4 Stages to Getting the Right Nutrients for Brain Health

Introduction to Dr. Heather Sandison 0:00

Welcome back to continue a conversation on Reversing Crohn's and Colitis. I'm your host Sinclair Kennally. And today I am joined by the wonderful Dr. Heather Sandison. She is a dear friend and a guiding light in the neuro health field right now. And this is huge. She has tackled one of the scariest topics of our time, which is neurodegenerative issues, and she has such a message for hope for us, and also is here to help us make those underlying connections between gut health and brain health in this crucial way.

So I'm just going to tell you a little bit about her and why I wanted her to share with you today. She is a naturopathic doctor specializing in Alzheimer's disease and related dementia. She's the founder of Solcere Medical Clinic, San Diego's premier brain optimization clinic, and Marama. the first residential cognitive care facility focused on recovery. Imagine that right through a combination of diet and lifestyle therapies, cognitive interventions, and comprehensive support, Marama offers an effective approach to Alzheimer's care.

The programs emphasize personalized treatment plans, brain healthy meals, physical exercise, sensory stimulation, engaging activities, and cognitive therapies. The dedicated team of health care professionals go beyond traditional care, emphasizing a person centered approach that promotes dignity, independence, purpose, and, most importantly, improvement. Dr. Sandison is also create an 11 week Reversing Alzheimer's course for individuals and caregivers to learn how to implement the same protocols used.

Marama. She's committed to advancing research and innovative approaches to Alzheimer's and cognitive decline management, providing hope for patients and families. Her clinical trial observed improvement in cognition during a personalized lifestyle intervention in people with cognitive decline was published in the Journal of Alzheimer's Disease in August 2023. Her highly anticipated book, Reversing Alzheimer's, has literally just published recently. Welcome, Dr. Heather, it's so wonderful to have you here.

So happy to be here. Thanks for having me. Yeah. So let's just dive right in, because this is such an area of passion for you. And this is such an exploding problem, right? If, just as we've seen gut conditions explode in the last couple of decades, we've also seen cognitive decline, you know, with a similar trajectory. It's really scary. how would you describe the what you have seen in this field?

Lifestyle Research and the Gut-Brain Connection 2:34

How is this, you know, taking shape over the last couple decades? Yeah. You know, my training, I was told there was nothing that you could do for Alzheimer's. That to suggest that there was something that we could do as naturopaths would be to give people false hope and that that's been completely turned on its head. My clinical experience through the my work with Dr. Bredesen, learning from him, working from other people and with learning from other people in the field. What we've seen is that actually to suggest there's nothing you can do for Alzheimer's that's factually inaccurate and it's false hopelessness, really.

This is we've gotten to a point where it's like almost overwhelming how much we can do to prevent delay and in some cases, even reverse the cognitive decline process. And I know that most people are here because we were interested in gut health, Crohn's and Colitis and gut inflammation. And these are intricately related. Right? I want to really dive in with you today on why the gut and the brain work together, how they work together, what we can do to optimize that. But I out of the gate here, I really want to touch on some of the most recent research.

This isn't even in my book that was released last week, because this paper was released just a couple of weeks ago in early June of 2024, and it was Dean Ornish, his work. he did the first randomized controlled trial, for people with mild cognitive impairment or early dementia. And the conclusions that they came to after just 20 weeks or five months was that in this randomized controlled trial, right, there's a control group and an intervention group in the intervention group, they saw that comprehensive lifestyle changes significantly improved cognition and function.

After just five months in patients with mild cognitive impairment or early dementia due to Alzheimer's. This is a really, really exciting time in this field because we're seeing over and over again through the literature what I published, what, the group, around Dr. Bredesen published in 2023, my patient paper was published, and then their paper was published before that in 2022. The reason you bring up the Ornish paper is because one of the things that they measured was the microbiome, and the microbiome improved only in the intervention group.

So we see these lifestyle factors that improve cognition probably are at work because they improve the microbiome and the gut. Right. Health starts in the gut. And so these again like these things are intricately intertwined. I want to go into them. But I wanted to just start by saying there is real research out there showing that there's a relationship between lifestyle and our cognitive outcomes as we age. This is so huge. And I'm so excited about your book and the way that you have demystified this for folks.

You did amazing job of talking about different lifestyle factors and of course, you're going to deep dive into nutrition today and those lifestyle pieces that relate to gut health. Can you explain for the audience, you know, the link between chronic inflammation in the gut and Alzheimer's disease and cognitive decline? Like, let's just connect those dots first off. Sure. So when we have chronic inflammation, there's essentially lots of mechanisms at play. But when we're when it comes to diet and and and digestion, right I think of this in four phases.

First we have to choose the right things to eat. That's step number one. And we can be eating all the right things. But if we have a porous gut, if we're not digesting, if we don't have the right amount of digestive juices because we're stuck in a fight flight freeze state, instead of getting into a rest digest and heel state. If we don't have enough digestive enzymes, if we don't have enough hydrochloric acid, then we're going to have these big chunky molecules basically hitting that part of the gut that villi, that, that that surface area that's responsible for absorption.

And so then if we have an inflamed gut and we have, I think of it like a promiscuous barrier, right? We have we're just letting everything in. We're not being selective about what's allowed to get across.

Inflammation, Digestion, and Gut Repair 6:29

We're essentially glorified donuts. Right. So like we have this hole in the middle. And if we're letting the everything into the actual organism, into our body, through that membrane in the gut, then we're going to get things in that are going to create systemic inflammation. So step one choosing the right thing. Step two can we digest it. Step three can we can we select to absorb the right stuff and not the wrong stuff. Right. So can we absorb and assimilate the nutrients so that they serve us.

And then step four arguably most important can we eliminate what doesn't serve us. So digestion happens in four stages. And what we're talking about when we talk about inflammation are these middle two. Do we are we able to digest and then absorb and assimilate. And when we have a lot of inflammation in the gut, we create a leaky gut. So when we have those cells are kind of puffy. Now we don't have those high integrity membranes keeping the cells together. We're less selective about what passes through.

Now we have systemic inflammation. Gut inflammation can most commonly caused by alcohol consumption. Gluten directly can increase inflammation in the gut, in the gut. Stress can increase inflammation in the gut. And then we've already touched on the microbiome. So too many antibiotics or even just taking antibiotics even when they're necessary, not repopulating. Having an imbalanced microbiome can create inflammation in the gut. Many, many other things can as well. This is not an exhaustive list, but this is a very common list.

These are the things that I think most commonly impact inflammation in the gut. Yeah I think that's a great summary. So in your mind, obviously we take everything starting in the gut and you and I are obsessed with that. How should somebody be thinking about protecting their cognition if they are stressed about the state of their gut health? You know, you've established this link so beautifully. You know, with the emerging research, you know, if inflammation in the gut issues in the gut are absolutely linked to cognitive decline, what do people need to know about this relationship?

And then we'll talk about what they can do about it. Yeah. So we made when we think about brain health and any complex chronic disease what's going on is imbalance, right. There's too much too little in the wrong place at the wrong time. So I think of this framework, okay, balance of any complex system, whether we're talking about education systems or financial systems or government systems or the brain or the gut, these are complex systems. And what we need is homeostasis, emic balance. It's not going to be the same 24 hours a day, 365 days a year.

But what we want is this ability to fluctuate for things, for hormones to go up and neurotransmitters to go up and then down and to metabolize them, and for things to come in at breakfast and then move through our gut. Right. We have these rhythms and what we want is homo dynamic balance within that. Now what throws it out of balance? Too much, too little in the wrong place at the wrong time creates dysregulation and dis ease. Now I would describe basically there's six components of brain health but really whole body health at a causal level.

Toxins, nutrients, stressors, structural issues, signaling and infections. These are the six things that I would put in that causal level category. When they become out of balance, they create disease. And so as we think through the gut, nutrients are what comes up very paramount. Right? If we don't have balanced nutrients, if we're not able to choose the right things and absorb them, assimilate them, digest them, and then eliminate the pieces that don't serve us, we're not going to have the right nutrient balance, a protein our brain, but also our bones and our heart and everywhere else.

Right? We can apply this to the entire body. And so when it comes to healing the gut, you know, I like to start at the top, but like, are we eating the right things or do we get enough of the right things into our system so that we have the substrate to create fuel, to heal, to repair, to detoxify? And I'm a fan of the organic I an organic ketogenic diet getting into ketosis seems to have phenomenal benefits for the brain. It also happens to be a Candida diet, so it helps with the microbiome. When we eliminate carbohydrates.

We stopped feeding the yeast in our gut. And that can be, I think, changing our diet when it comes to the microbiome, a significant change in what we consume in terms of food, it can lead to a significant change very quickly in the microbiome. And so and we can yeah, we can do probiotics and we can do all kinds of things. But I think diet is the biggest game changer. And of course fermented foods if you can tolerate them. I know a lot of your listeners suffer with sensitivities and mast cell issues.

So, you know, as I throw out these ideas, of course, do what you can tolerate. But aloe aloe juice is one of my favorite things. It tends to be very well, tolerated and it's food is medicine. Right. And you can get I, I can talk about brands. Yeah. Go ahead. The lily of the desert. This is available in both health food stores in an amber bottle. And you can get the one. The glass one doesn't have preservative in it. And that just an ounce of that as a shot on an empty stomach in the morning is so soothing.

If you think of putting aloe on a sunburn and how quickly it helps your skin to heal, we're essentially doing that to the gut lining, which can help then with assimilation, with absorption, and with the integrity of that tract, the the GI tract. So choose good things. Organic ketogenic diet, support the gut. Maybe consider taking some enzymes that can help to lower systemic inflammation. Also help us to absorb, to digest, and then absorb good nutrients and then make sure you're having a daily bowel movement that is just so crucially important.

The liver's part of the gut. We can talk about detox, we can talk about the gallbladder and getting bile flow moving. We can go in so many different directions, but, I'll let you lead. Oh that's excellent. And, you know, I'm so enamored with the liver and the gallbladder, and these are like, the unsung heroes, I think, of the digestive tract. So I would love to unpack that a little further with you, please. What do you think is most important for people to understand about those organs? Yeah. So intrahepatic recirculation right.

They said that this is a big fancy word that basically says if you don't have a bowel movement, if you don't eliminate every day, part of the gut's job is to absorb nutrients. And so we're going to absorb things that are sitting in the colon. And if it's meant to be, but pass if you're meant to get rid of it, but it's still sitting there because you're suffering with constipation and not having regular bowel movements,

Liver, Gallbladder, and Detox Support 13:10

you can reabsorb these things and it'll go back to the liver. And now the liver's got to take out yesterday's trash. In addition to today's trash, we're asking it to do extra work. The liver. This is very expensive. It requires a lot of resource and nutrients. And so having enough of the phase two nutrients in particular is really crucial to positive to getting the liver, to continue to detoxify, body. Thank you. I know you said enamored. I just have so much reverence for the body and the liver in particular, because it'll stop phase one detox if we don't have enough nutrients for phase two detox.

And this is just divine design because it's so intelligent, I just can't like it. Blows my mind. Right. But the the body is so intelligent. Those those intermediate steps that that secondary metabolite after phase one detox is often more toxic than the initial thing that we ingested. And so the wisdom of the body is to just go ahead and halt, to detox altogether. But what we can do is we can add nutrients like NK milks. This all can be helpful with the liver in general, but B vitamins, minerals, all of these can help us to continue phase two detox, continue phase one detox and then create that bile, that toxic sludge.

I love fat little choline to help move the bile along. There's bile salts can be helpful sometimes. There's lots of things that we can do here. there are herbs that I know that you probably get into throughout this conversation with other people, but there's just a lot that we can do to support this process. Some liver casserole packs over the liver is another really fun one that can feel very, just healing and soothing and like, taking time for your self-care. There's so many things that we can do to to support good, healthy digestion all the way from what we choose to put in to, you know, along the way the absorption and assimilation, the digestion, absorption, assimilation, and then that elimination of the toxins that no longer serve us.

This is so good. And since we've opened the door to the liver and gallbladder, I just would love for you to quickly answer for the audience. What does supporting the liver have to do with protecting ourselves from cognitive decline? Yeah. So does it matter so much? I'm trying to get them to do their homework. Yeah. I'm so really. So you know, imbalance rate too much, too little in the wrong place at the wrong time. The first thing that I list in terms of a cognitive health is from a causal perspective, is toxicity.

One of the reasons that I list that is because there's so much we can do about it. Right? And the liver is one of our detox organs. So I don't want to get a I want to create frameworks and ways for people to organize this in their brain. So get out a notebook maybe. But remember we have our six causal level factors or a six components of brain health toxins, nutrients, stressors, structure, infections, and signaling. And so we talked a bit about nutrients, right. And how we make sure that the gut is working with us to make sure we have those balanced nutrients.

Now toxicity. When we think about toxins, it's related to nutrients because whenever we have excess toxicity, it requires more nutrients because it's work. If think of your brain, my mentor, doctor Dale Bredesen, he likes to talk about the brain as a country. So think of your brain like my brain is done. And if your brain country is at war, if it's defending against invaders like infections, or if you're defending against toxicity, you need more resources. This is why the president of Ukraine is showing up and needs more money and more more weapons and all of the stuff, right?

Our brain is not all that different conceptually, right? The what we need is more research. We need more B12, we need more glutathione. We need more of all of the stuff that's going to help us to detoxify. And we're going to use that B12 to detoxify the heavy metals, or the more toxins or the petrochemicals or whatever other chemicals we get in touch with, we're not going to use it to build new neurons or build new connections between the neurons. We're going to use it to fight and defend, because just like a country at war, we shouldn't be building infrastructure, roads and schools and neurons and synapses.

We should be resolving the whatever we're defending and attacking against. And so this access requirement associated with toxins is something that I think some people miss, that it's like often people say, well, why do I need to take supplements? Can I just eat use food to get my medicine? Yes, I would love that. Supplements should be supplemental. And when we have this extra requirement because we're fighting defending, we often will need to supplement, at least temporarily. And so the toxin the toxicity.

Step one with detox right is stop the exposure that 75% of environmental illness figure out where the toxins are coming from, where the mercury is coming from, where the environmental chemicals are coming from, and just stop the exposure. Our body, again, it's divinely designed to get rid of these through our skin and limp through our liver, through our bowels, through our lungs and through our kidneys. And when we can upregulate, kind of just turn up the volume, amplify the ability of each of these organs to get rid of these things.

For the most part, we can get rid of them naturally, but if they're constantly coming in, if we're constantly filling up

Toxins, Diet, and Brain Health 18:38

and we've got more exposure than we have elimination now, we're in trouble. And directly toxins can cause inflammation in the brain directly. They also can cause inflammation in the endothelium along the vasculature. And that can then lead to more risk of vascular dementia. Maybe if we're not getting blood flow to the brain or if we have more atherosclerotic plaques, then this can create a type of inflammatory dementia. And so this can have can this can manifest in multiple ways. There's multiple mechanisms by which toxins create issues for the brain.

Right. Deplete nutrients, create inflammation directly create vascular inflammation that can have downstream effects in the brain. So there's many, many mechanism mechanisms at play here. Glyphosate is one of the types of toxins we can be exposed to. This is the active ingredient in roundup is a weed killer. And glyphosate sounds like glycine because there's similar biochemically. And glycine is very active in the nerve. The neurological system and glyphosate will take the place of that amino acid and change the form of proteins and the the ability of proteins to do their job in the nervous system.

And this can have very detrimental effects over time as well. And neurodegenerative effects. I'm so glad you're bringing this up because people think about glyphosate and they're like, oh yeah, that'll cause cancer eventually. Or that's about leaky gut, right? And like, well, not necessarily like that. As an analog for glycine, you could actually be destroying the health of your joints as well and your connective tissue right now. And it's highly neurotoxic, like right now, not down the road. Right, right today. So organic really matters.

Your sourcing for your food matters like this is a big part of that. You know what you were just advocating for avoidance in the first place. Like let's vote with our dollars. We're either going to pay for health now or pay for it later, right? Yeah, I could not agree more. That's part of why we recommend an organic ketogenic diet. Now in the Ornish trial, they did a vegan diet so they didn't get into ketosis. The use a vegan diet and you'll see some of the other brain doctors out there who are doing lifestyle medicine are advocating for vegetarian or vegan diets.

And I think that you can do either. And I think the best diet is probably going back and forth between the two. I think there are benefits to a ketogenic diet, but overall, the overarching advice organic non processed. Makes total sense. Yeah, I do see people recovering very quickly though. If it's like really clean animal fat. Oh I might comment on that. Yeah. So I think fats are really really essential to the brain whether you're plant based or vegan. I think really for me, you know, the research points in both directions.

I think that you can you can do either. And this is about accessibility, right. If somebody comes to me and they're like, there's absolutely no way I'm giving up meat. Fantastic. Let's get you on a ketogenic diet. That's okay. Let's get really good high quality animal protein. And you make sure it's fully grass fed, all organic A2 milk, sheep and goat cheese, only eggs, pastured eggs. Let's get you really, really high quality stuff and make sure we're feeding your brain and body with only the best.

And if somebody comes to me and they're like, no, you know, I just I'm worried about the environment. I can't eat animals. Fully supportive. Let's go vegan. Let's get the coconut oil and the avocado and the oh, the olive oil. Let's get all of those really good, plant based fats up. And then let's make sure that we're supplementing with B12. And, you know, if you're willing to do, I'd love to get some eggs. Maybe if you're willing to do eggs or maybe some fish, we can get some cold water fish. Nontoxic fish.

That would be, I think, ideal. Yeah. You don't have to supplement quite as much, but I think that there are ways to make this more accessible by saying, hey, there's more than one diet to get you a brain health. There's more than one brain healthy diet and variety. You know, when I think about ancestral diet, so paleo, even caveman diet or, you know, even, the carnivore diet, like when I think about these diets, what I, the consistent thing about ancestral diets was inconsistency. You couldn't get blueberries 365 days a year.

And so I'm a huge fan of metabolic flexibility going in and out of ketosis and also eating different during the seasons. Right. In the summer you eat different, you eat more cooling foods. Maybe you're having more seasonal fruit because it's available. It's seasonal. In the winter, you're having less of that and maybe going more in the nick towards a ketogenic diet. Is a pitta diet right? It's a more warming diet anyways. And so and then so there's the seasons, which is kind of obvious I think like what's available, what's what's seasonal, what's organic, what's local even.

But then there's also the seasons of our lives. And when we're post-menopausal versus premenopausal, when we're when we're frail and older, we just have different appetites, different things serve us. And I think coming back to these diets, kind of reconsidering them, even if they haven't been like perfect for you in the past, but like, just changing up our diet to see what kind of difference we can make, I think is well worth the time and effort. And using something like a continuous glucose monitor to see what's going on with your metabolism, this can just be so it's an end of one experiment, but you can learn so much about your individual metabolism at the phase of life, at the season of life, that you're in.

Such a good point. And whatever you do, just step away from the canola oil, right? Oh my gosh. You know, I was just having this conversation with Scott, the better health guy recently. I'm such a fan of his. He's done such great work. And he was like, well, I Beatles like canola oil, rapeseed oil, the a lot of these oils that are used in highly processed foods and also in restaurants that you want to stay away from them. But he was like, but don't throw out the flaxseed oil. And like, there are these pumpkin seed oil and there are these good seed oils.

I think he was making the point, like, not all seed oils are evil, but the you know, it. Depends on. How they're processed. Though. Like, yes, if they're first pressed cold pressed like under a seed oils like they do such a beautiful job. Like that's a great place to get your flax seed oil. But please don't get it from like Kroger or something. Right. And it's been because they go rancid so easily. They're so stressed. Yeah. Yes. Like you want it stored in you know them were in glass bottle etc..

Parasites, Stomach Acid, and Microbiome Balance 24:58

Glass bottle, amber bottle. It's sensitive to light sensitive to heat. If you ever smell something that's rancid, if you ever smell rancid oil, whether it's in food or in a bottle of oil, throw it away. Not only is it not good for you, it is now bad for you. Throw that out. Terrible for your liver. Yeah. No kidding. So much for feeding our brains. Okay, so we're. While we're still in nutrition, I would love for you to talk about, just to cover anything that you feel we haven't touched on yet about folks who have been really struggling with gut dysregulation for quite some time, and you're helping to guide them to cognitive repair.

Any other, clinical gems. Do you want to make sure people know about? Yeah. I mean, I mentioned having a bowel movement every day. I think that that's so crucially important. And so work with your provider if that's not happening. And then I'm a fan of the GI map stool test. I know not every provider is, but it's one that I've I've been using for years. I find that it's helpful clinically, and I probably trend towards treating parasites more liberally than other people, other clinicians. But I think doing parasite cleanses, you know, we do this for our mammals, our, family, furry friends, for our family members, but we don't tend to do it for humans.

And I don't know if it's the X factor or they just and I don't know what the problem is, but I think that doing some kind of regular, maybe annual anti-parasitic approach, with herbs, mimosa, put a cat or a potentially diatomaceous earth, some of the other herbs, Jacqueline's, black walnut and wormwood, Artemisia. And these can be hard on your liver. So working with the provider to make sure you're doing that safely is important. But just considering it, particularly if you're someone who travels extensively or has traveled extensively in the Third World.

If you have animals in the house, if you eat sushi or other food that you know isn't always cooked, if you eat a lot of salads or salad bars, you know there's a lot of places that we can be exposed to parasites that many of us don't realize, and it's not in our consciousness that this is something we should be aware of. But I think in terms of the microbiome, when we have these larger organisms in our in our gut, they can harbor the single celled organisms, the fungus, the viruses, the bacteria.

And so then we're constantly being re-exposed because we haven't gotten rid of the bigger guys. Right. And so, we in natural medicine, we're always had to treat big to small and start with the parasites. And I think this is why some people have maybe seen that, as, you know, going through Covid, some of the popular treatments were actually were anti-parasitic. And I kind of wonder if people were like, oh, I felt so much better after taking the the treatment and these popular medications. Like, I wonder if maybe there was a parasitic burden.

So having that as part of our of what we're considering and for Crohn's and colitis, you know as well. Not in a, in a flare, but potentially working with a provider to understand and uncover if some of that is there. Contributing to the dysregulated microbiome or nutrient deficiencies is, I think, important. And I've seen patients with Giardia coming back on stool testing to have constipation. So understanding that not everyone with parasites is going to be thin with watery, putrid diarrhea, it can look very different than kind of the text book, presentation.

Yeah, absolutely. I think that, still, you know, the in your MD's office, you are much more likely to be asked about parasites if you've been traveling, if you had a severe sudden weight loss, sudden onset of chronic gut symptoms, but so often they actually just creep in due to our toxin load and they just get out of control very slowly. Right. So you could actually be overweight. You could look like your traditional metabolic disease presentation when you got the spare tire tummy right. You could have that fatty liver insulin dysregulation in part because you have tapeworms feeding on your pancreas.

Like this is really fascinating interweaving of like how our how our body's trying to stay alive in a toxic environment. Well, in part they're letting parasites take over a bit to be those toxins sponges. Right. Right. And also we you know, with reflex, many people are guided in the direction of lowering their stomach acid through proton pump inhibitors or even just Tums or whatever it is. And that acid in our stomach is one of our first lines of defense, where most of the bugs were exposed to our through our mucous membranes in our mouth, or potentially a sinuses.

But when it hits the GI tract, part of our defense mechanism is that acid that kills things. And if we don't have enough acid because we're under too much stress, or we're taking something actively to reduce the stomach acid, we basically open ourselves up to colonization from some of these bugs that shouldn't be getting through our our stomach. Yeah, that's so important to point out. I mean, especially when, like, we're supposed to be at, what, a pH of two when we're digesting food and H. Pylori can help modulate or are all the way up to sex, which, just like, you know, each each number up gives us a factor of ten.

So that's way in the wrong direction. So as soon as we start, you know, messing with that with these, you know, like Tums and things, anything over the counter or, pharmaceutics is like, please, please, please don't leave your body defenseless like this. It, I'm so thrilled to have you here today. And and I'll, I'll give us back into cognitive and gut territory in just one second. But I just wanted to speak to how crucial it is to understand that there are so many other tools out there from the natural health perspective, because, you know, often our first go to is like these immune suppressor drugs.

And of course, that opens the door to parasites as well. Like what do we think was going to happen if your immune system can't defend itself, you know, defend your body, of course you're going to get this overgrowth of parasites. And yes, they're here to do a job, but they come at such a high cost for you, whether it's additional gut symptoms or, you know, skin issues or honestly, brain fog, anxiety, depression, sleep disruption. So how do you see all this fitting together? You have such a great comprehensive lifestyle program, you know, what do you think are the salient points to cover for folks about this?

Yeah, well, we talked about toxins a bit. We talked about nutrients, about stress structure. Excuse me. Stress structure. signaling and infections. We we haven't covered those. I mean, we could go in any of those directions, I think. Let's do infections. Okay. Let's talk about infections. So there and you know. We're so nerdy I think on. So excited to talk about infection. so we talked about gut health like health starts in the gut. Well, the gut starts in the mouth right. So oral microbiome we know that gingival is the,

Oral Health, Infections, and Sleep 31:50

bacteria that is responsible for gingivitis has been found in amyloid plaques and the autopsies of people with dementia. And so it amyloid plaque is there. And it's to protect us. It's to prevent things from getting out of control. It really, I think of it like creating this wall around the infection rate. We think of the blood brain barrier is keeping the brain totally microbe free. But that's just not the reality. We can have a leaky blood brain barrier, just like we have a leaky gut barrier, but also it's more nuanced than that.

And these infections can get in there and stimulate the microglia, stimulate the production of amyloid plaque in defense. And so Peachin develops and other microbes that cause gingivitis can trigger amyloid plaque production directly in the brain. They can also trigger, inflammation in the vasculature so they can put us at risk for cardiovascular events as well as dementia, but also as they affect the cardiovascular, as they affect the vascular system, and especially the, the capillary beds, the micro vasculature.

This can cause vascular dementia. Right? So it's just a different mechanism by which it affects the brain negatively. So oral microbiome an oral health is is crucial to brain health. And cardiovascular health of course as well. But things that we can do for this of course brushing and flossing. Brushing twice a day. Flossing once a day. I prefer the hydroxyapatite type the toothpaste and you never want to use, any of the like Listerine, the alcohol base? yeah, because these are going to reduce the good microbes in your mouth, and they're going to prevent you from being able to create nitric oxide.

That helps, again, to deliver oxygen and nutrients through the blood bloodstream, through the arteries. So avoid the toxic alcohol based mouthwashes floss every day, brush at least twice a day. I'm a huge fan of oil pulling because coconut oil, which you use for oil pulling, this is just swishing a tablespoon or so of coconut oil in the mouth for 5 to 20 minutes. Spit it out. You don't want to swallow that. Spit that out. And it's got a lot of siding in it. So coconut oil has MCT, which is great if you want to get into ketosis and you're swallowing it, eating it, consuming it.

But in your mouth, it's the anti-microbial benefits of lauric acid that helps with the the microbiome of the mouth. And so this can help with with gum health, but it can actually help with gum recession, even help with teeth whitening and detox in the mouth. There's a bunch of different mechanisms at play there, but also water pick using a water pick to help to get, to help with gum health and tooth health. I'm a fan of biological dentists and making sure that you've had a cone beam because latent infections can cause can trigger other issues.

Actually, one of the first people who I saw early in my career, I saw a patient with five years of bloody Mukasey diarrhea, diagnosed with Crohn's and had a root canal that was extracted and it was gone overnight. I could not make this up. I would not have believed this if you had told me this when I was in training. But I saw that with a glomerulonephritis patient. So an autoimmune glomerular kidney disease, she was in line for dialysis, had a root canal extracted and turned around overnight. Now, every Crohn's patient who has had a root canal done will not recover overnight from this.

Right? This is. But occasionally what we see is there's this very clear connection between and latent infection under a root canal or in a cavitation, some sort of low grade irritation on the immune system that is causing this, an autoimmune condition somewhere else in the body. I've just released you many times to to deny that there's a connection there. So I think seeing a biological dentist, being aggressive about finding those and then just taking really good care of your teeth throughout your life is important for whole body health, but brain health in particular.

Right? I just love that you're bringing this up because the the truth is, people are still treating dental health as if it is like a germ more in there instead of how to support the body to have a healthy oral microbiome, which is setting you up for an appropriate gut microbiome. Right. So a really appreciate that you're calling out the obsession with the alcohol stuff, like step away from the live stream like we're. Supposed to have some bugs in our mouth. They're helpful just about things. They actually can help strengthen your dental enamel.

So, like, we don't want to just, you know, take it down to ground zero. That would be really hard on you. But it's about balance. I've also become obsessed with sinus health recently because I know that it's not officially part of the digestive health tract, but it really does kick off your gut microbiome just gravity wise. So if you have these hidden sinus infections, not only is it irritating the immune system, right, but you're just swallowing this pathogenic material all day long. Recall. And I think, well, I have also seen people who had those kind of late or low grade dental infections in the top, you know, in the, in top teeth.

And that's creating this recurrent sinus infection. I am a huge fan of mouth taping. I don't know if you take that. So sleep and high quality sleep. You know, these are guidelines. Don't get obsessed and have this interfere with your sleep when I say these numbers. But for guidelines is a place to start. At least seven hours of sleep at night and 90 minutes of REM sleep a 60 minutes of deep sleep. I use an aura ring to track, and then I look at little things like travel and alcohol and temperature and light and stuff, and how that affects my sleep.

You don't have to nerd out on it too much. I just want people to get good, high quality sleep and know what the difference is. Number one most important thing about your sleep do you wake up feeling rested and refreshed? If the answer is no, it's time to look into that, right? Is it sleep apnea? Is it? Is it alcohol? Is it light? Is it temperature? Is it sound? Is it your partner? Is it you know, is it stress like what's going on? Is there a supplement that can help us to optimize sleep? Getting good sleep is crucial for digestion.

It's. And we don't want to be digesting at night. We want to have at least three hours before that last bite of food. And when we go to sleep so that our body can focus on resting and recovering and not digesting, not trying to digest at the same time gravity as well, right? We don't want to be lying down, digesting. We want to be upright. And so mouth tap, I want to just come back to this because mouth tape I think, is one of these unsung heroes. It can treat mild sleep apnea. And I've had patients who recover significant amounts of cognition go from severe dementia to pretty functional, like not going back to work, but much more functional, really impressive improvements in their cognitive function when they use a CPAp, when they get their sleep apnea treated, and now they have severe sleep apnea.

But there's a continuum here. And mild sleep apnea is essentially like having mild brain damage every night. So if you can treat that with a, you know, $5 and mouth tape, by all means start tonight. Right. And sinuses or use them or lose them basically. So you have to breathe in through the nose in order to maintain healthy airways, or they will collapse in a ridiculously short period of time. We're talking weeks, if. Not ten days. Thank you for connecting the dots there. That's exactly why we started this conversation, is because if you're breathing through your mouth at night, you're not breathing through your sinuses, and that will change the structure of your airways.

So when you start using mouth tape, we see people's anxiety go down. We see their allergy sometimes resolve. There are so many benefits to using mouth tape, not just the resolution of sleep apnea. I mean, like people just feel generally better when they're breathing through their sinuses at night because we're meant to breathe through our nose, not through our mouth. In this, I'm sure many of your listeners will have heard of or read or listen to James Nestor's book on breath. but diet, right? So diet has a lot to do with the formation of our jaw structure and our bones, and we really want to be chewing on hard things.

And if we're not, then maybe considering orthodontic or oral, devices to keep the airway open. but our the structure of our faces has changed a lot since our ancestors. Right? These ancestral diets, we had to chew on a lot to get enough calories each day. And we don't do that anymore. We have soft foods. And so that that has basically made our airways much smaller. And we have to work harder to keep them open. So true. So this is really interesting. We've basically laid out some important areas to support digestive health and cognitive health.

I want to give you an hour remaining time, because this is such an area of passion for you, and you're one of the few experts

Myths About Cognitive Decline and Practical Hope 40:48

that have a platform that are actually keeping up on the data. What myths still persist in the, area of cognitive decline that you really want to bust today? Yet the idea that nothing can be done? I still have patients who come into my office who say, we saw the neurologist, they took his driver's license away. They said, come back in 6 to 8 months. Here's some medications. They don't work very well. we'll just measure the decline. Sorry. And that is just. It's not the reality, right? There is so much that we can do.

The Lancet is a very reputable journal out of the UK. They suggest that 40% of worldwide dementia could be prevented. And I think that that number is actually much higher. But they have a list of modifiable risk factors. Things like treating hypertension, ideal weight, weight management. Right. Obesity is a risk factor for dementia, type two diabetes, exposure to air pollution, depression, anxiety, social isolation. Be being a lifelong learner. Education has an impact on cognitive health. Treating hearing loss.

There are so many things that we can do and we sort of expand this, this concept that there's a lot that impacts neurological function at a cellular level. What we want to do is be we want to be that country that's investing in infrastructure and and roads and schools. These are this is the neurons and the roads are those connections between those neurons. We want to be investing in that. And so that takes signaling. It takes nutrients. It takes resolving the things that we would attack or defend against.

And this we can get systematic about how we apply these things. And as I say this, I don't want anyone to feel overwhelmed, like you don't have to do all of this. In the clinical trial, we did 17 of the 23 participants who we enrolled in that trial, who did the six months with us got better and not one of them did everything. So it's about choosing the pieces that are going to have the biggest impact, doing the things that are doable. Right? If you know you're not going to change your diet, then go all in on the rest of it.

If you are ready to change your diet, get into ketosis or go vegan and you know, do the pieces that you can and just get started. I think that's the biggest takeaway is that you have so much control no matter what anybody's told you, the science is changing. You have a ton of control over the trajectory of your brain health as you age. I love that and I totally agree with you. I'm so glad you slid that piece in about the the hearing impairment as well. Michael's dad was rapidly declining in cognition and we resolved his tinnitus within two treatments, which is not typical guys.

Usually it takes several weeks, but it happened and it went away so fast he barely noticed. And we saw Michael's like where dad has your tinnitus like, oh, it's gone on day two. Like, okay. And we saw his cognition just like overnight shift because he could actually participate again. So let's focus on what we can control. I love your message of hope. I love that you're talking about just getting started and building on our momentum. is there anything else you want to share in terms of advice with our audience so much?

I know. I think it's stress management routine. Like, whatever your flavor, whether it's a prayer practice, a gratitude journal, meditation, I personally, I drink my much a tea in the morning and then I meditate. And if I don't do it, my data doesn't feel like it ever, like got started. I feel like I'm missing something. I'm more creative, I'm more patient. I just enjoy life more when I do it so I can speak from personal experience. But we also see this in the literature around Kirtan Korea, the Sa Ta Na Ma, and this helps with blood sugar regulation, inflammation with telomere length.

I mean with you 12 minutes a day, totally free. And of course, most importantly from my perspective, it helps with cognition. So when we can engage in some sort of daily routine, mindfulness routine, whatever your flavor, I, you know, choose what works for you. But when I when we can do that, we see positive outcomes. So that combination of movement, diet, exercise, and stress management and sleep, those are foundational. When you can make those changes, wherever you can optimize those things, you get better outcomes.

We see it over and over and over again I love it. Okay, so tell me the name of your book. Who should buy it. And then also where can people find you online? Yeah. So Reversing Alzheimer’s The New Toolkit to Improve Cognition and Protect Brain Health is out now. And you can buy it wherever books are sold. you can get a copy of that. And we also have a bunch of free resources and bonus materials. So we've got a workbook that goes with it and, videos of my best Summit, interviews, including ones with Mark Hyman and David Perlmutter and Dale Bredesen.

We also have summary videos of each chapter. You can find all that at reversingalzheimersbook.com. And, more about me at doctor drheathersandison.com I love it. Go buy a bunch of, guys. Give them to people who have last hope because it's not too late. Thank you so much, Dr. Heather. It's such a joy to have you. Oh, yeah. So much fun to see you. Thanks for having me.