Well, hello ladies and gents, Robert Sykes, Keto savage.com
and today I have a special guest, Doctor Heather Sanson on
the line. She just wrote a book reversing
Alzheimer's and we dive deep into neurological decline and
what you can do to prevent that or certainly mitigate that from
happening as you age. We dove deep into lifestyle
factors, nutritional changes and manipulations you can make, the
importance of quality sleep, removing toxins, all that good
stuff. She is incredibly passionate
about this. She has changed so many people's
lives and it's very evident as you, as I talked to her and just
her zeal and excitement and passion for helping people
mitigate this and improve their quality of life.
So I was very grateful to talk to her.
I learned a ton. I've got no doubt that you will
take something from this so that further delay, sit back, relax
and enjoy the conversation with Doctor Heather Sampson and we
are live Doctor Heather Sanderson, how are you today?
So great to be here. Thanks for having me, Robert.
I'm excited to be chatting with you because you're talking on
the importance of diet, nutrition and lifestyle factors
as it pertains to just hedging against all the Alzheimer's and
dementia that we seem to be plagued with as a society, which
I think is a topic that hits near and dear to a lot of
people. We all kind of know some of that
struggle with that. So I'm excited to be down into
that with you. Yeah, it's such a hopeful
message that we have because there many people don't realize
there's so much that we can do to prevent delay and yes, even
reverse cognitive decline as we age.
So I know a lot of people especially listen this podcast,
they have heard the term type 3 diabetes and that being kind of
linked to Alzheimer's dementia. But can you can you dive into
what that is from a mechanistic standpoint and why it's even
referred to as type 3 diabetes? Absolutely.
Part of what's going on in the brain is that the brain takes up
2% of body weight but uses 20% of energy expenditure every day.
This is a very resource heavy organ.
And you know, this is part of why we wear a hat to stay warm,
right? That the brain is burning so
much fuel each day that we give off heat and that fuel as we
age. You know, when we're younger and
in this day and age, we use sugar primarily, you know,
sugar, carbohydrates, glucose. We can use those inter
interchangeably. But most people at this stage in
human evolution, they're burning carbohydrates 24/7, 365 days a
year, Very unlike our ancestors who used to go through periods
of famine or fast, or maybe they had meat available, they didn't
have carbohydrates and fruits available.
So now our we're kind of going against our evolutionary
mechanisms that really support healthy brain function by only
having carbohydrates as a fuel source.
Now as we age, regardless of our diabetes status, we all become
somewhat insulin resistant. This means that the the peptide,
the molecule that we use or the molecules that the string of
amino acids that get used as the signal to allow glucose,
carbohydrate, sugar to go from the bloodstream into the cell,
whether turned into ATP or the fuel that our cells run on, the
mechanism that allows for that via insulin gets kind of sticky.
I think of it like a key that's been copied too many times.
If we have too much insulin showing up in the bloodstream,
it actually has its own inflammatory ramifications, but
it also doesn't allow that sugar to get into the cell.
Now, even if that sugar does get into the cell, if we've got an
abundant amount of it and some of that insulin is working,
we've got sugar in the cell in the brain.
And the brain doesn't turn that into to ATP, that currency that
fuel our cells run on adenosine triphosphate or ATP doesn't turn
it into that as well as it used to.
Now, that's regardless of our diabetes status.
So ketones are the alternative fuel.
And I just think that the body, the brain has this divine
design. It just blows my mind.
I have such a reverence for it, but the genius that is this
ability to switch between different fuel sources allows us
allowed our ancestors to survive, right.
So when we're when we're in a starvation mode, when we flip
that metabolic switch into ketosis, our brain actually
turns on. Now you mentioned type 3
diabetes. So if someone and this is a
colloquial way or like kind of a way that will refer to
Alzheimer's sometimes because many of the Alzheimer's cases in
this and age are caused by glucotoxicity or a toxic amount
of glucose, sugar, carbohydrates in the bloodstream, leading to
essentially like a caramelization of the cells
themselves. But also this resource
inefficiency and this, this, it's like you run out of fuel
because you can't turn the building blocks into ATP.
So that brain that that organ that needs so much extra energy
that it's really seen heat throughout the day, I can't get
it. Even though we keep eating more
and more sugar in the case of diabetes.
So when it comes to the the insulin resistance as we age, I
feel like we've all heard that to some extent.
We know that we get more insulin resistant as we get older.
But from a from a technical standpoint, is that lack of
insulin sensitivity coming from just a myriad of different
effects like dropping muscle tissue as we age, less activity
as we age? Like is there any one thing that
is the primary culprit to that drop in insulin sensitivity?
That's a great question. I don't know that we have a full
answer. And I think as you alluded to
that there's probably multiple mechanisms at at play there as
we age. But I think and exercise and,
and muscle mass being one of them, that metabolic flexibility
that we get from going in and out of ketosis and in and out of
glycolysis. So going back and forth between
burning sugar for fuel and burning ketones for fuel, that
allows us to maintain that insulin sensitivity, that
ability to help insulin shuttle glucose from the bloodstream
into the cell where it does the work.
And so I, I think there's multiple things, but being in
glycolysis, burning sugar for fuel creates a lot of oxidative
stress that can do direct damage to the neurons.
It creates a lot of basically, it doesn't turn ATP into ATP as
efficiently as ketones. And it's also very toxifying,
right? It creates more toxicity,
oxidative stress. A ketogenic diet is
anti-inflammatory because, and just in comparison to a glucose
heavy diet, which is very pro inflammatory, right?
A ketogenic diet is very anti-inflammatory.
A ketogenic diet reduces toxicity by mobilizing fat.
A lot of fat soluble toxins are stored where a high glucose diet
actually increases toxicity through glucose itself.
In that mechanism I described of glycation or these advanced
glycation in products called AGES, which makes a lot of
sense. As we accumulate them as we age,
we have more of them and they almost are literally this
caramelization of cells that prevents them from functioning.
And then in addition to the anti-inflammatory effects of
keto and the the detox benefits of keto, there's also that
antioxidant benefit or that relative reduction in oxidative
stress in the brain that we get from being in ketosis versus
glycolysis. Got you.
That makes no sense. So from like from an analogy
standpoint, when people are familiar with those that have,
you know, diabetes, not type 3 diabetes, but just diabetes in
general and they're experiencing neuropathy, they're having to
have, you know, toes amputated due to that glycolysin that that
glycation in the capillary cells in these extremities and in the
eyes. That's pretty much what is
happening in the brain as the age and that is resulting in the
the neurogenerative diseases that we're familiar with like
the Alzheimer's dementia. Precisely.
Gotcha. OK.
So I am, I'm interested in this because I feel like, you know,
from a ketogenic standpoint, I'm a big believer and proponent
that that is the optimal way that we should consume food as a
species. And when you look at it from a
longevity standpoint, it just seems like a good insurance
policy. Like, if you want to minimize
the likelihood of the risk of you having neurodegenerative
disease, simply avoiding the excess of sugars and energy
toxicity in general would probably be the best bang for
the proverbial buck. So that's actually what I tell
my patients is I think, you know, we have this robust
program that includes diet and exercise and stress management
and sleep and the functional medicine work up of looking for
toxins and infections and all of that is really important.
But 50% of the lift is getting into ketosis.
I just see the most profound benefits for people's cognition
for my elderly patients, cognition from flipping that
metabolic switch. It is like the lights come on.
In many cases, they start remembering their
grandchildren's names when they hadn't for months.
And so many people also share that they get better sleep,
their mood is better, they feel less pain because they're less
inflamed, their joints move better, and they get they feel
like they can walk in a different way and they have more
stamina. They don't get that slump of
energy in the afternoon. So there's a bunch of benefits
that help many of the mechanisms associated with
neurodegenerative decline as we age.
What was your driving factor for getting into this line of work
in the 1st place? Did you have a grand pen or
something that was plagued by this and that was the motivation
or what was the origin story? Really, it was that I had heard
it wasn't possible. I was trained by my mentor,
Doctor Dale Bredesen, in 2017, and then I was on his list of
providers who had been trained by him to see patients with
Alzheimer's. And I went to his training
because I was very skeptical. But the way he explained it, the
mechanisms and the potential of stacking all of these
interventions on top of each other to support neuronal
health, that made conceptual sense to me, right.
If that's common sense, if we give cells everything they need
to thrive and take out all the junk that prevents them from
thriving, then we get better function.
I mean, we could apply this, these concepts really to any,
any complex system, whether it's a plant or, you know, a child or
an animal or, you know, even financial systems and government
systems. We need balance.
We need homeodynamic balance in them.
And it's not about a one, a single molecule intervention or
one pill or one IV that's going to help with this disease.
And so I, I got that conceptually, but I was very,
very skeptical. Well, then Fast forward to me
seeing patients in my office that they had way more, way more
confidence in the process than I did because I hadn't seen it
work, right? I needed to see it work to be as
confident as some of these patients were.
And Doctor Bredesen was. But I did, I saw it work over
and over and over again. And as a provider, as a medical
provider, when you you see something like that happening
before your eyes, like the impossible is happening and
people are getting better. They're getting their lives
back. They're getting their parents
back and their spouses back. And they get that one more
Christmas, so that one more anniversary or that summer where
they're really fully engaged and present and participating in the
relationships that is. I mean, there was just no way I
could do anything else with my life, right?
It's like people were still, I still have patients coming in
saying the neurologist told me to get my affairs in order.
There's a couple of medications that don't work very well.
They might slow the progression, but he's got to take my driver's
license away and he'll see me in 6 to 12 months to see how much
worse I am, basically. And that is such a hopeless
message and it's the reality on the conventional side.
And yet there's so much that we can do.
And watching patients take control back of their own
health, of their brain health, seeing how empowered they are,
seeing how hopeful they are, seeing the work that they put in
and how dedicated they are to each other.
I often see families that have, you know, support through
multiple generations to put this plan into action.
And it's just so inspiring and meaningful.
And, and I'm very motivated to get out of bed in the morning
because I have the privilege doing this.
No, I, I love it. There's, there's very few things
I can think of that'd be more fulfilling with that.
I mean, that's, that's you're seeing people regain that spark
and they're like, what, what? What can be better than that?
Yeah, talking, excuse me, just talking to elderly patients the
way I get to, I often will ask, you know, what are your happiest
memories? What are what are you most proud
of? And it's 9 out of 10 times and
probably more than that, it's the connections.
It's the, it's those relationships with the people
that they love. That's what it's about.
And if we can be present for those, if we can participate in
those longer, that is is just priceless.
Yeah, I completely, completely agree.
I feel like there is. So I want to learn about your,
your, your practice, your clinic.
I want, I want to dive into that and it's going to frame my next
question. So who is your target
demographic? I'm assuming the elderly that
have been already diagnosed with a neurodegenerate disease.
So my very favorite is to see multiple generations in the same
family because they cheer each other on.
They all get it. They're all on the same page.
They hold each other accountable.
They eat the same diet. So I often will start by seeing
the person who's been diagnosed with dementia in the family.
And then typically, you know, and especially when things go
well and it it feels doable, then I start seeing the daughter
or the spouse. And then I start seeing the
grandkids who might be in their 20s or 30s.
And that is really, really fun because then everyone's in
alignment and I see even better results with patients who have
come with that, that support system.
And so, yeah, that's my my favorite.
It's when we get to, it's really a luxury when we're in the
prevention phase and we might know that somebody's APOE
status, APOEAPOE, if you have one or two copies of APOE 4,
that can put you at higher risk for developing dementia over
time. And so when we know that in our
20s, thirties, we can, I mean it for me as a provider, it's just
such a luxury. We can look for all of the
potential risk factors, all the causal level factors, and we can
eliminate them so that again, we can delay, prevent and
Alzheimer's from ever taking hold, hopefully.
And then in the later stages, some people might be starting.
Sometimes I'll see patients where they're like my brain,
especially postmenopausal women or kind of perimenopausal women
where their brain isn't working the way it used to, right?
They're, they're feeling more overwhelmed by hosting
Thanksgiving or planning an international trip.
They just don't feel like they can take on what they used to.
They're confused more easily and they have maybe some brain fog.
They're not sleeping as well. And potentially a family history
of Alzheimer's. And they, they remember, oh,
mom, this is where it started. She never really recovered after
menopause. It started to go downhill.
And that's a great time to work with someone as well, because
those earlier stages, we have the most confidence that we can
get reversal, and it happens the quickest with the least amount
of effort. Now, when I'm working with
people in later stages of Alzheimer's, there's no
guarantee that they're going to get improvement.
But often we do see improvements even for people with severe
Alzheimer's. In that case, it's rare that
someone, I've never seen someone go from severe Alzheimer's to
fully recovered and back to work.
I've seen them improve, maybe regain verbal ability, regain
the ability to engage in activities of daily living, get
enjoy life more right and be able to converse with people
more fluently. Those that's very common and we
see that a lot, but it's harder. It requires a lot more effort,
energy and resources when someone's more in that severe
state. But we see people across that
spectrum. So when it comes to you
mentioned that the menopausal year, I've had several guests on
the podcast talking about that as a pertains to hormone
regulation. And it seems as though the push
towards exogenous hormones, HRT during that time is is the, is
the prevailing modality that is gaining traction.
A lot of it is for, you know, the the disease prevention as
well, like increasing bone density.
Have you noticed anything as it pertains to that and how it
relates to neurodegenerative decline or lack thereof?
Is there an argument to be made there in the benefits of HRT for
brain health? Absolutely.
Yeah. So what my clinical experience
is that women who get on HRT it what it feels like watching a
flower go from being like wilted to getting water and perking
back up. It's just, it's so fun to see
and not for everyone, not everybody can tolerate it.
But there was a very validating research study that was
published in May of 2024, very recently.
And it took 11,000,000 Medicare aged women, so 65 and older, one
and a half million who were on HRT and nine and a half million
who were not. So after the Women's Health
Initiative study was published in, in the early 2000s, many
women become very fearful, many doctors became very fearful of
using HRT, hormone replacement therapy.
Now the, you know, when we look back, that really was a failure
of research, medicine and the media in terms of telling women
that it wasn't safe to take hormone replacement.
There are, you don't want to take oral estrogen, you want
estrogen that's topical or vaginal.
And that is associated with profound reduction in risk,
reduction in, in all 'cause mortality reduction and dementia
rates, reduction in breast cancer rates, colon cancer
rates, heart disease, the list goes on and on of and of course,
you mentioned bone density and and osteoporosis risk.
I think that there's no question anymore that thoughtful hormone
replacement makes a ton of sense for health risk reduction as we
age. Gotcha.
OK, that makes sense. I've, I've been tackling that,
that question because I get that question a lot and I'm not
qualified to answer because I'm not a menopausal woman going
through HRT therapy. But I feel like there is a lot
of science coming out. There was a lot of you know, as
you mentioned that the the poorly designed studies in the
early 2000s and I feel like that swaying people.
I feel like that the the new information is certainly
surfacing now, which is great. I'm definitely curious to see
what the, you know, long term outcome is.
But I feel like it's pretty hard to argue a lot of the benefits
that have come with the HRT if done correctly.
As long as everybody's got all the other environmental
lifestyle factors in place. I always sway people against
going to HRT route as the first, you know, first way to avoid any
adverse effects. But if you've got everything
else started in, then it becomes a viable option.
Well, you know what, I I would really urge you to read this
paper. I'm happy to send the link along
and we can put it in the show notes, but I, I don't think you
have to talk people out of HRT anymore.
We have this trial again, 11,000,000 women who were over
the age of 65. SA lot of the caution was OK get
on HRT to prevent the hot flashes while you're going
through menopause and then get off of it as quickly as
possible. It's not safe to safe to stay on
it, but this attracts women over 20 years.
So there is long term data. There is a ton of data and
overwhelmingly it suggests that there are many, many, many
health benefits to being on hormone replacement.
So I or hormone therapy. So I I get your caution.
I was also very cautious for a long time and we were and
clinically we would use it. You know, women were comfortable
with it if they had no breast cancer history risk.
We were obviously looking at mammograms and we'll continue to
do that to mitigate the risk because there.
It is risk if you have a cancer present and it is estrogen
receptor positive, so like a breast cancer, ovarian cancer,
potentially uterine cancer, but you should be on progesterone if
you have a uterus or if you have a progesterone receptor positive
cancer, it will go grow faster in the presence of these
hormones. So that's the reason to
restrict. But you know, breast cancer, you
reduce the risk of getting breast cancer when you're on
hormone therapy. So I hear, I hear the caution
and that had the cautionary tale has been told for many, many,
many years. I fully appreciate why, but I
think we can put that to rest now.
It is beneficial for women to be on hormone therapy.
What about males? What?
What do we know from an Alzheimer's dementia standpoint
as it pertains to males on or off HRT?
Yeah, there is great data suggesting that testosterone
therapy in both men and women helps to prevent dementia and
Alzheimer's. And what is what is the the
primary mechanism of action there as it pertains to the
neurological component? Like what?
What is the what? What hormones are taking place
that are causing preservation of cognition?
Yeah, great question. So testosterone as we know helps
with muscle building and muscle itself sends BDNF brain derived,
no trophic factor to the brain. So you've probably heard of
these maybe as extra kinds or you've heard that muscle is more
of an endocrine organ than just connective tissue.
When I was in medical school, we called it, we just classified it
as connective tissue. And now as the research has
evolved, we know that muscle itself is sending signals around
the body that are health promoting, including brain
dreadnatrophic factor, which goes to the brain and supports
neurogenesis and synaptogenesis. That's the creation of new
neurons and the creation of connections between them.
And also testosterone itself has receptor sites in the brain.
If you think back to when you're in your early 20 or yeah, early
20s, late teens, this is when our sex hormones are peaking,
right? We're like gone through puberty.
And we're also in college, right?
We're making all these social connections.
We're we're building skills, we're learning.
We're sort of at that peak of that ability to learn and
conceptualize and take on new ideas.
We're really open to new ideas and a lot of that is sex hormone
signaling. And so we don't necessarily need
people in their 70s to go back to feeling like they're 19
again. That can be, you know, it
involves libido and distractions in that in that arena.
So we don't necessarily have to go to that high of dosing.
But even, and in that paper that I was referring to that was
published in May, low to medium doses are the most beneficial.
So we want enough signaling of the sex hormones, but also
stress hormones right there, lots of hormones.
We want the right amounts in the right place at the right time.
So getting some testosterone, estrogen, progesterone,
pregnenolone, DHEA, but also vitamin D, vitamin K, BDNF,
thyroid hormone. All of these hormones have
receptor sites in the brain that put the brain in going in the
direction of repair, remodel, regenerate, create, grow new and
they get it out of that that defend, attack, shrink, get
smaller state, right. So we want to be oriented
towards that regenerative state and away from the shrinking
atrophy state. Totally, What are some other
lifestyle design factors that one can implement apart from the
HRT? Obviously we talked about the
ketogenic diet, but anything else come to mind is like low
hanging fruit to implement to preserve cognition and overall
psychological health. This is my favorite question.
Thank you so much for the opportunity to kind of just zoom
out. Okay, what are what are some of
the other factors? And this is a precision based
approach, right? So I've talked about balance.
So when homeodynamic balance, when we think about the brain,
we want to think through all of the things that might get out of
balance and at a causal level cause neurodegeneration or set
off, you know, and some people will say, oh, inflammation is
the cause of Alzheimer's. No, inflammation is the
downstream effect of something else that is the cause.
Same thing with amyloid plaques or Tau proteins.
Misfolded proteins. If you have a plant, right, that
you're trying to keep alive in your house, if it starts to wilt
and droop and turn brown, you don't go, oh, there must be
misfolded proteins, let's get them out.
You think to yourself, is it getting enough water?
Is it getting enough sunlight? Is it getting enough nutrients?
Are there toxins in the soil? Is it, does it have too much
water? Right.
So we want homeodynamic balance, the right amounts in the right
place at the right time in the brain.
And the there's six components of brain health.
And I'm going to double click on sleep.
But first I want to give us a, a framework for where this goes.
So number one is toxicity. And we talked about how glucose
can be become toxic and that's, that's basically too much of A
nutrient, right? But toxins also can come from
the environment, mold, toxins, metals, also chemical toxicity.
And so we look for that, particularly as we age, we
accumulate toxins. We want to keep our organs of
elimination open. That means having a bowel
movement every day, drinking plenty of good clean filtered
water, means sweating regularly, means maybe some lung detox,
breath work and some liver support supporting our organs of
elimination. So that the natural toxins that
we have from metabolic, which is the metabolic waste all of our
cells create each day, but also the toxins that we're exposed to
in a frankly toxic world. We need to be able to get rid of
those and eliminate them so they don't cause disease over over
the course of our lives. And then nutrients.
We talked about a macro nutrient or, or a couple, right, fats and
sugars, but there's also protein.
And then there's micronutrients. Do we have enough methylated B12
to keep our homocysteine down? Elevated levels of homocysteine
are associated with brain atrophy, but also carnitine and
creatine. And there's so many, I'm, I'm
just said a phosphatl serine and phosphatl choline.
There enough omegas. There are lots of
micronutrients, aminos, those minerals, vitamins, antioxidants
that we want to understand, are we not only are we eating the
right things, but can we then digest and absorb them?
And can we eliminate what doesn't serve us so that we have
a good healthy microbiome that's supporting our brain health?
So toxins and nutrients and nutrients kind of thinking
through not only what are we eating, but can we absorb them
and macro and micronutrients and then structure stressors,
signaling. We talked about hormones,
signaling is a really big component.
And then the 6th component is infections.
So again, those six are toxins, nutrients, stressors, structure
signaling and infections. The way the place I want to
double click is on structure because sleep apnea, the
obstruction of the airway at night is a huge culprit in
cognitive decline as we age. And many people who I've seen,
especially my little old ladies who maybe they have a partner
who wears hearing aids and takes them out at night or they don't
have a partner anymore who would know that they're snoring.
So we don't know they're snoring.
They're thin and they are not the classic obese male who you
would imagine is snoring at night.
And we catch the sleep apnea. They're women who don't fit the
stereotypical sleep apnea, a patient and sure enough, when we
test, they have severe obstructive sleep apnea that is
contributing significantly to their cognitive decline.
And when we treat it, their cognition improves also, mood
improves, right? Energy improves, of course, when
you start getting better sleep. But for everyone listening,
ideally, you know, and I, I don't want you to lose sleep
over these numbers, but I want to just give you some
guidelines. Ideally, you want to get at
least 7 hours of sleep. And, and you'll know, like I'm
someone who needs 8 1/2. If I get less than that, I'm not
functioning on all cylinders. But, and some people, maybe they
say, oh, I need 6 1/2. Like OK in that ballpark, but
usually a minimum for most people of seven hours of sleep
per night, 90 minutes of R.E.M. and at least 60 minutes of deep
sleep. I use an aura ring to track.
There's lots of other devices out there, but looking at that
and knowing are you getting enough quality, restful,
restorative sleep? The best question You know you
don't need any gadgets to to test this really.
Do you wake up rested in the morning?
If you can say yes the vast majority of the time I do, then
great, you're probably in good shape.
But if you have any cognitive decline and there's any
indication that you're not sleeping well, I recommend
treating it aggressively. I used to wait for someone to
tell me they were tired during the day or that they snored to
order a sleep study, and now I do it for every single patient
with any cognitive decline. And how do you go about
treatments like those, those older, small petite women?
How are you treating that sleep apnea?
Great question because a lot of people say, oh, don't even
bother testing me because I'm not going to wear a CPAP.
So there's a spectrum of interventions with mild sleep
apnea. Mouse tape works.
You can treat mild sleep apnea with mouth tape and sometimes
that will actually help to resolve it.
Now getting into ketosis helps with weight management often and
that can help with apnea, but not all the time.
Somebody has more moderate or severe apnea.
There are Cpaps, but there's also Apaps.
There's the pillow, there's the travel version.
There are many many different types of apnea treating devices
and I would recommend going through them.
It's a chore but it is so well worth it to have your cognition
back. And if it's that simple, this is
covered by Medicare, covered by insurance to get a sleep study
and then try work through those different devices.
You can also see a dental specialists who can help to fit
mouth guards for to, to keep the airway open.
There's all kinds of little devices you can find, you know,
online, a lot of like the tennis balls and the vest that doesn't
tend to work, but there are some pillows that can help.
And there are also Sleep Medicine doctors who are totally
dedicated to helping you make friends with your CPAP because
sometimes it's claustrophobic at first or the the sound keeps you
up. But for many people, they find a
solution and it's it's just crucial you you have to get good
high quality, restful sleep in order to have brain health as
you age. So I I'm AI am a self-proclaimed
workaholic. I don't sleep near as much as I
should. I know that's my downfall.
Like I when I'm going to prep like I'm averaging like 3 or 4
hours a night. Like it's not good and I've been
trying to sleep significantly more since that preps concluded
but I still have a like I still snore from time to time.
According to my wife at least, and I do wake up tired.
I think it's a lot loudly because just a lot of stress.
But I do like the mouth taping. I have like a an eye cover.
I do blackout curtains that turn the thermostat way down.
Like I do all the things you're supposed to do.
But I'm thinking about just going all in and buying a sleep
AB or one of those devices CPAP and then just rocking that and I
don't care how I look. Oh, Robert, I am so glad we're
having this conversation. This is critical.
And with stress, you know, there's lots of things that we
can talk about with sleep because people will hear me say
this. You've got to get good quality
sleep. And they're like, I try, I just,
I can't, right? I lay there awake at night and I
can't sleep and so talking to a provider or talking through what
are your options because there are great options for getting
you to sleep for helping you get to sleep.
Melatonin among them, but there's lots of sleepytime
herbs. Magnesium inositol is a type of
it is a type of sugar but doesn't raise our blood sugar
and it helps to prevent the accumulation of beta amyloid
plaques also helps us to get to sleep and get restful sleep.
Now, if you have trouble staying asleep, so long as you're not on
antidepressants that are SSRI's, you can take 5 HTP.
Serotonin helps us to stay asleep where melatonin helps us
get to sleep. And then phosphatidylstirine,
there's a product in particular that I like called Serifos.
It's a high dose that can help you to reduce, basically
metabolize cortisol before you're going to bed.
So that as your cortisol comes up in the morning, if it's
coming up at 34 AM and you want to sleep until six or seven, you
can take Serifos before you go to bed and that'll help to keep
the cortisol down throughout the night so that you don't that
threshold that triggers the waking response until a little
bit later. It's also Pinocchio, Magnolia
bark. There's a product called Hono
Pure that I really like that helps people with more restful
sleep. There are so many things that we
can do to optimize sleep now #1 and it sounds like you probably
already are aware of this, but it's that sleep hygiene and
allowing enough time for restful sleep and meditation is one of
my, I mean, I think meditation is probably the best medicine
that it makes a profound impact on the quality of sleep as well.
Yeah, I don't, I don't have a problem falling asleep or
staying asleep unless I am in a a prep and then my body is like
just fight or flight mode and it it wakes up super early without
me wanting it to. But I think the quality of my
sleep while I sleep is probably subpar.
And it's probably because I've just got this underlying chronic
level of stress that just doesn't let me to truly deeply
relax. That's my theory at least.
But I guess I'm probably breathing poorly as well, some
form of mild sleep apnea, because if I'm snoring to any
extent then that would indicate that, right?
Well, it could, yeah, there's something happening in the
airway. It's not ideal.
And when when people have sleep apnea, you're not going to be
able to get restful sleep because your body thinks that
you're suffocating, right? So I think some people are like,
oh, no, it's not a big deal. I get enough sleep and maybe I
have a little apnea. It's like, no, no, you're
hypoxic. Your brain is not getting enough
oxygen. That's essentially like mild
brain damage every night. Yeah, I definitely, I definitely
want to avoid that for sure. Yeah.
But I would imagine that is amplified on a whole nother
level with elderly people that for sure have sleep apnea and
it's just going undiagnosed or unrecognized and that's just
their norm every single night. Absolutely.
But you know, even in our 20s, thirties, 40s, just one night of
sleep deprivation leads to a measurable accumulation of
amyloid plaque in the cerebral spinal fluid.
Yeah, definitely something to be avoided.
So you mentioned the structure and systems and and you double
clicked on sleep as it pertains to structure.
What is the systems then? Oh, structure and stress
probably so and structure. So just like nutrients, we have
micro and macro with with structure we have micro and
macro as well. So the airway is what we were
just tracking chatting about, but also chronic pain.
So chronic pain will in increase cortisol, a stress hormone, and
that over time can be toxic to the brain and that can shrink
the hippocampus, the memory center of our brain.
So too much stress can be an issue.
And if we're not getting enough sleep or if we're in chronic
pain, that can increase that toxic cortisol level.
Now we need some cortisol to get us up and out of bed, but again,
it's that too much. If we have too much at the wrong
time then we can't sleep and it becomes toxic to the brain.
And also with structure is APOE. The genetics or molecular
structure can also put us at higher risk for developing
dementia. So the APOEAPOE, you get one
from mom and one from dad. You can have a 2-3 or four from
mom or dad and if you have one copy of the four, you have a 30%
chance of being diagnosed with dementia in your lifetime as
compared to people with in the full.
The full population is 13%. If you don't have APOE 4, it
goes down to 9%. Now, if you have two copies of
APOE 41 from Mom and one from Dad, you end up with a greater
than 50% likelihood that you will be diagnosed with dementia
in your Alzheimer's in your lifetime.
And there was a recent Nature paper that was published that
essentially suggested that it was inevitable that you would
get Alzheimer's if you lived up to a certain age and that most
people over 65 who are APOE 4/4 positive have enough amyloid to
be diagnosed with Alzheimer's. So this is scary, but it's also,
I hope, very empowering. If we know we have genetic risk
for dementia, we want to understand our risk factors
earlier on, in our 20s, thirties, 40s, before we have
any inkling of symptoms and take control of our brain health.
So stress is the other one that we can chat about here and
stress again, it's you don't want too much and you don't want
too little on the too little side.
Many people associate their retirement years right with
kicking their feet up, maybe enjoying cocktails at happy hour
and watching TV, going on cruise route, a cruise ship, you know,
adventures, eating to to the point of gluttony.
And that is going to set you up for dementia and Alzheimer's and
heart disease and you know, a myriad of other complex chronic
diseases as you age. We need engagement.
You want stress, not too much of it, but you want the type of
stress that provides purpose and meaning, right?
My daughter started kindergarten this morning and her grandpa
helped get her to and from school.
It's kind of stressful and overwhelming for him, but it's
so meaningful and it keeps him engaged, right?
And at the end of the day, he enjoys it.
But you, I think some people imagine retirement is having no
responsibility, but you want to be engaging in the things that
you love and creative pursuits in.
You want to be doing something. You want to be exercising.
Exercise is another very classic one with stress.
The, I'm sure your, your audience is well aware of the
hormatic effect and this concept that an increase in stress
actually creates more resilience.
That is exercise, right? We're getting micro tears in the
muscle so that we have bigger muscle and then we're stronger
and we're more resilient when the next stressor comes up.
So we can do that with fasting, the making diets like the
ketogenic diet, with exercise. Of course, we can do this with
hot and cold therapy. We can do this even with oxygen
contrast, oxygen therapy to increase resilience in the
system, which is more or less a definition of health, right?
So with stress, we want to use that hormetic effect.
We want to stress the system enough that it becomes more
resilient and it stays engaged, but too much stress.
So, for example, people who provide care to those suffering
with dementia and Alzheimer's, that is a very stressful role,
often with a high, a high burden, and it can interfere
with sleep, with exercise, with diet routines.
And people who serve as caregivers are anywhere from 2
1/2 to six times more likely to be diagnosed with Alzheimer's
themselves later in life compared to those who do not
serve as a caregiver. And that is, I think, the
manifestation of the risk of this stress, of too much stress.
Yeah, I feel like that. And especially in this day and
age, like people are just walking around with stress and
they don't even necessarily recognize that they're stressed,
but they are doing things day-to-day, like just simply
scrolling on social media mindlessly and comparing
yourself to others. Like you may not feel stressed,
innately stressed from that, but like your body recognizes it as
stress. And that's just like the chronic
norm that everybody's doing. It's also that lack of purpose
and meaning, right when you're just mindlessly scrolling, you
don't have the benefit of putting the grit into like a
project and seeing it to completion because you're just
there for the dopamine hit of, of the scroll.
And so I think it's twofold, right?
We have the depression for a couple reasons.
I'm sure many of us I've, I certainly have the experience of
being kind of burnt out after a long work week and.
Or maybe travel and I get on Instagram and I'm scrolling and
all of a sudden a couple of hours have gone by and I just
feel bad about myself. Not just because I'm comparing
myself to others and like dreaming of that amazing trip to
Italy or or Tahiti or whatever. I just, you know, scrolled
through. But more because I was so
unproductive. I didn't do anything.
I didn't get exercise that made me feel good.
I didn't read a book that, you know, inspired me in some way.
I just scrolled for hours. Yeah, I think it's definitely a
downward spiral that a lot of people face.
I feel like on the point that you just said, they're like
having a goal, having a project that you're working on, like
that sense of fulfillment that comes from that is so incredibly
rewarding and empowering. I feel like very few people
unfortunately have that like that they're working jobs they
they dislike, they're they're stuck in the monotony of a life
they're not passionate about. And I think there is so much to
be said from a health standpoint when you are doing your desired
tasks every single day now. So there's not going to be hard
moments in there. There's not going to be a grind
to it. But when you are working on
something that you truly believe in, I think there is like very
tangible health benefits that come from that.
Having purpose and meaning throughout life is so I think
important to our mental health, certainly.
And I think that there's always this, right, this too much, too
little. If you have work that takes over
your life, right? As I mentioned, I feel so
privileged to talk to older people who and I can ask them at
the end, looking back, what's most important to you, right?
Work has to fit into real life, right?
It has to fit in to our sleep, our health, like our our
priorities. And if your stated priorities
are your health and your family, but you spend all of your time
working and you're not getting sleep at night or you're not
making time to exercise, then your priorities don't match.
Your state of priorities don't match how you're spending your
time. And that leads to incongruence.
And so there, which can be also very stressful, right?
So I think that there's, this is dynamic again, this changes over
time and it requires sort of reevaluating and looking at
repeatedly throughout life. And especially as things change,
you know, children grow or when you hit retirement or you
graduate from a program or you make a big decision to shift
your life because maybe you're in a, in a job that doesn't feel
purposeful and meaningful. But then having that opportunity
those weekends away or, or that coaching program or that
therapist that you work with to just constantly, kind of maybe
not constantly, but you know, regularly go back and
reevaluate. Do my priorities, my stated
priorities, match the way I'm spending my time?
Well, I have to to applaud you because I can tell just in
talking with you like the the zeal for life that you have in
doing the work that you're doing is very, very evident and just
the way you're communicating. So I have no doubt that you are
finding, seeking and living that purpose every single day.
I feel so privileged really. I, I, I get to hear people say,
I got my mom back and, you know, recount their incredible holiday
season that they had with her and that I just feel so
delighted. But I also get to drop my
daughter off at, at school in the morning and pick her up in
the afternoon, right? It's, it's about and take her
camping and, and, you know, be in awe of nature with her.
And I think that that that balance is really important.
100% So I've got to, I want to, I want to talk tangibles here.
I've got, I mean, we all have people in our family that are
older and they're going through cognitive decline, health
decline. They're just facing the
challenges that come with getting older.
And one of my big frustrations, I'm sure a lot of people that
can relate to this, especially if they're listening to the
health oriented podcast, is that they feel like they know the
solution, whether that is a ketogenic diet, more activity
reduced, you know, processed sugars, like any of those things
would benefit our older loved ones that are in that state.
However, so many people have this notion of like, hey,
they're old, they're they're stuck in their habits.
Just let them do whatever they want to do and live out their
last years as they wish. Like to me, I've got a very hard
time embracing that mindset. Like how do you combat that?
So this is. This comes up all the time.
And I see especially women daughters, right?
They're they're just almost become a martyr to this idea
that like my mom is not getting the best care.
She needs more. My sister's wrong.
I'm right. And I think that there's a
balance here, right? Like you can take it too far.
And our parents are our parents, right?
And they do have agency and it's important to respect their
wishes. And I think that this is very
complicated, especially because the wishes of someone at 60
compared to their 80 year old demented self might be very
different. And then it's whose wishes do we
grant at this stage? The the 60 year old who wrote
their their will or, or their ideas of how their estate would
be handled? Or the 80 year old who's very,
you know, lucidly telling me that they want to marry this
person or that they want to, you know, do this other thing.
And it's so out of character And I, I don't think that there's
right answers to all of this. But I will say that if you feel
well when there's a lot more resource, right there's Dean
Ornish just published a trial. Now his was not on.
So he Dean, Dean Ornish is up at UCSF and he's created programs
for heart disease and for other chronic diseases associated with
aging. But he had a very recent
randomized control trial, the 1st randomized control child,
showing that an intervention, a lifestyle intervention like
this, a multimodal lifestyle intervention for those suffering
with mild cognitive impairment and early Alzheimer's, was
effective in improving cognition.
And so this was followed my paper that was published showing
that we could reverse cognitive decline associated with
Alzheimer's. And also Doctor Braddeson's
work, he used a vegan diet, but this can be done and the
research is there. So don't let anyone tell you
that there's no research supporting lifestyle
interventions for cognitive decline and what leads to
Alzheimer's. So the research is there.
You can point to the research. You can point to my book
Reversing Alzheimer's. You can point to Doctor
Bredesen's books, The End of Alzheimer's, The First Survivors
of Alzheimer's, and the The End of Alzheimer's Program.
Those are great books as well that all describe how to do
this. And I share many stories, true
patient stories of people who have reversed their cognitive
decline. So those stories are there.
The research is there, and if you give that to your loved
ones, and I think how you communicate with them is
important too, right? We don't want to be too pushy
because that just makes people resist.
But we can have all the answers. But if we don't communicate them
effectively, they're not going to be receptive to it.
And sometimes there's family dynamics that make people not
receptive. But if you feel like you're
banging your head against a wall, that's a traumatic brain
injury that falls under structure.
Stop bringing your head against the wall wall and refocus your
energy on making sure that you, particularly if you're
genetically related to someone with dementia, that you are
taking responsibility for your own brain health.
And walking the the talk, right? Like eating the diet, getting
the exercise, getting the sleep, managing your stressors, maybe
getting tested for toxins or infections or sleep apnea.
And I think that that is the best use of that energy instead
of projecting it on others. And what they should be doing is
making sure that you are doing everything that you can to
protect your brain health and being a model for those around
you. Yeah, and I completely agree on
all fronts there. And that's that rings true for
both the, you know, those in the older, you know, age gaps groups
and those that are on the complete other spectrum.
I've got people that have, you know, kids, they're trying to
showcase to them how they need to eat, yet they're not modeling
that that correct behavior either.
So it's like you most definitely have to practice what you preach
and just be the best example you can be for those older and for
those younger than you. So I completely resonate with
that message. It is frustrating when people
assume that people are past a point in life where change
cannot be made. And my, my opinion has always
been like, look, if if you get and one more day on this planet,
you might as well do what you can to capitalize and make that
day the best it can be. And if you focus on controlling
the things that you do have control of, which is the food
you put in your mouth and your lifestyle factors, if that can
benefit the the you know, the happiness in that time left like
that is all time energy well spent.
Maureen came into my office and I share the story in the book,
but I'll share it here as well because I think it's to your
point. She came into my office and she
joined our clinical trial and it was as a last ditch effort.
She was desperate, absolutely desperate because her husband
had passed away. He had also been her business
partner. They'd owned a nursery and the
nursery had just gone into disrepair.
She hadn't done our taxes in years and she only they didn't
have kids. And so her only two living
relatives, her older siblings had passed away.
Her two living relatives were cousins who lived a couple of
hours away up in LA and they lived in this senior living
community where the model was age in place.
So you could buy in and you could move in at a certain rate
and the rate didn't change. But if you had any indication
that you had dementia or cognitive decline, you weren't
eligible because it's so expensive to care for people and
memory care. So they wanted to reduce their
numbers of that, right? So I got where they were coming
from. But she was also in this very
desperate place of feeling like she was going to die alone in
her home, demented. And it was terrifying for her.
Now she would call my office. Like my staff literally had to
say on Monday mornings, I have to put aside an hour and a half
to listen to all of the messages that Maureen leftover the
weekend. And she was calling multiple
times a day. Like if somebody, if you think
of somebody needing handheld, she needed, like, both hands
held all the time. Yeah.
And my health coach, who we were working with at the time, she
called me up. And she's like, Heather, Are you
sure you want to let her into the trial?
Because I think like on a readiness score level, she's
like a generous, it's 2 out of 10.
Well, Fast forward to six months later, Maureen, like, walks into
the office. She's got perfect cognition.
She, you know, which is measurably improved by like 6 or
eight points. She's twirling around in this
dress she hadn't worn in years. She's not even thinking about
senior living communities. She's got our taxes done.
She's out on dating apps. She's going to like dance, dance
classes. She doesn't have time to see me
because she's going to go to lunch with her friend.
And it was just this absolutely miraculous transformation from
someone who we thought had no chance of doing it.
And it's like if Maureen can do it alone with poor cognition, I
mean, anyone can do this. It's a matter of will really.
And you know, something really interesting that happened to her
on her journey about 3 months into the six month program with
us. She had a neighbour who was
diagnosed with cancer. And so she had changed her diet
and was cooking all these healthy foods.
Lots of Brasca family, you know, she was eating a lot of cabbage
and broccoli and cauliflower and kale and Chard and all of the
veggies and had gotten really into cooking.
But she was only cooking for herself at that stage.
And when he was diagnosed with cancer, she started cooking for
him too. And she made it about something
bigger than herself. And I think that that allowed
her to have a lot of staying power.
Yeah. It made her get up and make the
meals, even on the days that she didn't really feel like it.
No, that's awesome. That's that's that's super cool,
very inspiring. I I got one more follow up
question for you, but I want to hear about your book too.
So you get your book that that was published when?
June 11th was our launch date. And how's it been going so far?
Great. We have the New York Times list,
which was, you know, every author's goal.
So we feel good about that and would love for more people.
The momentum of coming on this show and others is the hope is
that it has an impact, right? Is that someone picks it up,
passes it along, it gets in someone's hands who makes those
lifestyle decisions. That changes the trajectory of
their health and improves the quality of their relationships
and their health over the over that last chapter of life
especially. I love it and, and what what is
the where's the place to go to get that?
Anywhere books are sold, the title is Reversing Alzheimer's,
the New toolkit to improve Cognition and Protect Brain
Health. And my name is Doctor Heather
Sanderson. Awesome.
I'll definitely get to that. So my question my my final
question for you is a lot of people I love talking to older
people. I love talking to older people
that have lived a lot more life than I because they have, you
know, a deeper perspective on things that matter, things that
don't. And I try to be incredibly
present whenever I'm with them. And they often times offer such
insightful information. And a lot of times it's filled
with, you know, some sense of regret and you you want to try
and harness that and not be in a similar position when you're at
that stage in life. But you've got the interesting
phenomena of talking to several elder people that are on the
brink of feeling like they're on their deathbed, but then have
been rejuvenated. What kind of words of wisdom are
they offering you after having been to that point where they
think it is the end, but then getting their, you know, life,
even if it's not for a significant period of time, but
but they're having another chapter to look forward to.
What? What kind of insight are they
giving you? Yeah, it's so interesting.
But so a lot of people with Alzheimer's are actually not
close to death, right. This is part of what's so
torturous about it is that they live.
It's often unpredictable. Some people will be very healthy
physically and falling apart mentally and cognitively.
And so the, the people who I there was this interesting woman
when we took over Murama, the residential care facility for
the elderly, where we offer an immersive experience in this
program, there were six people there who were on Hospice and
they weren't part of our program.
They just kind of, they came with the, the community with the
facility. And I would take, my daughter
was a year old when, when that happened.
And I would take my daughter in on my hip and see the different
people on Hospice and check in on them.
And this one woman, Valerie, she said to me one day, you know,
raising children, having little ones, that was the happiest time
of my life. Don't let it pass you by.
It goes by so fast. And she was like, don't work too
hard, Doc. Like, be present for her, for
my, for your little girl because it will go so quickly.
And again, you know, we hear this over and over.
It's the connections, it's the family, it's it's the friends,
the people that maybe we work with, but it's about the quality
of your relationships at the end most of the time.
No, I totally, totally agree. And it's, it's interesting
because I feel like we all really know that, like we all
inherently know that to be true, yet so few of us live like that
is our truth. Like we we agree with that, we
say, yeah, that makes total sense.
And then we just get stuck working non-stop or, you know,
rushing off the next thing or not being present when you're
with your parents, with your grandparents, with the great
grandparents. Like it's like actually taking
the the the actions that represent that knowledge and
being. Yeah, and it's hard because
sometimes you're assholes, right?
It's just challenging and it's a practice.
And and this is again, what part of why I think meditation is one
of the best medicines is because it it, it helps us to practice
that equanimity, that not being too frazzled when somebody says
something that's offensive or when somebody doesn't show up in
the way we expect them to. And it allows us to deepen those
relationships without being too attached to outcomes or other
people's behavior. And and so it it, but it's,
yeah, it's important. And it's a practice.
And, you know, take it for what it's worth.
Yeah, no, I totally agree. I think, you know, removing the
emotion from things like that that you can't control is key.
Like knowing that you can look back on your life and recognize
that, hey, you were there for the people in your in your life,
that you were there for your family members that you were
there you were, you were always an open ear that they could talk
to or lean into. Like I think that would be the
most valuable thing to be able to confidently say you were
there for those that loved you and our families to you like
that, that that's so very important.
Yeah, how do you want to be remembered?
Yeah, very cool. This, this is, it's got me.
It's going to be thinking some deep thoughts here, I think.
And this is so, so applicable to everybody, like we all have
family, we all have elder people in our life, like we all have
the need to preserve our own health so that when we are
older, we we are not going through this cognitive decline
ourselves. So I think the, the message that
you're preaching in the work that you're doing is incredibly
impactful. And like I said, I could tell
just in the way you're speaking that you're passionate about it.
So you are most definitely finding the good fight.
And I think you are making you're making a difference on
way on more ways than you recognize.
So keep doing it. Well, Robert, thank you so much
for having me. As you know, we both are huge
fans of keto and like I said at the beginning, keto does I think
half of the heavy lifting. And so your work exposing people
to that, helping to teach them and get them access to such a
life changing health promoting diet, I think is is just amazing
work in the world. So right back at you.
I appreciate what all that you bring to the world.
I appreciate that. I appreciate that.
So I will definitely link out to your book.
And then as far as website, socials, any other place to find
you? Yeah, Doctor Heather
sanderson.com where you can keep up with the latest research and
what we're doing to support those with Alzheimer's, dementia
and their families. Awesome.
Only get to that as well. And if there's everything I can
do to help move your message forward, by all means just let
me know because I think, I mean, you are making an impact and I
feel like this is the message that needs to be heard.
So by all means, keep preaching them.
Thank you so much. It's such a privilege being here
with you, Robert. You bet.
Well, take care. You as well.