Boost Your Brain: Ayurvedic Neuro Secrets

Ram Rao, PhD, AP

Thank you so much, Dale. I’m very pleased to be here, and I think it’ll be a great discussion.

Dale Bredesen, MD

People may be aware that recently a study out of Stanford came out showing that a specific mutation within APOE4 removed the increased risk. There’s an increased risk of about three folds for one copy of APOE4 and about 10 to 12 folds. dramatic increases for people with two copies. As the group from Stanford said, it’s never been clear what it is about APOE4 that gives you this increase. I think Ram’s discovery answers that question. What Ram found is that APOE4 is not something that simply binds lipids. It enters the cell and, surprisingly, enters the nucleus and interacts with, as Ram found and published a few years ago, 1700 different gene promoters. What’s very interesting about that is that, if you look at the groups of promoters they tell the story of Alzheimer’s disease; it’s related to pro-inflammatory effects. What’s going to be anti-microbial would be that people who have APOE4 are better positioned to have a more brisk response, which can hurt you in the long run but is helpful so it could help them to survive. Part of simians becoming hominids, 5 to 7 million years ago was a pro-inflammatory response, not only from APOE4 but from others. But APOE4 was the primordial one for us.

I think that the story is very interesting, and that has become more interesting as was shown. Multiple argenines have positive charges that seem to be involved in binding to the negatively charged DNA and carrying out this transcriptionally repressive effect that was discovered by Ram and his team. Very telling and gives you new insight. Now, that the Stanford Group has found that a mutation in one of those arginines removes your risk, it fits very well. We’ll see where this goes. But I think it gives us some insight and also gives us some insight into what we can do ultimately to reduce the risk of people who are APOE4 positive. Ram, let’s talk a little bit about your Ayurvedic practice. When you see people who are either at high risk for cognitive decline or just beginning to have some cognitive decline, what is your typical evaluation and treatment for these people?

Ram Rao, PhD, AP

Yes, even though they say that Alzheimer’s is a modern condition or a modern disease, if you look back at alternative medicine practices, especially Ayurveda, even though they say they are ancient or maybe 5,000 or 6,000 years ago, medical science was not established, but there is, even though they don’t call on them a disease per se, there’s an entire body of literature in the Ayurvedic text that deals with nervous systems and associated nervous disorders. For example, now some diseases have been mentioned in the literature, in Ayurvedic literature that talked about migraine headaches, convulsions, paraplegia, hemiplegia, and Parkinson’s disease, and why they are, in fact, often diseases. We know that the first trigger descriptions were made in the Ayurvedic textbooks. Then there were even descriptions of TMJ, epilepsy, and insomnia. All these conditions were broadly categorized as Vatavyadhi. It is a condition where you have an increased abundance of space and an element. 

Even in this condition, there is a condition called Prana Vrtta Samana Vatavyadhi, this is a mouthful, but basically, that description of this disease is very similar to what we have in dementia in that sense. For example, in these references, what they talk about is that when you have somebody with this disease, they see that there is a loss of intellect and part-process makeup. That is also a loss in part of the discrimination or absorption they have. There’s a power, there’s a loss of reasoning and discernment, and then there’s a loss of memory or recall. These are mentioned, and the interesting, Dale. As we are looking into some of these texts, I don’t know. I don’t know whether they had these descriptions of them having imaging procedures that resulted in MRI. But it does say that in the brains of these patients, there is the presence of Phalakam which means plaques. Then they talk about another condition called Acchadana, which means bounded and or tangled mass.

Dale Bredesen, MD

Bounds, and tangles. 

Ram Rao, PhD, AP

Then they talk about this characteristic phenomenon is also associated with Srotorodha, which means the destruction of the information-carrying channels. Think about it the synaptic dysfunction. 

Dale Bredesen, MD

Yes. 

Ram Rao, PhD, AP

There’s another term that they called Vastikundalika that’s been out; it isn’t what experts.; they said a circular or oval, pellet-like structure is present in the nose, so it looks like they did have a condition similar to memory loss or dementia. They were trying to explain that in terms of the losses that accompany these. Of course, what they did was now think about a description of how to manage this. Now the question is, how do you manage it? What did they have? It’s very interesting, Dale, because, in the OMICS field, we have several different meters now. The latest one that we’ve got that everyone’s talking about is the phenomics. It is where you study different traits of the individual. Then you come up with the response, you come up with a big database. The database includes data on individual responses to lifestyle, diet, genes, environment, and other influences. Now the beauty of Ayurveda is that it was a phenomics-like science. They were collecting all this information about how these people responded to different kinds of diets, how they responded to different kinds of influences, whether they had a good amount of physical exercise, whether they had good sleep patterns, whether they had mental exercises, how long, and how was that available? All these things put together, they got a huge, let’s say, let’s put it this way, huge amount of data, which they then analyzed. They said, Now what are we doing for this person? It was a multi-sectoral approach back then, 16 years ago.

Dale Bredesen, MD

Interesting. Did they do neuropathology then? Did they look at the brains directly?

Ram Rao, PhD, AP

That’s very interesting because, looking at some of the textbooks, Dale. I didn’t find them. I mean, there was an entire bad batch of surgeries present. I should sensitize the guy or mention at the start some meta about various aspects of going into a person’s body and dealing with their bone or brain or whatever it is. They come out with various things. But I was puzzled. It did not come across in imaging studies. But here’s the thing: When they talked when they set about characteristics, they said they approached it more like a genome-based approach. They had what they call three media for each attribute there, but it shows that you’re the person, and then you observe the person for their traits, and then you question them. 

Then, based on this, they did was go further along, and then they talked about eight different ways of examination. They made pulse diagnoses and then they had urine assessment, some got stool assessment, and they had tongue assessment where they constrict the tongue as the timeline, the thumbnail sketch of the entire body. Then they took speech and voice assessments. They touch their skin to find out the skin assessment; they assess the eyes; and then they assess the entire body. Then based on that, we talk about diet, daily routine, sleep, digestion, appetite, elimination, their five-sensory responses; speech, sound, touch, sight, taste, and smell, and then exercises, and then, of course, their brain, their mind, and their body’s emotions. The spiritual aspects based on this deal, they got a huge amount of data, and then they could put forward their recommendations.

Dale Bredesen, MD

Now, did they talk in the Ayurvedic texts at all about improving cognitive decline?

Ram Rao, PhD, AP

Yes. The question is, once they had this data, they never delineated the mind or the emotions from the body. They said if you have to treat a person even if it’s not dementia-related, but more so for any neurodegenerative disease, you have to treat at all levels—body, mind, and emotions. Concerning the person’s age, the season, the climate, and the overall environment. Then they brought in the aspect of diet. They brought in the aspects of their elimination patterns: physical exercise, keeping all the fights to keep them healthy. Mental exercises, sleep, and developing positive responses as emotions. Based on this, it became about, if you notice here, Dale, this was, I would say probably about 70 to 70% of their entire paradigm. Even though we talk a lot about herbs and supplements, it’s only 15 to 20% of the entire Pitman modality. Of course, the herbs that they prescribed were very powerful nervine. They call them nervines to strengthen the functional activity of the nervous system and to restore memory. Based on evidence-based studies, we know how these herbs act, why they act the way they do, their pharmacological activities, their anti-inflammatory properties, anti-amyloid thickening properties, anticholinergic properties, hypolipidemic effects, and ulcer defects. A lot of these now know from the herbs that they were giving to these patients.

Dale Bredesen, MD

Yes, that’s one of the things that’s so exciting. It shows that they are addressing the very things that are causing the decline. Some are impacting the neurotransmitters, and you are impacting the blood flow. You, I think, have vascular status, blood flow, oxygenation, and all these sorts of things. Very interesting. I want to go, and I want to come back to the critical herbs and things like that because there’s been so much learned from Ayurvedic physicians on those. But I want to go for a moment to another interesting observation that they made thousands of years ago, as you said. Back in 2015, I published a paper saying, If you look at people with Alzheimer’s, will you see that there are these subtypes? There’s an inflammatory subtype, which is called type 1. There’s an atrophic subtype where they just don’t have enough support, enough hormones, enough growth factors, or enough nutrients. Then there’s a glycotoxic kind where you’ve got a little, you’ve got some inflammation, and you’ve got some atrophic because you’ve got insulin resistance and protein glycation. Then there’s a toxic form, a vascular form, and a traumatic form. I thought, this is cool. This is the first description of these subtypes of Alzheimer’s. It’s going to help us. Then you pointed out to me, No, but 5,000 years ago, the Ayurvedic physicians already had subtypes of dementia, and they came up with somewhat similar findings to what was published just 9 years ago. You talk a little bit about the subtypes that the Ayurvedic physicians described.

Ram Rao, PhD, AP

Yes. When I went back and looked into some of those older types, what’s interesting is that they said dementia comes from four. They had to be in that aspect of dementia and go for four subtypes. The first one they called the Vata subtype is very similar to atrophic, Dale. In the sense that they say that it comes more predominantly with age, and that’s where you have more. What they say is that this is a characteristic feature of these individuals is that there’s more air in space. Now you can think about that. There’s disruption of the neurons. Naturally, there’s more space in the neurons being destroyed. Then they talk about, the other aspect is degeneration. Degeneration, we know now that in the atrophic type, you have the withdrawal of hormones. There is no hormonal atrophic support. The atrophic support is withdrawn. 

Dale Bredesen, MD

Exactly.

Ram Rao, PhD, AP

Then they said, in medicine, you have people coming in the early and the mid-stage of life having dementia as well as. Then they call it the inflammatory type, and they associate that with more of a stress phenomenon because that’s the time when people are involved with work. That family has children and their work. They are always under stress. Then they said this stress is accompanied by inflammation, and if they don’t take care of that. This inflammation will attack their brains and will cause later destruction, resulting in memory loss. Then they describe the entire inflammation and dementia. By the way, all the information that they put in there is very similar to what we are seeing in the sense that we talk in terms of getting TNF-alpha; in terms of interleukins, they talk in terms of CRP. They didn’t see all those things, but they said prominently, There is heat. There is a fever, and then there is when you touch the person’s brain, you find that there’s a lot of heat generated, and this heat shows up in the form of memory loss. The third type is very interesting; again, they say that cathartic dementia. This is said to be associated with increased obesity, people with obesity, people with type 2 diabetes, people with metabolic and hormonal deficiency, and all this points out what you can talk about with that topic. We can; in our case, it would be like type 1.5 and type.

Dale Bredesen, MD

Right. Glycotoxins.

Ram Rao, PhD, AP

Then lastly, which is very interesting, it makes sense because those were the days when countries like India and the Southeast Asian nations were mostly tropical countries; they were inundated with all kinds of, let’s say, toxins—not only toxins but pathogens. They said the fourth type of dementia comes from Krimi. Krimi are parasites. They talked about microscopic parasites, such as viruses, molds, fungi, or bacteria. Now we have a classification of dementia coming from parasitic infections.

Dale Bredesen, MD

Yes, very interesting. Let’s talk a little bit about what to do about it. Let’s say you’re seeing someone in your Ayurvedic practice, and someone is coming to you. They’ve got mild cognitive impairment, says a MoCA score of 23. They’re well on their way to dementia. What do you typically do, and what do you like them to take for best outcomes?

Ram Rao, PhD, AP

Dale, when I see patients, and when they come to me for recommendations. Again, it’s a mixed bag; it’s a phonemic mixed-based approach, or we don’t give them one specific herbal or supplement. We say that won’t work. We approach them through a multi-pronged therapy. First of all, we address the diet, and we are very strict with our dietary recommendations are very similar to our keto flex diet recommendations because we insist on having at least 16 to 18 hours of fasting. Ayurveda is very clear; they said very clearly not to indulge in too frequent snacks. They say if you keep a 4 to 5-hour gap between two eating events, you end up having only two or three meals a day. That is what they want. Then they recommended very strongly cooked three meals, not more than that, especially for dementia patients. They said, Try to break your fast around 9:30 or 10 and try to make that your main meal of the day, and then they said, Don’t have another meal at least for 4 to 5 hours of gap, and then try to have your meal just when the sun is setting. Which means around 6:30 or 7:00.

Dale Bredesen, MD

You should have one when the sun is high.

Ram Rao, PhD, AP

The first one would have been when the sun is high because, that’s the time, the sun being at its highest peak at 11:30 or 12 noon, which they said coincided very well with our digestive system, now we call them circadian rhythm. But I would say, clock genes. They say your stomach talks to the sun, and now we know why that happens. Appetite and hunger peaks around that time. Wherever you go in this part of the world, everybody drops down around 11:30 or 12 to have their meal. Then they said the same thing in the sun. When the sun is setting down; they said, Your hunger levels are going to go down. We now know that. The clock genes are not very active at 6:30 and 7:00. 

Now by saying that what they did, and then they said sleep by 10:30 or 11. Now, automatically, you’re giving yourself 4 to 5 hours of gap between your dinner and sleep. That’s what I mean now for people. Then when it comes, and then they say to eat what is present as per your season. They said seasonal foods because probably they knew that in this global world, you will have food coming from all over the world, which means that you’re going to have all kinds of food that don’t matter the season, but they said they in certain seasonal foods because now we know summertime what crops grow and that’s what’s good for your hand, and then they said always try to prepare fresh meals that to make sure that it means they’re warm, and then they’ll say chewing is very important. They said, to be mindful. That’s what they mean by mindful eating. That is, they said to chew at least 25 to 30. They said very clearly that for you to choose your food, you have to count, which means that you cannot have any distractions, which means that you cannot sit in front of the TV and eat your food. 

By saying all this and putting on these guidelines, they made sure that people did a good job in terms of their dietary practices. Of course, then they talked about the microbiome—the microbiome in Ayurveda is called the digestive fire. What they said is that if the digestive fire is good, then your brain is good, your body is good, your emotions are good, your elimination is good, your blood values are good, and your lipid values are good. They said all of these will turn out to be good only if you have an optimal general neuro-digestive fire. They said the practice is to make sure that your digestive side is getting very good. Then sleep, which I read up. We put a lot of emphasis on good quality sleep. They tell them to have at least 6 to 7 hours of good-quality sleep. We tell our patients to have that, and then we have a detoxification procedure. This is mainly for people who have not just the Krimi toxins but even otherwise, we tell them to have detoxification procedures where we bring in a lot of therapies, detoxification therapies. It’s interesting, Dale. They didn’t say about the Nexus, but they knew that there’s a brain-skin nexus. There’s a brain-nose nexus; there’s a brain nexus. 

They said to act as a brain and go to these areas. Transcranial therapies were very good and prominent. we had, they used to have oleation therapy where they dropped oil on your forehead, on the skin, and did the massage. Now we know, I mean, people have done proteomic studies. They showed that the brain scanner has similar coping machinery, and then they say probably that’s the reason why people are more calm when they do a massage. Once they are calm, their emotions also become more balanced. Those are the different detoxification therapies. Then they said some of the herbs could be recommended. This is the reason why I’m surprised that even though they didn’t mention imaging therapies or imaging procedures, they knew that was a blood-brain barrier. Anything that has to do with the head, the eyes, and the head? Please make sure that your therapies include the nose or the nasal orifice, and now we know through the nasal orifice, but they’re not addressing that around that area. Whatever you get to the nose and does get to the hippocampal areas in the brain. They said to try using oil-based therapies. Then they knew oil was hydrophobic; it could easily get absorbed in your nose and enter the brain. They said, to put your medicines in a hydrophobic, like, environment and put them into the intranasal method.

Dale Bredesen, MD

Yes. Now it’s turned out that intranasal insulin, intranasal nerve growth, and intranasal peptides are going to be, I think, one of the best ways to get these intranasal glutathione, intranasal NAD, and all these things have been used. Of course, in the lab, we looked at the intranasal Natron one, although that doesn’t get into the brain very well, peptides related to it do. I think it’s fascinating that what we came through all these years from the test tube has ended up looking very similar to what the Ayurvedic physicians said all those thousands of years ago, which is remarkable.

Ram Rao, PhD, AP

Again, they didn’t just stop there. Now they knew about mental and brain-bending exercises. They told people—I mean, that’s what I tell my patients too, in addition to doing all this, make sure that your mind is very active. One way for them to make their mind active is to try to learn some skills. Some skills even at the age of 60, 78, or 80. Try to learn a new language, and they could learn some new musical instruments. For them to be motivated, they would say, Go to the temple, because at that age everybody would like to go to the temple. They said to go to a temple, but make sure that you either sing an entire song dedicated to the Lord, or you play a musical instrument. Why did they say that? It’s not because of religion; it’s only because they have to now learn those things. They learn the song, learn a musical instrument, which now gives them some mental exercise. In addition to yoga and yogic exercises, they also said how to keep your brain active. There are other beautiful things. They said if you can learn artistry and sculpture at that age, you can prepare portraits of gods and portraits of various natures. Now what happens is that they not only building the skill set, but in the process of doing it, they are in the zone. They are in a meditative zone. Which means it’s like a meditation. They don’t have to have separate meditation practices; just doing their skill set allows them to keep their mind focused.

Dale Bredesen, MD

Interesting. Okay. Let’s talk a little bit about the various herbs and things, their mechanisms, and how they can be helpful. Let’s start with the Bacopa because that’s used so frequently. Do you like to use Bacopa for people who have cognitive decline? If so, do you have a favorite sauce? Do you like Banyan or Metagenics? Do you like Gaia? Do you like others?

Ram Rao, PhD, AP

Well, I mean, there was a time when we didn’t have any of these herbs. But now, thanks to, so much information now. What’s happening is that a lot of companies out there are coming out with very good organic products. Fair trade practices are being used. Any company, Banyan, is a good company. Metagenics is a good company. Light South Chile has some good herbs.  

Dale Bredesen, MD

Cytoplan. 

Ram Rao, PhD, AP

Yes. Cytoplan is another. If you think about this, the question is: what exactly would you be recommending? Most of the herbs have been, inside with the practices, defined as either nutraceutical or cogniceutical in the sense that they are not ceutical, in the sense that either for part nutrition purposes to improve digestion or to improve the nervous connection, to improve these conditions is to improve the memory. If there have been a lot of herbs that have been recommended for this purpose. The first one that comes to mind is, as I said, Bacopa monnieri Brahmi, and they’re extremely good. They talk about that as improving longevity, intelligence, and memory is usually recommended at 500 milligrams per day twice a day. You take that either in the follow-up for tea or even taking the form of a whole herb in the form of a tea, a tablet, or a capsule, or you can put it in a suitable oil and take it intramuscularly.

Dale Bredesen, MD

Okay. Then what about Ashwagandha?

Ram Rao, PhD, AP

Ashwagandha. Yes, that’s a great no-tonic adaptogen. That is how they define an adaptogen as something that needs to be optimized or increased. But things are already elevated; it brings them down. It’s an adaptogen. For many people, the cosmos has a lot of stressful conditions and, I should say, is known to calm them down. Very good as a stress buster. It’s also categorized as a cyanide-rejuvenating herb. It has antioxidant properties. It’s scavenging free radicals, and it has the unique ability to support the immune system as well. We normally recommend that it be taken, 500 mg twice a day with the meals again, and again that it can be taken. I mean, of course, now that I see Ashwagandha, even the whole foods that come as Ashwagandha smoothies and all that, I wouldn’t recommend smoothies, but as you get into whole hog or as a whole up is a very good combination. Usually what happens is that some of these come as a combination, the mind formula, and so in the combination, it’ll usually be like a thousand milligrams, which is great. Which is good.

Dale Bredesen, MD

Yes. Great point. What time of day do you recommend this? I know people argue that some people like to take Ashwagandha in the evening. Other people say, No, I’d rather take it in the morning because it can keep me up at night. Other people say, Well, I like to be. It tends to relax me, when do you recommend that people take their ashwagandha?

Ram Rao, PhD, AP

Yes, it’s exciting because I think that the reason they mention the term adaptogen is that for people who are extremely stressed out, it does have a calming effect. But I think that the amount of it that it lowers may not be sufficient. These people are continuing to be in a high state of stress. Walking normally recommends that if you are going to have your dinner by 6:30, have your Ashwagandha by that time. Giving enough time for you, when you’re being able to sleep, doesn’t keep you awake. In the traditional classical idea, I recommend recommending that for people with insomnia. But now we know that, usually,  people with insomnia look at a lot of stress as well. That’s the reason why Ashwagandha may not be helpful for some people. But if you keep a 3 to 4-hour gap between dinner and sleep and take your sugar with your dinner, it should be fine.

Dale Bredesen, MD

It’s interesting. Of course, drug companies have spent billions and billions of dollars developing anti-amyloid therapies to remove amyloid. Of course, that has some effect, too, to help remove. But one of the things that’s always been intriguing to me is that if you look at curcumin, it has a wonderful anti-inflammatory effect, but it is a remarkably tight binder both to the amyloid and to the phospho-tau. It’s much more gentle than trying to rip it out with a monoclonal antibody. I’ve always been intrigued by the fact that there’s a great way to reduce inflammation and slowly start removing amyloid. You want the amyloid to be there as part of your innate immune system when it is needed when you’ve had exposure to these various pathogens. But as you’re now improving things, you want to slowly remove it because it also has this effect, which is essentially a synaptic plastic effect, pulling back on the synapses. How do you like to give curcumin?

Ram Rao, PhD, AP

It’s interesting you say that because I was not once talking to my uncle about this. He said that one of the ways that they were looking at people with dementia, whether classical or mental, was to look at their eyes after giving turmeric milk. He would say that six hours later when you observe the eyes of these patients, they have different coloration.

Dale Bredesen, MD

Yes. Which always binds to the amyloid in the retina.

Ram Rao, PhD, AP

He said, that discoloration is not present in normal individuals, but only in people with memory loss. I know what I’m going to find. That was the case. Now it makes sense because, as you said, it’s a binder. It doesn’t let it out immediately, but slow, gentle removal. But enough for them to catch it when they’re looking at the eyes. It was a very good way of incorporating turmeric, and curcumin these days. It is available in tablet and capsule form. But traditionally, they would give it in the form of a root, turmeric root. Usually, they give in 1,000 mg, but, in the turmeric root, it has a little slower absorption. You have to take it with other spices for it to maximize its action. But you can take turmeric root or take it as a curcumin supplement. Both are good. The best thing about turmeric is that whatever subtype of Alzheimer’s you have that they’re talking about models the way we define it all the way diabetic definition of dementia, turmeric is one component that is good for all the subtypes. It becomes a very good spice for these people. On the same note, Dale, there’s another one. Centella asiatica Gotu kola is equally good like turmeric binds to amyloid and binds to tau. Again, it’s a gentle binder. It moves slowly and traditionally, I always said that people who struggled would have difficulty maintaining their focus or attention give Gotu kola. Of course not in separate isolation, but in combination with other herbs, Gotu kola, they said is very good for this purpose.

Dale Bredesen, MD

That’s fascinating. Of course, Cat’s Claw is another.

Ram Rao, PhD, AP

Another great one. 

Dale Bredesen, MD

Also binds to amyloid. This has a very interesting effect. But you brought up something interesting about the Gotu kola because, if you look at the neuropathology, as has been pointed out, yes, early on, you lose your end to the renal cortex, which feeds into the hippocampus. therefore, memory issues. But what seems to be the first site is the locus coeruleus, which truly is the brainstem. This is where you have the projections of the norepinephrine. It’s essentially a waking, wide-eyed look. You see a lot of passivity in people, as they often look to their spouses for answers to questions and things like that. This is why some people take Adderall. They see a short-term improvement. My question is, what do you like to use for improved attention? Because it seems like going to Gotu Kola is one of those things that seems to improve people’s focus and attention.

Ram Rao, PhD, AP

Yes. It’s interesting because what they said is that good is very good for intelligence, longevity, and memory. Along with Gotu kola, they said to give Shankhpushpi another great herb again for improving learning memory and attention. They said if you give those two in combination an extremely good and allow me that. Now the question is, just so what they said both Gotu kola and Shankhpushpi also affect on, they said something about how it improves neuronal branching. I think that’s why they got all this branching, but a lot of little branching. They also said, but at the same time, you don’t want to have other areas of the brain degenerated. They said it’s very interesting because usually what happens is that along with Gotu kola and Shankhpushpi, they also give Razadyne, and now they’ve seen that this Razadyne contains specific acids called humic acid and fulvic acid.

Dale Bredesen, MD

Yes, and anti-viral.

Ram Rao, PhD, AP

Antiviral and others. Besides, they are very good for parasitic infections, and so they gave this along with Gotu kola and Shankhpushpi, which brings down all kinds of infections, which will then improve the neuronal branches, so they gave Gotu kola and Shankhpushpi given in combination with another lectin called synergy, and it is now known to have huge concentrations of humic acid and fulvic acid. so it became a powerful and effective detoxifier. Of course, it also chelates because it’s very prolonged; it’s a very powerful chelator as well. Probably the allies realize that there is some amount of mental toxicity. One way to bring down the metal is to have selected to chelate all these metals as well.

Dale Bredesen, MD

Very interesting. Then what about Saffron? Do you use saffron in your practice?

Ram Rao, PhD, AP

Saffron: we use saffron. Again, it’s very good. But the problem is saffron. You need to have huge amounts to have an effect. That’s the reason why they always do it, and it’s very expensive. It’s supposedly from those days; in fact, they were treating it. They were getting saffron along with gold because it was that expensive. So they did what they said, and at the same time, they said they didn’t want to lose the power of saffron. What it is is exactly some quantity of saffron along with these herbs. Once again, the saffron was given daily, and even though people don’t talk about it, it is a very powerful anti-inflammatory. You call it a cooling herb. It’s very good for people with a Pitta type of Alzheimer’s because it brings down the inflammation.

Dale Bredesen, MD

Interesting. Okay. When do you prefer to use Rhodiola?

Ram Rao, PhD, AP

We don’t use so much Rhodiola in our practice, mainly because, as we have, the ones that we normally use are saffron. It’s a combination that we normally have:  Brahmi, Gotu kola, Ashwagandha, and then, Turmeric, we’ve got it as a carrier, and in saffron, we can do that as a cofactor, but they call it a cool factor. Usually, our mind formula will have these five or six formulas. We don’t have Rhodiola in that formula.

Dale Bredesen, MD

When do you want to add Shankhpushpi then?

Ram Rao, PhD, AP

It’s along with this.

Dale Bredesen, MD

It is, okay.

Ram Rao, PhD, AP

Along with this,

Dale Bredesen, MD

Then let’s move to the gut for a minute. Could you talk a little about Triphala?

Ram Rao, PhD, AP

It’s like.

Dale Bredesen, MD

Do you use Triphala for your patients?

Ram Rao, PhD, AP

Triphala. Even though they say, People generally use it for the minute, when people talk about Triphala they say it is very good for elimination. People who have constipation, and we know people with dementia have constipation and all that. I would say that there’s a close link between the brain and the colon, and then they say the colon is the second brain; I’d rather be called the second brain. We now know that the movement of the fecal material is the nervous movement and the waves that cause the movement of fecal material. It’s very similar to the alpha and beta gamma waves that happen in the neurons. They said it’s very important that you maintain colon function. Of course, the liver is a very important organ for people with dementia. They said liver and colon function can be maintained by taking Triphala regularly. 

Triphala is a combination of three herbs and one of them is Haritaki. It is very powerful and anti-infection, so they knew about that, and of course, Amlaki because it’s supposed to be very good for inflammation, and Vibhitaki is supposed to help with insulin production. It’s very good for people with diabetes. So, it helps people with type 2 diabetes and obesity. It’s like a formula. We address three or four different subtypes of Alzheimer’s and not the majority of dementias. Triphala became a very important, rejuvenated herb. But now we know that Triphala, in addition to having these properties, It’s a very powerful detoxifier. Yes, it is so powerfully anti-infective. It’s a powerful anti-inflammatory. Triphala is given. You had the mind formula, and the mind formula was taken along with Triphala, but it was different because they always said to take it during the night time, they said probably during dinner time, and they were recommended a thousand milligrams as a capsule. You take it or if you take the three-powdered herbs, put them in warm water, and drink it as tea. Very good for the liver, very good for the colon, and, of course, the brain.

Dale Bredesen, MD

Are there others? What are we leaving out here? What are others that you like to use for people with cognitive decline—anything for anti-mold, anti-fungal, those sorts of things?

Ram Rao, PhD, AP

There is one more that’s not normally spoken of, but I use it in my practice very well. It’s very good. It’s called Guduchi or Tinospora cordifolia and is a very powerful detoxifying herb, so it’s very good. It cleans inside and comes from a good liver tonic and a lung tonic. As we know, people with emphysema and dementia do have issues with the respiratory system. They have a big issue with the liver. Guduchi is very good in terms of strengthening the liver and the lungs. Plus, it is a very powerful anti-inflammatory, and so the good thing about this is that even though we don’t know whether that herb can enter the brain, we now know that some of the bile components of this help can easily enter the brain through the blood-brain barrier. Tinospora is a good example of such a thing. People have seen that the bio component of Tinospora is present in the brain. They now know that one of the reasons why it’s not only liver and lung strengthening but also a strength for the brain is because some of the components of the Tinospora enter through the blood-brain barrier into the brain and can support the nose as well. That’s another great herb that we normally use.

Dale Bredesen, MD

Okay. What things do you give intra-nasally?

Ram Rao, PhD, AP

Usually what happens is that the mind formula itself is given in several different ways. One way where so usually all these formulas, depending on the amount of where you’re going to give the proportion of the amount increases. If you’re using it on the skin as a massage tonic, then you can increase the amount present in the oil massage so that you can get a good massage. Don’t forget your skin. If you’re doing transcranial therapy, then you use the same oil with a different proportion of all these components. Then you add it to your hand or you add it to your perineum. If you’re giving it intranasally, then it’s a little more concentrated because the amount that you’re giving it through intranasal is probably about 100 microliters to about 200 microliters. This entire mind formula can be easily given and people have noticed a remarkable improvement just by doing an intranasal it normally would be done three times a day, in the morning, afternoon, and evening, and the last one is given around six or seven in the evening up dinner so that by the time they’re ready to sleep, they’ll have a nice sleep and, it makes them want to get up. They don’t complain about headaches. Normally, they complain about headaches, but after intranasal therapy, they don’t complain about that at all.

Dale Bredesen, MD

Very interesting. Fantastic. Well, Dr. Ram Rao, thank you so much. Your background in basic neuroscience and the ability to translate it into your Ayurvedic practice is an unusual combination, and one that’s helping to advance the field and give us better treatments for cognitive decline. Thanks very much, Ram. 

Ram Rao, PhD, AP

Thank you very much, Dale.