
Hope For Your Brain: How To Reverse Cognitive Decline With Lifestyle Medicine

Founder, Stills Health Clinic
Hope For Your Brain: How To Reverse Cognitive Decline With Lifestyle Medicine
Joshua Helman, MD
Full Transcript
Summit Introduction and Guest Welcome 0:00
Hello. Welcome back to Mastering Your Menopause Transition Summit 4.0, our fourth year coming to you with the latest and the greatest information you need to know on your hormonal journey. I am your host. Still, doctor Sharon Stills, and it's always an honor, my privilege, my joy to be here with you all. And I'm super excited because I'm interviewing someone I've never interviewed before who has a lot of wisdom that he is going to share with us. And it's Doctor Joshua Helman. He's a Harvard trained physician.
He's licensed in 14 states, and he has lots of degrees, masters degrees. He's board certified. He is the former and current medical director of Hippocrates Health Institute. He worked at True North Health Center, where they do a lot of fasting. He's worked in a Tampa, Florida clinic for six years, reversing Alzheimer's dimension. And he co-hosted a summit called The Truth About Alzheimer's How to Slow Aging and Prevent Alzheimer's. And so that is why I wanted to bring him on here, because I know that you are either worried about Alzheimer's because you've seen your mother or your auntie or your grandmother go through it, or maybe you're already starting to have some cognitive decline.
I hear patients telling me that all the time. And so I'm bringing you the expert so we can learn what it's about and what you can do about it. So welcome to the summit. Hey, it's great to meet you, Doctor Sharon. And thanks for having me. Yeah. Excited, excited. So you have a very a vast, background from Harvard. So I'm just curious, did did you start out as a traditional M.D. and then kind of came over if maybe just tell us, like how you went from training at Harvard and then working at Hippocrates and True North and how you got into Alzheimer's?
Joshua Helmanu2019s Background and Path to Integrative Medicine 2:12
Actually, it starts a lot earlier. My father's, a g, a medical doctor gastroenterologist who actually way back when was interested in nutrition. So I remember as a little boy rounding with my dad at he was asking about the salami and beer that some of the patients were eating. And so and then when I was a teenager, my my grandmother got Alzheimer's. My grandma, my grandmother Eileen got got Alzheimer's. So I saw how Alzheimer's impacted not just my grandmother, but my parents. I saw they were like, wait, this is happening to Grandma Eileen today?
What's going to happen to us in 20 or 30 years? And I was one of these nerds, which is okay. I was studying biochemistry when I was 17 and trying to soak up all this information. And yes, then I went to Harvard and I got two degrees there. I got two degrees in biochemistry. I went to England, did a Harvard MIT med school program. I ended up getting double board certified in both emergency medicine and in lifestyle medicine. About a dozen years ago, I had my own health issues. I was overweight, 50 pounds.
I had high blood pressure in the traditional training I got from Harvard med School wasn't helping me fix these problems. And it's kind of humbling, right? You spend all this time, all this money, all this energy to learn, and then you can't even fix yourself. It was kind of crazy. And that's why that's when I started. I'm a problem solver. I started looking around for solutions. And that's how I found a more integrative, natural approach. And that's how I found Hippocrates. And I. I from from my background, I may seem like, you know, kind of a ping pong ball, but but the good news is, because my, my background is so wide and deep, I seem to be able to fix problems that no one else can, which is a great skill.
I mean, finally, these these years of, of study over decades has paid off. Not just for myself, but but improving the lives of my patients. And I've chosen to focus on reversing Alzheimer's because. And this is the exciting thing. There is hope. It is. I've been doing this for six years. You can reverse it. The problem and the issue is that most people, including most physicians, don't even know you can do this. Yeah. We've been we've been taught so many false things that things are just you know if you haven't, that's it.
This is what's going to be the rest of your story. And that's so not true. From Alzheimer's to cancer to everything in between. Right. Traditional medicine. It's like stay in your lanes, stay in your silo. Just learn about your little thing and then no, go outside and that's fine. If the problem happens to be something that's fixable in that little area, but something with like Alzheimer's that has between 30 and 200 root causes, that's very complex. Normally the traditional approach isn't working.
I'm just thinking you should write a book from Harvard to HyperCard. It's okay, because I think those are like students, you know, you think of Hippocrates with like, wheatgrass and it's like so diametrically opposed. I think that would be an interesting perspective. So let's say suggestion now I'll write the foreword for you. Okay. Thank you. So menopausal women, you know, a big concern is brain fog is I walk in the room, I forget why I'm there.
Brain Fog vs. Alzheimeru2019s and Early Warning Signs 5:53
I'm looking at the fridge and I can't remember the word. And so can, you know, you just mentioned there's a lot of root causes of Alzheimer's, and I'd like to get into that a little, but can can you just kind of for the listeners like discern out, you know, when do you need to be really concerned. How do you know the difference between this is just some brain fog or this is something more serious? Yeah. So the key thing is, is the is this a change? Right. I mean, have you had brain fog for 30 years or is this a change?
And normally if it's a change, that's what concerns me the most. And I'll say that with with Alzheimer's, actually two thirds of the patients with Alzheimer's happen to be women. So and to my mind, brain fog is on the continuum to, you know, formal, mild and then severe Alzheimer's. So but but you're right there, there there are very many root causes. But the things I would be worried about are if you suddenly can't remember where you put your keys, and this is happening all the time, or repetition, like if you're if you're asking the same questions over and over and over again and by the way, you haven't been, which is good, but or some of the emotional changes we see, whether it's anxiety, depression, I'm not saying all of those are related to brain fog or, or dementia or Alzheimer's, but it's one of the the possible causes.
How would you define the difference between dementia and Alzheimer's? I think that would be good. I don't think a lot of people understand the difference. Right. And it's interesting, when I lecture to the general public, I kind of use the terms interchangeably, but they're not the same thing. So dementia is a much wider term. What dementia means is there's something about your brain that's not working correctly, and something some of the examples of causes of dementia are if you have a brain tumor boom that can that's that's putting pressure on the brain.
The brain may not be acting normally. Or if you fell and have a big bleed in your brain, a big clot or something that's creating pressure, then you can have dementia from that. Now it turns out in the United States, 70% roughly of cases of dementia are from Alzheimer's. So because it's so common, I'll use it interchangeably, but it's not. And before giving someone a diagnosis of Alzheimer's, you want to make sure you're not missing out on and other causes that that you would treat differently. And what are what would you say are the root causes?
And can you also speak about like the ApoE gene? Sure. How to test for that and when you need to be concerned and what you do about that.
Understanding Dementia, Alzheimeru2019s, and Genetic Risk 8:54
Yeah. So ApoE specifically ApoE e4 is one of the genes that, puts you at an increased risk of developing Alzheimer's. It turns out it's not the only genetic risk factor. There are many others. That and I for my patients, I'm doing, I'm looking at dozens of different genes, not just the ApoE e4. But the exciting thing is, if you have 1 or 2 copies of this ApoE e4, it's not doom and gloom. It actually it will focus you to say, hey, I want to make the right changes in lifestyle and everything else, to take my increased risk of getting all the timers and bring it down.
But I think your first question was what? What are the actual risk factors for for Alzheimer's? And there are many, not just genetics. So it it turns out the, the the biggest one, the number one risk factor for developing Alzheimer's turns out to be poor sleep deep in three sleep. If you're not getting enough of that deep sleep, that's the time period when the brain is able to clear out the amyloid and consolidate memory. So it's not okay just to be in your bed for eight hours every night, sleeping lightly, because you're never going to get down to that deep and three sleep that is so restorative.
And but but there's so many other causes. A big category is inflammation. It turns out that inflammation of the brain can lead to Alzheimer's and this I'm really glad that we're talking now, because it turns out that it can take 30 years for Alzheimer's to develop. And the first 20 years, you're not necessarily going to be aware of it because the brain normally has such amazing reserves. So by the time you're asking the same question over and over and over again, you've had much damage in your brain so that these other pathways can no longer work.
So with the I want to circle back to the deep sleep. Do you like, do you think in hours, like, what should women be striving for? And do you like, like I wear like, an aura ring? Is that what you like to track it or are there other ways to track it? Yeah. So first of all, it turns out that as we get older, the amount of this N3 deep sleep goes down. When we were 20, we had about two hours a night of this deep M3 sleep. By the time if if we hit 65, we're down to just 30 minutes of this deep N3 sleep.
And by the time we're 80, we're we're all the way down to 15 minutes. And it turns out for every 1% loss of this N3 sleep, there's a 22% increase in the risk of Alzheimer's. So, there's no magic number. More is better. And I love the aura ring or Apple Watch to monitor your sleep. The problem is, as of today, it's.
Sleep, Inflammation, and Major Alzheimeru2019s Risk Factors 12:14
I think it's good for day to day monitoring. If you're concerned about it, I would get a formal sleep study or there are other devices you can use and then correlate that with your aura ring just to make sure that just because the aura ring is telling you that you're getting the deep sleep that you actually are, and is there anything we can do lifestyle wise, too? I mean, I know if we're aging, it's going down, but is there anything lifestyle wise that we can do to enhance and increase? You're talking about the the M3 sleep?
Oh, yeah, definitely. So, but again, everyone has different issues with their sleep. So for example, there's some people who have obstructive sleep apnea and that's really only to come out if you have a formal sleep study. And the treatment of that is sure you can. If you happen to be overweight, you can lose some weight. And but but there are people who are skinny who also have obstructed sleep apnea. So every case is a little bit different. Gotcha. Okay. And so is it just the deep sleep we're concerned about or are we also is the REM and like the cycling through and how long you're actually sleeping.
Like how much is or is it just the deep sleep that's really making you. It's specifically the deep n three sleep. It's interesting both during the deep N3 sleep and REM sleep you're getting. You're dreaming often dreaming. And the N3, the N stands for non. Your eyes are not moving like they are with with REM sleep. But from the studies I've seen, the biggest risk factor is to focus on this M3, deep sleep. Which is why is if someone's has brain fog or is concerned, I suggest they get a formal sleep study and say, yeah, that's always a good idea.
So what are other risk factors? Sure. So, besides inflammation, another big one is diabetes or inadequate blood sugar control. And we even call type two diabetes with brain involvement. Type three diabetes is one of the causes where you basically get caramelization. It's just too sweet. Your blood vessels end up in your brain, tissue ends up having these added sugar groups that that hurt the normal function. So that's that's one there are so many risk factors. Another one is toxins. Another category are infections trauma.
So head trauma can do it. And we talked about genetics. But the key is for every for every case there between 30 and 200 root causes. Each case is different. And and you may have some of the similar causes but in different amounts. That's why you're you're probably not going to find one magic cure that's going to fix everyone. Yeah, I mean that's for any disease process. And so are there specific viruses that you find more frequently or more toxins more frequently? Isn't metal, isn't mercury, isn't lead, is it glyphosate is it is.
Or is there anything you've been able to kind of piece together? Often it's all of those combined. So specific viruses, things like Epstein-Barr virus or Sitel or Miguel virus, CMV, they're many of the heavy metals you're mentioning. Parasites can do it. Bartonella infection, Lyme spiral kids. But often what happens is someone will have a leaky gut and a leaky brain. These toxins and infections are all there in the brain destroying it. And, your immune system's not working. And because your immune systems are working, these bugs can play in the brain.
And the toxins are just an added, layer of, of problems. How does someone, you know, we talk a lot about leaky gut, but we don't talk about the leaky brain is often. How could someone know if they have a leaky brain and what would they be experiencing? And what can they do to seal it and heal it? Yeah. So so often, most of the time, if someone has a leaky gut, they also have a leaky brain because it's the same protein design that's responsible for the tight junction in the gut as in the blood brain barrier.
So normally, if whatever toxins or infections that are there are hurting your gut, the same thing in the brain. And so, so the way and I know it sounds weird, I'm trying to fix my brain. Why am I worried about what I'm eating or, you know, getting the right microbiome in my gut? The the key thing is, if you can fix your gut normally can fix your brain at the same time because it's the same disease process.
Diet, Fasting, and Metabolic Approaches to Brain Health 17:20
What do you have a specific diet that you like? Do you prefer keto or carnivore or vegan or like, do you find there's better diets if you're wanting to prevent or reverse Alzheimer's? Yeah, and I know this is a controversial topic. I'll tell you my experience just working in this field for a long time. I'm I'm biased towards a vegan diet, eating lots of plants and, one of the reasons for that is as you go up in the food chain, if you're eating animal products, you're getting increased levels of toxins as you go up the food chain, you get, you're actually putting you are what you eat, you're putting in more toxins in your mouth, and then many of those toxins end up in your brain.
So for that reason, I recommend organic plants, vegetables, fruits, etc.. Now you raise the the point of of keto. And again, I know it's it's a popular approach, I think I think it really depends. How are you getting it to keto? I mean, as you as you mentioned at the beginning, I worked in a water fasting center where we would water fast people for up to 40 days. Guess what? After the first few days you're ketek you're not. All you're doing is drinking water. So I'm not against ketosis in general, but it really depends on the person.
So if you have someone who's super skinny and and needs weight, sure I can. I could see giving them a high fat diet to put calories on them. Oils are the most calorie dense food, but for everyone else, if someone is overweight, the last thing I want to do is add oil and oil. Well, in terms of diet, you want to avoid added salt oil and sugar because those three substances will do damage to blood vessels. And it turns out the brain is very vascular. You don't want to hurt the blood vessels in the brain, and you don't want to hurt the blood vessels from the heart to the brain, which includes the carotid in the vertebral.
If if you have a lot of processed food with added salt, oil and sugar, you're much more likely to do damage to those blood vessels. What about like, extra virgin organic olive oil? Is that okay, in your opinion? So in general, no. Unless I've got someone super skinny who's trying to put on weight, but from from the data I've seen, unfortunately even extra virgin olive oil right after you consume it, you are creating what's called sludge blood, where if you eat some extra virgin olive oil within 5 or 10 minutes, if I draw your blood, you're actually going to see the oil layer out on top.
And if you look under a microscope, the red blood cells will form Rouleau or stacks that you see with inflammation. And this has been studied. Now, I think the way that extra virgin olive oil gets promoted is they they compare it, they look at populations and they compare people who eat the olive oil to people who eat butter. And sure, olive oil is better than butter for damaging your blood vessels, but unfortunately they both do damage. And again, I know it's not a popular opinion, but it's just based on looking at the research and clinically looking at results.
So I want to go back because, you know, I'm not saying you should do a 40 day water fast on your own because you shouldn't have to just hear a little bit about that. You know, it's fascinating that you worked at True North and, you know, 40 days is, I take people through a five day prolonged cleanse and we get to eat some fruit. So and that's long, you know that. So that's like doing eight furlongs in a row just drinking water. So I'd love to hear like what the benefits are and what's that what that's like.
And who would you recommend like go check that out. Right. And so now you've got me interested. When you're doing you're not doing promotions back to back. You're giving people a month off or you're doing. Oh yeah. Yeah. Okay. Yeah. So it's I'm like, oh I hadn't heard that one. So, so yeah. So so basically what I found at True North is many different chronic diseases, from Alzheimer's to being overweight to certain types of slow growing cancers to other, other conditions, inflammation would all go down during a water fest.
And we talk. We talk about it like it's, it's it's obvious at the beginning, many times people would start a water fast and then after seven days, they their body would be like, no, you need juice. We would give them juice for a few days and then they could go back to water. So I agree with you. You don't want to be doing more than a couple days of fasting on your own. What what we would do is we would round on our patients twice a day. So it was it was it was monitored. It was in a controlled situation.
And and again I I've done prolonged I like that to the challenges. I was hungry all five days. I, I do the prolonged as opposed to with water fasting after the first couple of days hunger normally goes away because, you know, the body's like, okay, there's no calories, I'm not going to spend. I'm not going to torture you thinking about food when there's nothing to eat as opposed with prolonged you're, you're you're feeding a few calories there and the body's like, no, I want more, I want more, I want more.
So yeah, yeah, yeah, I, I don't find that I find that little bit of food is enough to. Okay. And but I mean, because what about like, with water fasting, you're losing a lot of muscle mass. That's very true. And and it it can take a while to build that back. So again, it's the risk and the benefit. I think the reality is our bodies, if you look at our ancestors from thousands of years ago, food was not readily available 24 seven throughout the whole year. So if you look at biochemically, our bodies are designed to go through periods of not on unavailable calories where you don't have a choice, you have to fast.
So so so I understand that you will lose some muscle mass. But the cool thing is, through autophagy, you're going to break down the muscle. That's not good and you're going to build up stronger muscle. So your end result I think is going to be a lot better. The the other cool thing biochemically is when you fast it's almost identical to when you exercise. So they're both useful things to do now. So what about I was just going to ask you like movement and Sudoku.
Exercise, Mental Stimulation, and Daily Brain Support 24:10
Like what are things that you could be doing just preventatively that really go a long way to supporting your brain and preventing. Yeah. So I'm a big fan of exercise for everyone, including people with brain fog or Alzheimer's, because when you exercise, you release this growth factor called be DNF, brain drive, neurotrophic growth factor that not only creates new neurons, but new neural connections, new synapses. So I would be exercising every day if I was trying to reverse or prevent dementia or Alzheimer's.
That's number one. Number two, you asked about Sudoku. I think Sudoku or crossword puzzles are good to keep the mind active. We want to do that. But what's even better is to ask the brain to do something new, learn a new language, go to a new location, play a new musical instrument. Novelty. There's something about novelty that really challenges the brain, and you want to tone to the brain. If if you want to continue having a good brain, what about using like your less dominant hand? Is that beneficial for the brain?
I think it is, because, again, you're asking the brain and the body to do something new that it's not doing all the time. And, I'm not saying do that forever, you know, mix it up and then maybe every month find something new to do to, it's called promises. You know, what doesn't kill you makes you stronger. I sent my coach lunch every day. Awesome. What about supplements? You know, there's so many supplements out there. Are there any, like, must haves in your toolbox for brain health? Yeah, so? So there are many.
So one of my go tos is lion's mane mushroom. The studies show 1000mg a day for people with brain fog or Alzheimer's is able to reverse that in 49 weeks. So I love I love, lion's mane. I also love LG Omega threes, specifically three grams a day if I'm trying to reverse Alzheimer's, and the next on my list would be, nitric oxide supplements. My my favorite happens to be cardio miracle. But basically, you want a long acting nitric oxide supplement because definitely eat your leafy greens, eat your beets.
But normally nitric oxide levels only go up a couple hours. And for those of you who haven't heard, nitric oxide is a gas just one nitrogen and one oxygen atom that open up blood vessels and levels of nitric oxide go down as we get older. The cool thing is that there are supplements that are designed to last, keep nitric oxide out up between 24 and 36 hours. Yeah, I run when I do hormone testing. I run your 24 hour wet urine test. And we look at nitric oxide levels through urinary nitrates. And I have had patients like in their 80s and they're using Cardio Miracle.
And I'm like keep using it. You know we sometimes Berkeley life obviously has to die. But yeah it's it's definitely something that isn't spoken about enough. And I tend to see it low in patients unless they are supplementing, unless their hormones are balanced, especially as they age. It's going down. So, and another example along those lines are men who take Viagra are less likely to get Alzheimer's. Probably the mechanism there is if you're taking Viagra or that class of medications, you have increased nitric oxide in your blood.
Exactly. Yes. So good for more than one thing. Any any other before we wind up any other daily things the ladies can be doing that could be helpful for them. Sure. So I was definitely more supplements on my list which you can get it. Doctor josh.com/program. But daily things you want to decrease your stress. We're in a stressful environment. I find stress one of the most pernicious, problems
Supplements, Nitric Oxide, and Community for Brain Health 28:38
preventing people from getting over, brain fog and Alzheimer's. And then another thing, on a daily basis, make sure you're part of a community that you're connected. It's it's amazing how as humans were designed to have our own tribe and be interacting. And. Yeah, it's great meeting you. And yeah, no, we're not designed to just stay by ourselves in a in a cave and, you know, just disappear. So I would say interact, find, find friends and family if you don't have them, to, on a daily basis. Yeah.
I think, you know, even utilizing meetup groups or volunteering or. Yeah. And, you know, I know I'm very blessed and grateful. I have my two granddaughters, you know, right, right by me. And they keep my brain young, right. Because, there's a lot of good studies showing that, you know, if you're fortunate enough and I know a lot of people who have grand babies have a friend now she move and, you know, just to be because her son is pregnant, the daughter in law and, you know, so it's good to be near your people.
And if you don't have your people, it's never too late to find your people. Exactly, I love that. So you said your website, but say it again. So people sure it's it's doctor Josh, Dr. Jay, osha.com doctor josh.com and my email address is just doctor josh Dr.. Josh at doctor josh.com and then on social media you can find me a green brains MD green brains with an s M.D.. And do you actually still see patients or are you just teaching or. No I actually see patients and I'm involved with, FDA approved drug for compassionate use that we're using to decrease inflammation and reverse Alzheimer's.
We're seeing great results without side effects. So I'm I'm really excited. And and again, the most important point is there's there is hope. I'm seeing it on a daily basis. These reversals what drug. Yeah. So it goes after galectin three. Oh so you're using you know I v yeah. Well once a month. Okay. Can why am I forgetting what it's called? Yeah, it's it's a it's a true binding. It's true. Yeah, I, I actually it's funny. I have it right. It's the tbo six. Right. Yeah. Okay. I have it on my to do list for my new clinic.
Awesome. Yeah I would definitely include that. Cool. All right. Well thank you for being here. So if anyone's interested in the true binding where are you doing that in Florida we are. And, again you can reach out through doctor josh.com
Patient Care, Treatment Updates, and Closing Remarks 31:28
and we can get you more information there. Yeah. All right well thank you. Thank you for the work you do in the world and for being a part of our summit. And so you heard it, ladies. There there is hope. And you can heal your brains. You can have a strong, healthy brain, you know, the whole, Well, of course, I'm getting older, so I, you know, I'm losing my memory. Like, we don't have to buy into that. We can write a totally different story. So it's so true. Doctor Sharon was. It was great to be with you.
And and I appreciate you. Thank you. So stay tuned. We'll be back with another talk. Go check out doctor Josh at his website on Instagram. All the things and thank you for being here. Thank you for caring about your health and taking time out of your day to get educated and learn. So we'll see you at the next tech. Bye bye. Peace. Implants.

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