The New Science of Brain Aging: What 200,000 scans reveal | Paul Thompson, PhD

How well is your brain aging? Your birthday tells you one thing, but your brain may tell a different story. Today, I’m talking with neuroscientist Paul Thompson, PhD, whose work with the global ENIGMA Consortium is revealing how brain health connects to what’s happening throughout your body. We get into what brain scans can tell us and why those findings matter to you. We discuss: What your “brain age” means and how it can differ from your actual age Why your metabolic health deserves attention when you’re struggling with mood or memory How sleep and nutrition support your brain’s ability to function and recover What having an Alzheimer’s risk gene does, and doesn’t, tell you about your future How brain scans, blood tests, and AI could help identify the right treatment for you It’s so exciting to see researchers like Paul looking across thousands of brain scans and uncovering connections between the health of the body and the brain. For me, it opens up a bigger conversation about how we care for ourselves and how our everyday habits can help protect our memory and support our mood as we age. View Show Notes From This Episode Sign up for Dr. Hyman’s Brainshaping Academy to learn how to nourish the biological systems that support your mental, emotional, and cognitive health https://drhyman.com/products/brainshaping?utm_source=dr_hyman_show&utm_medium=newsletter&utm_campaign=may_27&utm_content=link Get Free Weekly Health Tips from Dr. Hymanhttps://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journalhttps://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Healthhttps://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Resultshttps://drhyman.com/pages/hyman-hive This episode is brought to you by BON CHARGE, Paleovalley, Timeline, Seed, BIOptimizers, and Fatty15. Explore red light products at boncharge.com/hyman and enjoy 15% off with code HYMAN. Shop nutrient-rich foods and supplements at paleovalley.com/hyman and save 15% off your first order. Support healthy aging and get up to 20% off when you subscribe on top of the new starting price of $79 at timeline.com/drhyman. Make your microbiome part of your daily routine with seed.com/hyman and save 25% with code 25HYMAN. Use bioptimizers.com/hyman and code HYMAN for 15% off, special bonuses, and a 365-day money-back guarantee. Head to fatty15.com/HYMAN today and use code HYMAN for 15% off your 90-day subscription Starter Kit. 0:00 Paleo Valley Superfood Bars 2:50 Enigma and Brain Mapping 10:30 Psychiatry Meets Brain Biology 18:35 The Brain-Body Connection 24:30 Mapping Mental Health Patterns 31:30 Brain Age and Biomarkers 36:59 Sleep, Nutrition, and Recovery 47:38 A Case of Brain Repair 52:50 Genes, Risk, and Protection 59:15 Brain Charts and Diagnostics 1:12:26 AI for Alzheimer’s Disease 1:20:06 Imaging and Prevention

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dr. Mark Hyman?

  What are the factors that seem to have the strongest influence over brain function, brain health over time?

• 0:04Speaker 01

  When we looked at brain scans of people that were maybe obese, overweight, their brain would look eight years older. So people who had below normal estrogen and testosterone, their brain aging was faster. But when they were treated, or when their nutrition was back in balance, all of these brain systems were restored. So I mean, the food is the fuel of the mind.

• 0:28Dr. Mark Hyman?

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• 1:11Dr. Mark Hyman?

  It's lightweight, it's adjustable, and designed to fit easily into your routine. BONCHARGE also has a whole range of red light therapy products beyond the face mask. So if you're interested in incorporating red light into other parts of your wellness routine, they're worth checking out. Go to BONCHARGE.com, that's B-O-N-C-H-A-R-G-E.com and use the code HYMAN to save 15% off site wide. They offer free shipping on every red light face mask, a 12 month warranty, and the mask is HSA FSA eligible for up to 30% savings. I've worked with Paleo Valley for years, and one of the reasons I really love partnering with them is that they care so much about the quality of their ingredients. They're not trying to create another ultra-processed health food. They're focused on real nutrient intense foods.

• 1:53Dr. Mark Hyman?

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• 2:37Dr. Mark Hyman?

  visit paleovalley.com/hyman and use the code HYMAN at the checkout to save 15% off your first order. That's paleovalley.com/hyman and use the code HYMAN at checkout. Welcome, Paul, to the podcast. So good to have you.

• 2:50Speaker 01

  Appreciate it.

• 2:51Dr. Mark Hyman?

  I am sort of in awe of your work. I think, you know, you're one of the few scientists out there who's connecting the dots in ways that most scientists don't because we're learned to be tunnel vision in science. We pick one topic. We have one trajectory we're working on our whole career. We're reductionist to a fault. And you've zoomed out and you created this extraordinary project called the Enigma Consortium, which is a global brain mapping collaboration involving 2,500 scientists across 47 countries. And you're looking at brain imaging, all sorts, and biomarkers, blood biomarkers. And you're, you're, you're kind of doing something that's kind of heresy in medicine,

• 3:36Dr. Mark Hyman?

  which is looking at psychiatric diseases by looking at the brain. The joke in medicine is that psychiatrists pay no attention to the brain and neurologists pay no attention to the mind.

• 3:48Speaker 01

  Yes.

• 3:49Dr. Mark Hyman?

  And you're paying attention to both, the mind and the brain and how they relate. And they're not the same exactly. And how the rest of your biology plays a role. And you're, you're not just looking at the typical neurologic diseases like Alzheimer's and Parkinson's and so forth, but you're looking at psychiatric conditions, which typically have been just diseases of description. You get these symptoms, you get this diagnosis. It's basically the DSM five, which is a, we all call the Diagnostic and Statistical Manual, number five. It'll be a number six soon, I think. They used to have visitation from the gods and things like that, but I mean, they've updated it. But it's not any better than that. Honestly, my opinion, I asked Thomas Insola, who you probably know is the head of the NIH for the National Institute of Mental Health for a while.

• 4:35Dr. Mark Hyman?

  And I said, Thomas, what, what do you think of the DSM five? He's like, well, he said it has 100% accuracy, but 0% validity. I mean, it's very accurate in describing and putting people into groups and categories according to their symptoms, but not at all about understanding the cause or mechanism of the disease. And for the first time, I think, I don't, I don't know too many people doing what you're doing, which is you're, you're looking at the biology of mental illness in a way that's not just, it's a chemical imbalance and takes serotonin reuptic inhibitors, but really a much more nuanced view of how the structure and function of the brain work together and how to, how that can help us understand these conditions, how it can start to kind of bring about novel treatments that we haven't thought about before, make discoveries we never thought of before. I don't know how you got into this, but like you, you were kind of a Greek and Latin

• 5:20Dr. Mark Hyman?

  major at Oxford, and I don't even, I don't even know where you go with that. I'm becoming a classics professor. What took you down this road and how did you get this aha that we should be looking at things a bit differently?

• 5:30Speaker 01

  Well, first of all, I really appreciate your invitation to be, to be here today. I admired your work for many, many years and it's, it's fun to be able to.

• 5:37Dr. Mark Hyman?

  I was hoping you'd say yes. I didn't even know who I was. I was like, I hope he comes on this podcast. He's a real scientist. I'm just kind of a quacky doctor.

• 5:43Speaker 01

  You do incredible work, Mark. So I was just, first of all, the classics, if we, we were joking about this, if we meet any ancient Greeks, we're going to be fine. We'll be able to look after them. But I, I grew up in England, as you can probably tell from my funny accent, and I had the chance to work at UCLA during my PhD in my twenties here in, in Los Angeles. And they had a brain mapping center, a brain mapping center. And so what you could do at UCLA, and now this is available across the world, is you could have a three dimensional picture of the brain, not just what it looks like, but the, the activity of the brain, what is the molecular content of the brain? Is the activity in the normal range? Is it depressed like in depression? Is it deteriorating like in dementia?

• 6:28Speaker 01

  So I just got absolutely fascinated by this. And I mean, you know, Mark, in your own work, you can use these technologies to give you insight into whether someone is doing okay, whether they need some medication or lifestyle intervention, or for that matter, in a drug trial, you can use these as a readout of whether or not the medication is, is, is working.

• 6:47Dr. Mark Hyman?

  That's incredible. You know, and you know, you have been part of this consortium and collaboration across 47 countries, done 200,000 brain scans, which is a staggering number of brain scans, over 30 different brain disorders. What are you seeing? What are the patterns that are emerging?

• 7:03Speaker 01

  So I can tell you a little bit about the different brain diseases and, and I know your listeners are going to be very familiar with, with some of these, perhaps less so with others. So in old age, a lot of people get dementia. And one of the kinds of dementia, Alzheimer's disease is a huge problem. And so as you know, maybe among 70 year olds, maybe 5% of them have this, but every five years after 70 years of age, its incidence doubles. So that, that's, that's pretty incredible. I mean, at 75, 10% of people at 80 years of age, 20% of people. So this is this looming epidemic hazard that is coming.

• 7:38Dr. Mark Hyman?

  Yeah.

• 7:39Speaker 01

  So one of the early results with brain imaging that really showed its, its value was that if you scan people as they progressed with Alzheimer's disease, there was this wildfire of tissue loss in the brain. And you, you could take a scan, a little like a Polaroid, you'd take a scan, you know, a month later, two months later, and you could make a time lapse movie where you could see the propagation of the disease. So it starts in the memory system. It attacks your language systems. Eventually it attacks the, the frontal parts of the brain involved in, in planning and making decisions. So that started to be used in drug trials. So people will say, well, I, I'd like to see if a treatment, it could be a pharmacotherapy, it could be a lifestyle intervention.

• 8:24Speaker 01

  Does that slow this relentless, you know, forest fire of change? And so then we got into psychiatry. So, so Lily, just to tell you the story of how it came about, they.

• 8:36Dr. Mark Hyman?

  The drug company.

• 8:37Speaker 01

  The drug company, Lily, they were testing.

• 8:39Dr. Mark Hyman?

  Not your friend Lily.

• 8:40Speaker 01

  My friend Lily. They, they were developing drugs for schizophrenia. So schizophrenia is very different. It, it, it's a mental illness where people hallucinate, that they have a distorted perception of reality. They have so-called psychotic outbreaks. But there are some medications for it, not, not always successful, moderately successful.

• 9:02Dr. Mark Hyman?

  And with lots of side effects.

• 9:03Speaker 01

  And with lots of side effects, one of them being obesity, which we, we'll get into. So Lilly said, could you come up with a kind of brain imaging where we can see what the drug is doing? Because there was an older drug, haloperidol, it was an antipsychotic. And the results of that trial were that the medication seemed to be slowing down the spread of schizophrenia in the brain. And you say, well, what does that mean, the spread of schizophrenia in the brain? You could see physical changes in the brain tissue. And if someone was scanned today and in three months, the people that were taking that particular medication would have a slower rate of tissue loss. So you can begin to see how, you know, in Alzheimer's, where, you know, pretty much all scientists agree, there's a degeneration

• 9:46Speaker 01

  of the brain. You could say, well, you're maybe 10% below the normal range for people of your age and background. And the drug trials started to use these measures. So you're very pioneer in the area of biomarkers. So you can think of a brain image as a source of physical evidence of disease in the brain. And there are plenty of others. I mean, someone's not going to just use the image. There'll be clinical assessment, there might be blood marker assessment, there could be whole body physical assessment, as you are doing. But the big picture of it all is that each of these is sort of an indicator, either to rule out or rule in a disease, and then even to see if an intervention is successful.

• 10:30Dr. Mark Hyman?

  Yeah, this is really important. I think, I think, you know, this is sort of novel, the idea that you can see schizophrenia on a brain scan, right? I think what's really interesting to me is, and I always say this, the body has only so many ways of saying ouch. And there are a lot of different things that happen, but often the pathology is similar. Some of the manifestations are different, right? So inflammation, oxidative stress, mitochondrial dysfunction, these are common phenomena across the spectrum of brain disorders. Metabolic dysfunction, schizophrenia, these patients have inflamed brains. They have mitochondrial

• 11:09Dr. Mark Hyman?

  dysfunction in the brain. And there's different types of causes. There's scientists, for example, at Harvard and other places, doing metabolic psychiatry, like Chris Palmer, and putting people on keto diets and seeing schizophrenia resolve without medication. So that like makes me wonder, sort of what you're looking at with these brain imaging, we can start to look at inflammation, we can start to look at mitochondrial function, we can start to look at, you know, metabolic function in the brain through various kinds of imaging.

• 11:37Speaker 01

  Absolutely. And I think, Mark, that line of work of functional psychiatry, metabolic psychiatry, I saw your interview with Ian Campbell, terrific interview. I think it's opening a door to therapy for patients that they really haven't known about. I mean, if they've read your work, they know about it. But it's a new window on how to come into these disorders. And I'll give you an example. So a lot of the radiologists look at brain disease as if there's got to be some lesion or, you know, very obvious, visible difference. So the techniques that tended to be used, you know, an MRI would say, look, in a stroke, we see a vascular event, that's what we're looking for. In Alzheimer's, we're going

• 12:17Speaker 01

  to use a PET scan. A PET scan can look at the buildup of amyloid, which is a toxic protein in the brain. And maybe in Parkinson's, which is, you know, is a disorder of motor function, where people have disturbances in their ability to walk or things like that, you look in the scan for an atrophy of the motor systems of the brain.

• 12:36Dr. Mark Hyman?

  Yeah, the basal ganglia.

• 12:37Speaker 01

  So in neurology, that kind of works. It's not the full picture, but it kind of works. So you can say-

• 12:41Dr. Mark Hyman?

  It tells you about the structure, not the function.

• 12:43Speaker 01

  Yes, it deals, absolutely. Now, in psychiatry, and I think you hit the nail on the head, when we were first publishing neuroimaging studies of schizophrenia, there were a lot of skepticism. And these were studies with maybe a dozen people. And they say, look, it looks like there's a change in the memory system of the brain, the hippocampus. But I think what we were missing, and you said it, Mark, is that there are physical, biological processes going on in the brain all the time. Some of them are functional, they have to do with the activity and the synchrony of parts of the brain. These are visible with newer imaging technologies. Functional MRI is going to look at the blood flow, is your blood flow healthy? Is your lifestyle enabling you to have the activity of the brain that

• 13:28Speaker 01

  you need? And I think part of the blindness to this was to treat the brain as something that we could assess with an X-ray. I mean, you know, an X-ray is, it's pretty good. If you break your leg, we're going to have an X-ray. But the brain is complicated. And if you are a pilot flying over Los Angeles, and you were trying to figure out what was going on, I mean, the map isn't all there is to it. You want to have a look at the traffic flow, and if anything blocked, or, you know, what's going on. And I think these functional neuroimaging methods, functional MRI is one of them, PET, which is another type of brain imaging, looks at the metabolic activity of the brain. And these are slightly

• 14:10Speaker 01

  less used. And certainly in psychiatry, it's absolutely, it's opening a whole new window into the synchrony of the brain. I've heard you interview people about the so-called resting state networks of the brain. On an X-ray, you're not going to see any resting state networks. And what we see is that-

• 14:28Dr. Mark Hyman?

  An X-ray meaning an MRI or a CT scan.

• 14:30Speaker 01

  Exactly.

• 14:31Dr. Mark Hyman?

  Or, because those are, those are really static images.

• 14:34Speaker 01

  They're static images. And that's the secret, isn't it? Because if someone is very depressed, it might not be evident in the physical structure of their brain. I mean, they could, and I've heard your guests say this, I mean, someone, I think Ian Campbell had a mental health condition, he went to a doctor, he had an MRI of the brain, and they said, well, this, this looks like you're fine. I mean, there's nothing any different than other people of your age.

• 15:00Dr. Mark Hyman?

  Bipolar disease on an MRI.

• 15:01Speaker 01

  That's right. But what he is doing, and what we're also doing in our ENigma project, is we're trying to collect assessments of the brain that can look at the metabolism, is your blood flow as it should be. And it's complicated. I mean, in something like depression, maybe the interactions among the brain's networks are slow, or they're sluggish. And you've done a lot of work on bipolar disease. So at certain times of day, someone's brain networks might not be functioning exactly as a healthy person would. But with a right intervention, maybe a metabolic intervention, maybe a keto intervention, or even with classical pharmacology, which some people respond to, you could see a resetting, you know, they

• 15:46Speaker 01

  get back into the normal range. So they, I feel like these two things go together. One is having a giant reference of what healthy people's brains do, which includes getting the right assessments. And then in a sense, you know, making sure that the therapy, as you know, is matched the kind of illness that they have. So if they have a neurodegenerative disease, you know, something like Alzheimer's or Parkinson's, you know, there's particular treatments for that in pharmacology. There's also particular lifestyle interventions, as you've pioneered, for their metabolism. On the other hand, if you have bipolar or major depression, these brain scans can give you a readout of whether or not the intervention

• 16:28Speaker 01

  has been beneficial. And I mean, that's, it doesn't get more personal than that. You have a physical picture of the result of the-

• 16:34Dr. Mark Hyman?

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• 17:19Dr. Mark Hyman?

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• 18:03Dr. Mark Hyman?

  reach the colon, where most other probiotics just die in your stomach acid. And third, DSO1 has been clinically studied and is shown to reduce bloating, alleviate gas, and improve regularity. It's not just marketing, that's real clinical evidence. And that level of scientific rigor, it's exactly what led me to join SEED's clinical board, and why I continue to recommend DSO1, and take it myself, even after all these years. Go to seed.com/hyman and use the code 25HYMAN to get 25% off your first month. That's S E D dot com slash Hyman and use the code 25HYMAN. In fact, even the whole distinction between neurology and psychiatry is sort of artificial. It's kind of a fallacy that they're separate because they're so connected.

• 18:45Dr. Mark Hyman?

  And, and, you know, the, what I find so fascinating is that, and functional medicine's really good at describing this, what are the fundamental physiological processes that underlie all disease? There's not that many of them. There's the microbiome, there's the immune function, there's your mitochondria, there's your, you know, communication systems and networks, hormones, so forth, there are transmitters, there's your circulatory vascular system, there's your detoxification system, there's your structural system, down from to the membranes, all the way to your biomechanical structures. Disturbances in these fundamental processes are what's driving all the downstream illnesses.

• 19:20Speaker 01

  Absolutely.

• 19:21Dr. Mark Hyman?

  And so when you look at the science, and you know, it's interesting, as a functional medicine doctor, like, I'm not a quote specialist, but I'm a super generalist. So I'm looking at everything, all at once. It's like everything, everywhere, all at once. It's like the movie. And so I'm like, oh, gee, if you look at the literature on depression, it's brain inflammation and mitochondrial issues. If you look at the literature on Alzheimer's, it's the same thing. If you look at the literature on autism, it's the same thing. If you look at the literature on schizophrenia, it's the same thing. So all these diseases are like, like leaves on a tree, and they have common roots. And often common therapies. But the common therapies aren't like, aren't, aren't like the same drug for the different diseases.

• 20:05Dr. Mark Hyman?

  They're like the fundamental lifestyle and causal, corrective causal systems.

• 20:09Speaker 01

  And I think, Mark, you have the perspective to see all of the connections among these things. Because if someone is an Alzheimer's doctor and they don't necessarily see patients with diabetes or with other psychiatric conditions, they won't see the connections between the things that were helpful. And, you know, some of the people that you've interviewed, they said, you know, the dietary change that I, you know, did, I noticed a big change. And that wouldn't have been on the radar for people that were doing the, you know, conventional treatment.

• 20:39Dr. Mark Hyman?

  What's interesting to me is that, you know, like Suzanne goes and a lot of brain imaging around autism. And she's like, oh, there's a lot of mitochondrial dysfunction. Or look at the same thing around schizophrenia. So the manifestations in an individual depend on their genetics, lots of factors, some of which we understand, some of which we don't. But it's, you know, like David Deutsch said in The Fabric of Reality, you can treat diseases, even if you've never seen them before, if you follow the fundamental principles and be successful. And that's what I've done in functional medicine. I've treated diseases I've never seen before successfully, because I just follow the fundamental laws of biology. And what we're discovering here, and your work is so key to this, is we're discovering these fundamental principles of human biology that we're heretofore never unpacked.

• 21:23Speaker 01

  Yes.

• 21:24Dr. Mark Hyman?

  And now they, and now they're like, wait, you know, what is OCD or schizophrenia have to do with Alzheimer? A lot.

• 21:31Speaker 01

  Absolutely.

• 21:31Dr. Mark Hyman?

  And, and so.

• 21:33Speaker 01

  I think you're so right, right, Mark. I mean, the, one example, and you've written about this, is cardiovascular health. So cardiovascular health, and people are familiar with it. I want to avoid a heart attack. I want to avoid a stroke. I'm going to have a better lifestyle, better diet.

• 21:46Dr. Mark Hyman?

  I would kind of rephrase it as cardio metabolic.

• 21:48Speaker 01

  Cardio metabolic health, that's, that's better. Now, a doctor who's treating Alzheimer's disease can say, oh, you know, the scan shows that you're, you're not doing, you're not doing so well. There's amyloid plaques building up in the brain. The treatment for amyloid plaques is, I mean, there's a vaccine that's experimental. Do you want to try that? But you know, Mark, that at the same time, you know, 60% of people that are diagnosed with dementia have cardio metabolic issues and problems that, to some extent, are treatable. They may be very treatable. And even going over to mental health and mental illness. We had a colleague, Thomas Hayek, and he treats a lot of people with schizophrenia and bipolar.

• 22:29Speaker 01

  And he said, do you know that the cardio metabolic health of these patients makes all the difference in the world? And he said, some of the treatments for schizophrenia, as you know, make you put on weight. It's, you're part of this. And he noticed.

• 22:43Dr. Mark Hyman?

  It's so ironic, the very drugs that treat schizophrenia caused the very problem. Cause the very problem that causes schizophrenia, which is mitochondrial dysfunction.

• 22:51Speaker 01

  Absolutely. And he noticed by looking at brain imaging, he said, look, I've seen the differences in people with schizophrenia on brain imaging, this tissue loss. But the people with high body mass index, or the people with cardio metabolic problems, they have worse brain scans. And he was very interested in it. He said, you know, in Enigma, let's start collecting that data. And I mean, Mark, you do this. So as well as the brain scan, let's collect data on their cardio metabolic markers in blood. And, I mean, you knew this, and in your work, you pointed this out. In addition to whatever it is that is going on in their brain, their systemic, their bodily health, when that is treated, it can make a whole world of difference to their symptoms.

• 23:36Speaker 01

  And this was true in depression, it was true in bipolar disease, it was true in schizophrenia. And just to be really precise, the amount of difference in their brain on a brain scan was far greater if there was metabolic disease, or if there was cardiovascular disease. And he said, you know, this is revolutionary, because we don't, I mean, we will certainly use antipsychotics, but we don't see all the time this other path to health.

• 24:01Dr. Mark Hyman?

  Yeah.

• 24:01Speaker 01

  And I mean, the patients are extremely interested in this, as you know, because it's, it's another path. And he said, it's a little like a bank account. I mean, let's say my bank account is getting low, but there's plenty of ways that that bank account can be topped back up. And we, we used to use this one, and it worked for some people, didn't work so well in others. But if there's another route, as you know, to replenish or protect or bolster the other processes that are going on, I mean, that can make the world of difference.

• 24:30Dr. Mark Hyman?

  Yeah, and it's so true. And I think that we really, we really don't think about treating the body to treat the brain. And that was the subtitle of my book, Ultra Mind, which was fix your broken brain by healing your body first.

• 24:42Speaker 01

  Yes.

• 24:43Dr. Mark Hyman?

  Or something like that.

• 24:44Speaker 01

  And you know this, but this is true in people that are sick and true in people that are healthy. So if you look in these brain scans of people with different mental health conditions, the people that have an intervention that protects their cardio metabolic health do better. The scan can show you it. So, I mean, we know that this is also relevant to, you know, everybody. But particularly in these illnesses that we blamed on something else, it seems to make the world of difference.

• 25:10Dr. Mark Hyman?

  Yeah. You know, you studied the spectrum of psychiatric and neurologic conditions. What, you know, they have all these different labels.

• 25:18Speaker 01

  Yes.

• 25:18Dr. Mark Hyman?

  What's in common?

• 25:19Speaker 01

  Kind of interesting. So you mentioned the DSM five, which is the way that doctors categorize a person's mental health condition. And people have heard of things like, you know, major depression, bipolar disease, schizophrenia. There's conditions like post-traumatic stress disorder, there's addiction. And they can be grouped. So there's a lot of mental health conditions with emotional blunting, lowered affect. There's sort of a depressive aspect of this. And on, on brain images, you very often see metabolic issues in the so-called limbic system. So the center of the brain, we often think of as the gas pedal, the motivation.

• 26:00Dr. Mark Hyman?

  It's like the reptilian part of your brain.

• 26:01Speaker 01

  The reptilian part of the brain. And this is a deep part of the brain that you could maybe think of as kind of the gas pedal, the motivator. What drives us to get out of bed in the morning? What motivates us?

• 26:11Dr. Mark Hyman?

  The fight or flight or feeding.

• 26:14Speaker 01

  Exactly.

• 26:14Dr. Mark Hyman?

  We called the four ups in medical school. Fight, fight or flight, feeding and reproduction.

• 26:20Speaker 01

  Yes, yes.

• 26:21Dr. Mark Hyman?

  The four ups.

• 26:21Speaker 01

  Yes, yes. So you can see this part of the brain on neuromaging. And a lot of the mental health conditions that are associated with poorer, your emotional flattening, I mean, loss of motivation and volition, and that would include depression. It would include, in some cases, anxiety. The depressive side of bipolar disease, which is very low emotion. You'll see on the brain scans that there is, in some cases, structural deficits there, but also metabolic. I mean, you know glutamate, for example, I mean, the neurotransmitter that's very important to brain. Excitation, you'll see your abnormalities in glutamate too. So that is one group of disorders where there's depression.

• 27:05Speaker 01

  We sometimes call them internalizing disorders, because they're disorders of thought, they're emotional disorders inside us. There's another group of psychiatric disorders that are associated with compulsion, addiction, substance. OCD is one of them. I mean, these are disorders. And on brain scans, you can often see these compulsive, even aggressive disorders associated with abnormalities in the frontal, the frontal parts of the brain, the frontal lobes of the brain. So these are sort of two systems. There's the, there's the, there's the gas pedal, the motivator, the primitive brain. And the frontal part of the brain, you'll often see damage, and the brain scans show this, in people that are disinhibited, that they might be manic, they might have, even in ADHD,

• 27:49Speaker 01

  where there's a sort of overactivity. And so these are, it's a very simple classification of the disorders into ones where there's depression, blunted affect, or the ones where there are compulsions. But you'll see similarities. So if someone who's addicted to a substance of abuse, you know, alcohol or meth or opiates or cocaine, you'll often see damage, and this is visible on the brain scan, in the frontal lobes of the brain. And the frontal lobes are kind of like the brakes. So if the limbic system is the gas pedal, frontal lobes are a little bit like the brakes. And if you've damaged the brakes, there's often a, you know, an out of control aspect to behavior. So these patterns. They're not just physical pictures of how these brain diseases look.

• 28:34Speaker 01

  They're sort of becoming diagnostic tests as well. So if someone wants to know if someone has anxiety or depression.

• 28:42Dr. Mark Hyman?

  Are these on functional MRIs?

• 28:43Speaker 01

  They're actually both. So to make a distinction, the functional MRIs are more useful in psychiatry. Because we tend to think of these are more disorders of behavior, of emotion. We may not see a physical loss of tissue.

• 28:58Dr. Mark Hyman?

  Right.

• 28:59Speaker 01

  But like you said, Mark, there may be molecular changes. There may be physiological changes that we can interrupt or block or restore. That can, the readout on the functional MRI shows a benefit.

• 29:11Dr. Mark Hyman?

  So for people, you just kind of help distinguish between what is a regular brain MRI?

• 29:14Speaker 01

  Yes.

• 29:15Dr. Mark Hyman?

  And what is a functional brain MRI?

• 29:16Speaker 01

  Okay, okay. So a regular brain MRI looks a bit like an X-ray. And the reason we don't use X-rays.

• 29:23Dr. Mark Hyman?

  It's a fancy X-ray.

• 29:24Speaker 01

  It's a fancy X-ray. The principle of how it works is a little different. So an X-ray is radiation wherever this bone or kind of fibrous tissue. I mean, you can see it if you've broken your bone, you can see the problem.

• 29:37Dr. Mark Hyman?

  Yeah.

• 29:37Speaker 01

  For the brain, a lot of the issues are with the tissue, the nervous tissue. The, it is obviously, brain's not made of the material that bones are made out of. So that's why we use MRI. And usually the types of things a structural MRI will pick up is if there's a tumor or a brain bleed, if someone has an aneurysm, you will see on the MRI that there's a physical structural disturbance of the brain. Now, what happened was, round about 30 years ago, there were people tinkering around with an MRI. And they say, you know, wouldn't it be interesting if this depended on how active the brain was? I mean, it's just a picture, but I mean, it is measuring physical processes in the brain. And so they started to do experiments where somebody did a task in the scanner.

• 30:23Speaker 01

  Like they would tap their fingers or they'd look at a flashing light. And they found tiny differences in the oxygenation of the blood in the brain. And if you could subtract the image when someone was active from the image when they were at rest, you could pick up, and this really took off. And so, you know, in the 90s, you'd get, you know, here's the map of language, or here's the map of planning, or here's the map of vision. And the brain is a landscape, it's like a city. I mean, there's places that control these different tasks. So you're right, the functional MRI is looking at the blood flow in the brain, which for many reasons can be disrupted, either because the blood vessels are blocked, as in stroke,

• 31:07Speaker 01

  or because there just simply isn't the metabolic supply to drive the blood into these key brain regions.

• 31:13Dr. Mark Hyman?

  Basically, you're looking at the biological function of the brain versus just the structure of the brain.

• 31:19Speaker 01

  That's right.

• 31:19Dr. Mark Hyman?

  And, and you can tell a lot about the metabolic function, what's working, what's not working, how it's working. And that tells you so much about the psychiatric diseases. So it's a way of like using imaging for psychiatric illness.

• 31:31Speaker 01

  Absolutely.

• 31:31Dr. Mark Hyman?

  When you, you've looked at so many brains, like what are the things that you're finding? Because you're not just looking at brains, you're also looking at lifestyle factors. You're looking at blood biomarkers. What are the factors that seem to have the strongest influence over brain function, brain health over time? Because, because you know, we, we all know, okay, I know from my heart, I should not need saturated fat. Oh, that's not right. Or I know I should exercise, I know I shouldn't smoke. I know these things are important for my heart health. But people go, how do I take care of my brain?

• 32:00Speaker 01

  Yes. Well, those same things, as you know, Mark, matter for the brain. And so when we, when we looked at brain scans of people that were maybe obese, overweight, their brain would look eight years older. And you know, there's this very interesting measure of brain age. So you've talked about this concept in your work. So, so the brain age would be, you know, how old does my brain look? And not just an opinion, I mean, a computer can identify the different features of the brain, the changes we age and give you a score.

• 32:30Dr. Mark Hyman?

  And what are those, what are those measuring?

• 32:32Speaker 01

  Well, they can be based on a few different kinds of measures. So the ones based on brain MRI are usually measuring the structures of the brain that change the most as we get older. And so, you know, your kids' brains grow, they reach a peak in your twenties. Obviously, there's a gentle loss of brain tissue throughout the brain. I mean, even helping people. The shrinking of the brain. So you can make a brain chart. So you can sort of say, you know, a pediatrician has a chart of how, you know, the height of a child should be at different ages. And they're not all the same height, there's a range. So what about if we were to make a chart of the size of the brain's memory system?

• 33:13Dr. Mark Hyman?

  Like the hippocampus.

• 33:13Speaker 01

  Like the hippocampus. And for a long time, even in drug trials, that, that single measure was used. So if someone was designing a drug trial of an anti dementia drug, it would be common to say, well, the primary endpoint of this trial is the person's memory function doesn't decline as much. I mean, that's the clinical endpoint. But we were interested in a physical biomarker as well. So they would pick either the size of the hippocampus, which is a little two teaspoon.

• 33:41Dr. Mark Hyman?

  Looks like a seahorse.

• 33:43Speaker 01

  It's like a seahorse. Over the course of time, I think people realized that, you know, just a single measure wasn't really going to cut it. It's not going to cut it. So, so even if you stay within a brain MRI, you could say, well, okay, what are the other things that decline as we age? You know, maybe the language area and the visual area and other thing, let's measure all of them. So what people do when they talk about brain age is they say, well, okay, in a particular person, let's measure them all. And we're going to see where this person is on a chart, like a percentile chart. And if the hippocampal volume is kind of low, maybe in the lower 5%, let's look at some other things as well. Let's look at the, the white matter connectivity of the brain. So there's another type of brain scanner, diffusion image.

• 34:28Speaker 01

  If those neural pathways are intact, that's another measure. And you could even put in functional imaging. You say, well, either the structure looks like there's a little bit of a problem. What, what if we look at this other measure of blood flow? So what will happen is all of these individual biomarkers on their own, they can certainly flag an anomaly on their own. But imagine how great it would be if there was a holistic picture. I mean, even just with imaging, all these cool types of imaging. And that has led to the notion of, for example, brain age. And so, so you could say, well.

• 35:01Dr. Mark Hyman?

  It's a composite number from a multiple different structural aspects of the brain.

• 35:05Speaker 01

  Yeah, absolutely. And you, I mean, you know this, Mark, and just for your listeners, you could have a blood age. So you could say, look, we can measure proteins in the blood. We know things like cholesterol and lipids are very important to healthy function. We want to look at hormones like estrogen and testosterone, maybe homocysteine, which is sometimes a sign of bad metabolism. Let's make a score. And there's several scores from blood. I mean, blood, I mean, you know this, you can get a blood panel readout and flag things that are off. But you can also have a summary, as you know, of, of cardiometabolic health. Are there any signs of Alzheimer's or the endocrine markers within range?

• 35:50Speaker 01

  And so I think, as you've said, the perspective, the hormones as well.

• 35:53Dr. Mark Hyman?

  Nutrients, hormones, everything.

• 35:55Speaker 01

  And these are also evident in a brain scan. So people who had below normal estrogen and testosterone, their brain aging was faster. And I mean, that kind of makes sense. If their thyroid hormone was too low, their brain aging was faster.

• 36:12Dr. Mark Hyman?

  Too low or like low normal or low?

• 36:13Speaker 01

  Out of, out of range. And that's a good point. So there's some markers where they're too high, when they're bad, something like homocysteine. So if someone was taking folate or the B vitamins, and it can lower your homocysteine. And these have been used, as you know, in clinical trials. I mean, there's been tests that have said, look, if somebody has some of these nutrients out of range, there's not just a health benefit of fixing them, but there's a physical measure in their brain scans that their brain is getting better.

• 36:45Dr. Mark Hyman?

  So brain, brain age is a useful tool to sort of see how you're doing. I want to take a little digression around this because, you know, we often think that aging is a linear process. Like we just decline gradually over time and then we die.

• 36:59Speaker 01

  Sure.

• 37:00Dr. Mark Hyman?

  It doesn't turn out that that's true. I can tell you that from personal experience. I've aged backwards and forwards many times.

• 37:08Dr. Mark Hyman?

  And not obviously willingly, I've had various conditions or illnesses that have knocked me back. But I recently went to Mexico where there's a compound called ibogaine, which is legal.

• 37:21Speaker 01

  Yes.

• 37:21Dr. Mark Hyman?

  And I took it as a sort of, as a way to enhance my neuroplasticity. Because I met with Governor Rick Perry, who's, was the 15 year governor of Texas. And we had a dinner and he's like, you know, Mark, I did this. And my brain size increased on MRIs. And that caught my attention, like, oh, okay, well, I'm 66. I'm like, I could use all the help I can get. And I was like, let me try it. And I went down there and I, and I was methodical. I did a brain imaging, a quantitative brain image. Because you're doing an MRI, so you can do MRI, just a regular one. And then you can measure ones that look at specific brain structures and actually measure quantitatively the size of them. And I did a quantitative before.

• 38:03Dr. Mark Hyman?

  A week after and three months after, and my cortical thickness, which is sort of the size of your brain essentially, like went up eight percent. And my white matter lesions, which is the level of inflammation, which tends to get worse as you get aged, aged is it went down 22%. I'm curious if you've seen this kind of phenomena happen before?

• 38:24Speaker 01

  Yes.

• 38:24Dr. Mark Hyman?

  And, and what can you talk about that can explain that? And what other things, lifestyle factors or other things, drugs that you've seen that can help do this?

• 38:33Speaker 01

  I mean, you know this, Mike, they, they, they make a huge difference. So there, there's dietary factors, there's physical lifestyle factors. And I mean, you, you saw this with, from your own experience and in the scan, it's just not regularly studied. And I, I think, you know, you're seeing

• 38:48Dr. Mark Hyman?

  By the way, I didn't tell the neuroradiologist what I did. I just, they had my scans and they were like, what the heck's going on here?

• 38:53Speaker 01

  Yeah, absolutely. And there are so many lifestyle factors as well. So what, one example that I mean, Mark, you've written about is sleep. So having good sleep and, and sleep, I mean, we think of it, your brain isn't doing anything at all. I mean, when you're asleep, that's, that's just downtime. But on imaging, neuroimaging, the images kind of had a surprise recently. There's something called the glymphatic system of the brain. And neuroscientists kind of knew a little bit about this, but they'd never really seen it in action. And what happens is when you're asleep, the, the, there's these sort of waves, almost like a car wash, where the brain fluid is cleansing out toxic products from the brain. And I mean, this wouldn't be a surprise.

• 39:36Dr. Mark Hyman?

  Thinking creates a lot of waste products.

• 39:38Speaker 01

  It creates a lot of waste products.

• 39:39Dr. Mark Hyman?

  God, you gotta poop at the end of the day.

• 39:40Speaker 01

  That's right.

• 39:41Dr. Mark Hyman?

  And your brain essentially has to get cleaned out at night.

• 39:44Speaker 01

  Absolutely.

• 39:45Dr. Mark Hyman?

  And we have a lymph system for cleaning out our waste from our body, but our brain has its own lymph system. We call it the glymphatic system.

• 39:52Speaker 01

  And it, I mean, it comes back to what you said, Mark. If you weren't thinking about that or weren't knowing that there was anything there, I mean, you'd miss it. But what started to happen is people said, well, if, if you have bad sleep, how, how does that affect brain decline as you age? I mean, something like Alzheimer's. And a lot of these things are circular. If someone starts to have Parkinson's or Alzheimer's, their sleep is going to be affected. And as you know, if you can fix their sleep, or if you can fix the lifestyle factors, some of these other things come back into line. So we were able to see in, in, in, in these brain scans, the effects of bad sleep. But until you think about the mechanism, this sort of detoxification of the brain that goes on during sleep, you don't realize how important it is.

• 40:33Speaker 01

  So in Enigma, our consortium, we have a sleep group and they look at insomnia. I mean, people have a sleep disorder, then they have people that, you know, would, would benefit from better sleep, maybe their job is very stressful. And you see these biomarkers come back into line. I mean, as you know, I mean, you see, see them restore. And so sleep is important. As you, as you know, you know, good, good quality diet is important. And I think the important thing you said, Mark, your, your brain restores. I mean, we, we were looking with, with brain imaging at people with eating disorders, people with anorexia. And it, it had the greatest effect on the brain of any disorder that we've studied in psychiatry. So we studied depression, bipolar, eating disorders.

• 41:17Speaker 01

  Now, you, you know that this is common sense. I mean, the food is the fuel of, of the mind. But when they were treated, when they went to the hospital, when their nutrition was back in balance, all of these brain systems were restored. And yeah, one of the things that you're taught in medical school is the brain, you, you know this, the, the brain doesn't regenerate tissue. And you think, wait, wait, wait a minute, the brain scan, like you said with Ibragen, the brain scan shows physical evidence for this. So I think your, your people shouldn't be so pessimistic about the potential for, for the brain to recover, because it's just not, not true.

• 41:55Dr. Mark Hyman?

  Yeah. And I think what your work is doing by kind of mapping the brain with imaging, by mapping the biomarkers, by looking at metabolic things and nutritional factors, hormonal factors, and probably, I don't know what else you're looking at, which I'd like to unpack. You know, you're, you're, you're actually seeing how the brain can repair. And, and many of these conditions can be treated in a different way.

• 42:17Speaker 01

  Absolutely.

• 42:17Dr. Mark Hyman?

  And you know, the thing that's so interesting to me is that even you're seeing that there's like some distinct patterns in different conditions, but there's a lot of shared patterns. Can you talk about that?

• 42:27Speaker 01

  Yeah, absolutely.

• 42:28Dr. Mark Hyman?

  Cross disease brain patterns, you described them.

• 42:31Speaker 01

  Yeah. So one of the puzzles about the brain's function is, is very, very complicated. And the more imaging that's done, I mean, the more complexity you, you start to see. And it's, it's like layers of detail. So one of, one of the things that you see is that the brain has synchronized activity in so-called functional resting state networks. And in something like depression, in something where someone's brain activity is less, even the switching between these networks is slowed, it doesn't work. And we talked about the x-rays, I mean, you would never see this on an x-ray. It just has to do with the ebb and flow. But if we were at the ocean side and we were watching the waves come in, there'd be something about the dynamic balance of these things.

• 43:15Speaker 01

  And we see this in depression, we see it in bipolar. The treatments are usually either pharmaceutical medication, you know, antidepressants, SSRIs. There's something called TMS, transcranial magnetic stimulation, which attempts to kind of reset the brain activity in a certain way. It's been very effective in treatment-resistant depression. Or neurofeedback, I know you've talked, Mark, about this in, in, in, in other episodes where a person tries, so maybe a patient with chronic pain or a condition that, that is, is really severe, they try and train their brain activity in a certain direction. And then, as you said, there's the lifestyle metabolic and other sources of fuel to the brain.

• 43:59Speaker 01

  And very, very often, you know, some of these things are like turning the dial way up. I mean, a stimulation is going to have a very radical effect on, on the brain. In fact, initially, people wondered whether that was safe. But the ability to influence the, your relative contribution of these networks is really important. And I'll, I'll give you an example. So the, there's a network of the brain that's active when we're ruminating. So, so if you, if you don't feel good about something, maybe you just regret something.

• 44:26Dr. Mark Hyman?

  Yeah.

• 44:27Speaker 01

  Your, your brain kind of fixates on this. So what, what, what is happening in the brain when, when you're doing? Well, I mean, it's not, we have a brain lesion. It's that there's a certain kind or pattern of activity. And, and this has been discovered to be something called the default mode network. It's a network that's kind of active when we're not really doing anything. You could say, well, that, that, that could be useful, but it could become, it could interfere.

• 44:51Dr. Mark Hyman?

  It's sort of our ego, right?

• 44:51Speaker 01

  Yes, yes. So one of the ways that the treatments are being evaluated for, for things like major depression, and as we said, there can be kind of behavioral therapy, seeing a psychiatrist, there can be direct brain stimulation or neurofeedback, which is kind of jolting the, the brain's activity, or lifestyle and cardio metabolic approaches as well. Every one of these has a role to play in shifting that balance of brain activity back into action. But it's very complicated. I mean, as you said at the beginning, this isn't something that would be evident from a standard brain scan. It has to do with the ebb and flow of activity. And I mean, there's even AI methods that are trying to identify exactly what it is

• 45:34Speaker 01

  about the brain synchrony that's off, and then tell us when it's back in, in, in balance.

• 45:38Dr. Mark Hyman?

  This time of year, your nervous system can be under a lot of pressure. Family obligations, holiday travel, end of year deadlines, all piling up at once. And here's the thing, stress can increase magnesium loss, caffeine and alcohol can add to those losses, and poor sleep can put even more strain on your system. That's one reason so many of us hit December wired and tired. And that's why I recommend Magnesium Breakthrough Advanced 10 from Bioptimizers. It's their most complete magnesium formula yet, with 10 bioavailable forms of magnesium designed to support restful sleep, restorative sleep, muscle recovery, stress resilience, and metabolic health. Use my link bioptimizers.com/hyman and use the code HYMAN to save 50% off or even higher

• 46:18Dr. Mark Hyman?

  discounts for friends of the show, plus surprise free bonuses and bigger discounts Bioptimizers rolls out during certain windows. And every order is backed by their 365 day money back guarantee, so you can try it with confidence. These statements have not been evaluated by the FDA or the Food and Drug Administration. Its product is not intended to diagnose, treat, or cure or prevent any disease. Let me tell you a secret about doctors. We're skeptical of most supplements, and we should be. Many of them aren't backed by strong science, and a surprising number of supplements don't actually contain the ingredients they claim to have on the label. So it means something when I tell you I take Fatty 15 every day, and I recommend it to my patients. From the moment I looked at the research, Fatty 15 was different.

• 46:59Dr. Mark Hyman?

  Over 150 peer-reviewed studies, over 60 patents, an excellent subcode trust score of 9.88, which is almost 10, more than a decade of development, and the product itself is simple. One active ingredient, C15, that strengthens your cells to support healthy aging. Don't take my word for it, look at the science. It's all published at discoverc15.com. That's what convinced me to take Fatty 15 every day, and it's what'll convince you to. Head to fatty15.com/hyman today for an extra 15% off your 90 day subscription starter kit. The discount will be applied automatically at checkout. I had a case of a patient, I'll show you the image and then we'll put it up on the,

• 47:40Dr. Mark Hyman?

  the video on YouTube and link it to it in the podcast. But this was a patient I had a long time ago, who was an ADD patient, ADHD, really bad. He was 12 years old, really intractable, kicked out of kindergarten, on Ritalin for years, you know, just a mess. And he had all these other behavioral issues, he had anxiety, had insomnia, but he also had health issues like gut issues and asthma and skin issues and just gut issues, just a mess. He's on seven different medications.

• 48:12Dr. Mark Hyman?

  And I, and I, his mother came in and I treated him and I basically gave him, you know, whole foods diet. He was eating only junk food, processed food. This is only diet. He's in so many nutritional deficiencies that I corrected with diet and supplements. His gut was a mess. I helped his gut restore. He had some lead. We kind of got rid of that. But even before we did that, I basically just did diet and lifestyle, a few supplements. He came back two months later and his mother brought his homework that was before he saw me. And then two months later, and the original homework was illegible. It was 12 years old and it was what we call dysgraphia, which is the common, you know, kind of a symptom of people with brain dysfunction and these kids with learning disabilities

• 48:58Dr. Mark Hyman?

  or, you know, ADHD and so forth. They, they have bad handwriting. It's basically bad handwriting, like really bad. And he comes back two months later, mom's bringing his homework in. And I'm like, wow, it was perfect. Perfect penmanship. And I was like, that was the aha moment for me. I was like, what is going on in the brain? Like this wasn't a kid who had handwriting lessons for two months. He had something go from chaotic and coherent and disynchronicity in his brain to coherent and synchronized and organized. And I was like, oh my God, this is something that nobody's talking about. And that's what led me to write the book, The Ultra Mind Solution, which was this case. And then, and I, and I, you know, I wrote about Alzheimer's and autism and many other things

• 49:43Dr. Mark Hyman?

  that are kind of quote incurable, that were curable. If you understood how the brain worked and how all these factors from diet, exercise, sleep, stress, environmental toxins, gut health, nutrient deficiencies, all these things play a role. And they're the things, and the things you're looking at. So like, you're doing this massive study, you're getting massive NIH grants, you're looking at 47 countries, you know, thousands of doctors and scientists and, you know, just so much work. And you're coming back to the same frigging conclusion, which is, it's these fundamental things that matter and that we can modify, that we have control over, that can change not only the, the function of our brain, but the structure of our brain.

• 50:25Speaker 01

  And I'm glad you said that, Mark, because it's so critical for mental health. I mean, whether someone's generally well or whether they have a mental health condition. I mean, you, you've described examples where this has made the world of difference. And I think one of the reasons that neuroscience sort of went in the wrong way is everyone said, well, you know, everything is neurotransmitters. If, if, if we could just get the level of the chemical right for dopamine or adrenaline or serotonin. And, you know, there's some validity to that. I mean, there could be an imbalance, maybe a, a drug. I mean, an example might be, you know, if you're anxious, you could take a drug like propranolol, a beta blocker, and you know, you'd feel a bit better. But that's missing the whole channel and stream of fuel that's going on

• 51:08Speaker 01

  in your brain, your body. I mean, we, we know this. And I, I think, I mean, you, you've pioneered this line of, of, of thinking, treating those things as well, the psychiatrists that we've worked with, and they all say the same thing. It, it can make the world of difference when all of the common remedies have already been exhausted.

• 51:25Dr. Mark Hyman?

  Yeah. I mean, the drugs don't really solve these problems. It's like you, you're treating, it's like you're, you're treating, uh, you know, a problem with a symptom suppression drug. And we, we talk about this in functional medicine. We call it the TAC world. So we're standing on a TAC. It takes a lot of aspirin to make it feel better. Take out the TAC. Right? If you're, have schizophrenia and your brain's inflamed, treat the source of the inflammation. Don't give them antipsychotic, right? Change your diet, get them on a keto diet, whatever, whatever the science is showing. And, and, and you're, you're seeing, you know, your work is so important because it, you, you, there's very few scientists, as far as I can tell, that, that, as I said at the beginning of this show, they're not just reductionist. You're like zooming out and you're like, what are

• 52:08Dr. Mark Hyman?

  the common patterns? What are the, what is like, you're looking at a, like tons and tons and tons of data. You're like, what are the, what are the emerging patterns? And you're seeing these patterns and these common patterns that run across all kinds of neurologic and psychiatric diseases. And there, there are common treatments that really work.

• 52:25Speaker 01

  And I think, Mark, you, I mean, you, you, in your writing, you, you have this perspective where you see that something is effective across so many different conditions. And it's because you're treating this systemic issue.

• 52:35Dr. Mark Hyman?

  Right.

• 52:35Speaker 01

  And, and you're just looking at the brain. You say, well, I don't see anything wrong here. And I mean, can you imagine the times when people have been told their brain is fine? But there's something else that could be the source of, of, of the malady. So I mean, it makes a whole other sense.

• 52:48Dr. Mark Hyman?

  Yeah. Treat the system, not the symptoms.

• 52:50Speaker 01

  Yes. Yes. Yeah.

• 52:51Dr. Mark Hyman?

  In terms of Enigma and the work you're doing, how much is determined by genetics versus lifestyle, environment?

• 52:57Speaker 01

  So Mark, I mean, both genetics and lifestyle are usually important. And just to give some examples, it depends on the disease. So there, there are some diseases of the brain that are genetic diseases. There's not, not many of them, but there's a few. So something like Down's Syndrome, Fragile X Syndrome, Williams Syndrome. These are usually developmental abnormalities of the brain where sometimes somebody's DNA, their genetic code has a deletion and it, it doesn't develop in the way that we would expect. Now you say, well, what about the more common disorder, you know, Alzheimer's or Parkinson's or stroke? Now there's some puzzles there. So something like Alzheimer's disease, there's one form of it that is genetic. So only 2% of patients have.

• 53:41Dr. Mark Hyman?

  It's the presenilin gene.

• 53:42Speaker 01

  It's the presenilin gene. So, so that's interesting in and of itself. So if there can be a form of the disease that's genetic and you can point to a gene, I mean, that's already very interesting. And there, there is, as you said, presenilin, there's an amyloid precursor protein gene where someone has a really serious genetic anomaly in that area. The brain overproduces these amyloid plaques and that, that can lead to dementia. But for the 98% of the other cases, the genes sort of tilt the scales a little.

• 54:13Dr. Mark Hyman?

  They're not deterministic.

• 54:14Speaker 01

  It's not deterministic at all. And there, there are some important ones. So I'll, I'll give you an example. So in Alzheimer's disease, there is a genetic variant that triples your risk and it's not rare. And so there's something called APOE, the apolipoprotein.

• 54:29Dr. Mark Hyman?

  APOE4, you have two copies. Yeah.

• 54:30Speaker 01

  Absolutely. And, and around a quarter of us have one copy of this. Three quarters don't have it. Around 6% of us have two copies and the risk can be, um, nine to 10 times higher just from, from this gene. Now that doesn't mean that someone's going to get Alzheimer's if they have this gene. It sort of tilts the, the scales. And, and a lot is beginning to be known about these genes. So, so one puzzling thing is, um, in people of African ancestry, the APOE doesn't matter as much. And people of Japanese and Chinese ancestry is really bad. And, and people of European ancestry somewhere in between.

• 55:09Dr. Mark Hyman?

  Interesting.

• 55:09Speaker 01

  And, and it was originally sort of speculated that maybe in those countries, other things determining health. But more recently, it's been found that even the gene sequence in, in East Africans, there's a genetic variation that's near the APOE gene that seems to neutralize it.

• 55:27Dr. Mark Hyman?

  Protect it.

• 55:28Speaker 01

  It seems to be protective. Now that's interesting because if you could somehow switch that on or introduce it, I mean, maybe there's a kind of direct genetic approach to doing this. And so when we started to look at the genomes of people that had Alzheimer's disease, we knew that this gene, I mean, number one, it's not deterministic at all. I mean, you can have people that have this gene and, and they're fine, which is already interesting. There is a protective form of the APOE gene. It's a little bit rarer called APOE2. But the problem with that is they often have cardio metabolic problems. So they don't get the Alzheimer's, but they tend to get these, these other problems. But going back to your question, there are genome guided drug treatments today. So there, there are treatments that are being

• 56:13Speaker 01

  developed that target these, these genes. They won't necessarily target the root cause of all these other things. They just, you know, look at that, that one gene. And I'll tell you a little bit of how they work. It's kind of interesting how they work. So there's something called polygenic risk. And you, you know this, you can look at somebody's genetic code.

• 56:30Dr. Mark Hyman?

  Yeah.

• 56:30Speaker 01

  You can add up all of these different genetic variants that matter.

• 56:34Dr. Mark Hyman?

  Yeah.

• 56:34Speaker 01

  For a particular disease and you can get a score.

• 56:37Dr. Mark Hyman?

  Yeah.

• 56:38Speaker 01

  And within these polygenic scores, there's different subtypes. So there, there might be a particular set of genes that have to do with inflammation or amyloid or tau deposition, these proteins in the brain, or immunity. Maybe that has to do with immunity. So there are, there are actively approaches, um, one of them in our AI for AD project that essentially take, um,

• 57:02Dr. Mark Hyman?

  And that's a research project using AI to help understand Alzheimer's.

• 57:05Speaker 01

  Yes.

• 57:06Dr. Mark Hyman?

  We'll get into that in a minute. Yeah.

• 57:07Speaker 01

  Absolutely. So, so you could say, well, okay, how, how do we influence these genes? I mean, the gene looks like it's destiny, as we know it isn't, but can we influence what the gene is doing? So some of these genes produce protein products. And there are known drugs, there are known drugs that are already approved by the FDA that influence those genes.

• 57:26Dr. Mark Hyman?

  Off-label uses. Yeah.

• 57:27Speaker 01

  That's right. And some of them, um, I remember your interview with Ian Campbell. You talked about the repurposing of epilepsy drugs in bipolar disease. It was very interesting. And I mean, they, again, these drugs are not the whole story. They can help.

• 57:41Dr. Mark Hyman?

  Depakote or, yeah.

• 57:42Speaker 01

  Exactly. And so genome guided drug repurposing has exactly that goal. It tries to find a, a, a drug that's already on the market. It's known through these databases of drug gene interactions to suppress a particular kind of, um, you know, protein product. And these are very interesting because if you could pair up a patient's genetic profile,

• 58:07Speaker 01

  With a particular treatment that might be effective for them. It may be less effective for

• 58:11Dr. Mark Hyman?

  This is personalized treatment.

• 58:12Speaker 01

  It's personalized.

• 58:13Dr. Mark Hyman?

  Precision medicine.

• 58:14Speaker 01

  It's precision medicine. And I, I, I started to look at the work. There's a, a person called Kyung Kae Choon. She's a, a neuroscientist in Boston University. And she, um, amazingly, she makes these genetically engineered stem cells that express a certain genotype, the genetic risk for Alzheimer's disease. And, and this sounds like science fiction. It's kind of science fiction. They make these, uh, uh, pluripotent stem cells that turn into brain cells called astrocytes and neurons. And they apply these treatments and see if it is effective at suppressing the gene products of the risk gene. So this is, this is an active genome guided drug repositioning.

• 58:55Dr. Mark Hyman?

  Really, this is, this is medicine by, by thinking rather than just by reaction. In other words, this disease, this drug, it's like, what is the pathway? What's the mechanism? What are the gene products? What are the proteins made? How do we modify those? What are the other things we can do? And it's just creative thinking about the biology of a human being that's not just so linear. It's fascinating. I mean, I just, I want to jump to brain charts and diagnostic tools in a minute, but I, I just want to sort of double click on the APOE4 gene.

• 59:21Speaker 01

  Yes.

• 59:21Dr. Mark Hyman?

  Conversation because people are scared. People don't want to test it. And we offer it at Function Health. We also offer PTOW testing, which is a biomarker that actually looks at progression and brain degeneration around Alzheimer's. And it's, it's kind of like a cholesterol test. You can modify it by lifestyle. All right. So let's talk about this concept that you've kind of developed called brain charts. And also, what kind of new diagnostic tests are you actually discovering from this large scale, brain imaging and genetic data and biomarker data?

• 59:49Speaker 01

  So the first one, it, it focuses on the brain scan. And we'll, we'll talk in a minute about the blood markers as well. But the, the ones that focus on the brain scan. So let's say you and I go and get a brain scan. And you could get an MRI at most, most hospitals. I mean, just looking.

• 1:00:03Dr. Mark Hyman?

  Now you can, now you can get it with Function Health. You can get a brain MRI and all the blood biomarkers.

• 1:00:07Speaker 01

  That, that, that's terrific. So, so the uninterpreted brain scan, I mean, we could ask a radiologist, but I mean, what can we do with a brain scan? So you can measure the components of the brain, you know, including ones that, you know, an automatic program can identify. And this idea has been around for a little while. So there's a company called NeuroQuant, which I think you've, I mean, this is an accepted method. I mean, you will basically say, let's run this on a huge range of people. And, you know, people have very different backgrounds. They, you want to make sure you include people from, you know, other countries, people that have different backgrounds, you know, people who are, you know, they, they live in a city, they live, I mean, you've got to have a very

• 1:00:48Speaker 01

  representative, uh, uh, population to make this chart. And then just like a growth chart for a kid, where you say, well, you, you seem like you're doing pretty well, or the, and the beauty of these charts, and, and you know this, Mark, is you can come back again after making a change and see whether or not your percentile, or, you know, where you are on this chart, has improved or gotten worse. And I remember, you know, my first encounter of these things, my, my daughter was born prematurely. She was born at 30 weeks. And they would plot her weight, or, you know, you don't say height for a baby, the length of the baby. And, and it would go back towards the, the, the healthy kids. And in much the same way, I mean, like, like you said, with your experience with, with

• 1:01:31Speaker 01

  Ibragen, you can make a quantitative map of how you are doing relative to this chart. And it can either be for, for a, um, a particular brain measure. It could be for your brain age, which is, again, it's sort of a overall summary of how old your, your, your brain looks. Now, does the brain scan tell you everything? No. So the, the brain scan is a tool. There are other.

• 1:01:57Dr. Mark Hyman?

  So the brain chart is based on these quantitative measures of the brain, like with a NeuroQuant or?

• 1:02:01Speaker 01

  With, exactly. And one of the reasons in Enigma, we do this is that we have access to a very large number of brain scans. So obviously.

• 1:02:08Dr. Mark Hyman?

  And you can reinterpret it through the quantitative analysis.

• 1:02:11Speaker 01

  Yes, yes. And, and it helps to have a representative population. So if you were going to use these charts in India, or Africa, or Britain.

• 1:02:19Dr. Mark Hyman?

  They're different.

• 1:02:19Speaker 01

  I mean, you, you want to make sure that, you know, comparable people are, are going to be in there. You know, maybe men and women are all different. You have to have a chart that's adapted. So, so the more data, I mean, you know this, the more that data that goes into compiling, the more accurate, uh, they, they are. And so, you know, with a hundred thousand brain scans, you have a pretty accurate picture of what is going on. The other angle to this, as you know, is, is the blood panels. So in research, clinically it's a little bit different, but in research, there are panels that measure 11,000 proteins in, in, in the blood. And we.

• 1:02:54Dr. Mark Hyman?

  We call proteomics.

• 1:02:55Speaker 01

  Proteomics. And we, you know, we talked about measuring, you know, people know about cholesterol. You measure cholesterol in a standard blood test. You can look at inflammatory proteins. You can look at, uh, measures of, um, you know, general hormonal or endocrine health. You can even look for telltale, tell signs of dietary, as you know, dietary abnormalities that are fixable. And, and also toxins. I mean, maybe someone was exposed to a toxin. And, you know, you know, this, you know, disorders like Parkinson's disease.

• 1:03:26Dr. Mark Hyman?

  Very much toxin.

• 1:03:26Speaker 01

  It, it is, is thought to be, and this is a puzzle. It's thought to be, you know, people that were exposed to a lot of pesticides or a lot of hazardous chemicals have a higher incidence of Parkinson's disease. So these blood panels, I, I mean, they have multiple uses. One of the uses that is beginning to use AI, and I mean, you, you know this, Mark, is, you know, we, we talked about how on a brain scan, there isn't a single measure that on its own is going to, you know, tell us the difference between, you know, recovery or not. I mean, there's a, there's a profile. So I really believe that within the next five to 10 years, we're going to be able to at least diagnose all of the major neurological and psychiatric conditions using a combination of scans, the brain scans we talked about,

• 1:04:10Speaker 01

  and blood markers. Now, blood markers are not going to tell you everything. As you know, you know, if you have a stroke, maybe the scan is the thing to use. If you have a metabolic abnormality, maybe both, or maybe the blood is going to be the thing to use. But what's, what's amazing about it is this data accumulates and the references get better. And the ability to have either, you know, AI or the charts or some way of combining this to, to flag the anomalies. It not only finds people where these treatments are going to be useful, but that measures the degree of improvement as well.

• 1:04:42Dr. Mark Hyman?

  It's sort of like personalized sort of brain treatments.

• 1:04:45Speaker 01

  Yes, yes.

• 1:04:46Dr. Mark Hyman?

  The effect psychiatry neurology that are combining brain imaging with blood biomarkers.

• 1:04:51Speaker 01

  Absolutely, absolutely.

• 1:04:52Dr. Mark Hyman?

  That are looking for patterns that are unique among them.

• 1:04:56Speaker 01

  Absolutely, absolutely.

• 1:04:57Dr. Mark Hyman?

  And so what are the suite of blood biomarkers that you're looking at that are most important?

• 1:05:01Speaker 01

  So there, there's been a huge revolution in the last year in the dementia field. And so, I mean, you, you know, all of the relevant processes to dementia. There is a test for amyloid beta, beta amyloid.

• 1:05:16Dr. Mark Hyman?

  4240?

• 1:05:18Speaker 01

  Exactly. And the FDA approved that. Now, as we've said, that is just one process. And some people with dementia have that as the main thing that's going on. But plenty of other people may not have any of that going on at all. So there, there are other inflammatory markers. There's also a, a measure of neuronal integrity, neurofilament light is another measure. There's glial fibromyaly, uh, GFA, which is looking at your, um, astrocytic helper cells. How, how are they doing? And this idea that for each one of these channels of abnormality, there, there could be a targeted treatment. I mean, you, you know this, Mark. I mean, you've, you've written about it for a long time. The dementia field is just coming around to this.

• 1:06:01Dr. Mark Hyman?

  And PTOW 217.

• 1:06:03Speaker 01

  And PTOW 217.

• 1:06:04Dr. Mark Hyman?

  A lot of these you offer at Function Health, the AB4240, neurofilament light chain, PTOW 217.

• 1:06:08Speaker 01

  Absolutely. So Ed, let me ask you, Mark. So are these tests you would recommend for everyone who's elderly or just people that are showing signs of a?

• 1:06:18Dr. Mark Hyman?

  I think if you have a family history, if you, I think as a baseline at some point to get, maybe when you're 50 or 60. I, I think we, we don't really know. Like, when should you check your cholesterol? When you're five? When you're 20? When you're 50? Like, you know, we're seeing kids with abnormality. We're, we, you didn't mention it earlier, but, you know, from brain imaging, we can see change in brain imaging 30 years before you have Alzheimer's.

• 1:06:41Speaker 01

  Absolutely.

• 1:06:42Dr. Mark Hyman?

  So something's going on and you can, you can see the smoke signals. So I think, you know, we're going to be learning more and more about these biomarkers. But I think there's, there's a continuum.

• 1:06:51Speaker 01

  Yes.

• 1:06:52Dr. Mark Hyman?

  Of abnormalities from optimal to fully abnormal. And I think it's just like blood sugar.

• 1:06:56Speaker 01

  Yes.

• 1:06:57Dr. Mark Hyman?

  Our blood sugar cutoff is 100. But we know from the data that if blood sugar over 85, you're starting to see a linear increase in risk of cardiovascular disease. So it's not, it's not that normal is normal.

• 1:07:07Speaker 01

  I think that's such a great way of looking at it because it, you, let's take something like Parkinson's. A, a fraction of people with Parkinson's, which is a movement disorder, have a lot of vascular abnormalities in the brain. And like you said, that, that didn't happen today. I mean, the, the scan that shows vascular damage didn't happen on the day of the scan. And so there has to be a whole period of time, maybe years, maybe decades, leading up to that. And I, I think it's a very different perspective. If someone had a scan that revealed that at an earlier time point, you know, maybe, I mean, some of the methods that you've been talking about could be proactive rather than just reactive to the.

• 1:07:41Dr. Mark Hyman?

  There are, you were talking about things like, like Alzheimer's and dementia with these new biomarkers like neurofilament light chain, A24240, PTOW 17, GFA. Those are, those are emerging biomarkers. And we're, we're adding those in function or they're already in function. What about psychiatry?

• 1:07:59Speaker 01

  Yes.

• 1:08:00Dr. Mark Hyman?

  What are the biomarkers you're seeing? Cause I, I think there are a lot of biomarkers of mental health. I think it's a whole unexplored area that I've been checking for a long time. And I think I'm curious to see what your research is showing.

• 1:08:11Speaker 01

  Yeah, I, I think many of the same systemic biomarkers that, that you've been referring to, I mean, things to do with inflammation, you know, all of the metabolome. I mean, this is a whole new landscape that's ripe for, for study. So, but I'll, I'll tell you a story. So one of my lab managers, Chris Whelan, he worked at Biogen and Pfizer. And we were using a data set called the UK Biobank. They, they, they assessed half a million people in the UK. And, and, and Chris said, what you said, why, why, why didn't they collect blood readouts, proteomics, I mean, all of these things that we know are useful to do. And he managed to get a group of people together. It's called the PPP. I think it's the Plasma Proteomics Project. And you can look at exactly about what you said.

• 1:08:54Speaker 01

  I mean, did the people that had a mental health issue who recovered or had a particular diet or lifestyle? And I, I, I think a whole landscape of discoveries is going to be made using that kind of data.

• 1:09:06Dr. Mark Hyman?

  So these are like proteomic metabolomic tests. They're not clinically used now.

• 1:09:10Speaker 01

  They're not used now. And I think, you know, some of them need to be developed. And so there could be, as you've said, a metabolic process or an inflammatory process, a good or bad immune process that is dysregulated. And as you know, there are many, many ways of nudging that back into the, the zone it should be. But by looking at this data, you could even have AI. I mean, I'm sure you do this, you even have AI find what is the signature of people that did well with this treatment? What is the signature that did well with a different treatment? And then is there a signature for just not great outcome? And it's immensely useful for people doing drug trials or interventional trials. Because if, if they have a plasma readout and, and there's a pretty good chance that

• 1:09:54Speaker 01

  these people will do well, or that these people will have a side effect, you, you know, ahead of time, you can kind of pre-screen. And neuroimaging is used for this. If, if there's a drug trial, you can often have neuroimaging be kind of a gate. It says, well, this, this treatment is probably going to be good for you. We think, you know, in, in Alzheimer's, also in, in depression, you know, this, this brain scan means that the probability is this is probably going to be the, the right thing. So I think that's a great way forward.

• 1:10:21Dr. Mark Hyman?

  That's true. And I would say that, you know, there's going to be emerging set of diagnostics to come out of things that are not typically clinically measured now, like metabolomics, proteomics, proteins and metabolites. And, and we're just kind of hitting the surface of that, the microbiome and so forth. But I think there are existing biomarkers, and we include these at function health, that, that not necessarily like are directly correlated to mental illness, but to play a role in mental health, like vitamin D, like iron, like omega three fats, like heavy metals, like your insulin levels and metabolic health, like hormones, like thyroid, like sex hormones, all these things we can actually measure. And we do homocysteine, methyl monic acid. These are, these are measures of B vitamin status. And these are all things that play a role in brain health, brain function and mood and cognitive function and all of it.

• 1:11:06Dr. Mark Hyman?

  And, and they're available to us and doctors aren't checking them. You know, you mentioned that the database in the UK, there's an American study that's called NHANES, which is the National Health and Nutrition Examination Survey, done every year on a set of people, about 5,000 people, 5,000 people. They should about 40 blood tests. Function health, we have over half a million people. We measure 160 blood tests a year in a longitudinal fashion that, that look at much deeper levels of these, these biomarkers that nobody's looking at. And I think, you know, we're discovering all sorts of things and the, the how sick our population is. And we have a health for our population. These people are proactive, want to join, want to know about their health. And they're not, they're not the average American typically, although we, we hit a broad demographic, they're people who are more proactive.

• 1:11:48Dr. Mark Hyman?

  So even within that population, we're seeing such massive amounts of problems that are fixable.

• 1:11:52Speaker 01

  And I think, Mark, I mean, you can, you collect the right data. So you have to ask the right question. You have to collect enough data. And if these panels hadn't been assessed, you'd miss this whole, you know, perspective on what's going on.

• 1:12:05Dr. Mark Hyman?

  We should collaborate because we're now doing, we're doing a lot of imaging now. We're doing brain imaging. We have Ezra, which measures brain MRIs, full body MRIs. We can do neuroquantum MRIs, brain age. And I think we're just beginning to kind of unpack all this. And, and, and we want to come up with, I think, I, I, you know, like you can get a cardiovascular risk score, we should be able to get a brain health.

• 1:12:24Speaker 01

  A brain health score.

• 1:12:25Dr. Mark Hyman?

  Risk score. And I think you should combine blood biomarkers, genetics and, and imaging in one, you know, informed data set that we can watch over time and learn. And it'll be a vehicle for scientific discovery and understanding. It's kind of an exciting time. And I just want to finish by talking a little bit about your project called AI for, AI for AD, which is means artificial intelligence for Alzheimer's disease. And, and, you know, we've, we've hit a dead end. I mean, we, we've spent billion, literally billions of dollars of federal money on hundreds and hundreds of studies and have come up with buckets, as far as I'm concerned, like just failure, failure, failure, failure. The, you know, great drugs now maybe extend the, the time to get a nursing home by a few months. That's like a, that's a win. That's ridiculous.

• 1:13:10Dr. Mark Hyman?

  So we're, we're, we're basically failing. And, and, and, and we're not basically looking in the right place. The same is true with, with this amyloid hypothesis. We're just barking up the wrong tree. I'm wondering, you know, with, with your work with AI, AI 4D, you're trying to look more broadly at genetics, brain scans, biomarkers, kind of not having such a, a, a prejudice view of what the causality is, to be able to understand actually, maybe we're thinking about this wrong and how do we rethink this whole problem? So it's, so what do we be learning about this? And tell us about like the fact that, you know, Alzheimer's is a name of a syndrome, but it, there's many causes and there's many subtypes that you're finding. And this is classic in functional medicine. We like, you just be, because you know, the name of the disease, you don't know what's wrong with you.

• 1:13:54Dr. Mark Hyman?

  It's just a label that we give to people who share a set of symptoms or pathology. So it's medicine by pathology and geography, not by mechanism or cause. So, so tell us about like briefly, what, what is this AI 4D project? What are you finding? What are we learning?

• 1:14:06Speaker 01

  Well, I, I, I think, I mean, you, you, you saw the full perspective of this, of this at a, at a very early time point. I mean, you, you know, the theory behind it and the evidence behind it. And each of these new observations coming from neuroimaging or from blood tests is sort of, you're validating and proving this is true. And you're one of the points that you made on, on subtyping dementia. So if somebody has amyloid building up in their brain, I mean, that's one particular pathological process. But if you look at autopsy of people that have donated their brain to science, there's a number of things going on. I mean, some of these people don't have amyloid, they don't have these, these deposits that are the, the target of a lot of the therapies. They, they have other things. There's something called Lewy bodies. There's a protein called synuclein.

• 1:14:50Dr. Mark Hyman?

  It's kind of like, almost like a combo of Parkinson's and Alzheimer's.

• 1:14:54Speaker 01

  And there's another one that's very, very, very recently discovered, TP43. So there's something called late. It's a type of dementia that has a different pattern in the brain. So rather than the memory system being hit first, you know, the, the frontal and other areas. Now, on a brain scan, you can say, well, look, that, that doesn't look like the same thing as the, the amyloid treatments are able to treat. That looks like a different thing. So one of the ways that AI can help, I mean, AI is terrific at seeing patterns. Humans are pretty good at seeing patterns, but AI doesn't tire. It can look at millions of scans. I mean, it's, it's got a lot of time on its hands. So you could say, look, could, could you, could you tell me if there's anything in the scan that would have found these Lewy bodies or the synuclein?

• 1:15:37Speaker 01

  Or, I mean, you, you, you mentioned the, the metabolic, I mean, also evident, and, and the AI can compare these things in vast numbers. I mean, vast numbers. And, and, you know, you, you know, if you go to an airport and you come back in and there's a biometrics thing that tells it's you.

• 1:15:54Dr. Mark Hyman?

  It freaks me out.

• 1:15:54Speaker 01

  It tells it's you. Well, the, the AI that does that, I mean, it's using a lot of information. It doesn't just say how tall is this, but I mean, there's a lot of information. So in much the same way, it can use the scan.

• 1:16:05Dr. Mark Hyman?

  Yeah.

• 1:16:05Speaker 01

  Pair it up with the pathology, same, same kind of technology.

• 1:16:08Dr. Mark Hyman?

  Yeah.

• 1:16:09Speaker 01

  So the reason I'm saying that that's very important is if the diagnosis is refined and personalized and subtype, I mean, you know this, the, the treatment that is most sensible to offer a patient with that particular type of dementia may be very different than what they're being offered today.

• 1:16:25Dr. Mark Hyman?

  Yeah.

• 1:16:26Speaker 01

  If they have amyloid.

• 1:16:27Dr. Mark Hyman?

  Sure.

• 1:16:28Speaker 01

  If they have a primarily vascular type of dementia, you know, the, the cardiac, the metabolic, the lifestyle factors are going to be important. And you said this, even being proactive, if we know a certain fraction of people are likely to get these vascular diseases, I mean, you, you have exactly the right approach and it's something they can do today. It's not something they're going to find out later only. I mean, they can look at this today and look at the readout.

• 1:16:52Dr. Mark Hyman?

  It's amazing. So this whole project is, is using AI and large scale brain data, biomarker data to maybe genetic data, metabolomic data, proteomic data, basically to look at how to diagnose and create prognosis and treat a broad range of neurologic and psychiatric conditions. It's really a new era. And you know, the joke in neurology is that the typical neurologist's basic way of practicing is diagnose and adios.

• 1:17:21Speaker 01

  Oh no.

• 1:17:22Dr. Mark Hyman?

  Have you heard that? You haven't heard that? Because there's nothing neurology, they're really good at diagnosing, but there's not a lot of tools in the toolkit. You have Parkinson's, you have Alzheimer's, you're kind of screwed. And so now we're in a different era. It's no longer diagnosed.

• 1:17:37Speaker 01

  Sure. And I think, Mark, through your work as well.

• 1:17:39Dr. Mark Hyman?

  Diagnose and buenos dias.

• 1:17:41Speaker 01

  It's good news. And you, you have, you have readouts that you can demonstrate the correction of many of these processes. I, I think it's.

• 1:17:50Dr. Mark Hyman?

  And, and AI is helping us because, you know, so much data, so much information, it's so much noise, like it's, you know, a human brain can't process all that. And so I think this is why it's such an exciting moment in medicine and science, because, you know, we've been in the dark ages, like really dark ages. I mean, just, just to paint a picture, like, you know, the average doctor is still practicing like Norman Rockwell's doctor in the, in the painting where, you know, it's just the seismoscope, listening to the different parts of the body, maybe a physical exam. Okay, we have some imaging, a few blood tests, like maybe 20, 30, maybe if you do a little more. I mean, we're really not looking at the scope of what's going on. We have 20,000 genes. We have 5 million variations in those genes. We have 6,000 metabolites. We have tens of thousands of proteins.

• 1:18:31Dr. Mark Hyman?

  We have a microbiome that's got 40 trillion cells with 10 times much genetic material as our own genes. We've got the metabolites from all that in our blood. We have all these biomarkers we can measure now that we couldn't measure before. It's just so much data. And including me, I've seen more data than most doctors because I've done so much diagnostic testing on so many people for so many decades. And I have my own little AI pattern recognition thing, but it's very limited when it comes down to it in terms of what AI can do and what it actually understands. And I think we're led just at the beginning. And I think Function Health is really leading the way, I believe, to disrupt all this thinking and to collect

• 1:19:14Dr. Mark Hyman?

  large data. I mean, you, I would imagine like to get the data that you got has been billions of dollars of investment to get all this imaging and genetic material and all this, right? And yet, and yet, people now are paying $350 and giving us the information. And it's their data, but we're able to kind of go, okay, well, can we learn that can help you? How do we use this data to help you learn about your body and what to do about it? It's such an exciting moment. I'm just

• 1:19:41Speaker 01

  Amazing. And I think you're right, Mark. I mean, you know, to correct, to collect the correct data. Like, you've got to look at the right things. Like, you could collect a lot of information that is tangential. But if you look at these blood markers, if you have a database that is so rich that the patterns that matter can be pulled out. And then all of these different corrective actions, I mean, it's wonderful for scientists. I mean, it's a really great idea to be able to

• 1:20:06Dr. Mark Hyman?

  I believe that that people should should get their blood work. And that's why I created Function Health, and should get a detailed panel. Imaging is a little more controversial. And this is your life. What do you say to people who are saying, oh, you shouldn't bother looking? And it's a waste of money and time? Because I do think that it's valuable to get imaging on yourself.

• 1:20:25Speaker 01

  I think you're right, Mark. People who care about their health, who are healthy today, might want to look into their future health. What is the downside? I mean, you've said this before, you know, if you if you have a brain scan and it finds something that you can treat, I mean, why not? I mean, that seems like a useful thing to do. I have had countless times when I've had a blood test, and it's revealed something that is fixable for me. I mean, either, you know, vitamin is off, or cholesterol was too high, and now we're fixing it. And I feel like, you know, nobody would claim that you should just go through life oblivious to all of these things that you could fix. But now, people have different points of view on this. But at least you've made this landscape available

• 1:21:10Speaker 01

  to people who are interested in availing themselves of it. And you have positive proof that it's, I mean, there's testimonials.

• 1:21:17Dr. Mark Hyman?

  That's true. It's pretty, it's pretty rewarding to see how many people's lives have been improved and saved just by knowing their data. And I'm really proud to have co-founded Function Health and be working with our team of 500 people to make this a reality for everybody. And, you know, I hope we can collaborate in this. I'm excited to kind of share more what we're doing. And thank you so much for your work. And Enigma is such an incredible project. I just sort of overwhelmed when I first learned about it. And I think, you know, the fact that you're coming to the same conclusions that I did 20 years ago, or 25 years ago, it's like so rewarding. So

• 1:21:49Speaker 01

  Well, thank you, Mark. Thank you for what you do. I appreciate it very much.

• 1:21:52Dr. Mark Hyman?

  Thanks so much. And people can learn more about your work where?

• 1:21:55Speaker 01

  They can look up Enigma. So if they put into the internet, Enigma and brain, and there might be a disorder or disease that they're interested in, they'll find us.

• 1:22:03Dr. Mark Hyman?

  Enigma. So it's Enigma, just go Enigma, what?

• 1:22:06Speaker 01

  Well, enigma dot I N I, because it's the Institute of Neuroimaging and Informatics dot USC, University of Southern California, dot edu.

• 1:22:16Dr. Mark Hyman?

  Okay, we'll put that link in the show notes. But it's an incredible project. Thank you for doing it. And thanks for all your work.

• 1:22:21Speaker 01

  Thanks, Mark. Much appreciated. Thank you.

• 1:22:23Dr. Mark Hyman?

  Hey, everybody. It's Dr. Mark here. I'm so excited to share that my new book is officially available for preorder today. After more than 30 years of practicing medicine and caring for tens of thousands of patients, I've written the book that brings everything together that I've learned about helping people get healthy and stay healthy as they age. It's called A Hundred: What to Do Today to Live 100 Healthy Years. It's a whole body guide to living 100 healthy years. It's grounded in a new understanding of how our bodies work. It's the new map of the body. And inside, I walk you through the seven core systems that drive your health from your gut, and hormones to how your cells make energy, to help you understand the signals your body's been sending you all along. Now, a lot of what's in the book, I learned the hard way, through my own body. When I got sick, the

• 1:23:07Dr. Mark Hyman?

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• 1:23:51Dr. Mark Hyman?

  If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only, and is not a substitute for professional care by a doctor or other qualified medical

• 1:24:36Dr. Mark Hyman?

  professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center, at ultrawellnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening. When it comes to supplements, you only want the best for your body, the kind with

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