Dr. Dale Bredesen: Early Alzheimer's Signs You're Missing (And How to Reverse It)

0:00 Today, we're going to get into the different phases of Alzheimer's

0:03 and how thousands of people now

0:06 that we've seen actually improve their cognition.

0:09 And no surprise, the earlier you start, the better.

0:13 The hope is that we will ultimately get everybody onto active

0:16 prevention so that we will make this a truly rare disease.

0:19 So, when you develop Alzheimer's disease and we tend

0:21 to think of this as a very late thing.

0:23 Oh, Alzheimer's, you know, this is a This is dementia.

0:27 Um the reality is, just like diabetes, pre-diabetes,

0:31 pre-pre-diabetes with insulin resistance,

0:33 the same thing happens with Alzheimer's.

0:35 You go through four major phases.

0:37 So, in the first phase, you are asymptomatic.

0:40 And this may occur in your late 20s, it may occur in your 30s or even 40s.

0:45 Uh and this is a phase where you can already see abnormalities in blood testing.

0:51 For example, the P-tau 217 test,

0:53 a very high sensitivity version, that's a very helpful to know.

0:57 You could also do a PET scan or have a spinal tap if you want to do that.

1:01 You can look and see these early changes.

1:03 And that may last several years.

1:06 Now, if you don't do anything about it at that time,

1:08 you may go into phase two, which is called SCI, subjective cognitive impairment.

1:14 That's where you know something's not quite right.

1:16 People will often say, um I've got a little brain fog,

1:20 you know, something's not quite right.

1:21 I'm not quite remembering phone numbers the way I used to, things like that.

1:26 Uh and by definition, SCI means you know there's something wrong

1:30 and often your your significant other may notice it.

1:33 But when you go to do cognitive testing,

1:35 you're still able to score in the normal range for cognitive testing.

1:39 And that has been documented epidemiologically to last on average 10 years.

1:45 So, you go through a rather large period.

1:46 We've got a real chance.

1:48 Virtually 100% of those people can be reversed.

1:51 Then the third stage is called MCI, mild cognitive impairment.

1:56 It's It's unfortunate they chose the term mild because in reality,

2:00 there's nothing mild about it.

2:01 It's the third of four stages of Alzheimer's disease.

2:03 Now, by definition, what MCI means is now

2:06 you are scoring abnormally on your cognitive tests,

2:09 but you're still able to care for yourself,

2:11 do your activities of daily living, drive yourself home,

2:15 balance your checkbook, calculate a tip, stuff like that.

2:18 Uh so, that's MCI.

2:21 And each year, MCI 5 to 10% of the people convert to full-on dementia.

2:27 That's the fourth and final stage.

2:29 And with dementia, now you are having

2:31 trouble with your activities of daily living.

2:33 You may get lost driving or you may have uh trouble with uh

2:37 doing your job or things like that or remembering uh you know,

2:41 where to shower, you know, things like that.

2:44 So, that is the fourth and final phase.

2:47 So, if you look at how to get started,

2:50 we first need to know what's causing the problem.

2:52 And that's been the thing that's been absent, unfortunately,

2:56 uh from so many of the physicians' uh armamentarium.

2:59 They They don't check and see what's causing it.

3:02 They just say, "Well, it's Alzheimer's.

3:03 We don't know what causes it." Well,

3:04 the reality is there are lots of things that contribute to it.

3:07 So, we want to do those tests.

3:10 So, you want to have there two separate tests.

3:13 One is if you have it and one is why you have it.

3:17 And so, the first one, we call a brain scan.

3:20 Um this is looking at the uh P-tau 217,

3:24 it's looking at GFAP, and it's looking at NFL.

3:29 The first one, P-tau 217, tells you if you have the beginnings

3:32 of the changes of Alzheimer's disease signaling in your brain.

3:36 The second one, GFAP,

3:37 tells you if you have inflammation and repair ongoing in your brain.

3:41 And the third one, NFL,

3:43 tells you if you have any neuronal damage from any cause.

3:46 So, for example, if someone comes up with a normal P-tau but a high NFL,

3:51 they may have head trauma, they may have frontal temporal dementia,

3:55 they may have some vascular disease.

3:57 If I often will see them where you have a normal P-tau and a normal NFL,

4:02 but your GFAP is high,

4:03 that means you've got some ongoing inflammation in your brain

4:06 and it's a good time to take care of that.

4:08 The good news is all three of these tests,

4:10 you can follow them as you go back down and normalize things.

4:14 And then, of course, if you've got someone who has a high P-tau,

4:17 that means Alzheimer's underlying process has started,

4:20 but please don't worry about it.

4:22 There's a tremendous amount you can do, get things optimized,

4:25 and then again, you can follow it as comes back to normal.

4:27 Now, if you see someone who has high uh all three,

4:31 that means that they have active Alzheimer's disease and they

4:34 really should get on a protocol uh right away.

4:36 So, that's the if you have.

4:39 Now, we want to think about why you have.

4:41 So, the if set, as I mentioned, P-tau 217, uh GFA GFAP,

4:46 NFL, and then also the A beta 42 to 40 ratio.

4:49 The why set, you need to determine six different things.

4:53 Are the energetics okay?

4:55 Is there inflammation?

4:56 Is there ongoing toxicity?

4:58 Are the neurotransmitters low, and especially acetylcholine?

5:02 Is there trophic support, and that's coming from hormones,

5:04 nutrients, and growth factors in the brain?

5:07 And then, is there ongoing stress that can interfere?

5:10 Uh so, we want to start You want to have a metabolic panel,

5:13 you want to have a complete blood count,

5:15 you want to look at toxins, inorganics, organics.

5:18 So, inorganics, things like mercury and air pollution.

5:21 Organics, things like glyphosate and toluene and anesthetic agents.

5:27 Biotoxins are things like mycotoxins,

5:29 trichothecenes, and ochratoxin A, and gliotoxin.

5:33 So, you can test for all these things.

5:35 And you can then see what's driving the process.

5:38 Hormones, if you are very low and especially uh around the time of menopause,

5:43 when the estradiol will drop and the progesterone will drop,

5:47 and they can drop precipitously,

5:48 that can increase the risk for cognitive decline.

5:51 So, you want to see where that stands.

5:53 You want a sleep study or at least use your wearable

5:57 to determine whether you are dropping your oxygenation at night.

6:01 Sleep apnea is one of the most common contributors.

6:04 80% of cases of sleep apnea go undiagnosed.

6:09 So, you want to not fail,

6:11 find out if you've got that, find out if your oxygenation is dropping.

6:14 You should be up in the 94 to 99%

6:18 uh 99% in your oxygen saturation while you're sleeping.

6:23 If you're dropping down to 92, it's not the end of the world.

6:26 If you're dropping into the 80s or the 70s,

6:28 that is going to uh give you some long-term problems.

6:31 So, you want to correct that.

6:33 And then, you want to look at your oral and gut microbiomes.

6:36 You want to look at pathogens,

6:38 and there's a whole list of these, various viruses,

6:41 especially the herpes family viruses,

6:44 various tick-borne illnesses such as ehrlichia and anaplasma

6:48 and borrelia and bartonella and babesia, all these.

6:52 And then, things like BDNF.

6:54 You can measure BDNF levels in your blood.

6:57 Um and then, of course, your genetics.

6:59 Uh APOE, do you have APOE4 positive or negative?

7:01 There are others like TREM2 that would be helpful as well.

7:04 And then, consider the possibility of epigenetics.

7:07 Those are getting better and better,

7:08 and you can look at things like your uh biological age,

7:13 the biological age of your various organs.

7:15 You definitely want to know your biological age of your brain.

7:18 So, these are the things that will tell you what is causing risk

7:23 and whether you're already on the pathway to develop Alzheimer's in the future.

7:28 So, let's talk for a minute about the big three bad actors in Alzheimer's.

7:32 So, it's reduction in energetics, it's inflammation, and it's toxicity.

7:38 So, when I say energetics, what I mean by that is you have an amazing brain.

7:43 It's only about 2% of your body weight and it takes up about

7:45 20% of the energy going to your in the blood flow that is going.

7:50 So, when when we say, you know,

7:52 this is an This is something that has a very high metabolic capacity,

7:57 that means you need a very good blood flow.

8:00 And you get about 750 mils uh per minute.

8:05 Um this is 250 for each carotid and 125 from each vertebral artery.

8:11 You've got this tremendous blood flow in That's why,

8:13 you know, things like exercise, really good for you.

8:16 Um sitting around, getting vascular disease,

8:19 eating a lot of junk, uh really bad for you.

8:22 And it's it's going to decrease that blood flow.

8:24 Then the second piece of this uh is for your energetics is oxygenation.

8:29 And we know again, we want want to see it up there,

8:31 uh 94, 96, 98, you know, 100 that that as you're doing.

8:35 You can look at that on your wearable.

8:37 So, that's a very, very important.

8:39 And that's where sleep apnea is a real problem

8:41 at night cuz you're really reducing um that supply.

8:45 Uh and then, the third piece of that uh is mitochondrial function.

8:49 These are the batteries of our cells.

8:51 Um and they are the things that use that oxygen.

8:53 They are the things that use the food we eat to to burn

8:56 and to generate that tremendous energy that we're using each day.

9:01 In fact, if you just take an animal

9:04 and you just inhibit its mitochondrial turnover,

9:07 just let the batteries run down,

9:09 it will get something that looks identical and identical to Parkinson's.

9:13 So, it's so important for these neurodegenerative diseases.

9:16 You got to have that whole system working well.

9:20 So, energetics and the last piece of that is uh ketones and uh glucose.

9:25 And you got to be able to use both of those.

9:27 That's called metabolic flexibility.

9:29 So, you use your ketones when you haven't had food in a while,

9:32 you use your glucose, and you should be able to go back and forth.

9:34 And it's actually helpful to have that fasting period at night.

9:37 So, you're going back into that ketosis.

9:39 And this is why we use a plant-rich, mildly ketogenic diet.

9:44 Then, uh in addition to the energetic piece,

9:46 then there's the inflammation piece.

9:48 So, anything that causes chronic inflammation,

9:51 part of your response part of your inflammatory response is

9:54 making the very things that we associate pathologically with Alzheimer's,

9:59 the amyloid, the phosphotau, things like that, the microglial activation.

10:05 Um and then the third big piece is the toxins,

10:07 and they are they are they are the inorganics,

10:11 the organics, and the and the mycotoxins {slash} biotoxins.

10:16 So, those are the critical pieces that tell you whether you

10:19 are going to develop Alzheimer's and what to do about it.

10:22 Then when you want to address these things, there are two pieces.

10:26 There are the basic pieces, which we all do,

10:29 and then there are the specifics to you.

10:31 If you've got a specific infection,

10:32 you want to deal with that specific infection.

10:35 So, let's talk about the basics.

10:37 So, you want a plant-rich, mildly ketogenic diet.

10:40 There are lots of different diets that have been used.

10:42 The one that has worked the best is a plant-rich, mildly ketogenic diet,

10:47 and you want to stay away from grains, dairy, and simple carbs.

10:51 These all can contribute to cognitive decline and the inflammation.

10:55 Uh you want to use exogenous ketones to begin with.

10:59 Um ultimately, you can get into endogenous ketosis.

11:01 It usually takes 2 3 4 weeks.

11:04 We want to get you in that at least once a day,

11:07 1 to 4 millimolar BHB, beta-hydroxybutyrate.

11:10 You know, if you're at 1 or 1.2, no problem.

11:12 That's fine.

11:14 There is an interesting paradox to be aware of, and that is this.

11:18 Alzheimer's is fundamentally a network insufficiency.

11:23 So, we're talking about something where we don't

11:25 have enough support for this remarkable neuroplasticity network.

11:30 And yet, we're starting with saying, "Okay,

11:33 you should do some fasting at night." Well, so on the one hand, we're doing

11:37 that so that you can become insulin sensitive again.

11:41 On the other hand, especially for people who are low in weight or who are frail,

11:46 you have to be really careful,

11:47 which is why I recommend at the beginning just take some exogenous ketones,

11:50 because there are only two things that support

11:52 the brain when it comes to burning fuel.

11:55 It's Of course, you've got to have oxygen and blood flow,

11:58 but you're only two things in terms of ketones or glucose.

12:01 And so, we want to make you insulin sensitive,

12:03 which allows you to burn your your glucose,

12:06 and then we want to make it so that you can make ketones.

12:09 Most of the people who have some some degree of cognitive decline,

12:12 even modest cognitive decline, fail on both of those.

12:16 They cannot use glucose optimally, and they cannot use ketones,

12:20 and they cannot make ketones either because of their insulin resistance.

12:25 So, be aware of that paradox.

12:27 Just be careful if you're very if you're underweight,

12:30 start with just adding some ketones,

12:33 and then slowly allow yourself to get into endogenous ketosis.

12:37 And then using organic fruits and vegetables,

12:39 and look at the Environmental Working Group's

12:42 Dirty Dozen and Clean Fifteen, very helpful.

12:45 We are exposed to a lot of herbicides and pesticides.

12:50 So, you've just got to be careful about that.

12:52 And then some wild-caught, low-mercury fish, the so-called SMASH fish.

12:55 And by the way, for anyone who wants

12:57 to make this vegetarian or vegan, no problem.

13:00 You just have to make sure that you have enough B12 and vitamin

13:03 D and choline and things like that that are that are key.

13:06 So, you can go either way, but in general,

13:09 what we recommend is a this plant-rich, not plant-only, mildly ketogenic diet.

13:14 So, for the fish, wild-caught, low-mercury fish.

13:18 Avoid the tuna, avoid the shark, avoid the swordfish, things like that.

13:22 The SMASH fish are salmon, mackerel, anchovies, sardines, and herring.

13:27 And then pastured chicken.

13:29 And those are hard to find, but they are they are wonderful.

13:32 So, you want to stay away from chicken has a lot of arsenic in it,

13:35 so beware of that, and use the pastured chicken if you can.

13:39 Grass-fed beef is fine, pastured eggs.

13:42 All of these things are fine,

13:44 and they keep you away from the the various toxins that you

13:47 get with the with the the lousy ones from the CAFOs.

13:50 And then, you know, 60 to 70% of your calories um will be fats,

13:56 mono- and disaturates and polyunsaturates,

13:59 very little in the way of saturated fats,

14:02 15 to 20% protein, 10 to 20% complex carbs, and greater than 30 g of fiber,

14:09 450 to 500 g of choline, and include some fermented foods.

14:13 So, we want to get that fiber up.

14:15 We want to get you probiotics, pre- biotic fiber,

14:18 and good postbiotics, all of the above.

14:21 Um and then after ketosis is established, you can cycle out after,

14:26 you know, one once or twice a week,

14:27 so that you can cycle in and out so that most days you'll get into some ketosis,

14:32 but one or two days a week, you don't have to do that, and that allows

14:36 the ketosis to be more effective over time.

14:40 And then at night, 12 to 16 hours and 3 hours before bed.

14:44 If you're APOE4 negative, 12 to 14 hours of fasting at night.

14:48 If you're APOE4 positive, 14 to 16 hours,

14:52 because you actually are better at absorbing fat,

14:54 and you're better if if everyone were starved,

14:57 those who are APOE4 positive would last

14:59 longer than those who are APOE4 negative.

15:02 So, that's why the fast is a little

15:04 bit longer for people who are APOE4 positive.

15:07 So, then the basic seven, number one,

15:10 as I mentioned, plant-rich, mildly ketogenic diet.

15:13 Number two is exercise.

15:14 Interestingly, you know, aerobic and strength,

15:16 they actually have very complementary benefits.

15:19 The aerobic is going to get you better oxygenation,

15:22 better blood flow, better sleep at night.

15:25 Uh you don't want to do it right before bed, obviously.

15:27 Strength training is very important for your insulin sensitivity.

15:31 So, these things really work together,

15:33 and there are other things where these improve your ability to get into ketosis.

15:37 You want to you know, shoot for 4 to 6 days per week.

15:39 If you want to do it 7 days, great, but at least 4 days a week.

15:44 Um and then you can look into Kaatsu.

15:45 Kaatsu is these uh restriction bands

15:47 that some of the Olympic athletes have used.

15:50 It gives you more bang for your buck.

15:52 So, you're doing some If you're doing some strength training,

15:54 you actually get more strength for the same

15:57 amount of strength training because of the restriction.

16:00 Um I happen to like EWOT a lot,

16:02 exercise with oxygen therapy, because it hits multiple pieces of this.

16:07 It is improving your cerebral blood flow,

16:11 while also giving you increased oxygen for the time that you're on there,

16:16 while also giving you some good exercise.

16:19 So, it's really a wonderful combination, and many people we see after some EWOT,

16:24 they actually will really kind of perk up and say, "Wow,

16:26 you know, that really does make a difference for me." And then sleep.

16:30 And you could spend hours talking about sleep,

16:32 and Professor Matthew Walker at Berkeley has

16:36 written a wonderful book, Why We Sleep.

16:38 Uh 7 to 9 hours a night.

16:40 You want your again, you want your oxygenation preferably over 94,

16:44 but at least over 92.

16:46 You want to get at least 1 and 1/2 hours of REM sleep,

16:49 and you want to get at least 1 hour of deep sleep.

16:52 So, I track mine every night.

16:55 Uh you can do it with, you know,

16:56 Oura Rings or any any sort of wearable will typically help you to track that.

17:01 And then stress.

17:01 Stress, I have to say, as a scientist,

17:04 I was very skeptical about stress really being much of an important thing.

17:08 It's turned out to be incredibly important.

17:10 Uh so, you want to get your heart rate

17:12 variability to better than the 50th percentile for your age.

17:16 You know, there are many methods to reduce your stress.

17:19 Uh you know, you may like to do some yoga, you may like to do some meditation,

17:23 some TM, you may like to do some shinrin yoku, some so-called forest bathing.

17:29 Uh you may like to do walks, listen to music,

17:31 whatever it is for you that gets that stress down,

17:35 really a good idea to do that repeatedly.

17:38 And there's a wonderful new book by uh Dr.

17:40 Neil Nathan, uh which is the Sensitive Patient's Healing Guide,

17:43 and he talks about things like DNRS and Gupta program

17:46 and things like that to help get that stress down.

17:49 And one of the interesting things that happens in the brain is you do

17:53 get this reprogramming uh where your limbic

17:56 system is responding to these things as threats.

17:59 So, get getting that to relax, very good for you.

18:03 And then you're relaxing the brain, but you're also stimulating it,

18:10 so that you can increase the trophic support.

18:13 It increases the production of your BDNF and your and your nerve growth factor.

18:17 You can do this with brain training.

18:20 BrainHQ is the one that actually got it rolling,

18:22 but there are other ones, Elevate and things like that.

18:25 Um and then there's photobiomodulation.

18:27 And then there are all sorts of things

18:29 like microcurrent and MERT and magnetic stimulation.

18:34 These are all the same idea.

18:36 You're providing some stimulation.

18:38 Now, remember, if you're doing nothing else,

18:40 and you're just doing stimulation, that's just running into the ground.

18:44 So, you want to be as you're getting on the whole protocol,

18:47 you're basically taking a brain that's been

18:49 on the wrong side of the supply-demand, and you're now improving that.

18:54 And then detox.

18:55 And when we first saw the patients,

18:57 this was the first one that we reversed was in 2012.

19:01 We did not know about how important

19:04 toxins are in cognitive decline associated with Alzheimer's.

19:08 Uh when we figured this out, we called it type three.

19:11 It's turned out to be a very common contributor.

19:15 So, you want to identify them.

19:16 Are these inorganics?

19:17 Are they organics?

19:18 Are they biotoxins?

19:19 You want to do some general detox,

19:21 you know, things like cruciferous vegetables, high-fiber diets.

19:24 You want to get at least uh you know,

19:26 over 30 g of fiber in your diet, as I mentioned.

19:30 Um sauna.

19:31 There was a very interesting Finnish study where they showed

19:35 that uh men who went in the sauna at least five times

19:38 a week had a much lower likelihood of developing dementia than

19:43 the ones that just went in once or twice a week.

19:45 A very surprising but interesting finding.

19:48 And then, of course, filtered water.

19:49 Basically, you want to look at how you

19:51 can detox through your skin, through your gut,

19:54 through your urinary tract, through your breath,

19:56 all of these things very, very helpful.

19:59 And we you know, we do live in a toxic world.

20:01 So, getting some time away from that can be very helpful.

20:06 And then targeted supplements and there are hundreds.

20:09 Uh and so um just to mention uh some

20:11 of these resolvins uh very nice work out of Harvard.

20:14 These things are essentially cousins of omega-3s

20:19 and they actually help you to resolve ongoing inflammation.

20:22 They can be very powerful.

20:23 Um and because the amyloid that we associate

20:26 with Alzheimer's disease is part of the innate immune system.

20:29 It's part of your inflammatory response to these various insults,

20:33 resolvins good idea.

20:35 Now, remember when you're resolving this, you're going

20:37 to you want to take away the cause over time.

20:39 You don't just want to resolve it and just let it sit there.

20:42 So, that gives you time to identify

20:44 what's actually causing this and then remove that.

20:48 And then modified citrus pectin, uh this interacts with a specific receptor

20:52 gal-3 that's involved with the inflammatory response.

20:56 So, that can be very helpful.

20:57 Whole coffee fruit extract, I happen to like that one because it

21:00 increases your BDNF actually even more than exercise.

21:04 So, that's been a very nice uh trophic support.

21:08 Omega-3s of course multiple effects.

21:10 They help you to build synapses, especially the DHA.

21:13 They help you with your inflammation, especially the EPA.

21:16 So, these are very helpful and multiple studies

21:20 showed reduced likelihood of developing Alzheimer's on omega-3s.

21:25 Vitamin D affects about 900 different genes

21:29 and some of these are related to synapse formation.

21:32 So, another good one.

21:32 In fact, low vitamin D is associated with increased risk for cognitive decline.

21:37 Citicoline nice work out of MIT

21:40 showing that citicoline plus DHA increased synaptogenesis.

21:45 So, you're able to make more synapses, which is why I like citicoline.

21:49 And again many many Americans are low in their choline intake.

21:53 You could check it on Cronometer.

21:55 Um I checked mine and I found out I was a little low as well.

21:58 So, it's a good idea.

21:59 Most of us are only getting about 300 or 350 uh milligrams

22:04 of choline and we should be up at the 450 to 550 per day.

22:09 And then nattokinase uh is a good one for lowering the risk for thrombosis.

22:14 Many, many microinfarcts that occur with Alzheimer's

22:18 and by the way also occur with COVID-19, which is one of the reasons COVID-19

22:23 increases our risk for Alzheimer's and Parkinson's.

22:26 Uh so, nattokinase something to think about uh especially for someone

22:30 who's who's just recently had COVID and has got some brain fog.

22:34 Um nitric oxide, so this helps dilate the vessels.

22:37 Many ways to do this.

22:38 Neo40, beetroot juice, uh super beets, lots of ways to dilate.

22:43 And again, studies showing that dilation

22:45 of the vessels decreases the risk for cognitive decline.

22:49 Urolithin A is one of the postbiotics.

22:51 So, uh produced by bacteria in your gut um and it

22:55 has an interesting property of recycling uh your uh mitochondria.

23:00 So, you basically get rid of the old batteries and make some new batteries.

23:03 Uh and so helpful with your uh with your overall energetics.

23:07 Uh PQQ is another nice one which uh increases the mitochondrial number.

23:12 And you could go on.

23:13 There are you know, hundreds more.

23:15 The goal here is to increase energetics, to have an anti-inflammatory effect,

23:21 to detox, have trophic support,

23:23 to optimize your neurotransmitters and minimize your stress.

23:28 With those targets, so many people get better and we've

23:31 got now sustained uh improvements for over 10 years.

23:36 So, uh if I encourage anyone, if you ever are concerned,

23:39 if you're ever feeling low, talk to some of the people who've actually improved.

23:43 It's really striking.

23:44 So, the specifics then we also want to look at, okay,

23:48 if you've got an infection that has been undiagnosed,

23:51 if you've got a toxin exposure that has been undiagnosed,

23:54 you're going to get your best outcome

23:56 if you also identify and address those things.

23:59 So, in addition to the basics we just talked about, think about the specifics.

24:03 So, we want to know about pathogens.

24:05 And there are dozens of pathogens.

24:07 Essentially, any chronic infection.

24:10 It's usually not the acute ones.

24:12 Uh it's chronic ones and that it does include long COVID.

24:16 Uh and it it does includes uh chronic Lyme and things like that.

24:20 So, herpes simplex, HHV-6A,

24:22 which is another herpes virus which gets into the brain.

24:26 Um tick-borne things, borrelia, babesia, bartonella, ehrlichia, anaplasma.

24:30 All of these chronic pathogens can increase your risk for cognitive decline.

24:36 Mold species, stachybotrys.

24:38 Not all the different mold species.

24:40 There are really five major ones that give you the problems

24:43 because they make these mycotoxins that can interfere with cognition.

24:47 It's the stachybotrys, aspergillus, penicillium, chaetomium, wallemia.

24:52 So, check out those and there are various ways to do that.

24:56 Um as I mentioned, mycotoxins such as trichothecenes,

24:59 ochratoxin A and gliotoxin.

25:00 The typical way in those, you can look for them in the urine

25:04 and you can also look for antibodies to these uh in your blood.

25:08 So, there are a couple of ways.

25:09 Leaky gut turns out to be very, very common.

25:13 So, please don't ignore that.

25:14 Optimal gut health is so important for optimal brain health.

25:18 And then looking at your oral microbiome.

25:20 And one of the things that's come up

25:21 and we used this in our first successful trial,

25:25 uh which is again freely available online published

25:28 in 2022 in the Journal of Alzheimer's Disease,

25:31 um cone beams uh which you can do in a dental office,

25:34 can look for occult abscesses that you may have.

25:36 And especially if you've got a root canal uh or if

25:40 you're sus if or if you're suspicious about any sort of abscesses,

25:44 it's a good idea to know.

25:45 These are very treatable.

25:47 Um so many now dental practitioners are getting

25:50 more expertise uh in their dealing with cognitive decline.

25:54 And then as I mentioned before,

25:55 Neil Nathan's new book, The Sensitive Patient's Healing Guide,

25:57 I think is an excellent way to look at for the the stress part especially.

26:02 So, that's the the the next piece here.

26:05 That's the day three.

26:06 The idea here is we can now look

26:09 at a specific protocol for the first time in history,

26:13 we can prevent and reverse cognitive decline.

26:15 We've now seen this in thousands of people.

26:18 And you have to get at what's actually causing it in order to improve it.

26:24 Please make sure to interact with a really

26:27 well-trained practitioner who's had good results.