← BETTER! with Dr. Stephanie Estima | Strength, Body Composition & Perimenopause
BETTER! with Dr. Stephanie Estima | Strength, Body Composition & Perimenopause
Is it Alzheimer's or Perimenopause? 5 Ways to Protect Your Midlife Brain with Dr. Majid Fotuhi
01:06:42
Your brain isn't broken… it's just going through perimenopause. Neurologist Dr. Majid Fotuhi explains why your foggy, forgetful midlife brain is not only completely normal, but with the right habits, can literally grow bigger and stronger at any age. Watch the full episode at https://youtu.be/W4SkyY9OW38
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- [00:00]
A
At Johns Hopkins, we have an epilepsy unit and some of the patients, especially kids, require surgery that removes half the brain. So these kids, 9 year old, 10 year olds who have only half the brain, move on to have normal life. Several studies have shown that 12 weeks of moderate to intensive exercise grows the size of hippocampus to such a high degree that you can see with naked eye on a brain mri. There are five pillars of brain exercise, optimal sleep, optimal nutrition, stress reduction, and brain training. Of these five pillars of brain health, exercise is number one. My recommendation to women is that please don't waste your time worrying about Alzheimer's disease and use that time to do some brain training. Do a sudoku, take a dance class, do something fun, go hiking with your friends, because that's a productive way of using your time toward having a healthier brain in the future. The frustration is when new synapses are being formed, I forget something, I repeat it, I forget something and I repeat again and I remember it. And you know, I may get frustrated, but that's a good thing. So when you're frustrated, great. Good job. You're doing it right.
- [01:28]
B
Hello, my friends. Welcome to another episode of better with Dr. Stephanie. It's me, your host, Dr. Stephanie Seema. And we have a little bit of a theme over the next two weeks. We are talking about brain health for women in midlife. And this is the first of two that we are going to be doing. My guest today is Dr. Majeed Fatouhi. So I think that a lot of times when we start to see in perimenopause changes in our thinking, maybe we get consonant confusion or we can't remember why we walked into a room or where's my phone again, I don't know where I put it. We're like, this must be early Alzheimer's, right? We always sort of jump to the worst possible conclusion. Dr. Fatouhi is here to talk us off of a cliff and really give us some solid science in terms of what may be happening and maybe most importantly, how to distinguish between perimenopause and menopause and something like early onset Alzheimer's or just the clinical picture of what Alzheimer's disease is a little bit about. Dr. Fatouhi. He is a pioneering neurologist, neuroscientist, and professor with more than 35 years of experience in brain health, memory, neuroplasticity, and the prevention of Alzheimer's disease. He earned his PhD in neuroscience from John Hopkins University, completed medical training at Harvard Medical School, and returned to John Hopkins for his neurology residency. He currently serves as an adjunct professor at John Hopkins U. So you are going to hear a lot about the female brain and how it ages and strategies through exercise and nutrition and brain training in terms of how you can help your brain age well, we walk through all of the different scenarios and what you can do about it. So please enjoy my conversation with Dr. Majeed Fatouhi. I want to talk to you about strength. Not just lifting heavier strength, but the feeling capable in your body. Again, strength for many women, especially in perimenopause and beyond. We start noticing fatigue. The workouts feel harder, the recovery takes longer, the mental sharpness declines. One of the most important supplements a woman over 40 can take is creatine. Our bodies make it, but we start to make less creatine as we age. And while it is often marketed to men, women actually experience the steepest decline in creatine production after 40. And it is essential for brain health, for focus, for cellular energy, and of course, for muscle. And this is why I love Qualia Creatine Plus. It uses two clinically tested, highly bioavailable forms of creatine plus magnesium, Magnesium plus electrolytes to support lean muscle energy and mental clarity. If you want to feel stronger, sharper and more resilient, this is a foundational supplement. Qualia Creatine plus is my recommendation because creatine is honestly just too important to get wrong. Head over to qualia life.com better and use my code better to save up to 50% 5 0% plus an additional 151 5% off. That's qualia creatine plus@qualiolife.com better. All right. And we are live. Dr. Majeed Fatouhi, welcome to the show. I'm so happy to have you here today.
- [04:45]
A
It's my pleasure to be on your show. Thanks for inviting me.
- [04:48]
B
Okay, so we have a little bit of a brain health theme going this month as your book is coming out, the Invincible Brain. So let's talk a little bit about. Actually, I want to talk about the title of the book first, because I feel like the Invincible Brain. This is a bold word in neuroscience to say that you have an invincible brain. So tell me what an invincible brain actually means to you. And do you think that that is something that's achievable for the demographic of the show? Let's say she's a 52 year old woman who already feels like her memory is slipping.
- [05:25]
A
Yes, I honestly think our brain is very invincible. It comes from my clinical experiences At Johns Hopkins, we have an epilepsy unit. And sometimes some of the patients, especially kids, require surgery that removes half the brain. So these kids, 9 year old, 10 year olds, who have only half the brain, move on to have normal life. They move both hands, they walk, they play, they go to school. I've also seen many patients who have had major concussions or gunshot wound or strokes who have recovered. I am always in awe about how invincible our brain is, how resilient our brain is. So when I chose the title, I wanted to convey in all the different ways that we can make our brain even more resilient against the effects of aging and how we can keep our brain sharp as we get older and defy the effects of aging in the brain, which I honestly think it is possible.
- [06:25]
B
Fantastic. Well, let's talk about our. Let's talk about the ladies who are listening to the show. So we have women who are in their 40s and their 50s. They're in the thick of perimenopause or menopause, which we know is, can be very well. There's a big hormonal transition. How that woman navigates that change. I mean, there's a lot of bio individuality there, but there's a cluster of symptoms that tend to happen together. There's the brain fog, there's forgetting words, there's walking into a room and having no idea why you did that. What is actually happening in the brain during perimenopause? And why are women so uniquely affected? Why are we, our brains, so susceptible to some of these changes in our cognitive faculties?
- [07:08]
A
Yes, our brain is very sensitive to fluctuations in all hormone levels. For example, if your thyroid level is up or down, your brain may not function optimally. The same goes with other hormones as well. And our brain is quite sensitive to estrogen and testosterone. So when women go through a menstrual cycle at any age, there are some changes in their cognitive abilities in some women. There are some women in college students who, during their period, they may have some difficulty remembering things, or they may not articulate themselves better, or, or they may not be as sharp as usual. So if they're not imagining it, the hormone levels do affect the brain. The exact mechanism through which these hormonal fluctuations affect the brain is not clear. Some imaging studies have shown that parts of the brain may actually get a little swollen and then come down. And little changes in anatomical features of the parts of the brain from memory may change too. So the symptoms that women report are not exaggerated and they're not like they're just, you know, complaining. These are very real cognitive things that women experience. The good news is that our brain is sensitive to fluctuations in hormones. And after menopause ends, and the fluctuations end, most women return to the cognitive abilities they had before the hormonal changes began.
- [08:40]
B
And we'll talk a little bit about what are some of the action items that some of the, you know, some of our listeners can maybe think about implementing in their own lives. But you mentioned something around, you know, certain areas of the brain. I would love to talk about the hippocampus, if we can, and the relationship between estrogen and the hippocampus. Can you walk us through that relationship? And of course, for the listener, just as by way of. Of explanation, this is memory and learning, where we typically consolidate memory. So talk to us a little bit about the relationship between estrogen and the hippocampus.
- [09:11]
A
I love the good questions you're asking, Stephanie.
- [09:15]
B
Thank you.
- [09:16]
A
So our brain has two areas that are very important for cognitive functions. One area is called cortex, which is like a blanket that covers all the other areas. And there's a structure called the hippocampus, which is roughly the size of your thumb. You have one on the right, one on the left. Now, hippocampus, as you said, is very important for consolidating memories. Hippocampus is also a part of the limbic system, which is in charge of emotional regulation in the brain. And your other cognitive abilities, typing, reading, writing, driving, cooking, arguing with somebody, planning, doing your taxes, all emanate from functions of cortex and hippocampus together. So these two brain areas are very important for everything you do with your higher brain functions. Now, estrogen has a neuroprotective effect on the brain. Usually we think of estrogen as a good thing for the brain. It keeps the neurons healthy. It's the same thing up to your skin, I guess. You know, when you receive hormone replacement therapy, when your estrogen level is optimal, the skin appears healthier, too. And neurons in the brain appear to be healthy, too, with optimal levels of estrogen. And so there has been trials where researchers try to give estrogen to men and women to try to slow down the effects of aging in the brain. The point is that there are other factors. So estrogen alone is not going to make a big difference. Estrogen is one component of 10 different things that can affect the brain. But one of the things that happen in women during menopause especially is development of new vascular risk factors. Many women gain weight. Many women start experiencing obstructive sleep apnea. Many women start having diabetes even though they eat the same amount of food and they're doing exactly the same things that they used to. However, they're now heavier and they have blood pressure issues and other issues. And then these vascular risk factors affect the brain through narrowing the blood vessels in the brain and limiting blood flow to the brain. So that's the mechanism through which estrogen affects the brain. Direct effects and a secondary effects. And it's a balance of all of these things along with genetic factors in individual women, which determines why some women, some women may have very little effects in their cognitive, cognitive abilities during menopause, and some have more effects.
- [11:47]
B
So if we have these new vascular risk factors. So you mentioned obstructive sleep apnea. Sometimes there's weight gain, maybe as you mentioned, like increasing insulin resistance, poor glucose disposal. What I often find is a lot of women will say something along the lines of, I'm doing the same things that I was doing when I was 20 or 30, but now I'm putting on weight and I, I don't know why I'm eating the same foods, I'm exercising the same way. But what we don't often recognize is that we tend to, as we age, become a little bit more sedentary. Sedentary. So we will walk less. I read a stat somewhere, made me honestly wanted to cry. It was something like 95% of people, men and women, don't sprint after the age of 30. So when you think about, you know, when you were talking about vascular risk factors, I'm thinking about lactate. Right. So if when you're sprinting, you're accumulating something called lactate, which is a direct signaling molecule for the brain that helps with angiogenesis, like, you know, creating good vascular supply in the brain. So there's some of these things that, that tend to slip right as we're aging. Walk us through in terms of, just in terms of movement capacity, how that might be something that women might think about in terms of stacking the deck in their favor as, as they're aging so that they can have an invincible brain that you're describing.
- [13:08]
A
Yes, absolutely. So people in general tend to be less active as they grow older. And that's a terrible thing that happens. I love my wife, she's just 50 something and she's as fit as you are, and it's great. And I think that's how she's dealing with menop. Because some of the effects of menopause in the brain is because of these new vascular risk factors seem to come out of nowhere. And when you exercise more, you negate those vascular risk factors, and then you can turn the table in your favor.
- [13:40]
B
So what is your beautiful wife? What kind of exercise is she doing?
- [13:43]
A
She is as athletic as she was when she was 17 or 18. She goes to the gym and she does these hardcore courses. She does cycling, she does Pilates and she does CS4. And she doesn't miss a day. She goes every day. In fact, when it snows, there are hardly any cars on the street. She's the one driving to the gym. That's why I'm the one.
- [14:04]
B
I mean, that's the one time to go to the gym is during a snowstorm.
- [14:07]
A
I think what she tells me is that she loves it. She loves how she feels, and she's addicted to it because she's in her zone when she exercises. But the point is that we need to keep our brains active through exercise. There are five pillars of brain health. Exercise, optimal sleep, optimal nutrition, stress reduction, and brain training. Of these five pillars of brain health, exercise is number one. Exercise is really the fountain of youth. Exercise increases the number of mitochondria inside the cells. Mitochondria are energy producing organelles inside each cell. And so when you have more mitochondria, your cells have more energy and they can function better. What's interesting is that when you do physical exercise, you have more mitochondria everywhere, including your brain. Your neurons have more mitochondria when you are on a treadmill. And exercise also reduces inflammation in the brain. Exercise increases levels of growth factors such as bdnf, brain drive, neurotrophic factor. In fact, exercise can have so many benefits that it can increase the size of hippocampus in three months. Several studies have shown that 12 weeks of moderate to intensive exercise grows the size of hippocampus to such a high degree that you can see with naked eye on a brain MRI. One study looked at a group of 37 people and they put all of them in an exercise program on a cycling machine, and they exercised for an hour, four times a week. That's all they did. And they all had MRIs before and after. And all of them increased their size hippocampus. It wasn't like half of them did, half of them didn't. Every person in that group grew the size of hippus in such a high level that you just look at the mri, you look before and after and you can see which one is after. When I teach at Johns Hopkins I put these pictures side by side, and I ask my students which hippocampus is larger. And they can just see, looking at the slide, that this one on the right is larger, and this is the hippocampus of the same person after 12 weeks of exercise.
- [16:33]
B
So if somebody's trying to model that and they say, okay, I'm going to one time, you know, I'm gonna exercise for one hour, four times a week for the next 12 weeks. I wanna do moderate to intense exercise. How are we defining that? Is that defined by heart rate? Is that defined by lactate? How can somebody say, okay, I'm. This is a moderate exercise for me. I'm in zone three. Or I'm in zone. Let's say creeping up into Zone 4 or an intense exercise, which would be, you know, zone five.
- [17:01]
A
Let's say I tell my patients to push themselves to the point of huffing and puffing. When somebody asks your phone number, you should not be able to say it comfortably. It's like,
- [17:15]
B
three, two.
- [17:16]
A
Now, I want to be very clear. Intensive exercise can expedite the duration and how quickly you increase the size of hippocampus. However, even walking for 45 minutes comfortably three or four times a week in six months and one year, increase the size of the campus. Another study that was done in Pittsburgh looked at men and women in their 60s, and they put them in two groups. One group was assigned to walking actually three times a week, 45 minutes each time. Just walking, not intense walking, regular walking. And the other group was assigned to stretching, just to simple stretching exercises. And this was the control group. And they saw that after one year, the group that did the walking had hippocampus, which was 2% larger. In other words, their brain was 2% larger just with walking three times a week, each time for 45 minutes. I really don't want people to be intimidated by intensive exercise and not do it at all. I really want everyone to appreciate that moving your body, even five minutes of exercise, even five minutes of walking, will be very helpful. If you want to be like my wife, go ahead. You know, if you enjoy it, do it, but it's not required. You don't have to do moderate or intensive exercise to have benefits. It's important that you make exercise a part of your daily habits, such that you know that every day you do, let's say, 45 minutes of exercise. But if you do want to do what an intensive exercise usually would consist of, you can do one hour of something like cycling to the point of huffing and puffing followed by 45 minutes of weight training. So it's an hour 45 minutes, three times a week. That will be more than enough to improve not only your brain, but your skin and your heart and your lungs and your liver and your kidney. Every organ in the body benefits when you exercise.
- [19:26]
B
Yeah, I love what you're saying because I often have, women will ask me like, tell me what your routine is, tell me exactly what you're doing. And you can have, I say this all the time. You can have incredible benefits in terms of body recomposition and growing muscle, like hypertrophy of the muscle strength, gains in the muscle mass. With two times a week, a full body strength training program. And of course you can, you can level up from there. If you have time and desire to do three times or four times, you can certainly do that. But to your point around this idea around just, just do something, you know, it's like you don't have to, you don't have to train like you're going to be competing in the Arnold or, you know, Mr. Olympia, but you, if you're doing two times a week, a full body program in terms of strength training and then the impact that that'll have on cognitive function, of course it's, you know, you're going to have, as you start to see your body change also just, you can extrapolate that your brain is also changing as well. So the hippocampal size and volume and then, you know, gray matter and, you know, and, and white matter sort of at large. And that was my next question for you is we were talking a lot about aerobic training and we know that, you know, aerobic training is very well established for positive outcomes in the brain. And you just answered my question by, by talking about strength training as well. Your midlife lack of energy isn't a caffeine deficiency problem. It's a mitochondrial efficiency one. If you're finding your energy dips between meetings and workouts and those perimenopausal ups and downs, I want you to think more about optimizing your energy production rather than having more coffee. Meet. Troscription's just blue. This is a precision dosed methylene blue buccal trochee. And methylene blue works like a tiny electron shuttle for your mitochondria. It supports a ATP production which is the energy currency that our cells run on. And we are after cleaner, steadier energy and focus without the jitters. Early human brain imaging even shows that low dose methylene blue can improve attention and memory networks, which is exactly the circuits that suffer the most in midlife and that we lean on the most in our midlife transition. Each trochee is 16 milligrams and it's scored so you can choose how much. You can choose your dose. I would start with a quarter trochee and swallow it because you probably don't want a blue tongue. Or if you do, you can just let it melt on your mouth and in about 15 or 20 minutes you're going to feel that smooth energy lift and that mood lift as well. So one pack has up to 16 doses. This is a completely new way to optimize your health and I want you to give it a try at troscriptions.com forward/better or just enter better at checkout for 10% off your first order. That's t R O S C r I p t I-O-N s.com better for 10% off your first order. If you have been here for any length of time, you know how deeply I care about recovery. Not just your workouts, not just your nutrition, but recovery. Because that is where the adaptation and change actually happens. And one of the most underrated recovery tools in your home is your bedding. I recently switched to the cozy earth comforter and I genuinely did not expect it to make as much of a difference as it did. First, let's talk about the weight. It is substantial enough to feel grounded and calming, but not so heavy that you can't move and you feel like you're suffocating. You know, your nervous system just settles in. It feels like a warm hug. Second is the temperature regulation. Obviously if you're navigating perimenopause and menopause, you know overheating at night is not just an inconvenience, it disrupts your sleep architecture, your recovery, your mood and your next day performance. This comforter is breathable and temperature balancing, which means that you can stay warm without waking up sweaty at 2am and third, the quality ladies, the stitching, the feel of it. I never knew that fabric had such a big part of the influence of a comforter. This is not just seasonal, trendy bedding. It feels like something designed to last, which aligns perfectly with how I think about health in general. It's built for the long game. Sleep is foundational. It's not just an indulgence. If you are serious about building a body that you can trust, your sleep environment really matters. Head over to cozyearth.com and use my code better for 20% off. And if you get a post purchase survey, make sure to mention that you heard about it here. That's cozyearth.com and use my code better for up to 20% off. Let's talk a little bit about Alzheimer's because a lot of women, I mean, we know that the risk for Alzheimer's, both men and women, get it, but it's disproportionately more women who tend to receive the diagnosis. It is my understanding of Alzheimer's that you don't just wake up at 65 with Alzheimer's. This is a multi decade slow deterioration. How can you help a woman? Let's say she's 47 to 50, let's say she's a 48 year old woman, you know, she's having consonant confusion and she can't remember where she put her keys and brain fog and the sleep and all of that. How can you help her distinguish between some of the symptoms that we see in perimenopause and whether or not this is, you know, early changes in her cognition? Like is this subjective cognitive impairment? Is this moderate cognitive impairment? Are there clinical clues, let's say that help us distinguish between those things?
- [25:01]
A
Yes. If somebody asks the same question three or four times and does not remember the answer, that's concerning. Now if you forget your keys, if you send an email and you forgot that you sent an email and somebody responds and says, wait, did I send that email? Or if you go to a meeting and everybody's talking and you said something and then you don't remember that you were the one who actually said that. But these things happen periodically. And when somebody tells you say, oh, you're right, you did do that, then those are considered what we call brain fog. But when somebody asks, what are we doing for dinner tonight? And you say, well, we're having steak for dinner tonight. And then an hour later somebody says, well, what are we doing for dinner tonight? And the person said, well, we're having steak. And then an hour later or 10 minutes later, what are we doing tonight? That is concerning. When somebody repeats the same question multiple times within an hour or within a day and does not remember that that person had already received the answer, that would be a red flag. And of course that's considered mild cognitive impairment, which is a stage between normal and Alzheimer's disease. Now, I have seen thousands of patients who were women between ages of 35 and 65, and I can't think of any of them who were in that young age group who had Alzheimer's disease because Alzheimer's disease does happen in young women, young people, men or women in their 50s. It does happen. One in a thousand or two in a thousand. But that it's really not fair for women to worry about Alzheimer's disease when they forget something and they're experiencing other symptoms of menopause. So Alzheimer's is so far in the list of possibilities that it's really a waste of time to think about it. It's like saying, oh, I have some nausea. I must be having cancer. Well, sometimes a cancer patient may have nausea, but nausea is really not a sign of cancer. And so memory lapses, forgetting things, you know, going to a garage, not knowing why you went there should not be a concern for Alzheimer's. And unfortunately it is, because I've seen the patients. And what I like about my job is that people come to me convinced they have early stages of Alzheimer's disease. And I would take care of their sleep. I would sort of make sure they're sleeping seven to eight hours a night. I'll put them on an exercise program. I would check their vitamin D and B12 levels. Those are very common factors in women. Especially, you know, some women may have anemia with their menstrual cycle. And I would give them some brain training exercises. We will show our patients how to memorize 20 words in one week, and they will repeat it in five weeks. And then they memorize hundred words. And so when they would come back at six weeks, they already had memorized 100 words. They were already thrilled. And they were so what? Alzheimer's. They just totally forget it. And that's why I wrote the book. Because in my experience, so many people worry unnecessarily about the worst case scenario. And it's so easy to improve your brain functions in a short period of time. So instead of spending time thinking, oh, I'm having Alzheimer's disease, oh, my mother or my grandmother had Alzheimer's disease, and I'm getting it. And I'd like to. If you don't mean talking to Maestri, I'd like to clarify the genetic role.
- [28:44]
B
Yes, please.
- [28:45]
A
The early onset Alzheimer's disease is something that does have a strong genetic component. So if your parents deal with Alzheimer's disease in their 50s or early 60s, unfortunately, you are at higher risk. But the kind of Alzheimer's that happens to parents and grandparents in their 80s or even 90s is really not a risk factor. It may increase your risk by 2%. And just to put things in perspective, let's say a woman in her 70s, has a 2% risk of developing Alzheimer's disease on average. And then if she has a parent or grandparent who had late onset Alzheimer's disease, her risk would be 2% more, you may call it double, but you know, it's gone from 2% to 4%. Now, let's say she also has diabetes, obesity, sleep apnea, and a sedentary lifestyle. Those will increase her risk 16 fold. So her 2% risk would be 32%. Now, you know, if you have 4% risk of developing Alzheimer's means that you have a 96% that you won't. But if you have a 32% risk, well, that's a significant difference. My recommendation to women is that please don't waste your time worrying about Alzheimer's disease and use that time to do some brain training, do a Sudoku, take a dance class, do something fun, go hiking with your friends, do the five pillars of brain health I mentioned earlier, because that's a productive way of using your time toward having a healthier brain in the future.
- [30:26]
B
And what if somebody is a 4, 4 carrier? So if they are, you know, mom gave them an APOE4, dad gave them an APOE4, what is the risk at that point?
- [30:34]
A
Yes, APO lipoprotein E4 is a risk factor. And several studies have shown that. If you have apolipoprotein E4, one copy, this study was one copy, and you're active. Your level of brain amyloid, which is the marker for Alzheimer's disease, is at the same low level as someone who is APOE4 negative. So in general, exercise can negate the effects of APO lipofructin E4 gene. That's very important for people to know. If you have APOE 4, it doesn't mean you will develop Alzheimer's disease. It means that you are at higher risk. So you may develop it at 72 instead of 82, which is a big difference. However, if you are exercising and you're in good shape, you would get it at 82, or maybe you get it at 84. The genes are not the same thing as like having hiv. So if you have hiv, you have hiv. It's not like you're more likely to get hiv. You have it, it's it. And if it's negative, it's negative. But the genes for Alzheimer's are not determined. They're not 100% positive that they will be developing. It's a risk factor. And the lifestyle risk factors are equally important. And if you have multiple risk factors, you are Far worse than if you're APOE4. So if you are APOE4 positive, use that as call to action, use it to exercise more, challenge your brain more, sleep more, and you will end up having a lower risk that you would have had otherwise.
- [32:14]
B
Yeah, I, I really do like that. I think that it's important to understand your genetic risk. But to your point, it's not, it's not causative. Right. We know that just because you are a 4. 4 carrier, that doesn't mean that at a rate of 100%, you're gonna get Alzheimer's. But maybe what that does mean is that you do have to double down on what you're talking about. You have to double down on your strength training and your exercise and your sleep and your nutrition and your brain, your stress management in order to either delay the onset or maybe the severity of it is, is, is changed as well, or maybe not at all. So I, I do really like that. And I see this in the social space now where there's a lot of espe around obesity in general. Like, the theory that's being floated around is that obesity is genetic and there's nothing you can do about it. And I, I reject that in the same way that I reject the idea that if you are a 4.4carrier, there's nothing you can do about it. Things that you can do in your favor, yes, there are things that put you at a higher risk, in a higher risk category. But though there's so many things that you have agency over that you can control, like the strength training that we've been talking about. I want to talk about, I want to actually talk about sleep. But just before we get there, I made a note here to ask you. When we were talking about Alzheimer's in, in, you know, sometimes we might start thinking, oh, I might feel brain foggy or I can't remember, I don't know why I walked into the room. I can't remember what I said on the meeting. I, I, I, there's so many women in their 40s and 50s that are on like a cocktail of different medications. So sometimes they're on antidepressants, sometimes they may be on sleep medications because they're having trouble, you know, initiating or maintaining sleep or hormone therapy. Can you maybe walk us through what women in midlife need to understand about the medications that they're taking? Maybe it's an ssri, let's say, and what that impact might have on, on brain health?
- [34:09]
A
Yes, sleep medications and pain medications are notoriously associated with Cognitive decline. Sometimes even people who take antihistamines to sleep better. Things like Benadryl make them foggy and groggy. But that's usually easy to figure out, because if I have a patient who says she has difficulty remembering things or she's forgetful, I ask her what medication she's taking, and if she tells me the date for each one, then I ask her when her symptoms began. And if there is a close proximity between starting the medication and the onset of symptoms, then we know what it is. This is very common in older women who may be taking, for example, Benadryl for sleep, and that they're really confused, and you take them in a little way, and they perk up. So anytime a person has cognitive issues, I go through a list of 40 different things, and I have this list of 40 in my book. I'll just give you some of it because they're all interrelated. So, for example, if somebody has swelling in their ankles, they may have heart disease, and heart disease is a risk factor for brain problems. If somebody has numbness in their toes, they may have B12 deficiency or they may have early signs of diabetes. And those are very important. If somebody has reduced libido. Many risk factors that cause libido or sexual symptoms also cause cognitive symptoms. And so I often ask about, you know, the sexual experiences, libido, and things like that. And if somebody, for example, has back pain, I ask about what caused the back pain and what medications they take. You know, if they have hearing problem, that's a major risk factor for cognitive decline. And then I ask about vision. I ask about adhd. I ask about every organ from head to toe. And once I have that, each person has positive answers for, let's say, four or five of the 40 things. And then I have a target to pursue in order to improve my patients. More than 80% of our patients who had mild cognitive impairment, which is significant memory loss, it's not just a little brain fog. These are women who are between normal and Alzheimer's disease. 84% improved. 84% had a statistically significant improvement in their cognitive scores. We also provided a program for patients who had persistent concussion symptoms as well as those who had adhd. And day two improved. The idea that you can nourish your brain through those five pillars of brain health seems to be very solid evidence that you can improve your brain.
- [37:00]
B
February always feels like that. Weird in between month. Winter's still here, energy's still a little lower, and most of us are craving something that actually helps Us unwind without stealing from tomorrow. That is where peak comes in. It's aspirational wellness for people who care deeply about how they feel in their bodies. So not just for tonight, but for the next morning too. Their newest creation is called Vesper and it's designed specifically for the evening ritual because, let's be honest, for a lot of women, winding down still defaults to alcohol. And while it might feel relaxing in the moment, it often comes with fragmented sleep and low grade anxiety the next day that only alcohol uniquely brings. Vesper was created as a better option. It's a non alcoholic adaptogenic aperitif that helps you relax without dulling your nervous system or compromising your sleep. What I notice first is how physical. Physical the calm feels. My shoulders drop, my jaw unclenches, my mind slows down. And that comes from ingredients like L theanine and tart, cherry and lemon balm and elderflower. It's nervous system support that you can actually feel. Vesper also includes Damiana, which supports that warm, open, receptive state which is perfect for date nights, if you know what I mean. Cozy dinners and just being more emotionally available without needing a drink. And the flavor, ladies? Gorgeous. It's sour cherry up front, layered with grapefruit and bitters, finishing clean and herbaceous. I actually love it. Over ice in a wine glass with some sparkling water. Put my phone away. Candlelight, slow slips, it's divine. You'll wake up the next morning feeling clear headed, well rested and genuinely glad you chose differently. If you want to redefine your evening ritual and still feel like yourself the next day, you can get 10% off. For life. Yes, for life. @peaklife.com better. That's P I Q U E L I F E.com better. Your nervous system will thank you.
- [38:59]
A
Don't let a label prevent you from taking advantage of how invincible your brain is. You have an incredible, beautiful brain. You can memorize a thousand words. You can memorize the Bible. You can do incredible things. And if there are other people doing them, you can do it. Don't ever think or say that, oh, I'm not smart. As my neighbor or my cousin or my co workers. You have the cortex and hippocampus and you can achieve anything. Now, some people are innately good at some things. Like some people are just good at singing without much effort. Some people are good at math without effort. Some people are good presenters. Some people can articulate things well. So if you have some talents that you are naturally good at, great. Enjoy it. We all have. Let's say there are 30 different forms of intelligence. We all have a handful of things that we are naturally good at. But there are 25 things that we are not born with. A deluxe version. But the good thing, the important thing, is we can acquire those talents. So let's say I am talented in giving presentations and writing, but my musical talents are zilch to begin with. But if I practice the piano for 10,000 hours, I'll be much better pianist than somebody who was born with a deluxe version of the talents for playing the piano, but who never practiced. So I want women to really appreciate how wonderful their brain is. In my practice, I see this all the time. People don't take care of their brain the same way they would take care of their skin or their teeth. See, there are things you do every day for your teeth. And as a result, most people these days have healthy teeth when they get their 70s and 80s. But 50 years ago, people in their 70s and 80s had dentures. Many people would end up having dentures because they would not take care of their teeth as they grew older. And I think we are in that stage of paradigm shift where we are about to appreciate that our brain is an organ. And if you take care of it, it will be brilliant and shiny and beautiful. And if you don't take care of it, it will be like you need dentures. But we don't have sort of a denture equivalent for the brain. We call that dementia. So don't get there. And the best time to start is midlife, because in college, you don't think about those things. You think that you will live forever, but in your 30s and 40s, when you're starting, the first hint that things are not perfect, use that as call to action. Use that as an incentive to really tap into a beautiful brain that you have.
- [41:48]
B
And I think for a lot of women in midlife, it's almost a chance to rediscover who they are, because there's been years of maybe going to school and getting married and raising young children. And so you're. You're in this caregiver mode for 10, 20, and then, you know, your kids are teenagers and then they're out of the house. And then you find yourself with all of this time because you no longer have that role to fill. So it's a wonderful opportunity to kind of get back to taking care of yourself in, you know, because you've spent many years giving to others.
- [42:19]
A
May I say one thing? Yes, of course. I think women should look at midlife as A new childhood. This is a new childhood. This is the time to enjoy life. You know, don't think that, oh, I'm gaining weight. I'm brain fog and losing my marbles. I'm not good at anything. No, no, it's a new childhood. Take care of yourself. Enjoy life. Go hiking, go dancing, you know, spend time with your friends. Take an art class, take a Zumba class. Go do things. You know, I sometimes do triathlons, and once, three years ago, I was doing the triathlon and it was toward the end, and I saw this young lady, well, young lady, she was in her 80s and she was trying to pass me. And I said, wait a minute, you're like 30 years older than me. You can do that. And I loved it. I loved it that she was doing that. And I think that's what we should all do. We really should look at midlife as the new childhood where we start having fun. Like you said, you know, many of the responsibilities are done. Kids are to college, you know, you know, hopefully you don't have parents to take care of that are ill and you have more time. And so let's take advantage of time and build a beautiful brain.
- [43:34]
B
I heard the term queenager, which I think is really great because you can have like your second teenage years, but now you can do it as a queen, which I think is really funny. You said something that I wanted to come back with and this back to. And this is just the nerd in me that just wants to know the mechanism. So you said, you know, when we have swelling in the ankles, I'm thinking about cvd, when we have numbness in the toes, could be early sign of diabetes. And then you said, hearing problems and vision, we know that there's going to be some type of cognitive deficit. Now in my head, I'm like, okay, the mechanism for that must be because these are cranial nerves. And now we. And the vision is like our one, you know, dominant sense. So is it because the brain is. Now, if we have hearing loss or vision loss or taste loss, is it because now those nerves are not directly stimulating the brain, and then it's sort of like a use it or lose it kind of thing? Like, what is it about losing our senses that also contributes to brain loss? Then I have a question about the 30 forms of intelligence that I made a note about here.
- [44:33]
A
You are correct. Your brain is like a muscle. Use it or lose it. And hearing loss is a major risk factor for cognitive decline. Let me give you an example. A friend of mine told Me that his mother, who was in late 70s, was developing Alzheimer's disease. I said, what are you talking about? I know her. I mean, she's fine. Said, no, no, no. She doesn't talk much. She's always in her room, forgetful. And so I called her, and I knew her from the past. So I called her and said, what's going on? And said, no, I'm fine. And then so I asked my usual question, going through head to toe, do you have any numbness? Do you have anything? And I. And I had to repeat myself. I said, can't you hear me? She says, no, I can't hear you. I said, well, do you have a hearing aid? She said, no, I don't like hearing aids. I said, well, that's the problem. So I asked the family to get her hearing aid. And that was like black and white difference for her, because after she had the hearing aid, she started to participate in conversations and she started doing more things. And, you know, 15 years has passed and she has no issues. And I see this all the time. When people have hearing loss, they withdraw because they can't participate in conversations. They don't hear things, and they can't keep up with who said what. And as a result, they withdraw. Like, for example, they may not answer the phone because they may not hear what people are saying on the phone. So they withdraw themselves from that. And as a result of that, their brain becomes lazy, their brain becomes less active. It atrophies. More recently, there was a randomized control study that showed that just giving people hearing aid significantly improves their cognitive functions. So they had two groups of people with hearing loss. One had just a hearing aid and one group didn't. And as a result, there was significant improvement in cognitive function. The same applies to vision. If you can't see things well, if you have cataracts or if you don't want to wear glasses and you can't read as well, you also reduce stimulation to your brain. Your brain thrives in stimulation. And when you don't use it, it literally falls apart. And that's one thing I check in all my patients. Like, if I have only five minutes to check with someone, an older person who comes to see me, I just say, do you hear this? And I show them a card that they need to read, or I ask them to read my id, just leave the small letters because I know how important it is. And then I check their toes. See, that's the thing. People I find interesting, that they come to see me, I check on their Belly. I check their, their back, I checked their hip, I checked their shoulder. I said, doc, I'm here for my brain.
- [47:15]
B
You're like, I know, but you know,
- [47:17]
A
every organ has a direct link to brain. Your heart and your brain is a two way street. Your lung and your brain, two way street and your gut and your brain is two way street and so forth.
- [47:28]
B
I love that. That's so great. And so we should be really trying to preserve the hearing that we have. And there's so many elegant, you know, there's, I guess that we call cochlear implants or you know, they're, you can even just have the ones that fit over the ear. Like they're really subtle. So I know that there's a lot of maybe resistance to maybe it feels like old or, or something. But I think that when we're thinking about this in the context of brain function, I mean you can't really participate in, in, you know, it's part of your humanity essentially to be in conversation with people and to answer the phone and to have conversation and to hear the television or to hear what someone's saying on a podcast. You know, your hear such a vital, vital, vital sense. So I'm sort of getting the, you know, the, the weight of that as, as you're talking. You mentioned the 30 forms of intelligence. 25 of them. We don't. We don't. I think you said we don't get the luxury version of them. I love this because I think that we've only ever been told that iq, right? So, you know, whatever standardized test that can test that is the intelligence that matters. Can you expand a little bit on some of the different types of, of intelligence and how we might, you know, you mentioned earlier that everybody has skills. They might be really good at singing or math. And I fundamentally believe that everybody has some type of brilliance, but it's up to us to figure out what that is. So maybe you can walk us through. You don't have to mention all 30, but you know, maybe go through some of the unconventional forms of intelligence that maybe somebody has never considered as, as a type of intelligence in the past.
- [49:04]
A
Yes, well, you answered the question already yourself, as you did. So there are different types of brilliance and the IQ tests are really misleading and they're really inaccurate. Why is it that we say that somebody who's good at math and physics is smarter than someone who's good at arts? Why? Who decided that being able to create a beautiful piece of art is any less important than to do a physics Formula, Why? You know, and also remember I told you about the cortex and hippocampus. So cortex and hippocampus are the seats of cognition. Your cognitive capacity arises from activity of networks of neurons in cortex and hippocampus. So the different parts of cortex and hippocampus form networks. Like, you know, do you see these maps of airline and the places they fly and have all these hubs and they're like lots of connections. Your brain is somewhat similar to that. There are lots of connections and the major hubs and lots of connections. You have a network for language, you have a network for memory, you have a network for attention, and you have a network for many different things. So each of these is a form of intelligence. And each of us. I only listed 30, but I can even list more. One important intelligence is emotional intelligence. Being able to read someone's emotion, and even more importantly, being able not only to detect the emotion, but feel the emotion, have empathy. This is a huge, huge form of intelligence that some people have, and some people do not have the deluxe version when they're born. As a physician, I've seen many of my colleagues who are great surgeons, but they just don't feel it. They just take care of it as a piece of bone and a carpentry. And the other thing I think is important is what I call lifestyle intelligence. In other words, everybody knows these days that diet, exercise, sleep, stress reduction are important for you. Some people seem to follow what they're supposed to do, and they're healthy and in good shape, and some people aren't. I think people who are doing this deserve to have the recognition that they're doing something that other people aren't, because everybody knows the same principles. And so the other thing I think is important to appreciate is to be street smart. You know, sometimes I see businessmen who come to see me and there are like five companies and they're millionaires, and we do it with a simple cognitive test. A cognitive test is different than intelligence test. The intelligence test connects the scores for five or six different cognitive functions and gives you one number. Like you are 124, which I think is crazy. It's like giving somebody score for beauty. Like, how do you come up with what number for beautiful eyes and lips and skin and body? How can you give someone one score? Whereas a cognitive test tells you your attention, concentration, memory, executive function, problem solving are, let's say, 65 percentile compared to people your age. There are some core cognitive functions that we can measure. So sometimes I see like this person who came to see me, a successful businessman who did poorly in all the cognitive tests. But he's a successful businessman. He's obviously street smart. And so you can't say he's not intelligent. What if. What about someone who is a master pianist and who does not do well on IQ tests? Would you say that they're not intelligent? So we really need to redefine intelligence as cognitive capacities that range widely. And we need to respect our own intelligence and never compare ourselves to others and feel that we are less intelligent than other people.
- [53:05]
B
Skin aging isn't defined by wrinkles. It's defined by skin quality. And skin quality refers to how well the tissue functions. So what's the skin's cellular energy like? How is its hydration retention? What is the skin barrier like? Elasticity and recovery after stress? As NAD levels decline with age, cellular energy drops and so does skin quality. The youth serum and youth moisturizer from Yungoos is designed to support NAD dependent cellular pathways in the skin skin. And when we improve those cellular energy availability pathways, skin cells are better able to repair and renew and to maintain their structural organization. And that is how you improve firmness. It's how you improve texture and clarity, not just temporarily, but at the level of the tissue. When cellular energy and barrier integrity are supported together, skin quality doesn't just look better, it functions better year after year. It's more resilient, it's more hydrated, and it's more responsive. This is Skin Quality Skincare. Head over to younggoose.com better and use code better for 10% off your first purchase. That's Y-O-U-N-G-G-O-O-S E.com better. I can even see that in my own two children. I have one child who is obsessed with math and science. And he has been like that. Like. Like when he was 2, he was asking me to give him little quizzes on like, the times tables. And the other one is obsessed with history and philosophy. And so, I mean, they're. And the other, you know, you can. And they're just so strong in each of those categories. And I think, you know, to your point around street smarts, I think there's so many entrepreneurs that I have, you know, have the pleasure of knowing. And so many of them, like, failed, like their dropouts from university, dropouts from high school, because they just could not make that system work for them. They were. They were labeled. It was like all the A's. Like, they were anxious. They had adhd, they had you know, all they were all. There was always a label associated with them. They were always called trouble. And so they just ended up dropping out. But then to your point, went to go and grow million, multi million seven, eight figure businesses because it's, because that's what they're. That you know, they sort of can read people and figure out what the right way is without necessarily being able to write out a physics equation or you know, to do finite or calculus or something. Right. I will also say even between me and my husband, he, I can, I will kill like I do so well on a Stroop test. And just for those of you that don't know what a Stroop test is, it's like it'll say the word green, but then the word is written in yellow, let's say. And you have to say the not. You can't read the word. You have to say that the what the color is. I kill that. I get like a hundred percent. I'm so fast at it. And the other thing I'm really good at is word scrambling. Like if you, if it says like here's a country, you know, and all the letters are scrambled like find what's the country name? I do that so quickly. My husband can do visual puzzles. So you know, I'm trying to think of like, you know, a picture of an eye and then a picture of a man running. It'll say what's the country? And it's like Iran. Right. So it's like Iran. So he's really good at those puzzles and I'm really good at things like Stroop tests and word scramble stuff. So it's really interesting even just to see artists different strengths in what we're really able to like pick up quickly. Which kind of brings me to brain training. In the book you talk about different ways to increase the demand of the brain, which I think is really important when we think about. In the same way that we want to increase demand on the body because that has knock on effects on the brain, we also want to continue to place demands on the brain so that it like you're working it like a muscle. So talk to us a little bit about some of the brain training that you would recommend to somebody as their, you know, just healthy habits that maybe are fun. Like, do you like Wordle? Do you like what are some of the things that we might think about language learning that you might think about that sort of increase that strain or that demand on, on you know, neuronal connections and brain growth?
- [57:22]
A
Yes, again you said it yourself. When you stimulate your brain, you stimulate new connections. You actually change the anatomy of your brain. And you have many opportunities to challenge your brain in dozens of different ways. Because, as I mentioned earlier, your cortex is like a blanket. You know, it's a large surface area with thousands of mosaic little dots. And these dots form networks. And so if you want to improve your ability to play golf better, the parts of the cortex and hippocampus that are important for knowing how to move your arm and move your eyes and your body in and motion will increase. If you learn a language, parts of your hippocampus and parts of your cortex grow. If you learn dancing, you know, six, seven different parts of the brain grow, and these areas literally grow larger to the degree that you can measure with MRIs. So my recommendation to people is this. Do something you enjoy. There are so many different ways you can stimulate your brain. Well, pick one that you actually enjoy. If you don't, like crossword puzzles or wordle or, you know, sudoku, take a dance class, take a photography class, take a painting class. Do something you learn. And another thing is, people say, oh, it's so frustrating to learn a new language. The frustration is when new synapses are being formed. You know, when you go to a gym and you try to do weight training, they say, no pain, no gain. The moment that you're really hurting is the moment that you are tearing out the muscle fibers and growing new muscle fibers. The brain is the same way. The moment you're frustrated is when the new synapses are being formed. So I like to, for example, learn languages. So, you know, I practice French, and I forget something, I repeat it, I forget something, and I repeat again, and I remember it, and, you know, I may get frustrated. Damn it, I looked at it twice. Why didn't I remember it? But that's a good thing. That's a good thing. So when you're frustrated, great, good job. You're doing it right if you play. Some people say, I play cards with my friends every Wednesday, but they play the same card game they've played for 30 years, and they're really not challenging themselves. So that doesn't count. Brain training should be a little uncomfortable. It should be something that's a little challenging, not so much that you're frustrated, a little challenging. For example, I love doing dance classes with my wife because, you know, you have to keep track of all those steps, and you have to think of your own body and body of somebody else, and you have to make sure you're not running into the wall or you're running to other people. And you have to also listen to the music while you're doing these things. So to me, that's great cross training of your brain. So if you do things that require multiple parts of the brain, then you get more brain growing in the same amount of time.
- [60:32]
B
Are there supplements that you like to recommend for brain? I mean, you mentioned B12 and vitamin D are often deficient. Particularly well, B12, I would find in practice a lot of vegetarians and vegans unknowingly would not have sufficient levels of. It was B6 and B12 really? So D and B12, do you recommend those as supplements? Are there other ones? There's a lot of fun. Not fun. Well, fun for me. Research on creatine and brain health, like, what are, what are your thoughts on supplementation for somebody?
- [61:03]
A
I think that women need to check their levels of vitamin B12, vitamin D and thyroid. That's like the bare minimum blood test that anyone should have. And if the B12 vitamin D levels are low, they need to be treated aggressively. See, vitamin D levels should be higher than 30, but 31 is not normal. It's just at the edge of being abnormal. In order to be optimal, you might be 40 or 45 or 50. The same goes with B12, the normal, the range is between 200 and 1000. And somebody may have a vitamin B12, 210, that's very low. It may not create a red flag for doctors to see it, but that's really bad. Your B12 level should be around 500, 600. So there's a difference between normal and optimal. So you need to keep your vitamin B, vitamin D and thyroid, and especially for women, iron within the optimal range, not just barely, beyond the abnormal range. And then the only recommend, the one supplement that I take and I have studied and I Recommend is Omega 3 fatty acids DHA and EPA at a dose of 1000mg per day. I have studied vitamins and I know all about them. There are at least a thousand vitamins and supplements that have been implicated to have benefits for the brain. Lots of different teas, lots of different compounds, plants, you know, lots of things. But very few things have had randomized controlled trials to show there is a benefit in multiple studies. Creatine recently was studied and showed that 20 grams per day seems to have cognitive benefits. But I don't see myself taking 20 grams a day of creatine. And I take omega 3 fatty acids. And there are many studies I included My own study that shows that people who have higher levels of omega 3 fatty acids are less likely to get Alzheimer's disease.
- [63:10]
B
And the mechanism of action there is, what is it? Just reducing systemic inflammation. Why is it that we have no.
- [63:19]
A
About 50% of the membranes of neurons are made up of omega 3 fatty acids. The omega 3 fatty acids are the main building blocks of the membranes of cells in the brain. Basically half the cells in the brain have omega 3 fatty acids. And so it's a very essential vitamin for the brain. And it's not something your body can make. You have to take it from outside sources. Omega 3 fatty acids have also been shown to reduce the aggregation of the amyloid, the toxic proteins in Alzheimer's disease. They also reduce inflammation and they also improve blood flow to the heart. So omega 3 fatty acids are good for your heart, your eyes, your brain and your skin.
- [64:04]
B
There's been some, we'll say, controversy around omega 3s. People like they're rancid. You have to be careful. So I would just say to the listener, you know, just do some due diligence. You know, not all supplement companies are created equal. And there's no real, we'll say, policing of the standardized. You know, you could go to Costco and get an Omega 3, and then you can go to Walmart and get another kind and then you go to your supplement store and get another kind. So I would just say look at the companies that are maybe investing in independent, you know, they're having their third party certified. Maybe they are investing in R and D research and development as well. Because I think that there are, there is some, there is some concern that not all, you know, at least supplement companies, when you're buying these omega 3s are, are giving you what you, what you think is in the bottle.
- [64:54]
A
Yes, totally.
- [64:56]
B
Okay, talk to us a little bit. So you mentioned already about this 12 week plan. You said 84% of individuals noted an improvement when they had SCI. We've talked about a couple of the pillars, we've talked about exercise, we've talked about a little bit of nutrition, we've talked about brain training. Talk to us about what this 12 week program is that you outline in the book and where can people find it? Is it something that you, that they can follow once they purchase the book or is there an online program like. Tell us what, tell us about the 12 week program.
- [65:27]
A
When I was seeing patients and they were improving so quickly within 12 weeks, I really realized that I need to make this program available not only for people near Where I live in Washington D.C. but around the world. And the things I did did not require special techniques, special machines or special equipment. It was really natural way of, of doing things to improve your brain health. So I have written all the little tricks of a trade, if you want to call them in the book. So, for example, there are ways to get you motivated to do things because a lot of people know what they're supposed to do, but the actually doing it requires increased motivation. And how do you find increased motivation, for example? One example is I ask people, what is your purpose in life? What gives meaning to your life? And you know, when people think about what it is that they find exciting and passion they have passion for, they're more likely to change their lifestyle. For example, some people say, my grandchildren. And when they say that, their lives brighten up. And I say, wouldn't you love to be dancing with your granddaughter when she's in her wedding? Wouldn't you want to be such a good shape to do that? And that becomes a purpose. And so I've written all the little things that I've found helpful over the past 30 years in my book. So the book is pretty comprehensive and has all the details, has all the questionnaires that I use for my patients. And I really don't want people to think they get better just a little bit. I want people to set a high bar because I feel most of us don't use anywhere near our full brain capacity, unfortunately. And instead of complaining about, oh my God, Alzheimer's runs in my family, or I can't do this, or I'm getting too old, don't ever say those things like that. I'm also working on an app and an online course to accompany my book. In fact, inside the book, there's a QR code for a free course and a free app.
- [67:30]
B
Wonderful. Okay, well, we'll make sure that those are all linked in the show notes as well. If people want to find out more about your work, is it the Invincible Brain that they should, you know, by the time we're going to release this episode to coincide with the. With. With the release of the book so they can get it wherever, you know, books are, books are sold. But if people want to find out more about you and your work, where can we direct them?
- [67:52]
A
I have an Instagram page, Dr. Fotouhi F O T U h, I I also have a lot of videos on YouTube and on LinkedIn. And so if you search for the Invincible Brain, a lot of my videos and my books and things that will come that.
- [68:13]
B
Well, Dr. Fatouhi, this has been just a delight talking to you, and I know this is going to be valuable for my Betty's, for my community who listen to the show and want to figure out ways that they can be better. So thank you for your time, your focus, and your energy today.
- [68:26]
A
My pleasure.
- [68:28]
B
Hey, friends, welcome to the afterparty where I give you the dish, the scoop on what I really thought of this episode, and Dr. Majeed Reid Fatouhi on the invincible brain. Okay, so here's what I thought. I think that it is so cool that we are starting to get Harvard alumni and John Hopkins instructors on board with what you and I have been talking about for years. I love that he was talking about exercise and sleep and nutrition and stress and brain training. Like, these are. These are the way forward. If you, whatever you have, you could be an APOE 44 carrier. You know, your parents or your grandmother or whoever had Alzheimer's, and there's still something that you can do about it. So I just think that that is so cool. So I really, really love that. Couple of my favorite highlights from the show. First, I'll say he didn't laugh at my joke. I was like, I like to call us queenagers. And he was like, that was. That was just a little bit of like, literally in my head, I was like, get it together, esteema. Stop making jokes with the professor. But other than that, I really, really loved the different forms of intelligence. So emotional intelligence, lifestyle iq, street smarts, being like a pianist, for example. And I literally wrote down in my notes as he was talking about the lifestyle iq, he's like, you know, we all know what to do, but there's only, only, you know, some of us are the ones who actually do it. And I was like, yeah, me and the Betty's, we get. We actually get a gold star on our chart. We have high lifestyle iq. So I literally wrote gold star beside when I wrote lifestyle iq. So loved that. I also thought it was super interesting, the conversation around hearing loss and vision loss as a loss of signal to the brain and then the brain getting essentially lazy and. And, you know, deprioritizing those areas. I think that as a former girl who used to always be clubbing, it was like I was out like Thursday night, Friday night, Saturday night with like, you know, like, it's like, like really, really loud. You know, like that when you come out of a concert and your ears are ringing. Like, that was me for years. Thursday. I was a bit of a wild Child. For a while, I had a. I had a bit of a wild era, but that I was really thinking about that. I was like, oh, I wonder what that impact is going to have on my hearing over the long term. But keeping our hearing, like, preserving what we can, and then if we do start losing our hearing, then what can we do to supplement our ability to engage in conversation? Because it's like I said on the show, like, it's part of our humanity. Like, how can you engage in a conversation if you can't hear what the person is saying? How can you, you know, have a conversation on the phone? And certainly, you know, you can start lip reading. And obviously there's lots of different types of people, you know, there's people who do not that are born without hearing, that have wonderful. Create wonderful lives for themselves. But if you've, you know, if you have hearing to start and then it starts to go away, how can we preserve that? So really love that. Same with vision. And then what's the other thing that I have here? Oh, this is my queenager joke that I. I put a big X through on my notes. Oh, and then the omega 3 stuff, I thought that that was cool, too. Like, 50% of the neuronal membranes are made up, like the. I think he was referring to the phospholipid bilayer made up of DHA and epa. And it also has been shown to decrease amyloid plaques and increase blood flow. I thought that that was really cool. So he said he takes one gram a day. I take a little bit north of that. I. I typically take somewhere between 2 and 3 grams a day. So two 3,000 to 3,000 migs a day at least. I like to get at least 1 to 2 milligrams of DHA. That's the. That's the sort of unofficial goal that I personally have. And then I just love the whole, like, you know, we're going to talk you off of a cliff, you know, like, it's not. It's, you know, it's like the Arnold. I'll give you my, you know, my Arnold Schwarzenegger impression again, if you haven't heard my tendon solo. So it's like, it's not a tumor. You know, it's like. Like it's not cancer. It's not a tumor. You know, it's like, it's not Alzheimer's. It's not, you know, HRT is not going to fix everything. So just really like that balance that he had. I felt like I was talking to a very wise elder who has all the clinical data and the clin, you know, the, the data, the literature and the clinical, you know, wherewithal to sort of put everything together. So my question for you is, what did you like about this episode? Let us know in Spotify, in Apple, wherever you listen to the show, we want to know. We are very curious. So until next time, please enjoy and we'll see you soon. All right. All right. I hope you enjoyed today's episode and I must give you the obligatory legal and medical disclaimer here. This podcast better with Dr. Stephanie is flying for general information only and the advice recommendations we discuss do not replace medicine, chiropractic or any other primary health care provider's advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship that has been formed and the use and implementation of the information discussed are at the sole discretion of the listener. The information and opinions shared on this podcast are not intended to be a substitute for primary care diagnosis or treatment. In other words, guys, be smart about this. Take it with a grain of salt. Take this information to your primary healthcare provider and have a discussion with him or her to make the best choice. That is for you. Remember, I am a doctor, but I am not your doctor and these conversations are meant for educational purposes only.