Why Fixing Fatigue Can Protect Your Brain

Introduction to Fatigue and Cognitive Decline 0:00

Hello and welcome back to the Reversing Alzheimer's Summit. I'm one of your host, James Maskell, and I have a treat for you right now. We are going to be diving into the connection between Alzheimer's cognitive decline and fatigue. This is certainly something that has a lot of cross pollination, both in the symptoms and in the root causes. And so we brought in an expert in this area, Doctor Evan Hirsch. I've known him for over a decade, done incredible work in his own clinic, and now is on the on a journey to educate about the root causes of fatigue and its connection to, lifestyle driven and, environmental driven chronic illness.

So, Doctor Hirsch, welcome, James. Thanks so much for having me on. I really appreciate you being here. So let's dive into the, you know, the beginning of it. You know, like, ultimately, you know, what we've seen is that almost everyone has sort of like a personal connection to the topic at hand. And you know why this is super critical. And, you know, I'd love to just share. You know, you've been a physician for a long time. You've taken the opportunity to do a lot of, postdoctoral education, you know, to, become an expert in fixing fatigue.

And so I just love to hear that, you know, as this topic, hits you specifically, what makes you passionate about it? So my story is, like you said, you know, from mess to message. So, you know, I had chronic fatigue syndrome, back in 2010. Lasted for about five years, just about destroyed my life. You know, I was already practicing functional medicine at that time. I had been practicing for about three years. After my residency. I had opened up my own functional medicine clinic. Did my first functional medicine training in 2007, and so was healing the gut and replacing deficiencies and all these things.

And then I got chronic fatigue syndrome, and I couldn't fix myself with functional medicine or with what I had learned.

Hirsch's Personal Fatigue Journey 1:56

And I was napping under my desk and locking my door. So because I was so ashamed and so embarrassed that I couldn't help myself and I could help about 90% of the people who were coming in to see me because of, you know, all the knowledge I had around lifestyle habits and replacing the deficiencies. But I had to go on this journey to fix myself. And along the way, I really figured out that there were over 30 different causes, with the real root causes being the toxic five that we're going to talk about today.

And I got over my fatigue. I wrote a book about it, and that became my mission in life to help a million people resolve their chronic fatigue syndrome. And now long Covid, because it's it's so similar. It's just a different infection. Awesome. Well, look, over this whole summit, we are going to share, you know, not only like the sort of foundational pillars of participation across environmental lifestyle and, you know, psychosocial elements. But we're also going to dive into the subsets of root cause.

And what are the you know, the causes that drive this is function. And so I'm excited because I'm, I know from your work that this is going to line up very clearly, and it seems to me that, you know, a theme that's recurring in this summit is that it's like the same, root causes drive dysfunction. And whether you end up with extreme fatigue in your case, or whether you end up with mental health challenges or whether you end up with cognitive decline, it's a function of your own physiology. And that's just, a nature of a complex system. Right?

Yeah, it's really well said, you know, because as we kind of get into these environmental toxins and these deficiencies, really is this combination of genetics plus environment where genetics is about 10 to 20% of the issue, environment is 80 to 90%. And then based off where they go in the body or where your quote unquote weak organs potentially will be, is going to determine kind of like how things are manifested. You know, oftentimes we we see certain trends in families and we think that they're genetic.

But oftentimes it also has to do with environmental toxins that are kind of passed down over the years. And so if you have the toxic five and they're affecting your mitochondria, which produces 70 to 90% of your energy and negatively affects your hormones, then you're going to have chronic fatigue with whatever other symptoms you have, body pain or whatever. If you have pain in the joints, and that's where you have your toxic five, then you're going to get rheumatoid arthritis, among other symptoms.

You know, if you've got it in the brain and in the central nervous system, you're going to get Alzheimer's and cognitive decline. Yeah, absolutely. Well, let's jump into these. You know, I'm glad that you said that about the mitochondria. You know, in the training or software, we have a way to identify whether the mitochondria are being poisoned and easy ways for any doctor to determine that this has been something that has been, like, really only available to, like, a small group of functional medicine doctors who have the kind of like education and skill that you have, but we're excited to bring it to more people.

But yeah, let's jump into these toxic five. And, if you want to share, you know, each one at a time. And and I'd love to, you know, feedback if I think there's some crossover from

Root Causes and the Toxic Five 4:54

what else I'm hearing in the summit and from working with doctors who are in the business of reversing cognitive decline. Excellent. And just to kind of give some context. So, you know, the we're looking at over 30 different causes, different categories of deficiencies. These are things that are not in the body that are supposed to be in the body. And toxicities, these are things that are in the body that aren't supposed to be in the body, where what I've found is that 80% of the deficiencies are really caused by the toxicities, and especially this toxic five.

And so that's why I think they're so important. But the larger context is that there's always going to be 20 or so different causes when it comes to chronic fatigue and cognitive issues. Alzheimer's. And the question is just which ones are present for an individual. And the toxic five I found in everybody who has chronic fatigue syndrome and long Covid. So I don't really test anymore. And we can talk more about that. But I we just treat because we want to make sure that we're leaving no stone unturned.

So in terms of the toxic fire, this is a combination of heavy metals, chemicals, molds, infections and nervous system dysfunction. Yeah, that really that really resonates, for sure. On the different causes. And, you know, over my 20 years of being in this space, you know, it's interesting that, you know, you've you've seen research and heard lectures about, let's say aluminum, you know, or, and different, you know, heavy metals. You know, to do with brain function. You've, you know, I've had my own experience of my father essentially having a rapid cognitive decline from mold and, you know, experiencing that and then me showing up on the other side of the world, kind of knowing that it is mold because I asked Doctor Burke about it and she was like, well, if it's not rapid, it's always an infection.

So take a look. And if you don't find an infection, find mold. And it's, you know, part of the reason and the genesis for getting into this is because, like, I realize that every medical professional that I spoke to that was totally unaware of any of these potentials. And so, one of the reasons why we're doing what we're doing is to get the word out there. So how did you how did you start to come across these and notice that this was the pattern? Well, essentially, you know, I had to as I was going through my journey and working with thousands of folks in my practice, you know, I kind of became a specialist in each one of these, one at a time, you know?

So I kind of started off with heavy metals, did some testing, found it in a number of people, and then there were a certain subset that I couldn't get better. So then I had to keep looking. And essentially I got a master's degree and kind of like each one of these. But I had to in order to be able to figure out that everybody really had them, you know, over the course of the last decade, I've been testing people every three months on all these different causes and and trying to get a sense of the patterns and initially when I see people, you know, more times than not, they don't show up with most of these because a lot of the testing

Nervous System Retraining and Mindset 7:48

is a look at your ability to excrete more than it is your total body burden. So, for example, if we're testing for heavy metals, chemicals, molds and infections all in the urine and none of them show up initially at month three, if we were to repeat a month six and month nine, and then all of a sudden they're all showing up, it's just a consequence of the fact that we're going through a four step process. We're opening up the exit pathways so we can get the toxins out, and then all of a sudden it's a it's a waterfall.

So sometimes people are like, well, am I worse now because I've got so much more coming out in my urine. And it's like, no, previously you just couldn't excrete all these toxins because they were bound up in the body. They were in the tissues. The more toxins you have, the harder it is to excrete them. And so as we go through a process and we open up those pathways, then all of a sudden you get a waterfall and you're able to discern a lot more of what's present. But over the last decade in doing this testing, I have found that over a 12 month period for everybody that I've worked with is that all of these toxins come out the heavy metals, the chemicals, the molds and the infections.

The question is just how much of each. And we don't know. We don't really care. We're just going to address all of them. And then the last of the toxic five is the nervous system dysfunction, where I've seen just really over the last couple of years, so many more people getting better faster, the more nervous system retraining that they do. So just six months ago, we started incorporating it into our own program because I've seen how important it is. Tell me some of your favorite things to do that because I agree with you.

And last year, in our content, you know, we were the, the, the, the theme of the year was, was unity. And, one of the doctors that I know convinced me that the nervous system was the organ of unity, because it was really like coordinating the function across all of the different organs and systems. And, and I started as I started putting that content out, I would hear from doctors like yourself that, you know, when people have done a lot of the food stuff and tried to fix that diet and done a lot of the lifestyle stuff, starting to like, you know, participate in the health regularly, that it was really the nervous system regulation stuff that like really, changed the game with regard to that, that health recovery.

So what what led you to learn that and then what have you found, has been the most effective ways to power your nervous system, and make changes that, that lead to healing. So I started first with mindset. And interestingly enough, I learned most about mindset through, some of my business trainings and some of the masterminds that I had attended where, I learned a four step process, mainly from day to day or in his program. And so this is looking at, gratitude and expressing gratitude re gratitude today, having a vision for your life and your health, looking at any limiting beliefs you have and slipping them into empowering beliefs and then asking yourself empowering questions.

And that actually comes from Tony Robbins work. So I kind of combine some of those that I found to be really helpful, started implementing it in our programs, finding success with those. And then beyond that, you know, going into, somatic experience and breathwork. So I was trained, I did my yoga teacher training back in 2004 at the Apollo in western Massachusetts, and I learned a lot about breathwork. So this was like an opportunity for me to reconnect with that. My wife is a trauma informed mindfulness coach, and she teaches, mindfulness and meditation for people in our programs.

So and then, my health coach, Nikki, she has done a number of these different programs. And then one of our participants, Lori, she had done the Primal Trust. Elizabeth had opened up the program and we kind of all came together and kind of created this, this a program of her own, which isn't it doesn't go into the depth of those other programs. It's more simple. We have the breathwork component. We basically create a schedule for people like what's recommended. How do you do nervous system retraining and a busy schedule.

What does that look like? And so there's the breathwork components, you know, holding breaths for a certain amount of times, you know, breathing in for, for four counts and then holding for seven and then exhaling for eight.

Reducing Chemical and Environmental Toxins 11:54

That's just one of the ones that we recommend. And then really trying to get into the, the somatic work around noticing. So, you know, this I consider or my wife actually taught me this, you know, that noticing really is a superpower. And so, it's just a really important part of mindfulness and then moving into meditation and having that relationship with yourself and then and then starting to grow some, some of that safety, some of that trust, some of that surrendering into trust. And some of these things were actually things that I learned during some of the psychedelic journeys that I've done from my own personal development.

And so that's something that we also coach people on in our programs if they're interested. So just kind of incorporating a number of these different things that we found to be most helpful to help people get to the goal. Awesome. Well, yeah, I guess let me, let me just dive in a little bit into, into a couple of the things that you mentioned. You know, let's talk about the chemical toxins and, and that sort of end of it. What are some of your, like, favorite recommendations like, this sort of like lifestyle behavior side and then on the clinical side for dealing with those kind of, those kind of toxins.

So it's really all about the, you know, I call it, a two step. It's not the Texas two step, but it's a two step process of removal in your exposure. You know, kind of like what's in your environment and then removing what's inside of your body. Right. So, and this goes for whether it's mold and mycotoxins or whether it's chemicals. So we know that we're exposed to over 90,000 chemicals on a regular basis, most that haven't been adequately assessed by the FDA and other governing bodies. And for women, it's about 500 chemicals they're exposed to before they leave the house in the morning.

For men, it's closer to 300. And this can be overwhelming for folks. So as I continue to talk about this, please, people just kind of take this with the understanding that this is something that you work out over time, but you kind of start going through your life thinking about, okay, what are all the things that I'm exposed to, you know, what is the air quality in my home? What kind of what is the food that I'm eating? Is it organic? Is it not organic? Non-organic food is going to have more pesticides, herbicides and other chemicals than my storing food and plastics.

Or is it in glass, which is what's recommended? How are you cooking your food? Are you cooking your food on, different textures that potentially are going to be, releasing plastics and some other things? Or are you using nontoxic cookware? And then when you go into the shower every morning, what is the shampoos that you're using? What are the cosmetics that you're using? What are the cleaning products that you're using in your kitchen and around your home? So, you know, starting to pay attention to those things become really important that you want to decrease your ongoing exposure.

And that's with the chemicals, you know, with the molds, obviously, you know, water damage happens in about half of all the buildings in the world. And a lot of those have mold. So we have to pay attention to that. And then in terms of heavy metals, you know, there's ongoing exposure to there's lead paint, potentially in homes that, you know, usually if it's homes have been built before the 70s, there's going to be lead paint on the walls. That lead paint hasn't been scraped off. Essentially, they've been painted over.

And so there's still might be lead paint in those homes. And then everything that comes out of the ocean, fish, etc. all have mercury in it. Now, unfortunately, if you have mercury in your mouth every time you bite down, you know those are the silver fillings that you have every time you bite down, you end up, releasing mercury vapor, and then you swallow that. So and then if you've had any sort of first, like smoking exposure, whether it's second hand or first hand that has, cadmium in it. And so that can build up in the body.

And it's all about the exposures that you've had over the course of your life. You know, essentially you start off with, you know, from mom through the placenta, you get a whole bunch of toxins. And then as you move through your life, you just accumulate toxins until you get a straw that breaks the camel's back. You know, for me, it was a busy clinic. It was having a newborn. It was, you know, having some stress in my, in my spousal relationship, you know, it was, stress at work. And so all these kind of led to a place that I couldn't tolerate.

And then I got chronic fatigue syndrome, and we're seeing the same thing right now, unfortunately, with long Covid. So that's kind of all of the ongoing exposures that we've had that built up over time. That's outside the body and then inside the body. We're using different kinds of binders, things like activated charcoal and bentonite clay and and then things for heavy metals like zeolite, Chlorella, August, which is a certain kind of, seaweed that we like, cilantro. Everything that I do is natural.

Even though I have an MD, I am now practicing online as a coach so that I can help people across state and national lines. So I no longer prescribe, but this is, and part of that is because I've found

Infections and Immune Dysfunction 17:00

that I've got really great natural tools that I really like that are tinctures. And so we can kind of ramp up one drop at a time because everybody's an individual and everybody needs a different dose in order to detoxify at a rate that their body can tolerate. And that's a really important part of this process, is making sure that everybody is being treated like an individual, and that they go through a process where their pathways are, in fact, open. So they don't feel worse when they start to get rid of these toxins that that cool.

Let's talk about the infections for a moment, that because you touched on it a couple times, and I know that that's a big part of the your, your protocol. And we've seen for sure that like brain related issues can be triggered by infections. We see it with kids with pans and pandas, and we see it with adults with cognitive decline. Tell us, you know, like a little bit of what we need to be looking out for, how you discovered that. And, what are sort of some of the main, main things to look for, and, and how you might know that, that happened to you or your family member or how to avoid it in the, in the future.

So I think one important thing to start with is that you cannot get rid of infections if you have heavy metals, chemicals in molds, the immune system is going to be distracted by these toxins. And consequently, you need a somewhat intact immune system in order to get rid of infections. So this is part of the reason why people, when they go directly at the infection with a Lyme literate doctor or whomever, either with antibiotics or natural antimicrobials, and they're not having success. They're either missing the infection that's present or it's because they have these other toxins that are hijacking the immune system, and they're not able to get rid of the infection.

You know, one of the challenges is testing to determine what kind of infection people have. And when you're looking at testing for infections, sometimes you can do a PCR test, which is basically a DNA test of the infection in urine. But more times than not, people are doing serology tests looking at the immune system's reaction to an infection. Well, if your immune system is not functioning correctly, kind of like what we talked about. It's the heavy metals, chemicals molds are present, then you're not going to get an accurate read on that test, which means that your immune system is not going to tell you if you have a particular infection.

And if you don't treat an infection, if you don't know that you have a particular infection and you don't treat it, you can't get better. This is one of the reasons why we treat all of the infections that we believe are possible to be present. So this is viruses, bacteria, yeast, Lyme and Lyme co-infections parasites. So we do that and it it's not going to take too much more time. It's not going to cost you money, energy all that other stuff. It's actually going to be so much better for you in the long run, because you're going to make sure that you leave no stone unturned. Right.

The last thing you know, I used to, when I was testing for everything, and we have these imperfect tests, I would get to a point, you know, a year into things where I'd be like, I repeat a test, let's say, for infections or for heavy metals or chemicals or molds. And I'd be like, oh, now you're showing up with molds. Gosh, I really wish we were addressing those from the beginning, and I don't want to do that anymore. I want to make sure that we're addressing all of these. And so that's a that's really important is that addressing all of these infections.

And sometimes we're rotating through different antimicrobials to give the body a little bit of a break, make sure that it can tolerate the treatment. Because sometimes certain infections, maybe the viruses are really more important than the bacteria or the Lyme or maybe in another individual, the Lyme is really more important than the viruses, but we want to make sure we're addressing all of them at a rate, once again that the body can tolerate. So I think those are some of the important things, realizing that the immune system really has to be functional to get rid of the infections, making sure that we're addressing all of the infections and making sure that we're using really treatments that work, you know, and I do really like the the herbs for that reason, because we can ramp up on tinctures so that we get the ideal dose for somebody.

We can modify if people are getting die off or a Horkheimer reaction where they're feeling worse so they don't have to go to bed for a couple of days, every single time we get the dose a little bit too high, they can pivot. The next day, they can take some additional die off support, and then they can pivot and they can continue moving forward. So I think those are some of the most important concepts. Okay. Let me ask you this. So, you know, I see that you're dealing with a fatigued population, right.

And ultimately, you know, we're talking here about like a population that has a hard time with with remembering and they're starting to forget or maybe mental health issues. You know, my my feeling is that, like, what you're describing is that you have to kind of go all in from day one, right? You're all in on dealing with this. You're going to deal with all these things simultaneously and do it. And we see the same thing with with cognitive decline.

Motivation, Support, and Long-Term Recovery 22:06

Like Doctor Burks amazing outcomes are because she gets people who are super motivated and they go all in and they're the ones that get the best outcomes. Do you have advice for people who are thinking like, oh, well, this sounds good, but I'm not sure if I'm feeling like motivated either because of fatigue issues or because of, you know, other impairments that would not allow them to participate in the full way and just give you, you know, just to give me an idea of what you're thinking as far as, you know, how to activate people, into being all in.

Yeah. It's really hard when you have chronic fatigue syndrome, or you're caring for a loved one who's having cognitive decline. To, to manage a lot of this, you know, so we take people through a curriculum that kind of breaks it down into bite size pieces. We have, a Google Sheet that kind of tells you the supplements that you're going to introduce that's specific for your causes that, you know, that we tell you, what supplements to take, how to introduce them, and then we provide a lot of accessibility to make sure that whenever there's a question or a bump in the road, because there always are that there that we're there for them, you know, we guarantee response to any question people have in two business days, in order to achieve those results.

So that's one way, but the challenge really becomes, is that motivation, you know, and people have to understand that it is commitment. We tell people it's going to take at least 12 months to get better, and we're going to hold your hand along the way. So you're going to be successful. But you have to show up, you know, not at home with people. You know, I can't, you know, get their supplements organized for them. And all that. So, it is an important part of this process. And consequently, if people have really bad brain fog, it's we've it's it's very hard for us to work with them, you know, because they can't they can't they can't manage or their executive function isn't especially good.

And the same thing goes for cognitive decline. If somebody is going to do a more complex protocol, they need to make sure that they've got somebody who's going to be providing that to them, providing the supplements to them. Now, one of the things I do really like the tinctures about is because for people who have cognitive decline, where they might start to get a little bit either combative or resistant to taking supplements, doing things with tinctures can be incredibly helpful because then they're just drinking that concoction that you create 1 or 2 times a day.

So oftentimes that can make things easier for people. But it's definitely about enrolling people. It's definitely about figuring out what's going to motivate people. You know, it's not just enough sometimes for them to get better. It's about the secondary gain for their loved ones, you know, what about their children and their grandchildren who they can't play with because they're too tired? I mean, that was a big thing for me. You know, my wife was actually coming out of her chronic fatigue. We had a young child.

I had my chronic fatigue, and my wife's like, hey, I need help with the dishes and my my two year old is saying, hey, daddy, play with me. And I couldn't. And those were really my big motivators for getting better, you know? So I think that, you know, oftentimes people have to look at, okay, what is my real motivation for anything in life? You know, and oftentimes it really is family, kids, grandkids. Or they want to have that energy so that they can do things with their grandkids, and they're not going to miss out on their lives.

Beautiful. Yeah, I love that. Well, duck is such a great source of, of information. And I know that you've helped a lot of people. And, you know, I really appreciate you, you know, taking this to the masses. I know when we first met, you know, you had your practice and you were helping people there. And I feel like over the last ten years just to, like, see you, you know, take this message out there and, and help so many more people has been amazing. And I think that, you know, as practitioners, as people and, people listen to this and they realize, you know, that, help is at hand and the biggest message of all is that, yes, there are underlying causes that drive dysfunction.

And there are ways that, being effective right now to you know, to, remove those underlying causes and get back to health. And whether you do it through Doctor Hirsch and his program or whether you visit one of the doctors in our network who, executing on reversing cognitive decline, I'm excited to, to see that there are many more options for people to reverse, all manner of chronic illnesses. Thanks so much for being part of the, of the summit. There be lots of many other, talks that we have coming up today and the rest of the week.

Thanks so much for tuning in, and we'll see you at the next session.