18. Dr. Dale Bredesen: This Hidden Risk is Damaging Your Brain, Can Alzheimer's Be Reversed + The New Breakthroughs Everyone Needs to Know

Have you ever wondered if memory loss or cognitive decline is inevitable as we age? What if I told you it's not—and that, with the right strategies, you can even reverse early signs of neurodegeneration? In this episode of Extend with Dr. Darshan Shah, I sit down with my friend and esteemed colleague, Dr. Dale Bredesen, a pioneer in brain health and the author of The End of Alzheimer's. Dr. Bredesen has completely changed the way I see cognitive decline, and today, we're sharing how cutting-edge science is making Alzheimer's a preventable—and even reversible—condition. Together, we explore some of the most exciting advancements in brain health, from blood tests that predict neurodegenerative diseases years before symptoms appear to the role of inflammation, toxins, and even oral health in driving cognitive decline. We also dive into the power of personalized medicine, showing how addressing root causes can lead to profound recovery. You'll hear inspiring stories of patients who were told they had no hope, only to reclaim their lives through Dr. Bredesen's groundbreaking protocols. If you want to optimize your longevity, this is an episode you won't want to miss. We Also Discuss: (00:02) Advances in Brain Health (07:58) Neural Systems and Disease Progression (13:09) Inflammation, Immune Response, and Neurodegeneration (28:07) Brain Health Through Sleep and Toxins (37:17) Early Detection and Prevention Strategies (48:38) Brain Health Advancements and Technologies (57:39) Aging and Brain Health Optimization (01:05:13) Embracing Life After Retirement Graduation (01:14:12) New Books in Alzheimer's Treatment Thank You to Our Sponsors: Timeline: If you are looking for a boost in a cellular level, Timeline is the secret to unlocking your mitochondria's whole potential. Go to: https://www.timeline.com/ TruNiagen: Whether you are looking to stay sharp, feel more energized or simple age better, go to https://www.truniagen.com/ IFIT: If you are looking to elevate your home gym fitness experience with the best in fitness tech, choose IFIT. Go to https://www.ifit.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/ Learn more about Dr. Dale Bredesen Instagram: drdalebredesen https://www.instagram.com/drdalebredesen/PreCODE and ReCODE: https://www.apollohealthco.com/solutions/

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

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Did you know that cognitive decline can often begin decades before symptoms appear? In this episode of Extend, we talk about the unseen factors driving conditions like Alzheimer's, insulin resistance, chronic inflammation, toxins, and even sleep apnea. The incredible part, which Dr. Bradison has made as life's mission on educating us, is that these aren't just the risks that we have to accept. We're breaking down how cutting-edge science is turning what used to be considered a hopeless diagnosis into something preventable and even reversible with early detection and personalized interventions. Dr. Dale Bradison is one of the foremost experts in neurology and brain health,

• 1:32Dr. Darshan Shah?

  and a colleague with whom I've shared multiple patients and many conversations. He's the author of The End of Alzheimer's and the creator of the Recode Protocol, which has transformed how we approach neurodegenerative disease. His work has helped thousands not only slow cognitive decline, but in many cases, even reverse it, making him a true pioneer in this field. I can't wait for you to hear what he has to say. It's an inspiring message for all of us.

• 2:04Dr. Darshan Shah?

  Dr. Bradison, thank you so much for joining us on the Extend Podcast. I've really enjoyed the friendship that we've developed over the last few years, referring patients to each other, collaborating on all things brain health. And for me, it's such a privilege to be connected to you. You're one of the foremost researchers in Alzheimer's, all sorts of neurodegenerative disease and brain health. You've written so much about the topic and I mean, I'm just in awe of how much you've contributed to the field. So, thank you so much.

• 2:34Speaker 01

  Thanks so much, Darshan. Always great to talk to you.

• 2:36Dr. Darshan Shah?

  Yeah. As a physician, you know, you really have changed my mindset around neurodegenerative disease. And for those of you listening, neurodegenerative disease includes all of the brain diseases out there, Alzheimer's, frontotemporal dementia, Parkinson's, we're talking about all of it. Because in Western medicine, we are typically educated that these are basically a death sentence. And the best you can hope for is slowing the rate of progression, right? And you changed my entire mindset about that. And just talking to you today, prior to this podcast, there's another massive mindset shift coming in brain health. I'd love for you to talk about kind of what you're passionate about and what you see coming, because I think that's a great way to frame this conversation.

• 3:21Speaker 01

  Yeah, such a good point. We really are going from the dark ages to the golden age with all these new things, new blood tests that now can tell you years ahead of time if you're headed for things like Alzheimer's. A new precision brain health program, the first of its kind in the world over at the Pacific Neuroscience Institute. Better imaging, things like ASL that weren't available or weren't in common use very much before. For the first time, we can really see these things coming. You know, I started brain research way back in the early 1980s, eons ago. There was nothing, just as you said, we would make the diagnosis of Alzheimer's and say, "Sorry, there's nothing we can do. You have Alzheimer's." As you know, it would tend to be diagnosed very late in the process.

• 4:05Speaker 01

  People didn't realize how much earlier that the earliest biochemical changes, all those things now have changed. We can see the earliest biochemical changes, often 20 years before you have a diagnosis of Alzheimer's. Now, instead of having to have repeat spinal taps, you can have a blood test and you can see where you stand and get very complimentary information between your P tau 217, your GFAP, your NFL, your 4240 ratio, all these things tell you. So we really get an amazing view inside of our own brains. And just as, you know, look what CGM is doing for metabolic disease. This is the same sort of thing. We're able to track where the brain is. You can start when you're 35 or so, check it every five years.

• 4:50Speaker 01

  If you see any changes, boom, you can jump on it, you can make sure. So the reality is Alzheimer's has gone from inevitable, you just, if you're gonna get it, you're gonna get it, nothing to do, literally to optional. You can now see it and say, I'm not ever gonna have the dementia of Alzheimer's. Such a fantastic change.

• 5:09Dr. Darshan Shah?

  That's a massive earthquake shift in this disease. And I don't think many people really understand that we're here now. This is not something that we're projecting in the future. We're actually doing this today, right? And so that's, that's mind blowing to me. And when I think about the patients that I see right now, a lot of them, their concern about Alzheimer's, we'll just use Alzheimer's as just the word that we're using for all neurodegenerative disease. Their concern is when they see me, either they have a PoE genetic test that tells them they're at risk, or they have a parent or grandparent that suffered from this. And they almost come in with a death sentence that this is definitely what I'm gonna be dying of, right?

• 5:51Dr. Darshan Shah?

  And I feel like that misconception is a conversation I have a lot now. Are you having that conversation a lot with your patients still? Or what are you seeing in your clinic?

• 6:01Speaker 01

  Yeah, great point. And I do hear that a lot of say, oh my gosh, you know, am I, is this my fate? And the answer is no longer. And in fact, you know, some of the first people, Darshan, that I saw a decade ago, literally have new lives. I mean, they're, one of them wrote to me recently and they've started a new nonprofit foundation. She's gone back to school, she started a new career and she's like, you know, I had no Hope to do any of this before. She also, by the way, got back her ability to play sight read music. So before she lost her ability to read music, she played, played the piano very well, lost the ability to do that, got it back now. Uh, so just amazing things we're seeing. And at the same time, we see people who don't respond.

• 6:41Speaker 01

  And who, especially the ones who wait really late and, you know, aren't really invested, aren't doing some of the right things. So it is really important, get in early. Uh, but when you do that, the, I mean, the, the, the stories I hear again and again are just, you know, they, they make my day. They, they, in fact, by the way, I, I met someone literally just a few minutes ago. Who walked up and as she introduced and I, I introduced myself and she started crying. And she said, you've, you know, you've given hope to my husband. Um, so, and, and I've had doctors email me and tell me they cried when they saw the first patient reverse. Uh, so, you know, you come back to, all this is, is an engineering problem.

• 7:24Speaker 01

  Where you have to do systems engineering instead of one little, one thing. And you've got to remove the things that are driving it. As we know, you gotta look for them. There may be infections that have been, there may be sleep apnea, there may be changes in oral microbiome, there may be CGM changes. You've got to identify, then you've got to optimize things, their nutrients, all the things you're doing here at Next Health. Their glutathione has got to be optimal, all these things. That's the second piece. And then the third piece is, you've got to bring back what's been lost. And that's where stem cells for some people will come in, some of the trophic factors will come in, things like that. So if you've kind of got those three things and you, and you can identify them and address them, people do very well.

• 8:05Dr. Darshan Shah?

  Yeah, I want to dive into all of those in a little bit, but I want to pinpoint one thing that you just mentioned. Is that we know this is a multifactorial problem.

• 8:15Speaker 01

  Yes.

• 8:16Dr. Darshan Shah?

  And the pharmaceutical industry has been looking for that one thing to solve it. And it's been, I feel like we've wasted 30, 40 years of drug discovery on this. When, you know, your book kind of lays it all out, that Alzheimer's is a multifactorial disease. So. On that, what are the multitude of causes that can lead to neurodegeneration? Can you kind of go over a few of them? You mentioned some of them briefly there, but would you mind giving us more of a laundry list?

• 8:42Speaker 01

  Yeah, great point. And you know, we should step back for one moment and look at, how did this happen?

• 8:48Dr. Darshan Shah?

  Yes.

• 8:48Speaker 01

  Why so common?

• 8:49Dr. Darshan Shah?

  Right.

• 8:50Speaker 01

  And what's really interesting is that this came because of evolution. So what happened throughout evolution, what happened was you select for performance over durability. And of course, the organism that suggests that selects durability gets killed by the organism that's selected for performance.

• 9:09Dr. Darshan Shah?

  Right.

• 9:10Speaker 01

  So you've got these amazing neural systems in your brain. Your ability to store information in your, you know, 1400 gram brain is equal to over 2,000 home computers. It's about equal to the largest supercomputer in the world. So again, we've selected for this incredible performance. That's what goes awry in Alzheimer's. The one that is fine tuning your motor movements and, you know, for anyone who wonders how if that's been selected for performance, just watch Simone Biles.

• 9:42Dr. Darshan Shah?

  Yes.

• 9:42Speaker 01

  You'll know. I mean, and people can dance and they can walk and they can do amazing things and play the piano and type on their computers, all that stuff. When that goes awry, you get Parkinson's. And then interestingly, there's a third system, which is for power amplification. When you have a thought, you give it about one millionth of a calorie per second. And when you then translate that into maximal capacity for your muscles, that's about a half a calorie per second. So you have a dramatic power amplification, more than when you stomp down on your accelerator in your car. And of course, these things all come at a cost. And so that's the thing that goes awry in ALS. So with these finely tuned systems, each one has its own Achilles heel.

• 10:25Speaker 01

  And then we can look at those. Now you mentioned Alzheimer's. Okay, what are the things that drive it? So the Achilles heel for that sub-network.

• 10:32Dr. Darshan Shah?

  Right.

• 10:33Speaker 01

  Is really an interesting one. It turns out, and what we discovered is that there, just as you have a sleep mode and an awake mode, your brain also. Also has connection mode, protection mode. So for most of the time, you can stay in connection mode. You're learning things every day. You're remembering what you're doing, all that sort of stuff. You don't have a lot to worry about because you don't have a ton of inflammation. You don't have a ton of toxin exposure, et cetera. But when you now get that, when you get a change in your oral microbiome, you've got organisms that are getting into your brain. You may have a tick-borne illness, all these sorts of things. You are triggering literally a shift in signaling from connection to protection. And what's amazing is it goes all the way down. It changes your likelihood of thrombosis.

• 11:18Speaker 01

  You have a more prothrombotic state. It makes amyloid. The amyloid is an antimicrobial peptide. It makes phosphotau. That is an antimicrobial protein. All you just go right down the list and you ask, you know, what are the things that drive it? So here are the common ones, and there are dozens, not millions luckily, but dozens. So the common ones are insulin resistance incredibly tight and some glyco toxicity. That activates your immune system. You get that inflammatory cascade. You get the inability to respond appropriately to insulin. The inability, by the way, to make ketones even when your insulin is high. So that's a big one. And then things like sleep apnea, another big one and common one. Leaky gut, another big common one. You mentioned APOE four, so there's a genetic one.

• 12:03Speaker 01

  But again, that's not your fate. That's just your proclivity. And then, you know, other common ones that people have exposure to things like mercury, like air pollution, chronic infections that go undiagnosed. You know, we had an amazing example recently. Fifty-three-year-old man, very successful VC. And he was actually tapped to lead a youth group. They sent him to a new location and within a couple of months, he began to be demented. And went to two major universities, two of the best universities in the United States. They both told him the same thing. You have Alzheimer's, nothing we can do, you're going to die. He was, you know, as you can imagine, he was very upset about this and depressed.

• 12:45Speaker 01

  He then went to one of the physicians I trained who evaluated him and said, oh, you have a massive exposure. To mycotoxin. So the new place that they had sent him happened to have a lot of mycotoxin exposure. He happened to be very sensitive to it. And so he started doing the right things and he improved. And he's still, you know, still improving, still working at it. But understanding what's driving this is so important. And unfortunately, is not being done in standard of care.

• 13:15Dr. Darshan Shah?

  No, no, absolutely. And I think, you know, you mentioned that these people actually reversing their disease is we're not, we're not talking just prevention. However, the same things you're doing for prevention can actually reverse once you start seeing symptoms, right? And so you mentioned glucose toxicity or diabetes, Alzheimer's is sometimes called diabetes type three, right? And I feel like that in, at least in the population that of patients I see, that seems to be more common than many of the other ones. We do see a significant number of mold toxicity as well now.

• 13:48Speaker 01

  Yeah.

• 13:49Dr. Darshan Shah?

  But with diabetes type three, Alzheimer's, glucose toxicity, what I've found to be a really useful tool is a CGM. Yes. Continuous glucose monitor, really teaching people how to modify their own glucose curves, their own insulin spikes. Is that part of your treatment protocol for a lot of your patients?

• 14:06Speaker 01

  Absolutely. We use them all the time. And in fact, we're in the middle now, we, we published a successful trial a couple of years ago. Another independent group published a successful trial using our same approach last year. Now we're in the middle of a trial randomized controlled trial at six different sites. And you know, some of the things we are doing, we are checking all those biomarkers. We are using CGM for everybody. We're also looking at cone beam to, to make sure that they have, don't have occult abscesses that haven't been picked up. So when you look, you have to realize that human beings are complicated. I mean, you trained as a surgeon.

• 14:40Dr. Darshan Shah?

  Yes.

• 14:40Speaker 01

  You know this, you have to hit all the right things to get, imagine that a surgeon just said, well, you know, I'm just going to make one cut and nothing else. I'm not going to make any ties. I'm not doing this. Like, where do I cut to get the best outcomes? Like, no, it's not that simple. Human beings, you have to understand their physiology. The cool thing though, is we're changing now from looking at just at the pathology side. Oh, am I? Bad, tau bad, to looking at the physiology side. Why did your body make these things? Because it is now dealing with these various insults that we that we've run into.

• 15:13Dr. Darshan Shah?

  Absolutely. The pharmaceutical industry was made for certain types of diseases. This is definitely not one of them. This is a systems biology type of a problem.

• 15:23Speaker 01

  Right.

• 15:23Dr. Darshan Shah?

  All systems need to be addressed. If we can, yes.

• 15:26Speaker 01

  But here's the cool point that you brought up, you know, about pharmaceuticals. Pharmaceuticals are, I think, are going to have a renaissance.

• 15:31Dr. Darshan Shah?

  Yes.

• 15:31Speaker 01

  Because now that we're understanding the physiology better, that in fact, you know, preons were proteanaceous infectious agents, as named by my mentor, Dr. Stanley Prusner, who won the Nobel Prize, brilliant guy, brilliant research for years, identified and discovered these preons. He named them so proteanaceous infectious agents. Well, guess what? They're also proteanaceous anti-infectious agents. These things are antimicrobial agents. So that's what your body is making them for. Because they have positive feedback, yes, they're also infectious.

• 16:04Dr. Darshan Shah?

  Right.

• 16:04Speaker 01

  But so again, we're seeing that how these things are happening now. Now that we understand the physiology better and the pathophysiology better, now we can design drugs that are targeting these things. And I think with these precision medicine protocols, layering the specific targeted drugs on top of them is going to be fabulous. And we're working with a group that we set up years ago at UCLA, Dr. Vargas John and the whole team at the Drug Discovery Lab. We set this up way back in 2007. They have now got a very interesting drug candidate that essentially negates the risk from APOE IV. It basically turns APOE IV into APOE III. So that you can have the same low risk with APOE III.

• 16:46Speaker 01

  And I think that's going to be useful both for prevention and for treatment. So very excited about that. It's early days. It still needs to be go into human trials. But it really is exactly the sort of thing. It's kind of the holy grail for APOE IV.

• 17:01Dr. Darshan Shah?

  Oh, yeah. I mean, if you have two copies of APOE IV, you have a 16 times increased risk to be able to negate that 16 time. It's massive. Is that a CRISPR type of thing? Is that a gene editing? Or is this something? Different.

• 17:12Speaker 01

  No, so what this does, this is actually a very interesting drug. Can't you drive, it's a orally bioavailable, highly active, highly brain penetrant.

• 17:22Dr. Darshan Shah?

  Wow.

• 17:22Speaker 01

  And what it does, it actually turns out that APOE four has a fascinating post-translational modification. That is, it's a little bit like phosphorylation on off. And so what it does is when in one form, it will interact with DNA. And it will shut down an anti-inflammatory effect. So you have a pro-inflammatory effect of APOE four, which has been known for years, but it wasn't clear how.

• 17:47Dr. Darshan Shah?

  Sure.

• 17:47Speaker 01

  So what it has, then you cycle it off when you make the change. And when it comes off the DNA, you no longer have that pro-inflammatory effect. So what this drugs does is it enhances the cycling off.

• 17:59Dr. Darshan Shah?

  Ah, very interesting.

• 18:04Dr. Darshan Shah?

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• 18:41Dr. Darshan Shah?

  You mentioned inflammation a few times, and you also mentioned the comb being for abscesses. I assume those are like abscesses around your teeth.

• 18:48Speaker 01

  Yes.

• 18:48Dr. Darshan Shah?

  Very highly correlated to having Alzheimer's disease, right?

• 18:52Speaker 01

  Absolutely.

• 18:53Dr. Darshan Shah?

  And so could you touch a little bit on chronic, low-grade infections that people harbor for years and decades sometimes that are not addressed? And why it's important to search and knock these out?

• 19:05Speaker 01

  Such an important point. So the amyloid that we have vilified in Alzheimer's disease is part of the innate immune system. And in fact, our latest research, what it's looking like, I'm starting to look at these as pre-inflammatory components. So you've got the adaptive, where the adaptive part of your immune system is identifying the thing, that's the last piece, you clear it, you reset. Prior to that, you've got the innate system with its inflammation and things. And that's kind of been, those two have been the standard approach. What it's now looking like is that prior to those two, there is a pre-inflammatory immune component, which is these antimicrobial peptides. And so what you can, this is why you can live

• 19:48Speaker 01

  with a lot of amyloid in your brain, as long as you don't have a lot of inflammation, you can live with an amyloid in your brain for years and have normal cognition.

• 19:56Dr. Darshan Shah?

  Wow.

• 19:56Speaker 01

  So what's happening is these things, as you said, you've got these chronic mild infections. And we see it with tick-borne illnesses. A woman I dealt with years ago had done well on the protocol, went from 35th percentile to 98th percentile. But after about five years, she started having some backsliding. And so I said, look, we need to look into what's causing this. She turned out to have babesia, which she'd had for 10 years, because we knew when the tick bite was. And she had been treated for Lyme, but that doesn't treat your babesia. So she'd gotten rid of Lyme, but she had babesia, which she never knew about. Nobody tested her. Now that was treated, she did very, very well. So with tick-borne illnesses, babesia, borrelia, bartonella, ehrlichia, anaplasma, as you mentioned earlier, the mold-related

• 20:41Speaker 01

  things. I mean, who thought that molds could give you Alzheimer's?

• 20:44Dr. Darshan Shah?

  Right.

• 20:44Speaker 01

  It's turning out that it's a way to stimulate your system. And of course, the most recent, COVID. That's well documented, people who've had COVID are at increased risk, unfortunately, especially long COVID. Anything that is giving you that constant mild triggering of your immune system. You know, COVID, we talked about, people died of cytokine storm. In Alzheimer's, they're dying of cytokine drizzle.

• 21:07Dr. Darshan Shah?

  Right.

• 21:07Speaker 01

  It's that constant little drip for years and years and years, keeping your IL-6 high, keeping your other interleukins, your TNF, your IL- L1 beta, all that, keeping this active and you've got this mildly inflammatory component, which is also driving your cardiovascular disease.

• 21:23Dr. Darshan Shah?

  True.

• 21:24Speaker 01

  And boy, when you come to the oral, you're talking about, you know, root canals, you're talking about periodontitis, gingivitis, of course, mercury amalgams, reduced airway volume. So there is a tremendous amount. And by the way, the whole dental community is getting all over this now. They're getting trained. They're understanding more that oral care is an important part of brain care.

• 21:47Dr. Darshan Shah?

  Absolutely. Yeah. And on that note, too, one other place where chronic inflammation is rampant is our gut health, right? And not having a healthy gut barrier causes the inflammation system to have that kind of low drip, like you're talking about, of inflammation all the time. What are some strategies or techniques people can use to assess and to ensure that their gut health is not leading to chronic inflammation?

• 22:13Speaker 01

  Yeah, this is such a good point. I say, you know, a lot of people would argue that if you get one thing more than anything else, certainly I would say, you know, metabolic disease is probably the number one, but I would say closely thereafter would be gut health.

• 22:25Dr. Darshan Shah?

  Gut health, yeah.

• 22:26Speaker 01

  And there's so many people I see where they're doing other things right, but they're saying, gee, why am I not getting that big improvement that I'd hoped for? Because their gut health is not good. And so, as you know, you've got malabsorption problems, you've got SIBO issues with, you know, small intestinal bacterial overgrowth, ongoing inflammation, you've got, you know, leaky, large bowel, you've got, you know, poor nutrient production, you've got poor postbiotics, you've got poor microbiomes. I mean, this is a very important area and getting it optimized is huge. And so, as you mentioned, there are important things. I like things like bone broth, very nice for helping the healing. I think it's a good idea for all of us to get checked out. Whether you like, you know, Genova GI FX or Doctor's Data, you know, whatever you like,

• 23:11Speaker 01

  find out if you have dysbiosis. And I myself had some issues, you know, about nine months ago, and I found out just some Atrentil turned out to be really good for some mild SIBO, all good without. And before that, like, well, something's wrong. Okay, and th- these things can be so helpful. Appropriate prebiotics, appropriate probiotics, and then making sure postbiotics. Of course, there's been a big push for Urolithin A, one of the big current postbiotics that everybody loves. Definitely, you know, helps your mitochondria. So again, getting this optimized, each of these things is a kind of a whole field unto itself. And you'll just find, just keep on optimizing one at a time, you will keep getting better and better improvement.

• 23:55Speaker 01

  And, you know, I have to say, there, this idea of, am I sick or am I well?

• 24:00Dr. Darshan Shah?

  Yes.

• 24:00Speaker 01

  What we're finding is people who are quote, "well", really can do much better.

• 24:04Dr. Darshan Shah?

  Sure.

• 24:04Speaker 01

  So I hear all the time, people will say, gee, I didn't know how much I'd lost until I started doing the right things. And I'm so much sharper, I have so much more energy, I need fewer naps during the day, and all these various things. I just feel better, I'm sharper, my memory is better, my planning is better, all that sort of stuff.

• 24:22Dr. Darshan Shah?

  Right, I think, you know, a lot of the things that we're talking about, we're not talking about really, like, treating a disease of your gut, for example, when you're optimizing your gut health. We're not talking about treating any named disease, really, when you're trying to minimize inflammation. But all of this stuff is not just preventative for disease, it also makes you feel better. And the brain is a great indicator of how your overall body is doing.

• 24:45Speaker 01

  Yep.

• 24:45Dr. Darshan Shah?

  If you're living in brain fog, if you're living in, you know, if not feeling sharp and getting tired early in the day, this probably is probably an indication that something's going on under the brain, too, right?

• 24:55Speaker 01

  Absolutely, and we see, you know, see it all the time with COVID. People will say, you know, I've had brain fog since I've had COVID, and it's just never really completely resolved. And so, again, getting on the right things, getting that inflammation down, getting the toxicity down, resetting your immune system. So many people have an immune system that's just suboptimal.

• 25:17Dr. Darshan Shah?

  Right.

• 25:17Speaker 01

  Whether it's they're low on zinc, whether they're low on vitamin C, whether they're, you know, whether they may need some low-dose naltrexone, that can be very helpful to some people. Where they've got some autoimmunity going on, these things are all critical. And you know, I would say, one other thing that's very common, and it's really come up, and I've noticed it's So much since Neil Nathan, Dr. Neil Nathan came out with a wonderful book called The Sensitive Patient's Healing Guide. When you have this chronic changes, you literally reprogram your brain. And as I was saying earlier, you're going from connection to protection. And so you make that mode switch from connection to protection and you literally get stuck. You essentially reprogram your limbic system, your vagal tone changes.

• 26:00Speaker 01

  So you're living with that kind of mild anxiety all the time. Often comes out as a little bit of depression, you worry, things like that. Change in your HRV, for example, you're just not quite the same. And it really takes something to switch that back. The guy that we had recently noticed big changes when he started doing essentially reprogramming his limbic system. The so-called DNRS from Annie Hopper.

• 26:24Dr. Darshan Shah?

  Okay.

• 26:25Speaker 01

  You know, again, as a scientist, I never thought that stuff was going to turn out to be important. I was wrong. It's turned out to be very important.

• 26:31Dr. Darshan Shah?

  What is DNRS and reprogramming?

• 26:33Speaker 01

  So this is dynamic neural retraining. And this is someone who came up with it for herself because she was having problems. So especially for people who say, you know, I noticed that I'm very sensitive to chemicals or I'm under a lot of stress or I'm chronically fatigued or I'm chronically stressed out and anxious. These are people where you probably do have some reprogramming and getting on this. There's also another related program set up by Dr. Gupta. So any way to get at that, it's like now you're reprogramming your brain backed into more of the connection mode and away from the protection mode. Now, to do that, you want to make sure that the things you've been protecting yourself from are not there. Remove those first and then you want to get back into that connection mode.

• 27:17Dr. Darshan Shah?

  Ah, I see. So once you are removing kind of the insults that we call them in medicine, the things that are causing you problems, then you need to start reprogramming as well. And this is a tool to reprogram to get back to a better baseline.

• 27:30Speaker 01

  Exactly.

• 27:31Dr. Darshan Shah?

  Got it. Back to, you know, I just read an article today about snoring and how that actually is also causing a lot of damage, just as bad as sleep apnea is or similar to sleep apnea. And so, you know, I would love to touch on sleep apnea and how that's related to brain health. And now it seems like even snoring might have an effect.

• 27:53Speaker 01

  It's a great point. And of course, you know, upper airway resistance, you know, UARS, because you're triggering your adrenaline, you know, dozens and dozens of times per night as you're trying to pull through a compromised airway. So these programs that, you know, increase airway size can be very helpful for, you know, for making it so that you have free and open access to good oxygenation throughout the night. And for so many people, you know, you're just not doing that. So yes, no question, sleep and the associated oxygenation, and the ability, you've got to have that adrenaline low because adrenaline actually prevents the activation of the glymphatic system. So you're not getting rid of these

• 28:38Speaker 01

  things at night the way you should be, the various damaged proteins, damaged mitochondria, damaged lipids, if you've got that adrenaline coming on all the time.

• 28:47Dr. Darshan Shah?

  Right. I tell people, if you have sleep apnea, it's the number one thing to get treated for your overall health, but especially your brain health because of the things you mentioned, you're reducing oxygen going to the brain.

• 28:57Speaker 01

  Yep.

• 28:58Dr. Darshan Shah?

  You, your glymphatic system never gets to be activated and doesn't get to clear out the toxins that develop throughout the day. And thirdly, the constant adrenaline activation just keeps you basically awake all night is massively disturbing to your sleep. So it's, and it seems like now too, like there's some evidence where if you snore at night, of course, get evaluated for sleep apnea, but maybe take some measures to prevent or to treat the snoring, use snoring as an indicator actually of oxygenation throughout the night, too.

• 29:25Speaker 01

  Absolutely. And there's some simple dental devices you can use to prevent that. So there are all sorts of, you know, better and better things. One of the guys said, I would rather die than to have to go on CPAP. So, okay, CPAP isn't for everyone. Some people, it changes their lives. They're like, wow, thank goodness for CPAP. And, you know, others will say, well, that's not my thing. Okay, there are other ways to go. There are some simple surgical procedures, of course. There are some simple dental devices. So one way or another, find a way to get to the point where your sleep is optimal. You want to have at least an hour. Of deep sleep at night, you want to have at least an hour and a half of REM sleep at night. You want to have at least seven hours of sleep at night and you want to have an oxygenation preferably over ninety four, but at least over ninety two.

• 30:07Speaker 01

  If you're into these eighties and we see people even in the seventies, that is not good for your brain.

• 30:12Dr. Darshan Shah?

  Right. And all the numbers you just mentioned, this brings up another thing, which is the importance of tracking.

• 30:18Speaker 01

  Yes.

• 30:18Dr. Darshan Shah?

  Importance of wearables. I think this is such a game changer. And a lot of people are hesitant to use them because they just don't want to know. They feel like if I stress them out more. So I tell those people at least six weeks, just wear it for six weeks. So you know what's going on and you can see what measures make things better. Then you can stop.

• 30:34Speaker 01

  And I've got my wearable on right here.

• 30:36Dr. Darshan Shah?

  Same. I got two of them on.

• 30:37Speaker 01

  Yeah, good. Yeah.

• 30:38Dr. Darshan Shah?

  I can't have three. I'm wearing a CGM right now.

• 30:40Speaker 01

  Are you really? Good. Good for you.

• 30:42Dr. Darshan Shah?

  Yes, yes.

• 30:43Speaker 01

  But you're absolutely right. You know, in the twentieth century, most people were dying of acute illnesses, simple illnesses.

• 30:51Dr. Darshan Shah?

  Right.

• 30:51Speaker 01

  Things like TB isn't acute. You'd call it more chronic, but it's a simple illness. It's one bacterium. Pneumococcal pneumonia, diphtheria, of course HIV late in the twentieth century. In the twenty first century, it's a complete change. We're dying of complex chronic network illnesses, systems illnesses. And so you need to get at that. And so the big thing that's helping us is wearables. So you don't. Whereas in the twentieth century, you could wait for the symptoms. Oh, you got a cough and some fever, you better get in. Now you get most of the way through these diseases. By the time you have symptoms of chronic renal failure, you've lost about eighty percent of your kidney function.

• 31:31Speaker 01

  By the time you have symptoms of Parkinson's, you've lost about eighty percent of your dopaminergic input to your striatum. So you want to get these things in early. And this is why these nice blood tests to be able to tell you way early. Hey, you're headed in the wrong direction and things like CGM. Hey, you're getting some glucose spikes long before you ever have diabetes. These are going to be the best ammunition we have against these complex chronic illnesses.

• 31:57Dr. Darshan Shah?

  Absolutely. I think, you know, chronic illnesses don't really develop symptoms until it's way late in the game, but we have. The technology through wearables and blood tests.

• 32:08Speaker 01

  Yeah.

• 32:08Dr. Darshan Shah?

  To detect twenty, thirty years, like you had mentioned prior. And one thing, you know, when you talk about systems illnesses and and network illnesses, another name for that is functional medicine.

• 32:18Speaker 01

  Yeah.

• 32:19Dr. Darshan Shah?

  We basically have a functional medicine practice. I think you do pretty much as well, too. And the way, one of the big things that we really believe in is proactive blood testing and urine testing. And one of the tests I love is called the total toxin test. And the reason I love it is because this is something that sneaks up on almost everybody. We live in the most toxic societies ever in human history. And you just don't know that this is building up inside of you until it's done all of the damage it can do. And you finally start seeing symptoms. So the total toxin test tells us about mycotoxins. We mentioned mold. It tells us about things like mercury toxin, which you had mentioned. We also learn about things like microplastics and PFOS, et cetera.

• 33:00Dr. Darshan Shah?

  And I'd love for you to touch a little bit, because you talk a lot about this in your book, is about toxins and how they affect the brain. Would you mind touching on that in your, what you talk to your patients about?

• 33:09Speaker 01

  Yeah, that's a great point, Doshawn. So, you know, when we, when I first started seeing patients and we started translating what we did in the lab for thirty years and saying, okay, we're going to have to go after things like glyco toxicity and inflammation and organisms. We didn't know how important these toxins were. And so when I published the first ten, nine of them got better. The tenth one did not. And I thought, what's going on here? And she turned out to have massive toxin exposure as part of her job, in fact. And so we started looking at these other people and we realized, yes, toxins are an incredibly common contributor to cognitive decline. And you know, with your toxin test, you hit on the three big groups. So it's the inorganics, air pollution, mercury, things like that.

• 33:50Speaker 01

  It's the organics, things like glyphosate and anesthetic agents. You hear this all the time. You know, this person, we went under general anesthesia for a couple of hours, then they never were quite the same. And then they, then they were diagnosed with Alzheimer's six months later. So it's the organics. And then the third one is it's the biotoxins. You know, it's the mycotoxin, the molds and the trichothecenes, ochratoxin A, gliotoxin, all those sorts of things. So those three. Groups are the ones and you know, as you pointed out, testing, I mean, testing is so helpful. You then know what you're up against. You know what has changed this neural network in this person's brain? And what do I have to go, go after to optimize this network?

• 34:31Speaker 01

  So you want to look at those things and then, you know, most, you know, many, many people low on glutathione. Many people are very poor with their detox genetics, very important. Um, many people will, you know, just have, uh, they, they've stored these things. One of the things that we saw early on was that women who were in their early 50s, for some reason, were the most common group that was presenting with this toxin related Alzheimer's. And what we realized was that what's happening is you're storing this stuff in your bones and in organs and your detox. You're doing everything possible to get rid of this stuff. And so these stores, then as you now head toward menopause, these stores are coming back out.

• 35:12Speaker 01

  And so you have a period, um, where you are so-called, uh, you know, you're, you're, you're, you're heading for osteoporosis. And they call this the osteoclastic surge or osteoclastic burst, and it lasts about seven years. And so we're emptying these things back into the blood. Now, if things are good, you're slowly getting rid of them. But if you're already at the max, then when you're emptying this back, this is when you then present with cognitive decline.

• 35:38Dr. Darshan Shah?

  Right.

• 35:38Speaker 01

  So again, as you said, getting in early, making sure that your levels aren't high, um, is going to really give you a much, much better outcome.

• 35:48Dr. Darshan Shah?

  Absolutely. And at least you know, because once you know that you're having exposure, you can start taking steps to minimize your exposure in your life as well. Because, you know, I think we can't see toxins, they're just out there in the world. And we, we assume there's some governmental agency protecting us from these, but it's not happening.

• 36:05Speaker 01

  Right.

• 36:05Dr. Darshan Shah?

  And I think it's really important to at least know and then take steps to eliminate. And then we're doing, we're researching technologies like plasma exchange, actually remove the toxins from the blood. And I think that's kind of be one of the next waves of what we've seen, this detoxification. Lastly, I want to kind of talk about some of the biomarkers out there that people. On the biomarker front, last thing I want to talk about some new biomarkers that you had mentioned briefly. I feel like this is such a game changer and you know, I did these on myself, brain scan, you call it. I also took the mycognoscopy test, which is I feel another great evaluation tool for, you know, if you're feeling like you might be having some brain fog or even some cognitive impairment, I think it's a great screening tool as well. So I'd

• 36:49Dr. Darshan Shah?

  love for you to maybe dive in a little bit on the new blood test and also the online evaluations under mycognoscopy a little bit, if you don't mind.

• 36:56Speaker 01

  Yeah, great point. So these are very much complementary. So you want to know, first of all, if, in other words, you want to know your status. Do I have any of the signaling that could lead to Alzheimer's in the future? Where do I stand? And for that, we actually worked with the group that has the most sensitive test in the world. This is Dr. Hans Frickman at NeuroCode. They've done a great job. And so it's three complementary tests. P tau 217 is the first one. That is specific for Alzheimer's and it will pick it up very early before you ever have dementia or even MCI. Often you can pick it up when you're asymptomatic. And this is the future. Now, everyone will say, oh, you know, Alzheimer's is no longer a scary term. Like, okay, I, you

• 37:39Speaker 01

  know, I was on my way. No problem. I'm never going to get it. So that's P tau 217. And what happens is tau is functions like a bolt. It is when you extend neurites, you're out there trying to make new synapses. These things have to be stabilized as the cell is growing, literally in space. And so you use your tau to bolt down the microtubules. Now, what happens is when you have to pull them back, oh, now you're switching from connection to protection. You literally take this same molecule, you put a phosphorylation on it and phosphorylation at 217 is the one. There's multiple sites, but that's the one that correlates the best with Alzheimer's. And that pops the tau off the microtubule, collapses the microtubule, and interestingly,

• 38:22Speaker 01

  changes the superhero tau from a bolt into an antimicrobial protein. It's amazing. The same protein goes from a construction guy into a superhero.

• 38:35Speaker 01

  Hero that's now killing bacteria. It's amazing. That's incredible. So yeah, again, physiology remarkable. Yeah. So that's, that's P tau. Then you also want to know your GFAP. GFAP is about, now this is coming from your astrocytes. So these supportive cells in your brain. And so very much complimentary. It tells you these things get activated when they are needed. And so when there are toxins around or when you have ongoing inflammation or when you're now repairing your brain. When they get activated, they make GFAP. GFAP is actually part of an intermediate filament. It's an intermediate filament protein. So it's telling you your astrocytes are growing. They're on the move. So you'll pick up a high GFAP. And what that tells you is in your brain,

• 39:17Speaker 01

  you've got ongoing inflammation and/or repair. Very early marker also for things like Alzheimer's and frontotemporal dementia and even if you've had a car wreck, those sort of things. So it's not specific for Alzheimer's, but highly sensitive. And then the third one, which is also complimentary is NFL. That's neurofilament light. Now that's coming from the neurons again, but it's not specific for Alzheimer's. So you can now look at the pattern of those three. If you have high NFL, you know, a little bit high GFAP, normal P tau, you may have something like frontotemporal dementia. If you've got high P tau 217, but low other two, you've got not very active Alzheimer's. Hmm. Jump in there, do something about it. If you've got all three high, you've got active Alzheimer's.

• 40:02Speaker 01

  You really want to then, you know, get in even more so. Get on, you know, get on the right program. So the, the three results together give you a great look about what's going on in your brain. Now that's the, the if. The why then you want to say, okay, let's say that I, let's say that my P tau, and this just happened to be the other day, a guy called me and, and just had come back and it just had gotten a high P tau. And guy's doing well. This guy's a brilliant, brilliant guy. He said, yeah, I mean, I might have a little symptom. I don't really know. I said, okay, no problem. You are the future. You got early, early Alzheimer's. We're going to make sure you never get anything more and we should be able to now follow this. You can follow the P tau back down, which we're doing in our trial. So now you want to know why. Okay. So that's what the cognoscomy that you.

• 40:45Speaker 01

  Mentioned does, and you can get a free online CQ test. You can see, you know, where do I stand? Because it does sneak up on people. We see that all the time.

• 40:53Dr. Darshan Shah?

  That's what happened to me. And so I took the mycognoscopy test. And my score was, you know, not in the green. It was in the yellow and I was concerned. And so then I did the blood test. It put me at ease because they all came back normal, thank God. But you know, like, people don't know this is available to them. They can for free go on mycognoscopy.com. Do the test and at least get some indication and see if the blood test is going to be something that they should look at, right?

• 41:17Speaker 01

  Absolutely.

• 41:17Dr. Darshan Shah?

  So I'm sorry to interrupt you, but I would love for you to talk about mycognoscopy.

• 41:21Speaker 01

  Absolutely. So then for mycognoscopy, what you do is you look at what's driving it. And so you want to know things like your homocysteine, you know, is your methylation poor? You want to know, is your HSCR P a little high? You want to know, do you have any infections? Do you are there, just as we talked about earlier, are there toxin exposure that you, are there metals? Are your hormones low? That's another common one. Is your B12 low? Is your vitamin D low? Is your vitamin E low? These are all things that are critical. So basically there, we're talking about a tune up. We're talking about getting your oil there, getting, getting your grease, getting your, your gas powered up. So that you're making your brain run on all cylinders.

• 42:02Speaker 01

  You know, just having one thing alone, just having that insulin resistance. That is, that you're literally, your brain is sputtering. And so just getting that finely tuned again makes all the difference. So with those two, the brain scan and the cognoscopy, those two together will tell you if, you know, where you stand. If you have problems and then if so, why?

• 42:26Dr. Darshan Shah?

  Right. And there's also a program called pre-code or recode.

• 42:30Speaker 01

  Right.

• 42:30Dr. Darshan Shah?

  That tells you what to do next, right?

• 42:32Speaker 01

  Exactly. Exactly. So we developed recode originally reversal of cognitive decline. Published that originally in 2014. And we've seen, we've had over 7,000 people now go on this. We've trained over 2,000 physicians in 10 different countries and all over the US. And some people are getting really fantastic results. That's another thing. Work with someone who's experienced, who's got good results. That's really makes a difference. It's very much like surgery. There are good surgeons. They're not as good surgeons and it's the same thing with this. So we've got a lot of people trained now. What happened was one of the, one of the patients actually was doing very well. Said, well, you know, there should be something for people who are relatively young, have no issues, but just want to get on some good things for prevention. So we developed pre-code for that.

• 43:13Speaker 01

  But if you've got a family history, if you've got any symptoms at all, if you've got an APOE four, I wouldn't, I would go on to recode and not try to do pre-code because it's really for the, you know, pre-code is really for the thirty something or early forty something with no family history, no problems. And you just want to kind of keep a good active brain.

• 43:34Dr. Darshan Shah?

  I love that. And with recode and the blood test, so if you had a eye level of P-tau, for example, and you institute the recode protocol, you're saying you can actually follow the levels come down. So you know if you're making progress.

• 43:48Speaker 01

  Absolutely. And that's going to be one of the great ways to follow. Now, of course, we've always been following it as what happens to your cognitive scores. And, and in our trial, we reported eighty percent, eighty-four percent of people improved their cognitive score. So it's striking. However, you'd like to have some biochemical support. Now, you can also do things like electrophysiology. But a lot of, a lot of places aren't set up to do neurophysiology. But there are some good ones like evoke and neurocatch. They're very sensitive and another good way to follow. Then we also looked at MRIs. The problem with the MRIs, and we did see improvement in the MRIs, that was striking and we reported that. The problem there is it takes months and months. You're, you're looking at it in anatomical change in the brain.

• 44:28Speaker 01

  Now, we've, we've had people go from less than first percentile in things like hippocampal volume or parietal lobe volume, you know, up to normal, which is great, but it takes a long time. And not every, we, we do see people who have cognitive improvements who don't see a lot of increase in their volume metrics. So it's also nice to then know what's my biochemistry doing? What is my brain signaling? Is my brain saying, uh-oh, I'm still pulling back? Or is my brain now moving forward? And that's where things like following P-tau, and you can also follow this forty-two to forty ratio, which is, that one's a little bit more about, am I still fighting inflammation, that sort of thing?

• 45:09Speaker 01

  But the great news is we have an armamentarium like never before. Just a few years ago, you couldn't get any of this and nobody knew what was causing it. So people would just say, sorry, you got Alzheimer's, you're going to die.

• 45:28Dr. Darshan Shah?

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• 46:07Dr. Darshan Shah?

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• 46:56Dr. Darshan Shah?

  Another major problem that I see out there on the brain health front is also head injuries. And specifically, I was just on the news, actually, because, you know, Tua was just removed from the, from playing, from his multiple concussions. And, you know, my kids are in elementary school. They're playing tackle football at elementary school, right? And so this is a massive problem that I think, especially in that estate, we're just kind of like turning a blind eye to this. Yeah. And my question to you is, do these blood tests pick up any signs of head injury? And could this be helpful for the parents out there with a kid in high school football and, you know, getting hit in the head over and over? Over again, and I want to say one thing on this before you answer is that it's not just a concussion.

• 47:40Dr. Darshan Shah?

  So concussions is a constellation of symptoms.

• 47:42Speaker 01

  Yes.

• 47:43Dr. Darshan Shah?

  That is a massive injury occurring at the moment. What's really leading to the chronic brain injury is the multiple hits they're getting over and over again in practice. So don't use the number of concussions as your indicator of is my kid going to be okay? It's really just playing the game and it being in practice that's really concerning, right? And so I want to see if you agree with that and talk about the blood tests on concussion syndromes.

• 48:07Speaker 01

  Yeah, this is a huge issue and you mentioned, you know, Tua Tagovailoa, who's got this whole issue, like, is he coming back? Is he not coming back? What's going to happen? And he's now, this is his third, as I understand it. But as you pointed out, it's not just concussions, it's CTE. And I just heard unfortunately recently about a football player who had committed suicide with CTE. And it happens. And they typically get a triad of aggression, depression, dementia. So they beat up family members often. They get extremely depressed and they commit suicide. It's really sad. And so again, I think everybody who is, who's got these head traumas, whether it's minor ones from playing volleyball or basketball, or even, you know, heading in soccer, or more major ones from football,

• 48:52Speaker 01

  should be on essentially a recode type program. And there have been nice publications, actually Dr. Daniel Amen had a nice publication years ago, using a, an approach somewhat similar to what we're doing with cognitive decline and Alzheimer's, and showing improvements in people with their cognition. So I think that everybody, including Tua, should be on these sorts of things to score. And then you can follow, NeuroCatch particularly, started with hockey players. And they've done a great job, came out of Canada, and they've done a great job with being able to follow head injury in hockey players as it gets better and showing when it does and when it doesn't get better. And again, I think this is something that could be used very effectively for Tua. So these are important and yes, you can pick up some of these biomarkers.

• 49:37Speaker 01

  Now, 217 is actually most specific for Alzheimer's. More work needs to be done. Is 181 going to turn out to be? Better. That was the one that was used before 217. Is that going to be turned out to be better? Are there other sites that will turn out to be better? But we know it is a tauopathy. So you're you are going to see phosphorylation of tau. And that's what you see in CTE. And interestingly, I've always thought to some extent, this is like getting Alzheimer's. You do have a transient increase, but it tends to be younger people. So you're able to clear that amyloid over time. And so what do you end up with a tauopathy? You don't see the amyloid 10, 20, 30 years later. So I think there is a close relationship between these.

• 50:18Speaker 01

  And I, you know, I think we're headed for a time when people will treat this ongoing. And they'll know because of the electrophysiology, when to sit out and when not to sit out. Not just because, you know, how do you feel? Did you pass the two fingers test? You know, that sort of thing.

• 50:33Dr. Darshan Shah?

  Yeah, no, it's so important. And I think using some of these advanced technologies can really help. Football players, hockey players, volleyball players, you know, even soccer players. Really understand where they are and if they just sit out a game or a season or maybe forever. I think that's kind of we're at that moment where we have the technology to tell us this. People just have to look for it and be able to utilize the advice. So on that, you're involved with PNI here, Pacific Neurological Institute. Is that right?

• 51:01Speaker 01

  Pacific Neurosciences.

• 51:02Dr. Darshan Shah?

  Neurosciences. Can you tell us a little bit about what the program is you're developing there? What are some of the advanced technologies that you're bringing to Southern California? And kind of the entire thesis behind PNI?

• 51:12Speaker 01

  Yeah, great point. So Pacific Neurosciences is part of St. John's, a medical center, very well known medical center here in LA. Was actually founded by Dr. Dan Kelly, a neurosurgeon, along with three other Howard Kraus and then two other neurosurgeons and neuro-oncologists interested in, you know, how can we do better for the brain? They've been very forward looking, which is great. So last year I presented to them when I retired from UCLA, I presented to them, look, there's not a precision brain health program in the world. We really need to have this, not just for Alzheimer's, for ALS, for CTE, for, you know, macular degeneration. We are starting to now look at additional people, as you know, and I really appreciate you've been consulting on.

• 51:55Speaker 01

  A person with Parkinson's. Thank you so much. Great. We want to understand what's driving this and do the absolute best we can for it. So this is something that just hasn't been available. So now for the first time, there's hope. People can come from all over the place and have this deeper look. And so Dr. David Merrill, who is actually one of the ones who took our training a number of years ago, set up a brain health program at PNI. And so then we've now added this precision brain health approach. And I think that this will allow us to do deeper dives and to get better outcomes. And of course, it's all about the outcomes. How can we get the best outcomes with these diseases?

• 52:33Dr. Darshan Shah?

  Right, right. And are you using advanced technologies at PNI for people that have some of these diseases? So what are some of the more, you were telling me a little bit earlier about potentially using treatments like stem cell therapies, et cetera.

• 52:45Speaker 01

  So actually, we were just on this morning discussing being part now of a trial that will use Omaya Reservoir to deliver autologous stem cells for the adipose derived stem cells directly to the ventricles. And they've had some very nice initial results with them. Now, again, this disease doesn't come from nowhere. So they've also got to begin looking now more at what's driving it. And by the way, one of the things they followed is a beautiful reduction in tau over time and improvement in cognition. So that's one of the things. They're doing light therapy, which has been very nice. They're doing, you know, some of the detox approaches. They've got, they've got one of the best brain health gyms that I've seen with Ryan Glad. He's done a great job.

• 53:28Speaker 01

  And Corwin Paddus, they've got a great group there. They're doing Ewad exercise with oxygen therapy. And so all sorts of things that are now helping. I know here at Next Health, you're doing a lot of the IV work with glutathione and NAD and things like that. These are all part of optimizing that system and resetting the brain toward a more effective path.

• 53:49Dr. Darshan Shah?

  Yeah.

• 53:50Speaker 01

  And you know, these are things that we need to get best outcomes.

• 53:52Dr. Darshan Shah?

  Absolutely. I've found that there's so much technology out there that people don't know about. We also do things like hyperbaric oxygen therapy, which can be extremely helpful. You know, I remember training at the Mayo Clinic. We would use our hyperbaric oxygen for mainly wounds.

• 54:04Speaker 01

  Yeah.

• 54:05Dr. Darshan Shah?

  We started using it for people that had strokes and drowning injuries.

• 54:10Speaker 01

  Yes.

• 54:10Dr. Darshan Shah?

  Immediately after the event in massive reduction in neurological damage by using hyperbaric oxygen. So this is out there and available.

• 54:20Speaker 01

  Yes.

• 54:20Dr. Darshan Shah?

  You know, we have it here at Nex Health, you have technologies at PNI, and I appreciate us working together on patients. I think it's fantastic that people can access these, these technologies now locally here in LA and hopefully all over soon.

• 54:32Speaker 01

  Yeah, and the great thing is as we're getting better and better ways to judge outcomes, it'll become clear. You know, what's working, what's not working, because we, there has been, you know, to be fair, there's been a lot of claims out there, often not backed up, as you know, with data. But as we now generate these and we're able to say, and you know, AI is going to be one of our best friends in terms of looking at large amounts of data and saying, okay, here are the pieces that are actually working best. Here are the things that are going to be the, the best chance. And for each person, it's going to be different. Different people have different profiles, depending on their genetics, depending on their exposures, depending on their various microbiomes and things. So to be able to understand what's going to work best for each person is going to make a huge difference.

• 55:15Dr. Darshan Shah?

  I'm, I'm so excited for this future. Let's talk about some fun stuff, you know? I'm so excited to hear about your new book. I remember, you know, when I was in my late twenties, I felt like my brain was on fire. I could learn anything. I could talk about anything. I felt like, you know, there was unstoppable. And actually that was in the point of my career, I was doing the best, actually. I was doing an incredible amount of surgery. I was learning it super quickly. You know, Einstein, he had his Renaissance time during his late twenties as well, when he discovered four theories that no one had ever discovered before. I mean, like that time period, I just always reminisce and get nostalgic because for my brain at least, it was the best time period of my life.

• 55:57Dr. Darshan Shah?

  And so your next book is about how to maintain a youthful brain. Is that right?

• 56:03Speaker 01

  Absolutely, yeah. So there's a, I have a book coming out in March, which is now taking what we've learned with all these diseases. Because, you know, if you look at someone who's aged poorly and you look at their brain. It doesn't have no pathology. It may have some vascular pathology. It may have some hippocampal sclerosis. It may have a little Alzheimer's in there. You know, whatever it is, there's something. So the idea was, okay, how with this whole, you know, in the zeitgeist, we're hearing everywhere, we're hearing about anti-aging and reversing aging. And with these parameters, you can now look at epigenetics and say, okay, you went from, you know, forty-three to thirty-five in terms of your biological age.

• 56:43Speaker 01

  So now, what's great is these epigenetics approaches can tell us brain age as well, can tell us organ age for other organs. How's your liver doing? How's your kidney doing? And so the idea was, okay, how do we now develop a program that keeps people youthful to a hundred? Basically for their entire lifespan. If your lifespan is going to be seventy, eighty, ninety, a hundred, a hundred and ten, whatever it's going to be. Because as we talked about at YPO, the last thing you want to do is live to a hundred and forty and have seventy years in a nursing home with dementia. So you want to have your brain span equal to your lifespan, whatever that's going to be. This is, you know, again, this is increasing health spans. When I was on the National Aging Council years ago, there was a study done showing that our health spans are very poor in the United States.

• 57:28Speaker 01

  Even though our lifespans are kind of average, we're thirty-first in the world. Not great, but our health spans are relatively poor. So we get our first, on average, as a country, we get our first chronic illness in our forties, but we typically live into our seventies and eighties. That's a long sick span. Whereas interestingly, in the UK, where we think of the UK doesn't have great health, they have about the same lifespan as the US, but they have almost ten more years of health span than we do in the US. Yeah, we got too many drive-throughs, you know, that sort of thing. So the reality is we're now taking brain span to be equal to lifespan and health span to be equal. So what do you do when you're thirty? What do you do when you're thirty-five? What do you do when you're forty-five?

• 58:13Speaker 01

  And then I've got a couple of illustrative cases of, okay, here's the things that you're doing throughout your life to, you know, to optimize your ability. My hope is that we'll all be able to say, look, I can get to a hundred and I can keep. Very sharp brain.

• 58:26Dr. Darshan Shah?

  Yeah, I would, you know, of course, that's everyone's goal. I saw a 60 minute episode on people that have lived to their hundreds. Did you see that one?

• 58:34Speaker 01

  Yeah.

• 58:34Dr. Darshan Shah?

  And some of these people are sharper than sharper than I am, I feel like they are. They can remember things from and give you minute details for such a long time ago in their life.

• 58:45Speaker 01

  Yeah, you know, so, you know, one of the things I said in the book was time is the broker through which we we trade our energy and youthfulness for experience and wisdom. So when you're a hundred, you're not going to be as quick. You're not going to be as fast of a runner as you were at 20. Of course you aren't. But you've got an advantage in that you've got wisdom and experience. No question, you know, you may not be doing what you're doing in your twenties, but you know a lot more now than you did in your twenties, a lot more. So you can help people that you could never help in your twenties.

• 59:18Dr. Darshan Shah?

  Right.

• 59:19Speaker 01

  So, you know, you do get this, it's a trade off, but you, if you stay sharp, you've got this unbelievable wealth of information and you can solve problems that you could never solve before.

• 59:31Dr. Darshan Shah?

  Right, right. You know, we've talked a lot about Dr. Bredesen, we talked a lot about, you know, avoiding toxins and not having too much insulin sensitivity and not having, you know, not having mold, all these like physiological things. But what can we do with our brain to keep it active and youthful? Is it Sudoku puzzles? Is it like, what is it that we can do to keep our brains on point?

• 59:54Speaker 01

  You know, I think the most important thing is to know not to overdo it. You, you want to have some stimulation. So what's interesting about stimulation, whether you do it through light stimulation, which has worked very well.

• 1:00:05Dr. Darshan Shah?

  Really?

• 1:00:05Speaker 01

  Magnetic stimulation. Yeah, things like Origin and other photobiomodulation, V Light and Neuronic have been very successful.

• 1:00:13Dr. Darshan Shah?

  Interesting.

• 1:00:13Speaker 01

  That's one. So any form of stimulation is driving the production of trophic support. But overstimulation, you're now going right back to that protection side. It's too much. So you want enough without being too much. So you always kind of want to drive it a little bit beyond your current status. So you don't want to run a marathon on day one. You'll kill yourself.

• 1:00:34Dr. Darshan Shah?

  Right.

• 1:00:35Speaker 01

  We used to run beta breakers every year up in San Francisco. Yes. And always someone would come out and die in the middle of beta breakers. Cause they hadn't been practicing, they hadn't been doing the thing. So you gotta be careful. But as you indicated, there are all sorts of good things. And Professor Mike Merznek has developed Brain HQ, which is a great way to go, and it is driving faster processing speed. It is driving improvements. What they showed was just using one of the programs, which is called Double Decision. They would have literally a couple of weeks of double decision. And they still could measure a reduction in your probability of developing dementia 10 years later. So it is striking how these things, yeah, supporting your synaptic plasticity. And then just doing that routinely.

• 1:01:20Speaker 01

  And then, you know, stress, again, I never thought stress was going to be important as a scientist. It turned out to be very important, as we talked about earlier. And keeping that to a modest rate, you want acute stress, fine, you know, you can be stressed in the OR for an hour, but then you want to go home and relax. You don't want to have that chronic, ongoing stress. When we were looking for targets for Alzheimer's treatment, one of the ones that popped out was actually corticotropin-releasing hormone receptor. So your brain is, you know, is recognizing this stress and is literally downsizing in response to this stress, and you can measure that on an MRI. So there's also things like a MERT, which is a specific guided magnetic resonance approach,

• 1:02:04Speaker 01

  which is used, actually, developed here in Southern California. So that's another good one. Some people like microcurrent. Some people like, as you said, Sudoku and brain games. Some people like learning new languages, learning new instruments. It's not so much important which one you use, use the one that you like. But getting yourself some recurrent, regular stimulation. You drive it, you let it make the trophic support, and you can enhance that trophic support with things like lion's mane mushroom and things like whole coffee fruit extract. And so again, we're understanding more the biology of how this is all working together. And we can optimize the outcomes by putting these things together.

• 1:02:44Dr. Darshan Shah?

  How important are topics like having a purpose and having good social connections and having, you know, the ability to be, just be happy in your life? How important is all of that to brain health?

• 1:02:58Speaker 01

  Yeah, so it's turning out that having a purpose is very important. Having social networking, very important. And one of the things that's come out of the trials is support groups where people actually interact. And that's turning out surprisingly to be very important for people to get best outcomes. So again, if you've got goals, if you've got things that you're enjoying, things that you're loving, you are going to stay sharp longer and you're going to stay around longer to achieve those. And you're going to also get positive feedback. So a lot of this is your brain is, is sending out signals and then saying, did that work? Did that, you know, it's like, did I, did I get food from that or did I not get food? And so now you're, you know, did this argument work?

• 1:03:44Speaker 01

  Did this new development work? And it's then saying, okay, that worked. I'm going to support that set of synapses. Or did that not work? Okay, I'm going to pull back on that set of synapses. So you can see why getting positive feedback. And interestingly, that's one of the concerns from people who are, you know, evil, who are having better. If they get positive feedback, they just get worse and worse and worse. That's the way the brain is set up. So this is why you need to identify that and get it out of society. Because unfortunately, it is self-propagating like a prion.

• 1:04:16Dr. Darshan Shah?

  Right.

• 1:04:17Speaker 01

  And so, and so you need to, so you need to get that positive feedback. And so, support groups, social networks, all these things, having a purpose in life, all of these are very, very good for synaptic plasticity.

• 1:04:28Dr. Darshan Shah?

  Right, right. And the, and the opposite also is not good, being lonely. Loneliness is a big problem, especially as we get elderly. Also, you know, I think even the concept of retirement, the old way we used to think about retirement, where you just kind of sit and not do anything anymore.

• 1:04:43Speaker 01

  Yes.

• 1:04:44Dr. Darshan Shah?

  I also think, and I'd love to get your feedback on this, is people that, you know, as, as they get older, they spend just a lot of time in front of the TV. They spend a lot of time just sedentary. As well.

• 1:04:55Speaker 01

  Yeah.

• 1:04:55Dr. Darshan Shah?

  It seems like if if you have a parent or if you know someone in that kind of environment where just sitting around all day alone, not doing much. Whether it be an older person or even a younger person, there there seems to be a lot of negative aspects of that for the brain health.

• 1:05:09Speaker 01

  Yeah. So for the whole ageless brain approach for, you know, let's be, let's have our brain span equal our lifespan.

• 1:05:15Dr. Darshan Shah?

  Yes.

• 1:05:16Speaker 01

  I use the term graduation, not termination. So when you are, you're not terminating your job, you're not retiring from your job, you're graduating to your next event in life. And I remember that the the old, the football coach, Bobby Bowden, they said, you know, you're really old and you're you still haven't retired from football. He said, well, you know, when I retire from football, there's only be one other significant event in my life and I'm not looking forward to that one. So the the point is, don't do that. Have have other significant events in your life. So I mean, now I'm I'm in my seventies, so I'm retired from my driving labs all the time. But this is an exciting new development in my life. We're now seeing clinical outcomes that have never before been seen.

• 1:05:59Speaker 01

  So this is a project. So, okay, then it's going to be the next project and the next project. Find the thing that you love, whatever it is, you know, if it's listening to to, you know, if it's listening to the country and western music. Whatever it is, find those things that you love and enjoy that because this is a this is a graduation, not a termination.

• 1:06:19Dr. Darshan Shah?

  Yes, I love that. Even even if you start traveling or reading books again, things that you, you know, I I know a lot of people that have even even younger that have exited their companies.

• 1:06:30Speaker 01

  Yeah.

• 1:06:30Dr. Darshan Shah?

  And they've done really well in life and these are CEOs and they've had such, you know, such they have to use their brain in such a robust way for so long, but when they stop doing that, they end up getting depressed, lonely and frankly, gets self-destructive, right? And I think it's because they don't have that graduation mentality. What is the next thing?

• 1:06:51Speaker 01

  Yeah, that's such a great point because, you know, when we, this is something we looked at at the Buck Institute. We were looking at, you know, what's happening to the baby boomers. I was the founding president and CEO there in nineteen ninety eight. So we were looking at, you know, what are we going to do for the future? Of America. One of the studies that actually came out of UCLA had said that now we now have two, you know, we have two Middle Ages now. And so one of the issues is you've got all this talent. Look at all the people. As you said, they've sold their companies. These are talented, talented people. How do we find a way for that talent to benefit the country, the world? You know, new startups. I mean, there's so much interesting now. We've got, for the first time, drug candidates that target specific things. I mentioned earlier about the APOE four, APOE three.

• 1:07:36Speaker 01

  There are ones now that I'm aware of that are things that will prevent future pandemics, things that will treat all respiratory viruses, all mutants, new things that will treat antibiotic resistant bacteria. We need talented CEOs, talented entrepreneurs to get in there. You know, and they stand to make, you know, their own, their next billion by doing these things because there's so much to be done now. So yeah, the last thing you want to do, I mean, golf is fine up to a point, but you know, it's going to get boring at some point. There's so much more for you to do.

• 1:08:10Dr. Darshan Shah?

  Yeah, I find, you know, you touch on AI a little bit, but with the rapid progress of AI, there's going to be so much discovered in the scientific space. Each scientific discovery needs an entrepreneur to take it to the masses and make something out of it. And so there's going to be so much opportunity out there. And even if you're doing it just as a, you know, benefit to society to be out there pushing some of these balls forward for humanity. I think it's a great, great way to look out into the future of your career, your life, whether you're retiring or selling your company or what have you, to make your next impact.

• 1:08:44Speaker 01

  Yeah. And this whole thing that they say about, you know, doing well by doing good. Okay, you know, maybe you made your, your first, you know, major sales with something that, that maybe isn't going to benefit humanity as much. Okay, now, now do a project that's going to make a big, a big impact. And hey, the next thing that's going to help, given that, that healthcare is 20% of GDP, you know, it's a multi-trillion dollar issue, you could really do very, very well by doing some. Good things for for health and that's brain health, bodily health and so forth and so on.

• 1:09:20Dr. Darshan Shah?

  Absolutely. You know, I think about my own story. I prior to Next Health, I had a surgical center business and, you know, I was pretty much, you know, ready to quote unquote retire from surgery. I done it for 25 years, but I really saw a needed to a need to develop an alternate health system. You know, we have the disease care system.

• 1:09:37Speaker 01

  Yep.

• 1:09:37Dr. Darshan Shah?

  And we need to have a health system.

• 1:09:39Speaker 01

  Yes.

• 1:09:39Dr. Darshan Shah?

  Kind of the whole, the whole concept behind Next Health is to be that system that focuses on health. And that's why I love talking to people like yourself that are involved, not just in treating disease, but want to promote long-term health as the new solution to getting out of this disease care mess we've kind of made where, you know, we're spending trillions of dollars in just to survive longer, but not have health span, like you say.

• 1:10:06Speaker 01

  Right.

• 1:10:06Dr. Darshan Shah?

  And I think, you know, we're, we can all be part of this solution with all of this incredible technology that's coming out.

• 1:10:13Speaker 01

  Yeah, and I love the name Next Health because, you know, it emphasizes it's health. It's not just medicine where you're waiting for something. It is your health, which really makes such a huge difference in every aspect of your life. And it's also next. It's where things are going next.

• 1:10:27Dr. Darshan Shah?

  Right.

• 1:10:27Speaker 01

  So I love that approach. And, you know, this is, to me, the 21st century is the century where we will see, you know, if not the complete disappearance, much more, 90 plus percent reduction in all of these complex chronic illnesses, Alzheimer's, other neurodegenerative conditions, lupus, rheumatoid arthritis, cancers, heart disease, chronic renal failure. These are all complex chronic illnesses that are killing most people today. They don't need to. And it's going to be the things like what's going on at Next Health and what's going on here at PNI that is going to make the difference, that's going to start reducing these things.

• 1:11:05Dr. Darshan Shah?

  Yeah, absolutely. I mean, you know, for the last 50 years, we saw an upsurge and I think I fully agree with you. We're going to see a massive reduction over the next 50 years and it's exciting, exciting time to be alive.

• 1:11:15Speaker 01

  Absolutely. And boy, just in my own career, starting with nothing, you know, look at these diseases, we would learn the pathology. Okay, there's the amyloid plaques, there are the tangles, this person died, you know, on and on. It was just so hopeless, so depressing frankly. And so now to be seeing these people getting better and to realize, okay, we're now taking this to Parkinson's and macular degeneration and in ALS and things like that. This is going to be a very exciting couple of decades here.

• 1:11:48Dr. Darshan Shah?

  It really is. So Dr. Bradison, you know, I am so excited to be working with you on patients. I'm so excited to have you here speaking about this. I'm excited about your new book. I can't wait to read it. I'm going to keep my own brain healthy for as long as possible. What are you most excited about?

• 1:12:03Speaker 01

  Well, you know, all the stuff we've been talking about, I'm excited about the fact that we've kind of broken through this old model. Now, what's happened is unfortunately, you're still seeing it. You go to your doctor today, mainstream medicine, it is a 20th century model. We wait for you to get symptoms, we write you a prescription, we tell you things aren't good. Oh, it's depressing. And so I'm excited that we've kind of broken through the ceiling now, you know, it's, that's gone. And now it's going to be, where's it going to go? We're going to be able to look at things earlier and earlier. You know, I'm excited about actually seeing statistics to say, you know what, the global burden of

• 1:12:44Speaker 01

  dementia has, you can actually see it dropping. That's going to be a few years, but not too many. We should be able to see this. I think when we look at it as an incidence rather than prevalence, you're looking at it as a year to year, we should see it falling pretty soon. And we got to get, you know, just as there were big programs for things like smallpox and polio, I've always said that there were scourges in the past of leprosy, syphilis, polio, HIV, Alzheimer's and other neurodegenerative diseases, and ultimately, all these chronic illnesses are going to become a scourge of the past. So that's exciting to me.

• 1:13:23Dr. Darshan Shah?

  That's, that's an exciting future. Dr. Bredesen, thank you so much for joining us today. I can't wait to have you back on again in the near future to talk about more exciting new things. And where can people find out more about you? And what could you give everyone a list of the books that you've written?

• 1:13:38Speaker 01

  For sure. Yeah, yeah. And again, thanks so much, Darshan, for having me on. I love what you're doing at Next Health. Thank you so much for pushing the medical world forward. This is really exciting and it's so needed. So you can lots of places to find out the books that we published. The first one is called The End of Alzheimer's, then the Alzheimer's, The End of Alzheimer's Program. After the first book, people said, we want a little few more details. The End of Alzheimer's Program is the second book. Third book is First Survivors of Alzheimer's, and I had seven people who got better, wrote their stories. And if you can get through that without an occasional tear, you're a strong person. Because just reading these people that had no hope, and then they did very, very well and are still doing well. So great to see. And then the fourth one, which is coming out March 25th, is called Ageless Brain, as I mentioned.

• 1:14:23Speaker 01

  And you can also look, you can follow on Facebook, on X, on Instagram, Dr. Dale Bredesen. Those are all fine. You can also follow on YouTube. I'm working, as you know, with Apollo Health, a fantastic guys from Silicon Valley that basically are digitizing all this information and allowing algorithms, which is, you know, the next version of recode will be impossible to do without the computer. The current one, if you spend a few hours, we took it from, it would take me two and a half hours per patient to go through every single thing and to then design a protocol. You know, you now get it with a few microseconds, you know, on Apollo. But the next version is going to be with whole genomes, with imaging, with epigenetics.

• 1:15:06Speaker 01

  You can't do this on your own. So I do think that we're all, you know, the era of computers working with practitioners together to get best outcomes is here.

• 1:15:16Dr. Darshan Shah?

  Yes, I fully agree. Thank you so much, Dr. Bredesen.

• 1:15:19Speaker 01

  Thank you, Darshan. Great to see you.

• 1:15:21Dr. Darshan Shah?

  Good to see you.

• 1:15:24Dr. Darshan Shah?

  Dr. Dale Bredesen is an incredible scientist and doctor. That episode was packed with such good information and so many actionable tips. Here are my top 10 takeaways from the episode. Number one, Alzheimer's is not inevitable. It can be prevented and even reversed. Contrary to the traditional belief that Alzheimer's is a natural consequence of aging, it can now be understood that cognitive decline can be prevented and even reversed, especially in the early stages through targeted strategies. Number two, Alzheimer's is linked to metabolic health. It's type 3 diabetes. Alzheimer's is sometimes referred to as type 3 diabetes due to its connection with insulin resistance and glucose toxicity. Managing blood sugar and insulin levels is crucial in preventing and even reversing

• 1:16:09Dr. Darshan Shah?

  cognitive decline. Number three, early detection is key to preventing cognitive decline. New blood tests and biomarkers such as PTAL 217, G-FAP, and Neurofilament Light can detect early signs of cognitive decline up to 20 years before symptoms appear. These tests help guide personalized prevention and treatment strategies. Number four, continuous glucose monitors, or CGMs, can help manage brain health. Using a CGM is an effective way to track and regulate blood glucose levels. By avoiding insulin spikes and stabilizing blood sugar, you can reduce the risk of developing Alzheimer's and improve your cognitive health. Number five, sleep plays a critical role in brain health.

• 1:16:54Dr. Darshan Shah?

  During sleep, the brain clears toxins, repairs cells, and restores itself. Conditions like sleep apnea disrupt this process, preventing the brain from detoxifying and impacting cognitive function. Number six, chronic infections and toxins can trigger cognitive decline. Exposure to toxins such as mold, mercury, microplastics and air pollution, and chronic infections like Lyme disease can significantly contribute to cognitive decline. Identifying and eliminating these triggers is a key step in reversing or preventing neurodegeneration. Number seven, personalized medicine is the future of brain health. There is no one-size-fits-all solution. Dr. Brenson's approach to brain health emphasizes personalized medicine,

• 1:17:37Dr. Darshan Shah?

  addressing the root cause of cognitive decline for each individual. This includes adjusting lifestyle, diet, and targeted treatments based on unique biomarkers. Number eight, the role of inflammation and cognitive decline. Inflammation and immune system dysfunction are critical factors in the development of neurodegenerative disease. Managing chronic inflammation through diet, lifestyle changes, and targeted therapies can protect the brain and slow the progression of Alzheimer's disease. Number nine, lifestyle optimization is essential for brain health. Optimizing factors like nutrition, exercise, and stress management can dramatically improve brain health. A healthy diet rich in anti-inflammatory foods,

• 1:18:19Dr. Darshan Shah?

  regular physical activity, and stress reduction techniques are foundational to your cognitive well-being. And number 10, it's never too late to take action. Even if symptoms of cognitive decline have already appeared, it's not too late to make meaningful changes. Many patients have successfully reversed cognitive decline through lifestyle changes, dietary interventions, and personalized medical strategies.

• 1:18:47Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.