How Brain Inflammation Drives Depression, Alzheimer's, and Parkinson's

Summary

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The Dr. Hyman Show

Episode: "How Brain Inflammation Drives Depression, Alzheimer's, and Parkinson's"

Date: July 8, 2026
Host: Dr. Mark Hyman
Guests: Dr. Richard Isaacson, Dr. Chris Palmer, Dr. Ray Dorsey, Dr. Michael Okun

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Overview

This episode explores the groundbreaking science connecting brain inflammation to cognitive decline, depression, Alzheimer's, and Parkinson's disease. Dr. Mark Hyman convenes leading neurologists and psychiatrists to discuss how addressing root causes—nutrition, toxins, metabolic health, hormones, and lifestyle—can not only prevent brain disorders, but in many cases, reverse early decline and improve quality of life. The discussion emphasizes the importance of personalized interventions, emerging biomarkers, and the urgent need to rethink conventional approaches to mental and neurodegenerative illness.

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Key Discussion Points & Insights

1. Root Cause Thinking: Inflammation as the Common Thread

• Many brain disorders—depression, autism, Alzheimer’s, Parkinson’s—are now understood to be driven by inflammation in the brain, not just isolated brain chemistry issues or genetic fate.

• "The narrative needs to be there is something wrong with this person's brain or body or combination of the two that is causing dysfunction or dysregulation that can be fixed." — Dr. Chris Palmer [00:00], [26:49]

• Dr. Hyman stresses that psychiatric symptoms may really be manifestations of an inflamed or metabolically dysregulated brain:

  • “The brain only has so many ways of saying ouch. When it's inflamed, you don't feel it. People who are depressed have inflamed brains. Autism has inflamed brains, Alzheimer's, inflamed brain.” — Dr. Mark Hyman [00:13], [33:06]

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2. Nutrition and Precision Medicine for the Brain

Best Diets & Foods

• The Mediterranean/MIND diet (omega-3 fats, green leafy vegetables, berries, healthy fats from fish/olive oil, nuts, avocados) delays cognitive decline and lowers risk of Alzheimer’s.

• Precision nutrition is ideal but not mainstream; patients respond differently (e.g., some thrive on keto, others see harm).

• “Different people, I believe, need to follow different dietary patterns... one day we'll have... a computer will spit out exactly what the person could eat.” — Dr. Richard Isaacson [05:12]

• Quality and sourcing matter: Grass-fed meats, pure cocoa, and high polyphenol olive oil are important.

Notable Strategies

• Berries were shown to delay cognitive decline by two years with regular consumption. — [07:10]
• "Half a cup of strawberries or blueberries two to three times a week... delay cognitive decline just by eating berries on a regular basis by two years." — Dr. Richard Isaacson [07:06]
• The “ELF diet”: Eat Less Food—caloric moderation is associated with better brain health.
• Plant-rich (not plant-exclusive) diets are preferred for balanced nutrition—avoiding extremes.

Vitamins & Supplementation

• Omega-3s, vitamin D, B-complex vitamins (especially in those with high homocysteine/MTHFR gene variants), curcumin/turmeric, and in selected cases, GLP1 agonists or hormone replacement.

Personalized Success Story

• Dr. Hyman recounts a patient with MCI (Mild Cognitive Impairment) whose cognitive function dramatically improved with a precision, multi-pronged approach:
  • "And completely cured her MCI... she called me at 85, going trekking in Bhutan." — Dr. Mark Hyman [13:45]

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3. Multimodal Lifestyle Interventions

• The single most impactful approach for preventing/reversing cognitive decline is intensive, multi-factorial lifestyle change:

  • Exercise, nutrition, sleep optimization, address deficiencies, stress management, social engagement, personalized medical follow-up (e.g., blood pressure, cholesterol, glucose control).
  • "Intensive lifestyle intervention, of all the interventions that we tried, moved the needle the most." — Dr. Richard Isaacson [15:30]

• Multimodal approaches outperform billion-dollar drug studies targeting amyloid (Alzheimer’s). — [15:34]

• Intervening on biomarkers with personalized plans shows better and more measurable outcomes.

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4. Role of Hormones & Women’s Brain Health

• A notable knowledge gap exists in managing perimenopause and menopause, which are critical windows for brain health and Alzheimer’s prevention in women.

• Properly-timed bioidentical hormone replacement therapy (HRT) may decrease amyloid/tau accumulation and improve cognitive trajectories in high-risk women.

  • "Perimenopause is a neurological disease... Hormone replacement therapy during the perimenopause transition, to me, is one of the most impactful tools that we can use to reduce the risk of cognitive decline, dementia and Alzheimer's disease in women." — Dr. Richard Isaacson [22:08]

• Estrogen decline correlates with rising Alzheimer’s markers; early tailored HRT is often “strikingly effective” for the right patient.

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5. Biopsychosocial Model & Trauma's Impact on the Brain

• Early life trauma (as measured by the ACE score) raises risk for virtually every major mental disorder, as well as metabolic and autoimmune disease—via inflammation, epigenetic changes, and the gut-brain axis.

  • "If an infant is severely neglected or abused, that infant is at much higher risk of developing autism... but every label in DSM 5TR is increased." — Dr. Chris Palmer [27:41]

• Trauma and chronic stress drive lasting changes in the microbiome and inflammatory gene expression.

  • "Amygdala activation... changes your gut microbiome within an hour." — Dr. Chris Palmer [29:25]

• Diet and psycho-social interventions can help “rewire” these pathways and lower risk.

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6. Metabolism, Mitochondria, and Disease—A Unifying Theory

• Mitochondrial health is the “final common pathway”:

  • Disrupted metabolism impairs brain energy, leading to psychiatric and neurodegenerative symptoms.
  • “Dysregulation of metabolism leads to chronic disease... Dysfunction of mitochondria broadly leads to chronic disease.” — Dr. Chris Palmer [42:28]

• All root causes (biological, psychological, social, environmental) converge on mitochondrial function.

• Dr. Hyman: "The absence of metabolism is the definition of death... Dysregulation leads to chronic disease." — [41:27], [41:55]

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7. Toxins, Environment and the ‘Leaky Brain’

• Environmental toxins—particularly air pollution and heavy metals—are implicated in surging rates of Parkinson’s and Alzheimer’s.
• Parkinson's described as “new” in 1800s London, coinciding with the Industrial Revolution’s air pollution surge.
  • "Dr. Parkinson is describing the effects of chronic exposure to high levels of air pollution." — Dr. Ray Dorsey [43:58]
• Pollutants enter the brain via the olfactory nerve and a compromised blood-brain barrier.
• "It's a super highway from your nose to your brain." — Dr. Ray Dorsey [44:43]

Leaky Brain Parallel to Leaky Gut

• The blood-brain barrier is permeable and can be breached by toxins, stress, and even gut disturbances.
• “This is the front door to your brain... it doesn't go through the blood-brain barrier.” — Dr. Ray Dorsey [44:48]
• “There's a big myth about Parkinson’s... it's a whole body disease.” — Dr. Michael Okun [49:00]

Whole Body Disease Paradigm

• Parkinson's and other “brain” diseases involve multiple systems—gut, skin, metabolic health—not just neurons.
• "We have to start thinking about Parkinson’s in a different way. It's not just a brain disease... The textbooks need to be rewritten." — Dr. Michael Okun [48:21], [49:00]

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Notable Quotes & Moments

• "Perimenopause is a neurological disease." — Dr. Richard Isaacson [21:30]
• "The absence of metabolism, the cessation of metabolism, is the definition of death. There are zero exceptions." — Dr. Chris Palmer [41:27]
• "Hormone replacement therapy during the perimenopause transition, to me, is one of the most impactful tools..." — Dr. Richard Isaacson [22:08]
• "This is a whole body disease." — Dr. Michael Okun on Parkinson's [49:00]

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Timestamps for Important Segments

| Time | Content | |-----------|-----------------------------------------------------------------------| | 00:00 | Opening: The fixable root causes of brain dysfunction (Palmer, Hyman) | | 04:02 | Precision nutrition for cognitive function, real case studies | | 10:04 | Caloric restriction, ELF diet, plant-rich diet | | 12:19 | Vitamin B & D, individualized supplementation, MCI reversal | | 15:28 | Intensive lifestyle intervention outperforms drugs | | 18:24 | Biomarker-driven approach, HRT, and GLP1 drugs | | 21:30 | The overlooked crisis in women's brain health/perimenopause&HRT | | 27:41 | The biopsychosocial model and the biological cost of early trauma | | 33:06 | Inflammation: the final pathway linking depression, Alzheimer's, etc. | | 38:29 | Mitochondria as the center of metabolic/brain health | | 43:37 | Parkinson’s origins and pollution as a root cause | | 46:43 | “Leaky brain,” toxins, and the olfactory superhighway | | 48:21 | Parkison’s as a whole-body disease |

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Summary Table: Drivers & Interventions

| Driver | Key Insights | Interventions | |------------------------|---------------------------------------------------|-----------------------------------------| | Inflammation | Common to all major neuro/psych diseases | Nutrition, stress mgmt, sleep, exercise | | Nutrition | Plant-rich, high omega-3, precision where possible| Mediterranean/MIND, possible keto | | Trauma (ACE scores) | Lasting biological impact; microbiome changes | Gut repair, social support, therapy | | Toxins/Heavy Metals | Air pollution, mercury, lead raise risk of disease| Avoidance, detox, quality food | | Gut-Brain Axis | Leaky gut/gut-first disease paradigm | Probiotics, fiber, anti-inflammatory | | Estrogen (Women) | Drop in perimenopause: brain protein/trgt risk | Bioidentical HRT where indicated | | Metabolic Dysfunction | Mitochondria regulate health & disease | Blood sugar control, exercise, fasting |

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Final Takeaways

• Brain disorders are often body-wide processes: Inflammation, environmental exposures, diet, trauma, hormones, and lifestyle choices all shape brain health.
• Personalized, root-cause medicine is the future: Testing, not guessing, and using prevention/intervention tools tailored to the individual’s biology and risk factors yield the best outcomes.
• Empowering Change: Many risk factors are modifiable, and early, aggressive, multi-modal intervention gives the greatest chance for prevention or reversal—even for those with genetic risks or early decline.

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Suggested Actions from Episode

• Eat plant-rich, berry- and omega-3-heavy diets; "precision nutrition" when available.
• Address hormone health early, especially for women entering perimenopause.
• Manage exposure to toxins; prioritize air and food quality.
• Test key blood biomarkers (vitamin D, B12, homocysteine, ApoE4, amyloid/tau).
• Pursue holistic lifestyle changes—diet, exercise, sleep, stress, and connection.

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This episode provides a hopeful, science-backed roadmap for anyone looking to preserve cognition, prevent depression, or protect loved ones from neurodegenerative disease.

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This summary preserves the conversational, hopeful, and actionable tone of Dr. Hyman and his guests, while capturing the depth, nuance, and practical wisdom shared throughout the discussion.

Transcript

[Dr. Chris Palmer]

The narrative needs to be there is something wrong with this person's brain or body or combination of the two that is causing dysfunction or dysregulation that can be fixed.

[Dr. Mark Hyman]

The brain only has so many ways of saying ouch. When it's inflamed, you don't feel it. People who are depressed have inflamed brains. Autism has inflamed brains, Alzheimer's, inflamed brain.

[Dr. Richard Isaacson]

If you look at multimodal lifestyle intervention that included exercise, nutrition, vitamins, supplements, sleep, sleep, sleep modification, stress management, keeping the brain engaged, learning, social connection, intensive lifestyle intervention, of all the interventions that we tried, moved the needle the most.

[Dr. Mark Hyman]

More than any of these billion dollar amyloid drug study because coal was what they used to heat and do industry with and that's full of mercury and lead.

[Dr. Ray Dorsey]

And so we look in the brains of people with Parkinson's, they have high levels of heavy metal.

[Dr. Michael Okun]

Is there's a big myth about Parkinson S and the myth is, is that it's just a brain disease. Yeah, it's a whole body disease, Mark.

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[Dr. Mark Hyman]

Let's talk about nutrition, because there's the mind diet, which is Mediterranean. And you know, like, the way I think about it is, you know, if food is medicine, what's the drug, what's the dose, what's the duration? Right. And I think, yes, the mind diet, which is a sort of a modified Mediterranean diet, lots of omega 3 fats and anti inflammatory foods. Great. But there's different levels that you can push on the gas pedal to get more effect I had a patient once who had MCI, my COG impairment. She had a whole bunch of problems, the 21 things. And we fixed all. Her thyroid was off, she has heavy metals, she was pre diabetic, she had methylation issues and high homocysteine, she had low omega 3 fat. I mean just the list went on and on. And we fixed everything and her cognitive function dramatically improved. And then after like three or four years, she started noticing a little bit of the dwindling. And I said, geez, why don't we try a ketogenic diet? Cause I've been reading about ketogenic diets and changing the metabolism of the brain by cutting out all sugar and starch and carbohydrates pretty much, and eating 75% fat. And we did it and like the lights came back on and I was like, holy cow. So again, how do you approach diet with all this?

[Dr. Richard Isaacson]

Yeah, well, so nutrition and dietary patterns versus single or multiple nutrients, like this is a long topic and you and I both have written books about this and we could talk about this probably for an hour. But to me, different diets, we're not in the realm yet where precision nutrition is like easy, off the shelf, straightforward. But different people, I believe, need to follow different dietary patterns. And I too, back In, I think 2007 was the first time that I put someone on a ketogenic diet and saw something that I just did not think was possible. But then I've had other people where I put on ketogenic diets and like things kind of went the wrong way. And to me, you know, we're gonna get there very soon where one day we'll have, you know, whether it's a blood test or a genetic test or something where we could put into a computer and the computer will spit out exactly what the person could eat until, until we get to that time. I think you think about the big bucket. So the Mediterranean style diet, fatty fish, brain healthy fats, omega 3 fatty acids, especially people with one or more copies of the APOE4 gene. We have to have enough omega 3 brain healthy fats, otherwise people will have cognitive decline. And the synapse, because a lot of

[Dr. Mark Hyman]

your brain is made up of DHA, which is 60% as far as I remember, which is.

[Dr. Richard Isaacson]

And DHA and EPA are the two most brain healthy fats. And DHA is especially important for people with one or more copies of the APOE 4 variant. So brain healthy fats, that's PUFAs, polyunsaturated fat. Then you have monounsaturated fats, monounsaturated fats. Like if you want to drink olive oil, an ounce or two a day and your doctor says, okay, that's like anti tau protein. Like that is good for.

[Dr. Mark Hyman]

But it's gotta be good olive oil, it's gotta be bitter and burn the back of your tongue. Otherwise it doesn't have the polyphenols.

[Dr. Richard Isaacson]

Exactly. And 60%, one study I read of the alcohol of the. Of the olive oil out there is corrupt. Exactly. So you know, getting quality olive oil, like literally taking a shot of it, one or two shots a day or pouring it on everything. You know, I have olive oil stash in different parts of the house and just pour it on, pour it on, whatever I can get it in because I need. And if it burns the mouth. Yep. That's exactly the proxy as a taste to it. So. Avocados, olive oil, fatty fish brain. Healthy fats are so critical. Green leafy vegetables. So berries, half a cup of strawberries or blueberries two to three times a week. Nurses health study published over a decade ago showed you could delay cognitive decline just by eating berries on a regular basis by two years, just from one intervention.

[Dr. Mark Hyman]

That's why I gave you a berry shake this morning.

[Dr. Richard Isaacson]

You did. It was good with goat milk whey, which was a first for me. So I appreciate it. Which is really nutritious and actually, actually tasted really good. So you know, green leafy vegetables, high antioxidants. People should be eating mostly plant based. You know, I would call it plant rich. Yeah, plant rich. Yeah, plant rich. Plant rich. And you know, there's totally different.

[Dr. Mark Hyman]

Because plant based is vegan.

[Dr. Michael Okun]

Yeah.

[Dr. Mark Hyman]

That might be problematic for people who

[Dr. Chris Palmer]

want to build muscle.

[Dr. Richard Isaacson]

Mostly plant rich. Okay. Yeah, that's a better. And I wouldn't maybe. Yeah. I don't know the exact terminology, but you know, and then like meat is all not created equal. Like, like red meat. Grass fed beef is totally different than other beef that isn't, you know, whatever. So I think people need to eat, you know, where they feel comfortable with, whether ethically or otherwise. They need to get protein levels, whether it's through whey protein through goat or whey protein through regular milk from cows. I think each person needs their own individual kind of thing. And some people may be more sensitive to one thing versus the other. And there's lots of different.

[Dr. Mark Hyman]

And I saw you putting like cocoa polyphenols in your.

[Dr. Richard Isaacson]

Oh yeah. This morning I travel. I travel with dark cocoa powder, which is completely ridiculous. But I never leave home without My dark cocoa powder. And yeah, I have, I have coffee in the morning with dark cocoa powder because to me I actually. Caffeinated coffee I think is brain healthy and has been shown to have better brain outcomes. Dark cocoa powder, again, it has to be pure and not have heavy metals in it and things like that. But dark cocoa powder can help with insulin regulation, blood pressure control, and has shown to be beneficial for brain health too.

[Dr. Mark Hyman]

So Richard Isaac starts this morning with a mocha.

[Dr. Richard Isaacson]

I do a mocha for your memory in the morning.

[Dr. Mark Hyman]

And it's funny because mocha is actually one of the names for a test we use the Montana Cognitive Assessment Test, which is actually something you can actually do at home. It's something you download on the Internet and it's a pretty good way of tracking your, your brain health.

[Dr. Richard Isaacson]

Exactly. Yeah. We don't want people to do it too much at home because then they practice and the doctors see the doctor and they memorize the test. But I, I don't disagree. Yeah, yeah, for sure. There are definitely ways to, to track, track.

[Dr. Mark Hyman]

So fatty, fatty foods, omega 3 fats, monetize fats, berries, leafy greens, you know, nuts and seeds.

[Dr. Richard Isaacson]

You know, balancing the Omega 6 with Omega 3s and there, there's so much nuance with nutrition, but I think that's it. Also the ELF diet.

[Dr. Mark Hyman]

What's that?

[Dr. Richard Isaacson]

Oh my.

[Dr. Mark Hyman]

Eating moss in the Arctic Circle.

[Dr. Richard Isaacson]

I just saw Dr. Mark Hyman on a dietary pattern that he's never heard of. Wow, this is a great day. I'm never going to forget this day. The ELF diet. Eat less food.

[Dr. Mark Hyman]

Oh, eat less food. Yeah, yeah, like Michael Pollan, eat food. Not too much, mostly plants, right?

[Dr. Richard Isaacson]

Yep. So just less. Like people just eat so much in excess, like it's crazy. And you know, there was a study out of Mayo that showed that people that ate like, I think the cutoff was like 2100 calories a day. Less than 2100 or more have delayed cognitive decline. And again, this is imprecise.

[Dr. Mark Hyman]

So the Okinawa principle, right? Hari hachi bu, which is eat percent full.

[Dr. Richard Isaacson]

Exactly. Hari hachi bu. That's exactly it. So the take home here is though, if you're trying to gain muscle, well, you better eat sufficient protein and calories because you need both carbs and protein to build muscle. And you don't want to just starve yourself. And there's good carbs and bad carbs and know the difference. That's really key.

[Dr. Mark Hyman]

Berries and leafy greens or carbs, right?

[Dr. Richard Isaacson]

Exactly. Yeah. And some whole grains in moderation. I think Are okay, but not if a person's not active. So anyway, yeah, nutrition's tricky. Vitamins, we Talked about omega 3 fatty acids, but vitamin D, especially people with one or more copies of the APOE 4 variant, we check vitamin D. And just like you mentioned earlier, we don't just tell everyone to take vitamin D. But I think the statistic in Miami as an example, 60% of the people in Miami, even with sun exposure, are deficient in vitamin D. So we check vitamin D. Well, you have to be

[Dr. Mark Hyman]

naked between 10 and 2 in the morning and 2 in the afternoon for 20 minutes. And if you're not, you're not going to get enough vitamin D. If you're a lifeguard, you will, but otherwise, forget it.

[Dr. Richard Isaacson]

Exactly. People wear sunscreen now. People are indoors. And yeah, I usually tell people you need 15 minutes of 12 to 15 minutes between the hours of 11 and 1 to try to split the difference. I don't want to. It's hard to know for sure. But we check vitamin D and supplement if needed. We also talk a lot about B complex vitamins, and B complex vitamins, again, are not. Not something that's one size fits everyone. The Vitacog study, which was published over a decade ago, showed that when people had a marker in their blood called homocysteine, if homocysteine is high, the people that took B complex vitamins, B12, folic acid, and a tiny little bit of B6, those people, not only did they have slightly improved memory function on cognitive testing, but those people actually also had slower shrinkage of the memory. Sorry, of the total shrinkage of the total brain size.

[Dr. Mark Hyman]

So there was a paper published a number of years ago in Jamar New England Journal I read, where a pure homocysteine was over 14. You're 50% more likely to get Alzheimer's or dementia. And that's again, something we test at Function Health and also methylmalonic acid, which is a marker of B12 function. And I remember a patient who came to me who was a very successful businesswoman, was on multiple boards, she was in her early 80s, and she's like, I got diagnosed with MCI, mild cognitive impairment, early dementia. And she was pretty upset. And I'm like, well, I don't know, let's see what we find. And she had extremely high homocysteine and high methylmalonic acid, which is a marker of B12, which are probably better than measuring folate and B12 in the blood.

[Dr. Richard Isaacson]

Probably had a double mthfr.

[Dr. Mark Hyman]

She did. She had the genetics that made her having trouble with some of her pathways. Yeah. And she was older and probably not absorbing B12, which is common as you get older, you get less stomach acid and so on and so forth. There are people thinking acid blockers, they don't get. I mean, that's what. That may drive me crazy. I mean, there's the third most leading prescribed drugs after statins and psychiatric drugs is the acid blocking drugs, which are now over the counter and they're dangerous to take long term, fine, short term, but long term. And so I said, I found this and I gave her B12 shots and I gave her high dose of methylfolate and some B6, some of these methylating nutrients and completely cured her MCI. Now it's not that everybody with MCI or pre dementia has that problem, it's just that she had that problem. And then a number of years later, probably five years later, I got a call from her and I thought, oh, she's probably going downhill and I'm a little worried about her. And I saw her in my schedule and I'm like, what's going on? She says, well, I'm going for a trek in Bhutan. She's 85 and I want to know what I should be doing to prepare and take and blah, blah, blah. Okay, great.

[Dr. Richard Isaacson]

Amazing.

[Dr. Chris Palmer]

Yeah.

[Dr. Mark Hyman]

What else? Supplements. What other supplements? Vitamin D, fish oil, The B vitamins.

[Dr. Richard Isaacson]

Yeah. I mean, turmeric, I think curcumin, the active ingredient. Curry. I think in certain people, especially with elevated amyloid levels in the blood, we sometimes use this. And I think in terms of the big picture, those are the one size fits many ones. But I mean the list just, I mean the list is really long. So I mean there's definitely other things people can do. But the take home here is, you know, we check it in the blood, we do the history and then we personalize the plant for them. So I think nutrition is really, nutrition and exercise are like critical, critical levers. And you know, in our research study that we presented data that I can talk about cause we presented this at the 2025 Alzheimer's Association International Conference in July 2025 and we showed that when you looked at. And I'll talk about different interventions in a moment, but if you look at multimodal lifestyle intervention that included exercise, nutrition, vitamins, supplements, sleep, sleep, sleep modification, stress management, keeping the brain engaged, learning social connection, seeing a doctor on a regular basis to make sure their blood pressure, cholesterol, blood sugar is all modified in an optimal range specifically for them, when put all those together but no drugs. If you look at the groupings of the categories of the people we followed.

[Dr. Mark Hyman]

So intensive lifestyle intervention.

[Dr. Richard Isaacson]

Intensive lifestyle intervention, of all the interventions that we tried, moved the needle the most.

[Dr. Mark Hyman]

More than any of these billion dollar

[Dr. Richard Isaacson]

amyloid drug studies in our study that we've and this hasn't been fully published, but I can talk about it because we present an abstract form. There are people that for example took GLP1 drugs. And GLP1 drugs are tricky because I believe that too high a dose, if you're not eating right and doing the right thing, you can lose muscle and have all the things lower dose. I'm more of the microdose crew when it comes to GLP1s. GLP1s positive effect on biomarkers. In my opinion, based on our results, impressive results when used in the right person at the right dose for the right duration of time.

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[Dr. Mark Hyman]

metabolic health which, and there's many roads to roam to do that.

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Right.

[Dr. Mark Hyman]

If you dramatically improve your diet, I mean, I mean before GLP1s were on the market, I was reversing diabetes, getting people to lose 200 pounds, 100 pounds, 150 pounds. And you can do it, it's just, and I think my guess is that they would do a head to head comparison of GLP1s and the same diet that you would eat if you were on GLP1s. There would be no difference in any of the biology. That's my feeling.

[Dr. Richard Isaacson]

So while multimodal treatments, I would say work the best, the other categories that worked exceptionally well, meaning exceptionally well to me means statistically significant improvements in a variety of pathologic proteins that are associated with, with neurodegenerative disease.

[Dr. Mark Hyman]

So, so you're testing, not guessing.

[Dr. Richard Isaacson]

We test everything.

[Dr. Mark Hyman]

Here, let me try these 20 things and let's cross our fingers and maybe do a, like a, a sort of semi, semi subjective objective test, which is a bunch of questions. You're actually looking at blood tests.

[Dr. Richard Isaacson]

We would show changes, try one thing, we repeat it. We don't try 10 things. Well, for multimodal interventions, we try a group. And then if we're gonna try a drug, we're gonna recheck the 150 biomarker proteins, we check the proteins on different machines in duplicates. Every blood test we do, we run twice. This is not norma cost effective. We do it anyway because we care about quality, not about anything else. And we just try to do things as rigorous as humanly possible. And what we show is that when we do these tests, call these NF1 studies, we'll try a GLP1 and we'll check, we'll try hormone replacement therapy, hormone replacement therapy, bioidentical hormones for women during the perimenopause transition in the right woman at the right dose. The women in our little hormone replacement therapy group, believe it or not, the age ranges from 42 to 67. We have multiple women that have actually started on hormone replacement therapy with approval and agreement by the GYN and the primary care doctor and our team we've had, I'll just Say what I feel like I should say amazing success with using hormone replacement therapy. And when that rapid drop of estrogen comes in, a genetically susceptible woman. We did this whole women's brain imaging study at Cornell and spent millions and millions of dollars on this. Women that had hormone replacement therapy on board had better brain volumes and less amyloid. But it had never really been proven in a study that you could use H, hormone replacement therapy. And then there was that woman's health study that used synthetic hormones and horse urine derived whatever. Like when you use a bioidentical patch and you use progesterone, and we talk to the GYN and we talk to the doctors. Hormone replacement therapy during the perimenopause transition has helped improve brain biomarkers associated with Alzheimer's and neurodegenerative disease risk. It's been striking.

[Dr. Mark Hyman]

So this is more than just what has been done before, which is population based studies which can't really directly look at cause and effect. You're actually looking at blood biomarkers that change that improvement, that the blood biomarkers that are associated with neurodegenerative disease. That's a big deal. And the other thing I want to just say is that the consensus, most that I've heard is that it's important to start right away after your menopausal transition. But what I hear you saying is that you can actually start it later.

[Dr. Richard Isaacson]

Well, end early. I want to start both.

[Dr. Mark Hyman]

Yes, start early. Does that mean every woman should be on hormone replacement therapy? Like, what are the implications here?

[Dr. Richard Isaacson]

Yeah, these are really. And by the way, why hasn't this been better studied? Why are we the only group?

[Dr. Mark Hyman]

To my knowledge, because we have misogynistic research infrastructure.

[Dr. Richard Isaacson]

Like, it's, it's just so, it's demoralizing. It's just so wrong that women are taught that, like, oh, you're having night sweats. Oh, oh, you don't feel good. Oh, you're having brain fog. Oh, okay, sorry. You know, we'll see you back in six months. Perimenopause is a neurological disease. Like, you're just gonna have a woman suffer. These are, these are symptoms that are treated. Oh, change the temperature in your room and maybe you'll sweat less or maybe change your sheets, get better sheets. No, this is a medical condition. Really. Or the cooling thing.

[Dr. Chris Palmer]

Okay.

[Dr. Richard Isaacson]

Or a weighted fine. Okay. Treat the problem. And what we've shown is that through ridiculous amounts of time, effort, money spent, and research which needs to be quadrupled or probably increased even much more than that, We've shown that when we use hormone replacement therapy in the right woman, at the right dose, at the right duration, in collaboration with the multidisciplinary team, when we start seeing the estrogen drop, even if the symptoms are very mild, you get the estrogen back up, the tau starts coming down, even though the tau wasn't elevated to a degree where we're like, oh, sky is falling. But the tau is higher than it should be in that woman who's 47 years old. And this whole concept of, like, you know, it's normal. Well, no. Optimal is where we want a brain protein. Normal, a little borderline, a little high, like, no. In order to have the most benefit, we need to make these incremental changes. And hormone replacement therapy during the perimenopause transition, to me, is one of the most impactful tools that we can use to reduce the risk of cognitive decline, dementia and Alzheimer's disease in women. And I think, you know, it's tricky. I think there's risks and benefits with every one of these decisions, but, you know, I've just seen too many women suffer and it's just not fair.

[Dr. Mark Hyman]

So if they're symptomatic or if you. If you do evaluations and you have a higher risk based on your Alzheimer's risk score, which you developed, then maybe it's a good idea. But even. Even if you're not symptomatic.

[Dr. Richard Isaacson]

Well, I think if you're symptomatic, it's. It's like. Like, how could you not. I think it's like, you know, it's unethical not to try to figure out how to. In our cohort, we track estrogen, estradiol levels and other hormone levels. You know, I mean, women 21 and above, we also. This is crazy, but, like, you know, this hasn't been done before. To my knowledge, we do multiple blood draws through the menstrual cycle to try to figure out, like, as estrogen and progesterone change during the cycle, guess what? P tau217 changes. And these other markers change too. How has this never been done before? So we have women, we have, like, thank you. Thank you. I'm not going to say their code numbers. In our research study, they get six blood draws on day one, on day three, on day seven. But, like, we get six blood draws during the menstrual cycle. We're just trying to figure out, like, what should the P tau be? Depending on what day the blood was drawn, we need to correct for what the tau level should be based on where the estrogen and progesterone is. Like these are things that just haven't been figured out yet. And these are the types of questions we're asking and these are the types of things that need to be figured out. And when you take this approach, precision, personalized, individualized approach, We've seen women in their early 40s, like 42 is the earliest we've started where we've seen the estrogen going down and we've seen the amyloid going up. Well, maybe they're a little symptomatic, but it's not really bothering them. But we're going to start on low dose hormone replacement therapy if everyone is in agreement. And guess what? She feels better. Her cholesterol comes down. That's interesting. Her amyloid's improving even though it wasn't abnormal. And this is really the key. Like we have to personalize these therapies and we have to, you know, we also just monitor for a change. We've been monitoring these women for so long. We see the change and then you intervene. And so to me it's if symptomatic, like please talk to your doctor and if your doctor says tough it out, like go to another doctor. If you're pre symptomatic, follow it closely. I think women perimenopause should probably get, get checked every six to 12 months for these brain biomarkers and hormones.

[Dr. Mark Hyman]

So essentially what you're saying is if you're symptomatic, don't suffer and if you're not symptomatic and you have a lot of risk factors and some of these blood biomarkers that were emerging are abnormal, then it's better to get on early even if you're not symptomatic.

[Dr. Richard Isaacson]

I believe that specifically in people that are at the highest, women that are in the highest risk category, which are APOE4 positive, especially women with two copies of the APOE4 variant, some of the most striking improvements actually one woman actually lives in Austin. One woman is in California. I mean, I know these cases like the back of my mind. You just start and you see everything improve.

[Dr. Mark Hyman]

This is honestly, Richard, why we co founded Function. And I don't mean to kind of oversell it here, but these tests are not things that your doctor likes to

[Dr. Richard Isaacson]

order or often will order.

[Dr. Mark Hyman]

And for very low cost, we've dramatically reduced the cost. You can get all these biomarkers, including ApoE4 and some of these brain biomarkers, and then you can kind of start to decide what to do. And take control of your own health.

[Dr. Chris Palmer]

The narrative needs to be, there is something wrong with this person's brain or body or combination of the two, that is causing dysfunction or dysregulation. That can be fixed if we can ask the question, what might be causing the problem? And we can systematically look for causes.

[Dr. Mark Hyman]

So what do we know now about those causes? And what are the mechanisms that are going on that are causing this brain dysfunction? Because it's things like insulin resistance, inflammation, oxidative stress, mitochondrial dysfunction, all these fundamental concepts that are rooted in functional medicine thinking that we've been talking about for decades. It's happening in the brain, and we know what's causing it, and yet we're not treating it. So can you talk about what are those causes in a little bit more depth? And how do we start to begin to think about fixing those and even diagnosing them?

[Dr. Chris Palmer]

So the part of the field that I really want to embrace, which has been around for, you know, 50, 60 years, is this concept of biopsychosocial, biological, psychological, and social. Those are the root causes, and we know it. So adverse childhood experiences, if they occur early enough in life, they increase risk for all of the mental disorders and even autism spectrum. If an infant is severely neglected or abused, that infant is at much higher risk of developing autism because that infant will never learn appropriate social skills. But every label in DSM 5TR is increased. You're at increased risk from adverse childhood experience. What else do adverse childhood experiences increase risk for? Obesity, type 2 diabetes, cardiovascular disease, autoimmune disorders, all sorts of other physical, metabolic health. Health conditions.

[Dr. Mark Hyman]

Yeah. Anybody listening? You should go online and look up the ACE questionnaire. Ace? It's adverse childhood events. And get your score, and it'll tell you what your score is. And the higher your score, the more likely you are to have your health issues driven by what happened to you. Because what happens to you is not just a emotional thing. It actually gets written in your epigenome and written in your biology in a way that that changes everything and drives inflammation. So when you have adverse events happening to you, it literally turns on different genes that drive different metabolic pathways that drive inflammation and oxidative stress and even things like insulin resistance. We know the biology of this and

[Dr. Chris Palmer]

interestingly, can change your gut microbiome. So we just had a paper out, research study out in last year showing that amygdala activation. So this is your threat in the brain, the amygdala actually activates a specific pathway in the vagus nerve, which then lands on something called Bruner's glands in your digestive tract that secrete an enzyme that changes the acidity of your gastrointestinal tract that within an hour changes your gut microbiome. And so stress and trauma impact your gut microbiome, which can then impact whole body health, mental health, all of it. But as you might know, what you eat also impacts your gut microbiome and so we need to put it together. So even if stress or trauma is causing changes in your gut microbiome that then increase your risk for a disorder, we can use diet and nutrition to treat those changes in your gut microbiome to restore a healthier gut microbiome, which will then reduce your risk for disease or improve your health.

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[Dr. Mark Hyman]

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[Dr. Mark Hyman]

Just one note on that, because it's really important. It seems to me a final common pathway is anything that triggers inflammation. Whether it's toxins, your diet, psychological stress, changes in your microbiome, allergens, infections, anything can drive changes that drive inflammation that ends up in your brain, that causes mitochondrial dysfunction, and that becomes part of the root dysfunction in the brain that you fix with the changes that you do with diet and other therapies.

[Sponsor/Brand Representative]

Right?

[Dr. Chris Palmer]

Yes, that's the way I think about it.

[Dr. Mark Hyman]

So I think there's many roads to roam and there's many things that can drive it, but the brain only has so many ways of saying ouch. And so when it. When it's inflamed, you don't feel it. But when you look at the science, people who are depressed have inflamed brains. Autism has inflamed brains, Alzheimer's, an inflamed brain, all the psychiatric illnesses, their brains are literally inflamed, on fire. But we don't feel it except as psychiatric symptoms. And we think of that as something that is, like you said, genetic or because of it's in our head as opposed to it's in our body. And there's something we can do to find the root cause and effect.

[Dr. Chris Palmer]

I think about inflammation. I mean, the way that I think about it really is that there are a series of pathways that are all connected, like a series of dominoes that are connected. And so inflammation is one of those dominoes. It is not the only domino, because all of us get inflamed when we get a cold, and that includes brain inflammation. And yet most people don't become psychiatrically ill from a cold. Some do, but not most don't. And on and on. COVID infection caused severe neuroinflammation.

[Dr. Mark Hyman]

I mean, I remember when I had Covid, I got severely depressed afterwards, and I could feel my brain, and I'm like, wow, I've never felt this before. And I felt suicidal, and I actually took exosomes and it was gone, like, literally in a day.

[Dr. Chris Palmer]

So the su. The depression part is common, and. And a lot of people don't think about that, but researchers have been talking about this for decades. High levels of inflammation cause behavioral motivational changes in most animals. So if you get the flu, you have a decrease in energy, you have a decrease in confidence, you are less likely to take risks. And what does that do? That drives you to want to go to your bedroom, get under the covers, and hide from the world and stay away from the world. You are less interested in reproduction, less interested in sex, even if the opportunity is right there. You're like, get the hell away from me. Leave me alone. I'm sick. I don't feel well. Leave me alone. Let me recover. And in my mind, those are all adaptive responses that your body is hardwired to have this response. And the response is conservation of energy. Because your body is expending tremendous amounts of energy on your immune system right now. It is waging war on this thing that is infecting you and trying to take your life. It is waging war, and it is spending every ounce of energy possible to create new immune cells, antibodies, cytokines, other things that are all trying to defend your life. And it is telling you, as an organism, do not spend an ounce of energy that is unnecessary. Get into bed, go into that cave and hide from the world. Don't challenge anyone right now. Don't go out and get into a fight where you have to fight or flee. Don't do anything. Stay away, hide from the world. The suicidality, so that part is actually really common with infections and high levels of inflammation. The suicidality part is not. And that's where I think about the brain becoming dysregulated from the neuroinflammation and people getting all of the constellation of symptoms.

[Dr. Mark Hyman]

Well, you talk about the genetic vulnerabilities, but then there's a lot of inputs that can drive the same final common pathway of energy dysregulation in your brain cells.

[Sponsor/Brand Representative]

Right.

[Dr. Mark Hyman]

Diet, sugar, refined carbs, which affects Everybody. I mean, 93% of Americans are metabolically healthy at some level. I would say most of those have some degree of insulin resistance. We forget how tests for it. At Function Health, the company I started with a bunch of folks, we actually can measure insulin resistance. And we can see the degree. It's probably over 90% of people who we test have some degree of insulin resistance. It's pretty striking. Chronic stress and trauma. So psychological traumas can be transmuted into biological signals. Sleep deprivation, substance use, toxins. We talk about microplastics in a minute. Not exercising and being sedentary drives inflammation and anything the other, like infections or allergens, microbiome changes, all those kind of lead to this final dysfunction, which you kind of think is at the root of it. And when you look at things like Alzheimer's or autism, which are not psychiatric, particularly diseases, the same phenomena is going on. Suzanne Goh, who's been on the podcast, talks about mitochondrial dysfunction, autism, and treating kids by treating their mitochondria and helping them with autism. And you're doing the same thing with mental illness. So can you talk about this kind of final common pathway of energy dysregulation and how it ties everything together? Because there's a lot of ways to grow on this. But the final dysfunction is very similar and the therapies can be cross diseases, very effective. So whether you have fibromyalgia, whether you have, you know, alcohol use disorder or eating disorder, whether you have Alzheimer's, autism, depression, bipolar, schizophrenia, anxiety, ptsd, these can be impacted by changing your diet.

[Dr. Chris Palmer]

The way that I think about it, because some people think, oh, you know, Chris Palmer, you're being too reductionistic. You're saying everything's mitochondrial dysfunction. And so I really, like, I'm struggling. How can I explain this so people understand what I'm really trying to say? Yeah, so what I'm really trying to say, we're on the edge of our seat, is that biological, like, wide range of biological, whether it's infections or, you know, hormones, like all sorts of things. Gut, microbiome, diet, biological, psychological, social, and environmental. In particular, environmental toxins. All of those four buckets are the root causes of chronic disease. Those four buckets. So there are lots of things that go into those four buckets, but they all converge at this central pathway called metabolism. Mitochondria. Mitochondria are regulating and controlling metabolism because. Because they are, they are really mitochondria.

[Dr. Mark Hyman]

Give us a 60 second. Like when you say metabolism, people. I have a slow metabolism. You're not talking about that.

[Dr. Chris Palmer]

I'm not talking about that.

[Dr. Mark Hyman]

Talk about what you mean by metabolism because it's important for you to understand this.

[Dr. Chris Palmer]

So most people think of metabolism as burning calories. And yes, it is burning calories. Most people think of it as well. It's metabolic syndrome. It's high blood pressure, high glucose, insulin resistance. That's metabolism. Yes, those things are, are tiny parts of metabolism. But metabolism, in fact, is a fundamental definition of a living organism. The ability to take food and turn it into energy or building blocks is a fundamental definition of a living organism. Viruses cannot do that independently. And so many biological authorities will say viruses are not independent living organisms. They are not a life form unto themselves.

[Dr. Ray Dorsey]

They.

[Dr. Chris Palmer]

So life, a living organism, whether it's a bacterium to a human being and everything in between, has to be able to take food, oxygen, nutrients, and turn that into energy or building blocks to maintain life. And in fact, the absence of metabolism, the cessation of metabolism, is the definition of death. There are zero exceptions. There is no cause of death that does not involve the cessation of metabolism. Suffocate somebody, you're depriving them of oxygen, which stops metabolism starvation. Toxins. You will not find any toxin that can kill a human being that does not disrupt metabolism.

[Dr. Mark Hyman]

Cyanide, that's what it does.

[Dr. Michael Okun]

Boom.

[Dr. Mark Hyman]

You're dead in seconds because it interrupts.

[Dr. Chris Palmer]

It is a mitochondrial toxin. Arsenic, a mitochondrial toxin. Tylenol overdose, mitochondrial toxin. Alcohol poisoning, mitochondrial toxin. You can go on and on. And the reason is not. It's not. You know, when I first started doing this work, I was initially like. Like shocked by what I'm saying. And I was a little bit in disbelief. I'm like, it can't be that simple. It is that simple. And why is it that simple? Because metabolism is a fundamental law. Like, we don't really have laws like they do in physics. They have laws. And this is a law of biology. Metabolism is fundamental to life. The absence of metabolism is the definition of death. Dysregulation of metabolism. This is what I am proposing. Dysregulation of metabolism leads to chronic disease.

[Sponsor/Brand Representative]

Yeah.

[Dr. Chris Palmer]

Dysfunction of mitochondria broadly leads to chronic disease.

[Dr. Mark Hyman (Host)]

Ray.

[Dr. Mark Hyman]

Michael, just sort of talking to me about, you know, Parkinson's. What is it? Give us a little background on the biology of it and then the increasing incidence of it.

[Dr. Ray Dorsey]

It.

[Dr. Mark Hyman]

And what you think are the major reasons why we're seeing this increasing, dramatic, increasing incidence. It's like orders of magnitude. It's not just like a 10 or 20% increase.

[Dr. Ray Dorsey]

Parkinson's, the first major description of the disease was by Dr. James Parkinson in 1817 in London. So he's 61, he's a surgeon, actually, and he's actually even a geologist. And he sees something new on the streets in London, something so new that at 61, he bothers to write a case series. He basically writes his case series on six people, five at least five of whom are men. They're all older, and they have tremor, which has long since been described. But they have this stoop posture, this hunched posture, and this tendency to walk faster and faster and to fall forward. And he said in 1817, this has not been described in the medical literature.

[Dr. Mark Hyman]

Really? This is 1817.

[Dr. Ray Dorsey]

So in 1817, Dr. Parkinson says that park disease that became known as Parkinson's has not been described in the medical literature. Ergo, I'm describing something new.

[Dr. Mark Hyman]

And this was the beginning of the industrial Revolution.

[Dr. Ray Dorsey]

And it's the beginning Industrial revolution. And where is it? It's in London.

[Dr. Mark Hyman]

Yeah.

[Dr. Ray Dorsey]

And air quality in 1800 London is equivalent to what is in Delhi. India today is equivalent to what was over in New York City with the Canadian wildfires. Remember two or three summers ago.

[Dr. Mark Hyman]

Yeah.

[Dr. Ray Dorsey]

The sky's turned orange. That was every day. 1800 London.

[Dr. Mark Hyman]

Yeah.

[Dr. Ray Dorsey]

So I think Dr. Parkinson is describing the effects of chronic exposure to high levels of air pollution. And so Parkinson's, we think as.

[Dr. Mark Hyman]

And by the way, it was coal.

[Dr. Ray Dorsey]

Coal.

[Dr. Mark Hyman]

Because coal was what they used to heat and do an industry with. And that's full of mercury and lead.

[Dr. Ray Dorsey]

Exactly. And so we look in the brains of people with Parkinson's, they have high levels of heavy metal. And so when you look at smog in la, for example, you're seeing little pieces of dirt and soot that are suspended the air. The fancy term is particulate matter. Most of them we cough out or sneeze out. But some are so small, less than 1/30 the width of our hair, they penetrate the nerve that hangs down, responsible for smell that hangs down on our nasal passages. And hitchhiking on those pieces of dirt and soot are toxic metals.

[Sponsor/Brand Representative]

Wow.

[Dr. Mark Hyman]

So it's a super highway from your nose to your brain.

[Dr. Ray Dorsey]

It's exactly. It's the front door to your brain.

[Dr. Richard Isaacson]

Wow.

[Dr. Ray Dorsey]

And it's the blood brain barrier, you remember from medical school. Right. Doesn't let things in.

[Dr. Mark Hyman]

Well, kind of it does, but.

[Dr. Ray Dorsey]

It kind of does. But this is a little leaky. But this, this is the front door. This doesn't go through the blood brain barrier. It's just going through the olfactory nerve. This, the nervous smell that's hanging it and it's hitchhiking. Are these metals lead from gasoline, Iron from brakes, Platinum from catalyst converters. And so people with Parkinson's and Alzheimer's both have high levels of metals in their brain. No one's really been able to explain why, but I think one of the reasons why is air pollution, which is one of the toxins that are inhaled that lead to Parkinson's.

[Dr. Mark Hyman]

Yeah, we're exposed to. I mean, listen, we're exposed to mercury in the fish we eat. Lead is, you know, in their food. And, you know, if you eat a lot of kale is grown in urban environments, it's. It just picks up all the lead. You know, what you said was so interesting to me about the leaky brain because, you know, when I was in sort of my early years of practicing, we were talking about leaky Gut. And I used to get laughed at all the time by traditional doctors because they're like, oh, that's nonsense. It's just, you know, you're quack. And for a long time I've also basically been saying that there's a leaky brain. Well, Michael, you sort of just, just sort of brought this to attention because I think people don't really understand what that is. I mean, leaky gut is when the berry breaks down and food and poop leak in and affect your immune system and then start to cause all kinds of havoc, you know, and, and as you mentioned. Michael. Michael. That you basically have this barrier, this blood brain barrier, but it becomes permeable and then all of a sudden things get in from the outside. So it's not like a, like completely impenetrable barrier. And I think we're seeing increasingly things that cause a leaky brain, like stress and many other things, like tox. Maybe you could talk a little bit about this leaky brain phenomena because it's really how the toxins get into the brain that are causing all these problems. When you do bioptopsies and you're finding toxins and heavy metals in the brains, what's happening?

[Dr. Michael Okun]

Yeah, and you're absolutely spot on when you talk about leaky gut too. And it turns out the gut is also a pathway where you can hitchhike in and potentially cause Parkinson S as well. And we talk about now brain first Parkinson S and gut first Parkinson S. And so this leakiness, you know, this permeability to, you know, to stress and other factors that can get across is really important. So if you think about the brain as having like a force field, if you're a Star wars fan, you know, it's kind of got like a force field. And we've always kind of taught all the medical students, we've taught everybody in medicine that this is this impenetrable force field. Nothing's going to get through this force field. It's actually not.

[Sponsor/Brand Representative]

Not correct.

[Dr. Michael Okun]

Not only is it not right, but as we develop, you know, treatments and as we develop, you know, different, you know, therapies, we're actually able to defeat the blood brain barrier is what we call it, or the bbb. We're able to defeat that. And, and it's so super important for us to remember that things can get through it. We can use that for therapeutics. We can also need to be thinking about that for cause and getting to the root cause of Parkinson S. And one of the things. And even treatment, and even treatment but one other thing I just wanted to bring into the discussion and I'm so glad that you mentioned the gut is there's a big myth about Parkinson S. And the myth is that it's just a brain disease. It's a whole body disease, Mark. And we see it in the gut. You know, we see the proteins in the gut, we see it in the skin, we see it in multiple systems. And so we.

[Dr. Mark Hyman]

Proteins that are expressed in the body in Parkinson's.

[Dr. Michael Okun]

Absolutely. And so. Yeah, and misfolded. I mean, we have twice the risk of malignant skin cancer, melanoma and Parkinson disease, twice the risk of osteoporosis and Parkinson disease. This is a whole body disease. And as we think about it, and I love kind of how you describe yourself as someone that thinks of everyone thinks of the whole. We have to start thinking about Parkinson S in a different way. It's not just a brain disease and it's not just a disease of dopamine. There are certainly multiple circuits in the brain. And then, you know, this barrier that we, you know, have, you know, invested so much in, in all of our textbooks, we've got to rewrite them.

[Dr. Mark Hyman (Host)]

If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels @DR. Mark Hyman, please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Drmy Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness center, my work at Cleveland Clinic and Function Health where I am Chief Medical Officer. This podcast represents my opinions and my guests opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. Health this podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.