30. So she could answer with yes or no. Her handwriting had been affected. So it was a bit shaky. It was at a very severe slant.

(08:35): It was very, very small letters. Her relationship with her husband of course, was severely affected. They couldn't hold a conversation and he loved her so much. I mean, it was so inspiring to watch how committed he was to her and how much he wanted to work hard to get her back. And I could see in Linda, she had this big, bright smile, and she was in there. She wore these loud, amazing clothes, you know, lots of mismatch and lots of color and hats and accessories. It was just great. And you could see who she had been and these little remnants personality that were peaking through. Well, her and her husband went home and they got out of a moldy bedroom. She got hers removed from her mouth. She got on biodentical hormones. She started all of the supplements. They went fully keto. They started ballroom dancing three to four times a week.

(09:28): And they started walking like vigorous walking exercise every day of the week and low and behold, six, seven weeks later, she came back and her mocha was a seven. Her life had been transformed. So she was now bickering with her husband about something that had happened on the ride to the clinic, which I was just like in disbelief. I could, I thought, you know, I was looking at her mocha scores, her worksheets and going, did we do it wrong? Like, did we miss anything? Like I just, my brain couldn't process that this was possible because I had been told the old refrain that people are still told that, that you couldn't do this. That this was impossible that I started crying because I was like, wait, what? This really works. And especially, I didn't have the confidence that it would work with someone with such severe disease.

(10:18): So when I saw in that moment, when I saw what was possible for Linda, I mean, how could anyone not commit themselves to this for the rest of their lives, right? Like this is possible for Linda. Then what's possible for everyone else who is younger. Who's just noticing those first signs that their brain isn't working the way it used to 10 or five years ago. What's possible for people who know their genetic risk, if they can prevent it from ever even starting. We know that dementia, the changes in the brain, the inflammation, the toxic assaults, the, the infections, the imbalances that cause dementia, the trigger that scar tissue formation, those imbalances start decades before anyone notices changes in their cognitive function, in their memory. And so if we can intervene sooner, we can make Alzheimer's optional. People do not have to go down the torturous path that your mom has.

(11:19): You could be scared. Your children could be spar. The torture of having to watch that of having to put someone in a home because they don't feel like they have the capacity to both raise their own children, work their full-time job, manage their house and care for the, their debilitated loved one with dementia. My life's purpose is changing the narrative around this, which is why I was so grateful that you joined me on the reverse Alzheimer's summit to help me in this crusade around telling people that I'm sorry, respectfully. I disagree with your neurologist who told you here's acept and Meda. It doesn't work very well. Get your affairs in order. There's nothing else that can be done. There's actually an overwhelming amount that can be done to support someone who's noticing their memory fading.

(12:07): Oh my gosh. She said so much in there. And when you told Linda's story and how she and her husband just went and made radical changes in seven weeks had marked improvement. I cried because it's just such demonstrative of what is possible when people really take this seriously and they do all the things and they radically reevaluate and change their lifestyle. What is possible? It's sad to me that it requires us to have such pain in order to do it. We have to go so far that people aren't willing to do it, but I love that they did it. Oh my gosh. You've said so many things. <laugh> all right. So let's dive into this, but I, I think this idea of complex systems science approach versus reduction approach really is the whole shift in paradigm in medicine that is about antiaging, metabolic, functional medicine.

(13:06): It is the healthcare revolution. It is the next frontier. There's so many areas where we take this reductionist approach. Like it's just a disease, it's just symptom management and you have to deal with it and you have to control it, particularly not only with dementia. I think dementia is where this shows up as just this hopeless attitude of, oh, this is it. Get your affairs in order here, take these medicines. They don't really help. So let's dive a little into all the things that you've got to do, but I wanna start by talking, you mentioned genetic risk and I know people have heard there's Alzheimer's gene. They can't, most people readily access this, or maybe they can maybe, you know, of a place that people can get this, unless their doctor orders it. Can you talk a little bit about the genetics? What is the genetic determinism level with Alzheimer's and what's available? Mm-hmm

(14:04): <affirmative> yeah, there's a lot of agency here, right? Like, so even if you have the worst genetics, there's still a chance that you'll be in the camp that doesn't get dementia. Right. So there it's much more about epigenetics than it is about genetics. Right? So that, that, the way I describe it to patients is it's as if an architect has written the, has drawn the plans for a house and that's your genetic, so that's the plan. And then where you build that house, if it's by the beach, or if it's up in the mountains or it's in the desert, if there's carpet or tile, or, you know, if it's facing east or west, if there's a happy family or a sad family in it, right? Like all of these epigenetic effects determine what that house ends up looking like. And, and if it's a great house to live in or not, and that's essentially your body, right?

(14:50): So there's this genetic plan. And then there's the phenotype or what actually gets expressed, which is the actual house that gets built. Right? And so what we put into that house, what we put into that house that, you know, houses our soul that is so critically important to how that plan gets manifested. And so when we look at genetics, there are a few things and we are now, uh, you do have to get it through a doctor, but we are now offering the Alzheimer's risk test. And this takes not only APO E for genetics. So APO E genetics, let me describe APO E real quick, because this is kind the one that people know the most about and is the most indicative of late onset Alzheimer's. So there are a very rare form of early onset Alzheimer's and this would be your AP P your amyloid precursor protein and your Priscilla one and two.

(15:41): We do not test for that. So for that, we have people go to a geneticist and, and understand their risk there. Now, even if they do have that risk, that elevated risk, we wanna be as proactive as possible, right? This just means you need to work a little harder than your neighbor or your spouse to do all of the things on the bison protocol and prevent this risk for manifesting. There is still a way this genetics are not determination, right? You, you, it's not black and white that you are destined to have, uh Alzheimer's if you have these genes. So, but what we wanna do is we wanna get on top of it faster. So then APO E APO E our ancestors all had APO E four, four, APO E basically predisposes you to create amyloid plaques earlier, quick, more quickly, when you are exposed to something that's causing inflammation in the brain.

(16:34): So amyloid and tell proteins that they're antimicrobial, they're there to protect us. So they've been vilified and conventional medicine as the cause of Alzheimer's, but they're actually there in response to a trigger in the brain. And so, if you are creating these quicker, you do have a higher risk of dementia. And what we see this also APOE also affects fat metabolism, particularly saturated fat metabolism. So if you have a co you have a copy from mom, a copy from dad, and if you have an APOE four from mom and an APOE four from dad, you have a 50% chance of developing dementia. So my job is to make sure you're in the 50% that never gets any sign of cognitive decline. Now, the general population has about a 13% risk of developing dementia. So this is a highly increased risk. Now, if you have an APO E there's two, three, and four, two is pretty rare, but a three, four, it happens.

(17:30): And this means you've got one, a three from mom or dad, and then a four from mom or dad. You have about a one in three risk of getting dementia. So again, I wanna keep you in that 66% that never gets dementia. Then if you have a, a two, three or a three, three or 2, 2, 1 of the other combinations without a four from mom or dad, then you have about a 9% risk of developing dementia. There's a little bit of protection actually from having an APOE two. So we use the Alzheimer's risk test, which takes another 112,000 single nucleotide polymorphisms, and takes them through an algorithm that was developed in the UK, and then gives someone a score. A very it's easy to look at, right? It's not a lot of snips. It's not one of these kind of through the internet, you get your raw data things.

(18:16): This is a, this gives you a score that has a, a lot of very sophisticated data. That's been compiled and then analyzed. And it gives you a score out of one. So one being very high risk, zero being very low risk, and it includes a O E four, but also other genetic snips, single nucleotide polymorphisms. So if I'm talking to someone who is, say the daughter of someone with dementia, or the son of someone with dementia, maybe even the sibling or cousin of someone with dementia, this is a great test to take because there are people with a O E four who actually have relatively low genetic risk. There are people without a O E force positive alleles who have relatively high risk. And so we don't wanna oversimplify. Uh, and this test is the most accurate in determining whether or not someone will develop dementia. It's even more accurate than looking at amyloid in say, imaging or cerebral spinal fluid, or however, they're they find, um, ways to do that. Now, uh, I think they might even have a blood test that's available for research.

(19:22): Okay. I know everybody's listening and, and really, I have never met a person who's not concerned about this. Although most women are most concerned about breast cancer. They're I think this is really where they should focus, because if you do get breast cancer in this day and age, you're most likely not going to diet from it, but an Alzheimer's dementia will certainly pause significant disability and premature death. So people can get this from your clinic. Can they get this from any doctor? Cuz I know there are women listening who are like, okay, I hear you, Dr. Heather, I need this test. Where do I get it?

(19:58): So anyone in the us can get it through our clinic. What we do is we have a doctor who will review it with you and then they can help you find a BR trained provider near you. If you have high risk, we're gonna wanna do that quick. But if you have low risk, you know what a relief. So we have a doctor who can help you get that test. It's it's a pretty new test. It's clear. So it it's not reimbursed by insurance yet. So it's on the cutting edge. It's used most commonly actually in the pharmaceutical industry so that the scientists there can determine who's at higher risk and then target those people for drug discovery and for, and for the, the science that they're doing. Now, we wanna apply this so that we can get people preventing dementia. And so that's why I've really done my best to make it as widely available as possible, even though not many doctors in the us are offering it. So through my clinic, anywhere in the us, you can get this test done. And then we'll, you'll talk to a doctor here at Ary who will talk you through the implications and, and the interpretation of that, and then help get you supported by the bison train provider who can take it from there.

(21:05): Okay. Awesome. And we will have the links and the show notes for all of this. So you can go there and get the links. And Dr. Heather has a great download for you, which will come to before we wrap up. So, okay. So we've got our risk, everybody. I think everyone should get checked now do not wait. And then let's talk about this complex system science approach versus reduction approach. You mentioned my favorite topic, hormone therapy. My mom was without hormones for, you know, over three decades. And that really was the only risk factor she had for dementia. And I am a huge proponent of the benefits of hormone replacement therapy. Not only for cognitive function, I mean, se what is it? 77 or 79% reduction in getting Alzheimer's if a woman is on hormone replacement therapy, I mean, that's just insane. It should be criminal not to give it <laugh>

(22:05): Well, you, you mentioned the breast cancer risk, right? This is I think what, yeah, a lot of people from pulling the trigger on a hormone replacement and I think what you said was perfect, right? Like, no, of course we don't want anyone to get breast cancer. However, there's been a lot of data that was misconstrued by the media that was misinterpreted. You know, they've gone back to the women's health initiative study and put some caveats on this whole idea that there was an increased risk of breast cancer. That was with oral estrogens. That was when non-bio identical estrogens. So we're not talking apples to apples when we consider bio identical hormone replacement now. And when you think about aging and what's going to be the most torturous, the most debilitating, the most expensive breast cancer is highly treatable. We are so lucky that we live in a time when breast cancer is really highly treatable. Mm-hmm <affirmative>. So even if there is this like a little bit of increased risk, which my understanding of the data.

(23:05): Actually it's reduction, there's a reduction in risk of getting breast cancer. If you're on biodentical hormones. So you have a reduction in risk of breast CA of cancers. It all cause mortality, the, any reason for death, you have a reduction in risk for, and then the two things that affect women as they age, the most that are the most debilitating are gonna be a fall or dementia. These are gonna be the things that end you up in, in skilled nursing for too long, and then result in death and a torturous death where you're separated from your family, because you have to be in, in, in, you know, some kind of high acuity care and then dementia. I mean, this is torturous. Not only because just in and of itself, it's absolutely demoralizing. You lose all of your, of course cognitive capacity over time, but you also, you lose your dignity more than anything.

(23:54): And this can last for a decade or more. No one knows when the torture is going to end it also it's financially bankrupting, right? Not only is it emotionally bankrupting and exhausting for any caregiver, it is financially bankrupting as well. And so if we can prevent falls and we can prevent dementia by getting on hormones, particularly if someone already has say osteoporosis or risk of bone disease or has risk of dementia, either genetically or they're starting to notice changes, particularly as they go through menopause, then the risks are far outweighed by the benefits when we consider hormone replacement therapy, if it's bio identical and the estrogen is used topically.

(24:39): Yeah. So, so well said, thank you for sharing all of that. I agree. And wouldn't you say that the causes, uh, the factors that contribute to the creation of dementia are, are similar same factors to what contribute to bone thinning and osteoporosis.

(24:59): Absolutely. Well, that's one of the amazing things about this co this complex system science approach, right? Is that instead of saying, what's that one thing that causes dementia, what we say is, Hey, how can we get every cell in the body working and functioning better? And when we do that, well, low and behold, the side effects are that your blood pressure normalizes, your hemoglobin A1C goes back to normal. You no longer have diabetes, your osteoporosis starts to improve. Yeah. The, the kind of the four part approach to like my formula for osteoporosis is estrogen replacement with, of course with progesterone and testosterone got nice and balanced and help with muscle building. So biodentical hormone replacement with estrogen being most important there, vitamin D with K minerals and then, uh, weight bearing exercise. And with those four things, I also like to check osteocalcin and beta cross ops and the blood every six months and then a DEXA scan every two years. And with that kind of plan, that basic simple plan. I see the majority of my patients, their bones get stronger on Dexus year, uh, every other year when we check.

(26:07): Yes. Awesome. So I hope everybody's listening and taking care of these things. And I know in the summit that you're hosting, I'm super excited about it. You have experts that are gonna go in way more detail into all of these. So everybody listening needs to click the link in the show notes and sign up for that now, because you know, hopefully you're getting the, the message loud and clear that dementia is preventable and you can do things and you need, need to get on this early and often and take care of it. Or if you're already walking down that lane that you need to get out of it. So definitely wanna check that out, but briefly, what are some of the other factors I know you've touched on them. We've D we've talked about genetics in a little more detail, bioidentical hormones. What are some other factors that need to be addressed?

(27:02): Yeah, well, we're giving away the keto diet guide. So I wanna talk a little bit about the fuel that brain runs on. So the vast majority of us live our days in glycolysis burning sugar for fuel. So ATP is that fuel it's like that gasoline that gets our cells going. It gives them all the energy to make new memories, to make those connections in the brain. We've all had that feeling of being kind of tired and it's a heavy lift to do something mentally. Well, if we are on our burning sugar for fuel that over time as we age, our brains are less sensitive to both sugar and to insulin that allows the sugar into the cells from the blood into the cells to be turned into fuel. So this doesn't work as efficiently. Now this is regardless of if you have diabetes or insulin resistance, anyone as we age, if we have been on a sugar, uh, burning carbohydrates for fuel.

(27:55): And when I say sugar, I also be pasta bread, corn, you know, tortilla chips, all of the carbs, even squash and fruit. When we have been having consuming that every day for our entire lives, we don't get an opportunity to go into ketosis and burn fat for fuel. And so the brain starts to become less sensitive. It no longer efficiently burns sugar. And what we can do, this is the magic of the ketogenic diet is that we can flip the switch. We can turn our energy production from turning sugar into fuel, to turning fat into fuel and just switching the fuel. I mean, this is I, this is just divine design. It makes me I would get chills. When I think about how intelligent the body is and how is able to change out the fuel and burn it really efficiently. And so what people notice is that after getting on a ketogenic diet, they sleep better. They wake up with more energy, they lose weight. If that's the goal, cuz it's, it's very modulating for weight, their blood sugar improves and their memory comes back. They feel sharper cognitively. So I don't know if Kyrin you've ever been asked like, yo, is there a way that you can get more hours in my day? I just feel like there's not enough time

(29:16): For everything,

(29:17): Especially women, right? We're like doing so much constantly juggling and a ketogenic diet in my personal experience is the way to get another for me. I get another hour and a half in my day because instead of dragging myself out of bed at six 30 or seven, I'm up at five and I'm ready to go. This is certainly for me. I personally find it magic. And for so many of my patients, there was actually a, so many of my patients also report this. Now there was a, a trial done. It was a small feasibility trial of just nine participants. It was done in Florida and it was published in January of 2022 where they took nine again, nine participants with some co measurable cognitive decline. And they put them on a ketogenic diet for just six weeks. And they had statistically significant changes in cognitive functions. Six weeks later, if you were struggling with cognitive issues, this is the first spot. This is the first place to go. This does a lot of the heavy lifting. And I would say, this is about if I were to weight all of the interventions, cuz there's a lot, right? This can start to feel overwhelming and complex. But if I were to weight them, I would say the ketogenic diet does about half of the lifting.

(30:28): I love that you really put it into perspective. So it's not about weight. I think people hear keto diet and they think it's only about weight. And a lot of people don't have a weight problem, completely dismiss it, but you really highlight the importance of it and this metabolic flexibility and theology that you get with it. It's like the diet that keeps on giving. But do you think people should do it all the time?

(30:56): Yeah. Such a great point. I'm so glad you said that because no, it's just as bad to always be burning sugar for fuel as it would be to always be burning fat for fuel. So that term metabolic flexibility is really the goal. Our ancestors, our hunter gather ancestors did not have sugar available all the time. They did not have fat available all the time. They had periods of fasting. And so again, our divine design, the way we are, our design is to go back and forth between ketosis burning fat for fuel and glycolysis burning sugar for fuel. And when we, if our body, the chance to do that, the way our hunter gather ancestors did our body works better. It's almost, it's a bit of a stressor. This concept is called the hormetic effect or hormesis where we ask the body to be under a little bit of stress, just like exercise does this. Some calorie restriction or intermittent fasting can do this. And then the ketogenic diet is a fasting mimicking diet where we stress the body a little bit in order to get it to be more resilient. And so as we do that, we, we have, we also get, as you mentioned, auto, we senescent cells are kicked out of the system. We recycle them. We get rid of them. So that the cells that, that replace them are new and more efficient, more optimally functioning.

(32:17): Yes. Awesome. What other factors? So you, you laid it out keto diet as big does 50% of the heavy lifting. I love that. What are some other factors though that people might be alerted that they might need to attend to in

(32:31): Our practice at SOCE? And certainly through the medicine protocol, we wanna be comprehensive about how we do this. So there are two big things that increase my confidence that this approach is going to work one you're early on in the disease process. So you've just started noticing changes. If you even have it all the best is prevention, right, where you've never even noticed changes. So first thing that increases confidence is that we aren't waiting until the disease is severe. The second thing that increases my confidence is how comprehensive you can be about applying the treatment plan. So if you can do all of it, then my confidence goes through the roof. This is a lot like Linda. They did it all and they did it all right out of the gate and they got the benefits. So I get it. Not everybody's able to do that.

(33:15): And even small changes you will get benefit from. But as we stack them on top of each other, you get, you get this kind of virtuous cycle. They all work better when they work together. Okay. So we wanna be systematic about how we approach this and Dr. Bren trains providers this way. And certainly at Ary, we aim to be, uh, systematic and have check boxes, right? Because it can be a lot and feel overwhelming. So the way I think about it is we want to address there's five primary things that cause complex chronic disease. In my model, that it's toxicity, which have three flavors of toxicity microtoxins or biotoxins that come from the indoor air environment, most commonly heavy metals and then chemical toxins. These are things like petrochemicals. If you live near the freeway, this can be parabens, PCBs, SS, pesticides, herbicides, things that are in groundwater that contaminate groundwater, uh, those can come from lots of areas in the environment, but we can measure all three flavors of those toxins and then we can get them out and check that box that hopefully becomes something that you complete.

(34:21): So you get rid of all the mycotoxins get rid of all the metals, change up your environment at home or the personal care products or the cleaning products you use. And then we don't have to worry about that anymore, unless there's a new exposure. So toxins, I start there because that's a nice way to kind of check that box and move on. Now your cells can work better, cuz they're not defending you from toxicity or they're not, they're not trying to, uh, the way that Dr Renison puts it. It's great. Um, he says, imagine your brain is like a country. My brain is St right? You're focused on fighting off invaders like infections or defending from things like toxins. You're not building the infrastructure of new memories of roads and schools, right? In this analogy, you're not creating new memories. You're too busy defending, right?

(35:06): All of your resources are going in that direction. So we wanna get rid of toxins. We wanna have enough nutrients, right? We've gotta have the resources. We've gotta have the building blocks. We need those amino acids. We need those fats. We need those minerals to make all of these biochemical reactions that are necessary for memory building for quick thinking, we need all of those present. If we're depleted, then that's not going to happen efficiently. And then third, we wanna address stressors on the system. So this could be things like sleep deprivation. This could be as stress from, you know, psychosocial stressors, ort S D caregivers are very high risk of developing dementia. They have two and a half times the risk of the population, just because you're a caregiver for someone with dementia, because we often right caregivers wanna put the person they're caring for first.

(35:57): So they're not getting their own exercise. They're not getting enough sleep. It's highly stressful situation. So I really encourage caregivers to listen closely and prevent this disease. Managing stressors. I often will recommend meditation. Meditation is personally something I benefit from having a regular daily practice of mindfulness, meditation, prayer, whatever feels best for you. So managing stressors is another one. Then structure is another one. So we have toxins, nutrients, stressors, structures, structure is gonna be, is your airway open? Are you getting, are you getting oxygen to your brain at night? If you have sleep AP, even if it's mild sleep apnea, you wanna treat this aggressively. I don't care what sleep medicine says. If you are having apnea events at night, that is basically mild brain damage. And I am not okay with that. We have to treat. So whether that means going to your dentist and getting an oral appliance that keeps your airway open.

(36:59): Some people use the mouth tape. I know that sounds a little bit counterintuitive, but you can tape your mouth closed at night so that it forces you to breathe through your nose. Some people will get the nasal strips that, and I like the breathe, right? If you get the generics, they don't work as well. There's of course, the C a P the, the, which has forces pressure into the airway. The other thing that you can do is get the a, a P, and this is the Cadillac. What, from what my patients tell me, this is the Cadillac of C P much more Cadillac.

(37:30): Why is that? Why did they say that?

(37:33): The con, so the AAP is alternating pressure. So the C a P is continuous pressure. And so it doesn't matter what your body's doing. There's no feedback in the system. It just blows, you know, pressure in air I interior system. And when you use the AAP, it adjusts as you're sleeping as, and as you go into different events and then getting the mask that fits right or getting the pillow, whatever, I know that it can take effort going back and forth with sleep medicine, and it can be costly, but this is worth it. Find what works for you. And I've had patients say, oh, I feel like I'm gonna die when I have that mask on. And then it, I push them like, no, no, you've gotta figure this out and do something. Whatever works for you. And then, sure enough, a couple weeks later, they're like, I can't sleep without it.

(38:21): I it's changed my life because now I wake up feeling rested for the first time in a decade or more. So treating sleep apnea, excuse me, very, very important, getting enough, sleep enough rest. And then of course, you know, structurally traumatic brain injuries put people at risk for dementia. So again, the falls, you know, if a woman has a fall regularly and she's hitting her head, this is a really big deal. I'll also say here, the research on women and traumatic brain injuries is lagging behind because a lot of this is done on professional athletes and combat veterans, where there is an epidemic of untreated brain traumatic brain injuries that happens in women who are victims of domestic abuse. And I really hope that in the next couple of years, we see a lot more resources going into this because it's just such a tragedy.

(39:14): Just the way I think about our seniors, right? Who are unnecessarily suffering with dementia is that this it's the squandered resource. They are these people at the height of their wisdom and experience who are, are leaving society. And my job is to help bring them back into the fabric of society so they can be contributing to their families while women who are victims of domestic violence is a very similar thing, but almost just more awful to think about that. We don't know what the combination of asphyxiation. So if someone's being, this gets so graphic and Ugh makes me shutter, but someone who is being both strangled and having, getting traumatic brain injuries at the same time is really having severe detrimental effects on their brain. And we don't know what if progesterone is high. What if she's at a place in her cycle where progesterone is high or low or estrogen is high or low, and these things are happening at the same time and it's happening repeatedly, right?

(40:09): If this is something that ha occurs over and over again, what we see is that these women don't get the help that they need. We don't have the science going into what's going on. And then, because they have essentially a form of dementia, their social worker, who, whoever is there to help them, doesn't realize that maybe they're not working the plan. They're not following the instructions just because they're so overwhelmed and their brain isn't working any as well as it used to because of these injuries. So I really hope that, you know, as speaking to a female audience, there needs to be more compass. There needs to be more support for those who are suffering with dome domestic abuse. And we basically need to understand that they have a form of dementia. Structurally traumatic brain injuries are a very big deal, right? If you get hit over the head with a baseball bat, if you were in a car accident, if you've slipped and fall and hit your head and lose consciousness, even if you don't lose your con lose consciousness, if you have headaches or some sort of recovery time after this is a sign that you have inflammation in your brain, and there are things that we can do right away.

(41:17): Afterwards, we use IV N a D S choline, PSAL serum, high dose fish oils, high dose meth B12, and the sooner we can treat a traumatic brain injury, the better the, the potential that there will be significant recovery. So we talked about toxins, nutrients structure, and now infections. So therefore infections that really stand out here, what is herpes? So herpes. If you ever get outbreaks, whether they're cold sores on your mouth or genital herpes, you wanna treat this relatively aggressively. So I'm a naturopathic doctor, right? I got a big med per medication person, but when it comes to herpes and, and chronic herpes outbreaks, you wanna be treating that aggressively because that can trigger inflammation in the brain, right? We know that herpes kind of stays dormant in the nervous system. Well, whenever it gets retried, that is causing more inflammation in the brain. And this comes out of studies in Taiwan where there's big epidemiological data that showed that people who were treated aggressively with like a, an antiviral, a medication, a prescription antiviral had a lower incidence of dementia than those who had herpes, but were not aggressively treated with, with the pharmaceuticals.

(42:25): So we wanna be getting ahead of that, basically, making sure that those outbreaks are not happening regularly and work with your doctor, of course, on that. So herpes is one PGE GVAs is another. So this is oral health, making sure that there aren't infections in the mouth part of this is just geography, right? You, your mouth is pretty close to your brain. The other thing is that when you get, uh, many people will know that in dentistry, if you've had a knee replacement or a hip replacement, before you go in for a cleaning, you take an antibiotic. Well, the reason is because when you get that cleaning, it introduces those bacteria into your blood and it, that bacteria can then get onto that artificial joint and not be detected and create a, a big problem. It can also create heart disease. It can create cardiac inflammation, can lead to strokes and to cardiac events, and it can trigger the inflammation associated with dementia.

(43:20): So we want to make sure that our oral health, you health starts in the gut and the gut starts in the mouth. So this is really critical that we ha see, I think, a biological dentist we're getting cone being x-rays so that we're catching any insidious small infections in there, early on and effectively treating them. So we have herpes P and GVAs and Lyme disease. So neuro Lyme can be very debilitating. There's a lot of controversy in the field around Lyme, but my opinion is that that there's ly or co-infections present for anyone exhibiting symptoms of dementia, or Alzheimer's that you wanna aggressively treat that with a Lyme literate doctor and get rid of that once. And for all, a neuro Lyme can be very debilitating and also confusing because Lyme is the great imitator. So it looks like a lot of other things and will often go undetected.

(44:13): So anyone with dementia, I do screen them for Lyme and Lyme coinfections. And then the fourth one, many people are familiar with is COVID 19, right? So I know there are a lot of people who would not associate themselves with having dementia at all, but they've suffered with the brain fog following COVID and these viruses. And I think COVID was such a great illustration that it's really these foundations. And I would say it's stressors, structure, nutrients, and, and toxic burden that create whether or not we have balance in those, right? If we have balance the right amounts in the right places at the right times, we have the right amounts of things, then our immune system functions. Well, right. And these are the people who got COVID, but never had a single symptom. And then if we have a lot of imbalance in the system, these are gonna be the people who got COVID in either passed away, right.

(45:03): Unfortunately, or who suffered with long haul COVID right. There's alway already some sort of inflammation, some sort of imbalance. And then that virus comes in and the host that body, that house, that we're in succumbs to the perpetuating cytokine storms or whatever is next in terms of signaling that comes after that virus. And so we want to make sure we're getting that house in order those foundational pieces set. And also