Optimizing Epigenetics for Peak Cognitive Function

Heather Sandison, N.D.

Thanks so much for having me.

Kashif Khan

So, the work you’re doing, there’s genetics, the genetic expression, then there’s understanding environment, nutrition and lifestyle, everything around you. So, what do you think are those core factors that really affect genetic expression?

Heather Sandison, N.D.

Yeah, great question. So the way that we approach dementias is very much, what we’re aiming to do is, be comprehensive, right? Because what affects the brain, everything, it’s everything that’s coming in, how much is coming out, especially of the things that you don’t need or the things that are gonna muck up cellular function. So if we think about balance, that might be a synonym for health, right? Even a healthy brain needs to be balanced in terms of neurotransmitters, toxins, inflammation, lots of different things. And so what we wanna do is say, what’s the comprehensive, what’s the sum total of things that are gonna affect cell function in the brain. And I would argue that it’s toxicity, nutrients, structure, stressors, and then infections. And structure includes DNA, this is our molecular structure that sets us up to have like an Achilles heel, right? This thing that maybe will manifest as dementia can in fact start with a genetic predisposition. And I love what you said, like how you started this conversation. 

There are so many people that don’t want to know if they have a genetic predisposition to dementia, because they’ve been told by very well meaning providers or experts in field that there’s nothing you can do and the things that we can do, like an Acetylcholinesterase inhibitor like and Aricept, that these drugs, although we have them, they don’t work very well, so get your affairs in order, if you start to notice cognitive decline. And there’s even social stigma, right? That as soon as you notice cognitive decline, hide it, right? There’s nothing you can do and people are gonna ostracize you, or you’re gonna have to be sent to an old folks home. And this is the narrative that I am here to change because what we see over and over in my clinical practice is that the earlier we intervene. So if you know ahead of time that you have this Achilles Heel, that you have this genetic predisposition, then you can work harder. 

You can work harder than your neighbor or your spouse or whoever doesn’t have it, but you have the choice to start prevention earlier. And then the other thing we see is that those who have the genetic predisposition and then start to notice, “Oh, my brain isn’t working. “I would’ve remembered that number. “I would’ve been able to do that math in my head. “I would’ve remembered that person’s name or that address “10 years ago.” The second that starts to happen, if we can then, that can motivate us to make behavior changes, then we are in business. We can do a lot. I firmly believe that Alzheimer’s is optional based on what I’ve seen. Now, I would not have said that three, five years ago, I’ve just watched it happen over and over and over again clinically and prevention is hard to prove, right? And you certainly can’t do that in a handful of years, You need big long term studies to prove prevention. 

However, what inspires me most are the people with severe disease, severe dementia and we get their, I think of them like flowers we like, their head, even their posture is forward and they’re folded and they’re not verbal. They’re depressed, they’re anxious, they’re communicating with like, not always violence, but somehow like shaking and just, they can’t find the words, they can’t express themselves. And we see them like perk up and start to communicate and engage. And they’re not, even people with severe disease, we haven’t had anyone go back to work, but they are able to say, “I’m hot, I’m cold, I’m hungry.” And experience joy in life again. And so that quality of life can change. We can see reversal happening. And to be fair, I’ve only been doing this since I was trained by Dr. Brendesen so, there’s a lot of potential and possibility here, of course, for the people who don’t have the disease yet, but even for those who are already suffering.

Kashif Khan

Right and for those that are, I mean, you say it’s hard to prove prevention and first of all, there isn’t a lot of support for that either, right? Meaning that the studies aren’t designed that way, but in proving reversal in itself proves prevention. It’s the same thing. The mechanism of reversing disease is exactly what you do to prevent it. You’re saying I’m gonna get to the root and gonna eliminate that root, forget about what you’re feeling. I understand that’s the pain point, that’s the thing that you’re complaining about, but there’s something going on layers before that, that’s what you’re gonna work on and yeah, I agree that the clinical experience, the clinicians that are saying, it’s gonna happen genetically it’s because they haven’t understood that there’s other tools available. So that scientist is coming like trailblazers like you are building it and eventually it becomes mainstream and then everybody adopts it. But for now the toolkits are limited so, that’s what you get. So if I gotta find people like you. So now, to do what you’re describing, like to some people just sounds like that doesn’t even make sense, like how is that possible? So how do you actually put a plan together? Like what does it look like to manage somebody’s genetic expression and take them from where they’re at or prevent something from coming? What does that look like?

Heather Sandison, N.D.

Yeah, so, it’s funny ’cause people care like there’s nothing you can do. And it’s almost the opposite. There’s so much we can do, it can sometimes start to feel overwhelming. And so what we wanna do is create a plan, and this is a disease, as you kind of alluded to, that it doesn’t happen overnight. You don’t just get dementia. There are decades of degradation in the brain that then lead to the manifestation of memory loss or even personality changes or cognitive dysfunction. And so of course we wanna start as early as we can, but sometimes, and this is the way we actually design the trial that we’re doing in my clinical practice at right now. We just have two more data points to collect and then we’re done with data and then we’ll be published by later in 2022. 

And Dr. Brendesen had a very similar trial that they published in April of 2021. They took 25 participants with measurable cognitive decline. In our trial, we went down to MoCa, this is the Montreal Cognitive Assessment, and it’s a 30 point dementia scale. So we took participants with MoCas down to 12 so, struggling with activities of daily living, but still verbal, still able to put a sentence together. And this perfect score is 30. And so normal is above 26ish and in our trial, we took people with measurable decline, so between 12 and 24. And then what we measured over six months is what happens when we throw everything at it. So we do the medicine approach. We measure all of the tests. We look at the APOE44 genetics, we look at, their cholesterol of course like what a conventional doctor would do, but on steroids, thyroid testing, cholesterol testing, vitamin D testing, hormonal testing. And then we also looked these, what I was talking about earlier, these causal level factors, so toxic burden, and this toxic burden is, I think of it in like three flavors, like ice cream. 

Like you have mold toxicity, you have heavy metal toxicity and particularly mercury arsenic, cadmium lead stand out and mercury especially as the very neurotoxic. And then you have chemical toxins, things like Roundup, glyphosate, things like petrochemicals, parabens, PCVs, organ phosphates, that kind of thing. So we measure all three of them and then where they show up for people, we get rid of them. And that’s one of the first steps is making sure that we get rid of the things, again, that are mucking up the system in the cell that allows you to make enough energy. So we look at toxicity, we measure it and then treat it. We look at nutrient levels, we measure that and treat that. And then I use some nootropic support, which means it’s getting all of those building blocks to the brain that you need in order to have neurotransmitter function in order to have good neurogenesis. We also suggest that people get on and support them with health coaching to get on a ketogenic diet. 

So many times as we age, because we’ve been on a standard American diet maybe, or at least getting sugar carbohydrates every day for most of our lives, we, unlike our ancestors, we have that available 24 hours a day, seven days a week. And so we tend to consume a lot of carbs. And the way that we’re designed is really to go back and forth from burning carbs for fuel or sugar, for fuel, to burning fats for fuel. And over time, the brain can become less sensitive to, less efficient at burning sugar for fuel. So when we just switch the fuel to keytones, we get enhanced cognitive function. People also get the benefits of better sleep and better mood and weight loss if they’re looking for that. So there’s a lot of wins around that. Sometimes there’s a bit of a hump to get up and over, but we, again, we have the health coaching support that really is the hand holding that’s necessary. This is a hard program and right, I’ve only talked about two pieces, the toxins and the nutrients so far, and it’s a lot, it’s a lot for people to take on and so, I get that, and having enough support, this is a lot for somebody with full cognitive capacity to do so let alone somebody who has declining cognitive capacity or where we need to get caregivers involved and lots of people involved. So making sure there’s enough support that people can be successful is really important here and I also wanna acknowledge, like it’s hard.

Kashif Khan

Yeah, it is people, the behavior change element of things is, it’s one thing to be told it, first of all, what’s wrong and then how do I fix it? But how do I actually do it?

Heather Sandison, N.D.

Yes.

Kashif Khan

That’s very challenging. We should probably talk about that. But I wanted to ask you the one thing you said about APOE. There’s people here that, they know that it bad news thing, but what’s actually going on there? What is happening that people need to be worried about?

Heather Sandison, N.D.

Yeah, so APOE again like thinking about our ancestors, all our ancestors for the vast majority of human evolution until like this tiny blip and our recent history have had APOE44 status. So, that they express these genes and, or they had this genetic potential and APOE4 helps, it basically has it codes for cutting proteins in different places. And what happens is, the APOE and amyloid that gets formed more easily when you have this APOE44 genetic status it’s antimicrobial. So you can imagine that in a world that our ancestors lived in, where there were many more parasites, there wasn’t as much of a sterile environment as what we live in now, this was very, very helpful. To have more inflammation, a little more inflammation in the brain that helps, there was anti-inflammatory that helps with infections that we’re getting into the brain. Particularly if we only lived for 40 years, right? 

If we weren’t living into our eighties and nineties, then this could be really beneficial. We would have a brain and we would be able to live longer with this sort of defense mechanism in the brain. So the APOE44 status means that you create more inflammation, more easily, and you create beta amyloid plaques in the brain more easily when you have that genetic predisposition. Now, what we’ve seen is that, the statistics are essentially that the general population has about a 13% chance of getting dementia. And if you have that APOE44, two fours, one from your mom, one from your dad, then you have about a one in two chance of getting dementia. Now, if you have a three four, you have about a one in three chance. So a 30% chance, which is still of course, much higher than your 13% chance. And if that’s the case, then what I would recommend is seeing a Brendesen train doctor, as soon as possible if you know you have a three four, or a four four, and getting started on this plan, make sure you have no toxins, no metals, no molds, no chemical toxins. We live in a toxic world so I don’t want, you know there’s this crazy meat game thing that can happen here, where you get too obsessed with that. 

So, it’s doing the things that you have control over, right? And taking the steps that you can’t eliminate, or at least reduce that toxic burden as much as possible, doing that from your thirties and forties, so that you don’t have to worry about it, doing the damage and turning on that genetic potential of inflammation. And then treating infections, so we went through toxicity and then nutrients. Now stress is a big one and meditation the Kirtan Kria, the, SAA TAA NAA MAA, we have all of our patients. And then at Marama, so I have a residential care facility for the elderly, where we offer an immersive experience in this lifestyle and it’s because implementation is so challenging. And what I was seeing clinically was that most people get better and the ones who don’t just don’t have the ability to intervene or to implement. 

And so I created this residential care facility where people can come and just immerse themselves in it. And so every day, for 12 minutes, all of our residents do SAA TAA NAA MAA and there’s good literature supporting that this helps with cognitive function. It’s also really wonderful to watch because when people first move in, they can’t, they keep their eye one eye open to make sure their fingers are touching each other and then, as they do it day after day, they learn, you can see their brain is making those connections, those kinesthetic connections to get their thumb to hit their pointer fingers, great.

Kashif Khan

That’s awesome, and then, these people are blessed that they’re able to work with you directly in the facility and get access to this so then how about somebody that has the information, okay I know my APOE status, I know what’s happening or I’ve been diagnosed, even if they learn from you, how do they implement these changes? That’s the key thing that you kept saying it’s like, it’s one thing to know it’s another thing to understand. That’s the very beginning of the journey. Now you gotta start working on it. So what are the tricks or hacks that people can do to actually get themselves to do it?

Heather Sandison, N.D.

Yeah, such a good question. So I highly recommend working with a health coach and through Apollo, which is Dr. Brendesen’s company or through we have health coaches available that can support anybody anywhere in the world. I’m also working on a new project that we’re calling Marama at home right now and so I offer free webinars where people can come and learn about what we’re doing at Marama, learn from some of the mistakes we’ve made. Some of the issues we’ve faced to help support their loved ones at home. And there’s certainly a growing community of people who are looking for this information, compiling this information, teaching each other and learning from each other.

Kashif Khan

I know that, in Doctor Bredesen’s work, there was some mention of a unique vitamin E called Tocotrienol.

Heather Sandison, N.D.

Okay. So Tocotrienols are, that’s a name for vitamin E and vitamin E is an antioxidant and certainly important, one of the nutrients important in cognitive function. And, my opinion is that you wanna get mixed to cougher rolls is another word. So you don’t wanna get just gamma or just Delta. You wanna a mix to cough roll, which is what is present in foods and what your body needs to utilize.

Kashif Khan

So the intention is by taking this cocktail that you’re promoting antioxidative behavior, or is that what’s going on?

Heather Sandison, N.D.

Yeah, so well, you know really my primary message is that it’s not one thing. So to pick on vitamin E, I probably wouldn’t do that too much, but really go back, so like, what are all of my nutrients? Is there an opportunity to measure them? Can I get more vegetables in, that are gonna be highly nutrient dense foods? Can I get out the foods that are not as nutrient dense and or just full of carbohydrates, and then just really increase, this can help with the gut it can help with sleep, and a lot of the foundations are better when our diet is better then our energy is better and then we can get that foundation of exercise involved and then we’re getting better blood flow. So it’s really, I come from, a complex system science sort of perspective of we wanna make sure we don’t fall into that trap of being reductive, it’s like, what’s the pill to make this better. It just does not work that way. 

We have tried that, billions of dollars, and countless hours of very smart people’s time have been wasted, kind of going down that path for dementia. And what we find is that, about 75% of the time, based on the tupes Brendesen paper from last year, we can reverse dementia by doing this comprehensive approach. There was actually a recent, a small feasibility trial of nine participants out of Florida looking just at the ketogenic diet. And in six weeks alone, they were getting an improvement in cognitive function on their testing, in just six weeks getting them into ketosis.

Kashif Khan

That’s awesome. That reminds me that I’m in Toronto, right? So different country, the other side of the border, and Health Canada, the equivalent of your FDA, about, I would say a year ago, said that we have to start calling Alzheimer’s type three diabetes.

Heather Sandison, N.D.

Yeah.

Kashif Khan

And the interesting thing is that that was the first and last time you heard that in Canada. So the science or research that drove that conversation was there, but it wasn’t sort of picked up, nobody ran with it other than people like yourself, who already understood that that’s where things happen and how you actually get to the root cause. So, a lot of people have this challenge where, I get what you’re saying, it makes sense to me and I know you’ve helped people. How do I convince my doctor to work with me?

Heather Sandison, N.D.

Yeah, so that’s, I hear you, that’s an uphill battle and I think if you’re talking to a doctor that, is telling you, “No, don’t listen to them, “there’s nothing you can do for dementia. “There’s not enough science.” I mean it’s a fair criticism that there isn’t enough science and where we are is that we’ve done feasibility trials. The reason that this wasn’t done 10 or 15 years ago is because the IRBs or the Internal Review Boards who are very, this is, I applaud this, right? Like, there’s nothing wrong with this. But IRBs are set up to protect human subjects in any research. And the IRBs were in a place 10 and 15 years ago, even until like five years ago where they did not approve research trials that had so many factors in them, they want their variables limited. And so this is a place where, and we see this in a lot of, this is that reductionism, right? So we’re reducing down to one pill, we wanna change one variable and our, I mean, this really applies not just to medicine, not to just to dementia. 

This applies to diabetes, this applies to autoimmune disease, this applies to government systems, this applies to financial systems, this applies to education systems, right? When we try to get reductive, when we’re talking about a complex system, we’re not gonna find solutions. So this is a place where the science and the model of, there’s this hierarchy of double blinded, placebo controlled trials. And that model, doesn’t serve us. It doesn’t allow us to find the of solutions that we need for these more complex diseases. It helps if you have strep throat and you can compare an antibiotic to a control, and some people get better and the people in the antibiotic get better and the people that don’t don’t. 

But if you have dementia, which has, can be from blood sugar dysregulation, like you suggested, type three diabetes is another synonym for dementia. But I would also say that’s an oversimplification. Because you can have perfectly controlled blood sugar, but have low hormone levels, or you could have had a traumatic brain injury, or you could have an infection like herpes or pygemnalis in the mouth or Lyme disease, and that can trigger enough inflammation in the brain that you start to have cognitive disfunction. So, we don’t wanna, I think, although many, many, many people would, and most, I would say the vast majority of people would benefit, from getting into ketosis, from having that metabolic flexibility of going back and forth from burning fat for fuel, to burning sugar for fuel. That isn’t going to solve all of it. And so, yes it’s a lot.

Kashif Khan

Sometimes yeah. It sounds like, the kitchen sink approach, sometimes it’s like, no, let’s figure out what in that pile work, but that’s not, you know when you’re dealing with something as complex as dementia Alzheimer’s, your brain, you’re losing your brain. It’s the multi factory approach. That’s what it is, that the truth is that there’s many things hitting you on many fronts, you gotta deal with them. And then there’s the gap between, men and women and there’s an organization up here in Toronto called The Women’s Brain Health Initiative. And they do a really good job. They raised a lot of money to help gear research towards women because, I think it’s something like 80% of the research dollars are spent on men, but 70% of the cases are in women. And so, we’re not solving the right problem, right? So, do you have any insights into, is it a hormone thing? Is it, why is it that so much more prevalent in women?

Heather Sandison, N.D.

Yeah, such a great question. So there’s a few factors, a handful of factors, and I probably won’t have a comprehensive list of all of them, but certainly there’s a hormonal component and estrogen and progesterone and testosterone all of our sex hormones, are extremely important for cognitive function and for signaling the brain to make new neurons, right? These hormones are associated with youth. Imagine like when your hormones are raging and that they’re highest, this is like your teens and twenties. And this is when you’re learning so much, right? This is typically when we’re in school and we can take on new things and that is what we want to, you don’t need to go back to being a 19 year old male, but you can increase, we can increase our estrogen and progesterone and testosterone and DHE, and pregnant hormone, in our, for women in these postmenopausal years, and, if you talk to postmenopausal woman, who’s struggling with cognitive decline nine outta 10 times she’s gonna say yes, when menopause hit, that was a big shift for me, there was a massive hormonal component to what was going on. Even hot flashes. 

So hot flashes happen because there’s not enough estrogen getting to the part of the brain that regulates temperature. And so women will swing from hot to cold and hot to cold. And then this, I mean, it’s just such a great illustration that this is the effect of estrogen on the brain and having very real impacts on how you feel day to day. And so we can’t just think that like, oh, these sex hormones only work in the torso, they absolutely affect the brain. And that shift, that dramatic shift with menopause is a big one. So, everyone needs to work with a doctor and I would say, if you’re working with a doctor who’s telling you that this isn’t real go find another one. And there, Dr. Brendesen on his Apollo site has a list of doctors who have been trained or you can Google like Brendesen trained doctor, and I’m sure wherever you are, hopefully, I know that they’re working on training as many people as possible, but finding somebody who’s been trained by Dr. Brendesen who’s aware of this and familiar with this and can guide you through the risk benefit analysis of replacing hormones. So did do that with all of our study participants. 

We replaced hormones when they were low and certainly many of them anecdotally, say adding the hormones makes a big difference. It also helps, because muscle, building muscle is that sends signals to the brain BDNF and trophic factors, lots of things that are important in the feedback loop. And if you have energy, which is associated with those hormones, if you’re able to build more muscle, which is gonna happen with the addition of certainly testosterone, then you’re gonna get more of those benefits for the brain, this becomes a self perpetuating cycle in the right direction.

Kashif Khan

And that just, it goes right back to what you’ve been saying all along that it’s not any one thing, you have to be multifactor. You gotta look at all of it ’cause even within one person, so you may have this dashboard, if you look at it like digitally here’s the 10 dials that we need to turn, right?

Heather Sandison, N.D.

Yeah.

Kashif Khan

And you may be low where somebody else is high, but you still have the same outcome, ’cause there’s so many other dials to look at. So, really gotta work on all them, there’s testing you can do to understand where you’re at so you know where to focus. So what would you recommend to people in terms of where do I start? What test can I take to know what my priority should be?

Heather Sandison, N.D.

Yeah, great question. So Dr. Brendesen wrote a book in 2017 called “The End Of Alzheimer’s.” He also has a couple of follow ups. One is “The End Of Alzheimer’s Protocol.” And the other is “The First Survivors Of Alzheimer’s” where he interviews, and tells the stories of people who have reversed their dementia.

Kashif Khan

Amazing.

Heather Sandison, N.D.

And so, those three books are very insightful and particularly that first one in there, there is a list of all of the labs that he recommends doing. And you can even sign up for his program called “Recode” or “Pre-code.” So Pre-code for those that wanna prevent and then Recode for those who are looking to reverse cognitive decline and you can get labs directly through them and they put them into an AI generated Recode report that then gives you suggestions. And that is a fantastic place to start. So either the book itself and just reading the book, getting into ketosis, doing what it says, I’ve had patients show up in my office who have done that, gotten phenomenal benefit, and then they wanna take it to the next level, by getting all of the comprehensive testing done and working on those pieces. And then there are other people who just, read the book and that’s good enough for them. Other people get on the Recode subscription and in their program and that works really well. Some people hook up with a health coach. There’s lots and lots of resources and options and whatever works for you so that you’re implementing as much of it as possible at home is the best thing.

Kashif Khan

You know, when I’m listening to you, it’s obvious that you have a passion for this. I mean it’s not just, we are at work, it’s what you live and breathe. But also you said that this is fairly it recent for you so prior to this, what were you doing in medicine? I’m just curious.

Heather Sandison, N.D.

Yeah, so I’m a naturopathic doctor. I was trained that way and I was always interested in sort of how to organize ourselves around health and there’s a lot and it can feel a bit overwhelming. And I had this tension of kind of going back and forth between telling people to do a lot, but having them feel overwhelmed and then kind of paralyzed by that and then not telling them to do enough and then they weren’t getting the outcomes that we were hoping to get. And I, again, like I come from this complex system science background, so I heard Dr. Brendesen speak at a conference probably in 2016 or 2017 and I had heard, from well meeting instructors, that there was nothing you could do about dementia and that to suggest otherwise was really to do harm right? To mislead people and to give them false hope. 

And so when I saw him speak, his complex, he was taking this complex system science, comprehensive approach, it made sense to me, it made common sense to me that if you could up-regulate cell function in the brain, you could reverse the disease and again, I’m a naturopath so I believe that everybody has the ability to heal. That’s kind of like our superpower. And so I saw Dr. Bredesen’s talk, I was intrigued but skeptical. So I went to his training and then when I got back from the training, I was on the list. So then now patients were coming to see me. I had been doing a lot of women’s health, some complex disease, some like neurohacking, biohacking stuff that was intriguing. And then once I was on Dr. Bredesen’s list, I started seeing dementia patients. And I was, I think the only person in San Diego at that point trained and the first patient I saw, Linda, came in with a mocha of two. So on that 30 point scale,

Kashif Khan

Wow.

Heather Sandison, N.D.

She was very progressed. I would ask her a question and I could see the real spinning. And I could see that she heard my question and understood it, but she didn’t have the ability to remember it long enough to give me an answer.

Kashif Khan

Wow.

Heather Sandison, N.D.

Really simple things, she could say yes or no to, her handwriting had been affected, but you could see like, you could see her personality. There was, she had like really loud clothes and this big smile, and her husband was very committed to this process. And so we sat down and we laid it all out. I recommend they change their diet, have her dental work done, they started ballroom dancing. They moved out of the moldy home. They got her on hormones and all of the supplements that I recommended. And then I saw her seven, eight weeks later, her mocha was a seven out of 30 instead of a two out of 30. And her experience of the world was so different. Her handwriting had gone back to normal. She was bickering with her husband about something that had happened the night before, which like, I was just in disbelief, like I was like, did we do something wrong like last time? What happened? And they were like, “No, we just did everything on the plan.”

Kashif Khan

Incredible.

Heather Sandison, N.D.

And I couldn’t believe it. But I remember like what I was wearing, I remember the whole day so, it was just one of those moments where like my whole life changed. Because, watching what happened to Linda and seeing what was possible for her when she had a mocha of two, well then what’s possible for everybody with a mocha of 19 and 20 and 25, we could, especially when you, I have seen so up close the suffering that comes with this, like awful torturous disease. There’s a reason a lot of people don’t wanna talk about it before it happens is because you wanna just ignore, like you don’t wanna even go there. And so, it’s awful, I mean it’s financially bankrupting and it’s emotionally bankrupting, It’s physically exhausting to care for someone with dementia. And so if we could do what we did for Linda, but do it sooner, do it less expensively, put a little less effort in, but prevent this from happening.

Kashif Khan

Yeah.

Heather Sandison, N.D.

Like that changes the world.

Kashif Khan

Yeah and people take for granted not of their own doing or fault but, what we’re taught in terms of how do you, what’s your relationship with healthcare? It’s that I can do whatever I want. And when I break myself the doctor will fix me and there’s somebody else has to pay for it. I’m insured by an employer or whatever it may be in Canada we have, a government one single payer that pays everybody’s bills. So, that conversation, how do you speak to somebody about, or what would you tell people here in terms of waiting to get the thing that your insurance company will cover? Cause how often do you hear from people that, “Oh, that sounds amazing “that’s what I need. “it’s not covered by insurance. “I’m not sure.” So how do you have that conversation with somebody who’s not understanding that the thing that they don’t wanna pay a couple hundred dollars for may be the reason why they go literally bankrupt in 20 years.

Heather Sandison, N.D.

I know it’s, I mean this is so challenging and this is part of why I mentioned, like the way that we’re solving problems and this reductionistic way, whether we’re talking about the healthcare system as a whole, or we’re talking about the financial system or pharmaceutical companies and insurance companies and the food industry. I mean like you wanna talk about root cause. Let’s go figure out like what we feed ourselves and what’s available, what’s inexpensive, what’s subsidized, what’s not. There are really big problems in society, right? We’re not making ourselves healthier. We’re making us ourselves sicker. And even just in how much we work, how much we overwork, and what we’re driven to do and how we spend our time and these solutions, they require the wisdom and experience of our elders. And so that’s another kind of piece of this that drives me, is that we need them on our team helping us, we can’t just put them in elder living facilities, parked in front of TVs, eating cake and cookies. 

That does not bring them back into the folds or keep them in the folds of society where they can contribute. And so, it’s so heartbreaking to me to have someone say, I can’t afford this and I want to get them, I wanna help as many people as we can. But I think focusing on the parts that are free, those foundational pieces and many of the things that are covered by insurance, like a sleep study, if you have sleep apnea and you have cognitive dysfunction, number one thing to do is treat the sleep apnea and that can be done through insurance. Changing your diet, it takes some effort and it takes new recipes and maybe a new grocery store going down different aisles, picking out different things. It takes some effort, but that, you gotta eat, right? So just changing what you eat can have a big impact. Making enough time for sleep. Meditation is free. Exercise is free. Those foundational pieces will do a lot of the heavy lifting. And then, as you work those things in, then hopefully, if you have more earning potential because you’re healthier. Then some of that can be invested back into this long term kind of health trajectory and using the labs, using the tools that cost money yes, but using those tools in a highly leveraged way.

Kashif Khan

Yeah we find that, so like everything you’re talking about, the meditation and sleep and all these things, as you start to develop habits small and slow, the challenge is when you try and flip everything overnight and just, you’re not gonna be a different person when you wake up the next day. So you implement these changes and then you get to a point where all of a sudden you do become a new version of yourself and your identity has changed and you aren’t that old person anymore and you understand that the way you prioritize your spending is also a change and it becomes intuitive, right? It’s just part of who you are. But, knowing that the months that it takes to get there, versus the years of pain later, it’s a very small trade off. 

So people, as long as you can understand that it steps to get there and that day will come where you wake up and you’re a different person. And then all of a sudden it’s permanent. When you were speaking of Linda, you made me think of something where, one of her triggers was the mold. And the funny thing is that prior to talking to you, there was nothing else that triggered her to think about the mold. And when you look at United States like regionally, there’s certain cities that are like hotspots. I have a friend who actually works with us. He’s a plastic surgeon that actually sells some of our tests who says that Austin where he lives is a hotspot for mold. So how many people-

Heather Sandison, N.D.

Houston, New Orleans, the places where there’s been hurricanes and floods.

Kashif Khan

Exactly. So how many people entail and it’s kind of like what we’re saying about health until something hurts, you don’t go to the doctor to ask why. So how many people are living in mold don’t even know and what should somebody do today to find out? Like they may not even realize that there’s little brain fog and pains and things that are happening that are gonna turn into something worse later. And it’s a simple fix.

Heather Sandison, N.D.

Yeah. So, well, not always a simple fix, right? Because living in a moldy environment, it can mean a move which can be a lot, especially if you don’t feel well. And molds is relatively ubiquitous and some people are more sensitive to others. And so there’s a spectrum of how intense you wanna intervene. And, what I don’t wanna do is scare people about naturally occurring mold and suggest that we need our mold exposure to go to zero. Humans evolved on this planet, exposed to lots of mold. What happens is when you’re exposed to toxic mold or toxic water damage buildings. So as the building materials like drywall starts to decompose, there’s a lot of chemicals in there. There’s also fungicides in the paints and in the building materials that then make the molds more toxic. 

And so if you are in a water damage building and you have the resources, get it dealt with for right away, and it’s certainly at Marama, like we had a dishwasher that leaked. We had a gasket that came off the shower and then leaked into somebody’s downstairs closet. And like, these are things we get on them immediately. We do not cut corners. We do not worry about costs. We tear out the drywall, replace it within 24 hours, make sure it’s dried, go back and look two, three, four weeks later, make sure that there’s absolutely no mold growing. So being proactive about this kind of thing, understanding that it is a risk and instead of, going to like, “No, it’s not a risk at all.” What we see is really insightful from the animal husbandry industry. So, there’s a lot of financial incentives here. If you’re a landlord and you own a apartment building, or if you own a house and you have tenants in there and they’re complaining about mold. You don’t wanna get sued. 

You don’t wanna spend a lot of money replacing or getting, or doing all this stuff ’cause that there’s financial repercussions from that. If you are somebody who owns sheep or cows or chickens or horses, or something that’s livestock that’s going to market and needs to be fertile and needs to be healthy, well then you are highly incentivized to make sure that there are no mycotoxins in those animals. And so this is like a trillion dollar industry to get mycotoxin out of mammals that we then consume for whatever reason. But when we talk about humans, there’s this big question mark. “Oh, well maybe molds isn’t that big of a deal. “Maybe mycotoxins are not “actually causing any sort of problem.” But CellCept, CellCept is a medication that is used in Rheumatology, just to suppress the immune system. Well, it’s a microtoxin just in a pill. So we know a scientific certainty that CellCept reduces immune function and that that microtoxin, which we can measure in people. It is sometimes present. And so we, it depends who you’re talking to and what the answer is, is what’s convenient for them. 

From my perspective, as a doctor whose ultimate responsibility and priority is my patient’s highest health, I think that reducing mold exposure and mycotoxin exposure and then increasing our body’s ability to get rid of those toxins is the highest priority. And so there’s some easy and free ways to do that. One have a bowel movement every day. If you’re not, talk to your doctor and figure it out, that is, it’s not healthy to be constipated, which is at at least one bowel movement every 24 hours. And then drink plenty of good high quality filtered spring water that comes from glass, stainless or ceramics, not from plastic. And so get your kidneys flushing toxins out of your system, make sure that you don’t become dehydrated ’cause then you’re not gonna be able to flush things out. 

And then your liver, so good liver supportive foods, things like artichokes and beets and dandelion and arugula, those, all of the leafy green veggies eating plenty of garlic and onion that have those sulphur compounds that help you make . Just eating the rainbow of foods so that you have all of the nutrients that are necessary for you to properly to detoxify. And then getting exercise and blood flow and sweating, dry skin brushing, bouncing is really helpful for lymphatic movement. And then breath work, detox breath work. So again, meditation can kind of overlap with doing really intentional breath work. This is why, if a cop pulls over somebody they think is driving, they can give ’em a breathalyzer test, because we exhale toxicity, we exhale toxins and we can amplify that with certain techniques and get rid of more toxins that way. And that might not specifically be a mold toxin, but if we can reduce the total toxic burden in the body, then our cells function more efficiently.

Kashif Khan

And you remind me of a clinician I once spoke to who literally her whole focus was getting people to have the proper and right volume of bowel movements because she said her patients would come into her, after having measured and found out that they had some heavy metal issue or some kind of toxicity in the blood. And then they would get to a detox program, and eating, changing their diet, whatever it was, they were supplements that they were taking. And what she would say to them is if you’re not eliminating, where is it all going? So you can take your supplements and some kind of pill that says detox on it. But if there’s no movement, then where is it going? Nothing’s happening. So that’s a key item where it’s kind of like before you turn on the valve of flushing toxins out, make sure the door’s open.

Heather Sandison, N.D.

Exactly.

Kashif Khan

It’s got nowhere to go. So, with all this, what you’re doing, I’m sure that anyone listening is like, “Well I wanna work with you.” Somebody in my family had it or I’m tryna prevent it, so tell us about, what your work looks like and what’s coming up and where you’re gonna be, what are you gonna be doing with all this?

Heather Sandison, N.D.

Yeah so, we have Celery is our clinic in San Diego and the doctors here are all licensed in the state of California. So if you’re outside of California, we welcome you to come visit sunny San Diego and established care with us here. And, or if you’re in California, we can do that ’cause we’re licensed here in the state and then we can get you set. We have a wonderful team of well trained, Brendesen trained doctors. And then at Marama, if anyone is interested, has a loved one where they don’t feel like they have the capacity to do it all at home, our Marama facility is here in San Diego and it’s Maramaexperience.com. Carrie is our director of operations over there and she can walk you through the process and answer any questions. And then, our Marama at home program, if you just sign up for the email list on the Marama website, then you’ll get emails about what’s coming there and how to access all of those educational materials.

Kashif Khan

Great. One thing I should ask you for everybody’s benefit is, you are pioneering this work, like if you go talk to 15, 20 doctors, it’s unlikely that one of them will be able to speak to this the way you do, right? Because you’ve dove in and it’s a passion and you know it and you can help people and you’ve proven it already like met with actual metrics like you empirically measured and proven that numbers have changed. So with all that you see and you know these tools are real and you’re kind of in the community of people that are doing it, how do you see this? What does medicine look like in five or 10 years? What does it look like in 20 years? Where is it going?

Heather Sandison, N.D.

I love this conversation, because this is, I feel like we’re like the people thinking about the iPhone in 1995, like how do we reimagine aging and how do we create a compelling future around this? And I think it involves community. It involves engagement. It involves meaningful relationships, meaningful contribution. And we need our cognitive capacity for that. And so I think all of us deciding collectively together that like, we’re not gonna eat that crappy food that like what they sell in the 7-eleven like no, like that is not okay. And that we need to have warning labels on McDonald’s food and warning labels on Cokes. Like this is, we’re we are allowing, so like, as collectively we’ve said, it’s okay to harm our environment and to harm our bodies by like this slow drip of toxins and creating foods that are not nutritious. 

And by overwork and by creating social media that drives our brains, it sets us up for depression and anxiety, which is associated with later dementia. Overwork that prevents us from sleeping enough, which is through our thirties and forties, which is then sets us up for more dementia. So if we can collectively say like, Hey, no, we’re not, we will not tolerate this anymore. Then I think we, like we start to imagine a future where we are healthier and we are living longer. There’s a gentleman he’s at Harvard Davidson Claire, yeah I’m sure you’re familiar with his work because a lot of that has to do with how do with, how do we get the genome? How do we get our genetics to stay healthy so that we can live 150 or even beyond which is totally wild to think about. But if we’re gonna do that, we need our health. We need our health and these foundational pieces and the way that we build our communities are this collective consciousness around what health means is pretty important, really important.

Kashif Khan

That’s awesome. I feel like you’ve reversed dimension me just by listening to you for an hour because of the stimulation of my brain and all the neuroconnections developing that take all this in. It’s awesome. This was really a blessing to be able to speak to you and for everyone listening, Dr. Sandison, she’s given you an ability to reach out to her and work with her if you’d like but, dive in, get into the materials, read the books, go to the website, study, learn, understand that this is not what we think it is that I don’t wanna know if Alzheimer’s is coming ’cause I just rather enjoy my life and not have anxiety for 20 years. No, what you should know is that it’s coming meaning it’s time to get to work and start working on it, prevent it because you can, if you can be two out of 30 on that scale and make a dent and an impact on that person, if you are at 30 right now, let’s just keep you there. That’s what you were born. That was your sort of God-given gift. That’s what you were born with now just keep it, maintain it and with the science that you have it’s possible. Highly possible. So thank you for joining. This was truly mind opening, eye opening, mind blowing and I hope everyone enjoyed it. Thank you.

Heather Sandison, N.D.

It’s been such a pleasure. Thank you for having me.