Welcome to the Cutting Edge Health Podcast. I‘m Jane Rogers. My plan in starting this podcast is to create a community empowered to prevent Alzheimer’s and cognitive decline. Yes, the latest research shows it can be prevented when caught early and we’ll talk with the medical experts who can help you do that.
This is personal. My mother is in memory care. My father passed with AZ. I started experiencing memory issues, visible to those close to me, six years ago in my mid-50’s. With the right interventions I’m thriving today.
It helps to think of preventing a neurodegenerative disease in baseball terms. Most interventions are base hits. They’re pretty small changes in your lifestyle, but eventually one by one they all add up to a big win. I want you or a loved one to have this big win for your brain! The key to making a difference in your brain health is keeping at it and asking the right questions.
Upcoming episodes will cover: tackling pre-diabetes, getting inflammation down, ramping up deep sleep and ridding yourself of toxic metals in your brain like mercury and aluminum. Together we can learn to change the trajectory of our brain health and our lives!
Dr. Sharon Hausman-Cohen - Personalized Medicine Through Genomics
For those who want to truly assess your genetic risk of Alzheimer’s, IntellxxDNA has created a tool to help. With a simple cheek swab, this Austin, Texas based firm can provide you and your health care provider with a personalized genetic report that goes much deeper than what you’ll get from most genetic testing. For those with the APOE-4 Alzheimer’s gene there are other genes to know about that either can dramatically increase or decrease your risk of developing the disease. Having this information allows one to take action early to prevent its onset.
Sharon Hausman-Cohen, MD is our guest for this podcast episode. She and her co-founder, Carol Bilich, developed IntellxxDNA. Their research is focused on making genetics actionable and understandable for each individual patient and their provider.
There are dozens of gene variants that can interact with ApoE4 and act as gene modifiers that decrease or increase ApoE4 dementia risk. Some of these include:
• TOMM40 and ApoC1 - If no TOMM40 or ApoC1, the risk of ApoE4 is lowered to very close or equal to ApoE 3/3.
• BCHE–K variant - This variant, when present, makes it more likely for amyloid to form tangles. Only about 35% of people have this variant. Being part of the 65% of individuals who do not have this variant or being "BCHE-K variant" negative halves the risk of ApoE4. Conversely, being BCHE - K variant positive doubles the risk.
•There are other variants in detox pathways, hormone receptor pathways and inflammatory pathways and more that also interact with ApoE4.
Listen to learn more.
Dr. Sharon Hausman-Cohen is the Chief Medical Officer and co-founder of IntellxxDNA™. She received both her master’s degree and medical degree from Harvard Medical School. She is a fellow of the American Academy of Family Medicine and a diplomate of the American Board of Integrative Medicine. Dr. Hausman-Cohen has been in the field of integrative medicine for over 25 years. She is the co-author of many publications relating to genomics including three that focus on cognitive decline and two that focus on autism. She is also the primary author of a precision medicine textbook chapter on genomics and neurodegenerative diseases and a chapter in a book published by Frontiers in Neuroscience and Aging relating to frontiers in dementia treatment. She and her co-founder developed IntellxxDNA as an answer to an unmet need in the medicine community; the need for an accurate, evidence-based genomics tool geared at helping physicians practice personalized medicine.
They envisioned and created a tool that could help identify root causes of cognitive decline, autism, environmentally acquired illness, and common chronic illnesses such as heart disease, diabetes, depression, anxiety and obesity. IntellxxDNA’s research has focused on making genomics actionable and understandable, so that clinicians know how to address these genomic factors in a precision way. IntellxxDNA is being used as part of 3 IRB approved clinical trials relating to helping individuals with memory concerns and early dementia as well as children with autism and other complex illnesses. It is also being used as part of medical decision-making by physicians across the country.
Dr. Hausman-Cohen loves combining her passion for science and medicine and using her scientific mind to integrate large amounts of complex data. She also enjoys teaching and has taught extensively across the country at conferences for physicians as well as for community members. Dr. Hausman-Cohen is the co-founder of Resilient Health which is her patient facing practice in Austin, TX.
For access to publications, podcasts and videos see: IntellxxDNA.com
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Dr. Manju Sabramanian - The Eyes Have It: Potential For Early Alzheimer’s Diagnosis
Research at Boston University has led to the discovery of a non-invasive method to diagnose Alzheimer's. This opens the door in the coming years to possibly detecting the disease in its early stages, decades before real symptoms appear.
Manju Subramanian, MD and her team found that proteins in eye fluids are providing this window to the brain. These eye fluids are confirming pathological brain conditions like dementia in the Alzheimer's form. Until now, MRIs and lumbar punctures were the tools to aid the clinical diagnosis of Alzheimer's, but that has meant late detection when the disease is already in place. Alzheimer's is not actually confirmed until after death and a post-mortem examination of the brain is done.
"We know that patients with eye disease tend to be an at-risk population for dementia. Patients with macular degeneration, glaucoma and diabetic retinopathy, those are the three big ones," says Subramanian.
The potential of an eye fluid exam at an optometrist's office is ideal as it's non-invasive and not expensive. But, it is still several years out before potentially becoming commonplace. More research is needed. Still to be determined in future research is just how early eye fluid proteins become abnormal when dementia is developing.
"As they say, the eye is the window to the soul. It is also very much the window to the brain," says Subramanian.
Manju Subramanian is an Associate Professor in Ophthalmology and Vice-Chairman of Faculty Affairs. She is an ophthalmic surgeon specializing in Vitreoretinal Disease and Surgery, and is in academic practice at Boston Medical Center. She also sees patients at the Dedham Ophthalmic Consultants. Her primary areas of clinical interest include medical and surgical management of diabetic retinopathy, age-related macular degeneration, retinal detachments, hereditary retinal diseases, ocular inflammation, and ocular trauma. Dr. Subramanian graduated from the University of Missouri School of Medicine and completed her residency at the University of Kansas Medical Center in 2002. She completed a fellowship in Vitreoretinal Disease and Surgery at Tufts University School of Medicine and Ophthalmic Consultants of Boston in 2004.
Dr. Subramanian’s research interests include the study of eye-based biomarkers for Alzheimer’s Disease (AD), age-related macular degeneration, diabetic retinopathy, and the role of anesthesia in eye surgery. She was Principal Investigator for the first head to head clinical trial comparing the use of bevacizumab and ranibizumab in the treatment of age-related macular degeneration, and she is currently the Principal Investigator for a study assessing the role of oral sedation in eye surgery. She is also a recent recipient of an R03 Grant Award by the National Institutes of Aging as the Principal Investigator of a study looking at protein biomarkers for AD in the eye.
In her role as Vice-Chairman of Faculty Affairs at Boston University Eye Associates, she works in a supportive role in the professional and career development and engagement of the clinical faculty. Prior to 2017, she served as the Vice-Chairman of Clinical Services for 8 years. She serves on several institutional committees, including the Women’s Leadership Advisory Council, the Boston University Medical Group (BUMG) Research Committee, the BU School of Medicine Promotion Criteria Working Group, and also serves as Chair of the BUMG Professional Development Committee. She additionally serves on national committees, such as the International Meetings Committee for the American Academy of Ophthalmology (AAO), the Diversity Initiatives Committee for the Association for Research in Vision and Ophthalmology (ARVO), and a Special Emphasis Panel for a Study Section with the National Institutes of Health.
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Dr. Kat Toups - The Science of Reversing Dementia
Dementia can be prevented, and Kat Toups, MD knows this firsthand. Dr. Toups is a San Francisco Bay Area psychiatrist, but she is also an accomplished researcher who led investigations in 20 extensive clinical trials focused on Alzheimer's and MCI (Mild Cognitive Impairment). While working in this area, she developed dementia herself, and by using functional medicine, she reversed her own decline.
Dr. Toups thrives on helping people. She partnered with Dale Bredesen, MD on a clinical trial using functional medicine, often called precision medicine, where 84% of the study patients with MCI and early dementia had improvements as shown on their MRI brain scans and other cognitive assessments. The study’s results were published in the Journal of Alzheimer's Disease in August 2022: Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project.
Following this success, Dr. Toups has now launched a much larger clinical trial in six cities around the United States. Participants must live within an hour’s drive of one of these locations:
Walnut Creek (San Francisco East Bay), CA
San Rafael (San Francisco/Marin County), CA
Sacramento (El Dorado Hills), CA
Miami (Hollywood), Florida
Nashville (Brentwood), Tennessee
Cleveland (Rocky River), Ohio
For more information: www.dementiareversaltrial.com
Dr. Toups says dementia happens for multiple reasons. It doesn’t just come out of nowhere, but likely has been slowly building for more than a decade. Dr. Toups says it’s critical to search for contributing factors at the earliest opportunity if you want success in stopping or reversing disease progression. In this interview, she elaborates on the importance of partnering with a functional medicine doctor to do this work. Some of the core contributors to cognitive problems might be inflammatory load in the body, heart health, hormone levels, exercise, stress, sleep, toxins, and infections amongst many other factors.
Kat Toups, M.D., DFAPA, IFMCP is a functional medicine psychiatrist at Bay Area Wellness in Walnut Creek, CA. Dr. Toups is a distinguished fellow of the American Psychiatric Association (the highest honor bestowed by the APA), board certified by the American Board of Psychiatry and Neurology, and previously boarded in geriatric psychiatry.
Dr. Toups is a former assistant professor of psychiatry at UC Davis, where she was the inpatient residency training director, and later the owner/medical director of Bay Area Research Institute, a clinical trials research center in Lafayette, CA. After serving as the principal investigator on over 100 clinical trials for 12 years, including 20 failed trials for Alzheimer's drugs, she realized that the elusive cure for brain and psychiatric illness was not going to be found in a pill.
She embarked on an intensive course of study (initially sparked by a quest to heal her own serious autoimmune disease) to learn functional and nutritional medicine and completed her training for the Institute for Functional Medicine Certification in October 2013.
Dr. Toups practices functional medicine psychiatry, which seeks to discover the underlying causes of inflammation (like diet/nutrition, lifestyle, genetics including MTHF/Methylation/Sulfation/Detoxigenomic genetic polymorphisms, GI health including food allergies and dysbiosis, toxin exposure, chronic infections, and biochemical abnormalities) that can all be contributors to problems with psychiatric symptoms and/or cognition difficulties. Detection and correction of these problems can result in the resolution of the psychiatric symptoms, rather than just providing a band-aid by only prescribing psychiatric medications without addressing the underlying causes of the problem.
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Dr. Eric Larson - What’s Aging Seattlites?
Dr. Eric Larson is a leading expert on aging and dementia and one of the creators of a massive living lab studying the brains of 5000 Seattle residents as they age over decades. The research is called the Adult Changes in Thought (ACT) Study. Dr. Larson is optimistic when it comes to preventing the devastating disease, but not because miracle medicines might be on the horizon. Instead, he believes Alzheimer’s and other types of dementia are directly impacted by the lifestyle choices individuals make. He’s finding people are increasingly paying attention to those lifestyle issues and doing the right thing for their health.
In fact, as an example, he says, the closest thing to a magic pill for reducing the risk of dementia is probably exercise. But that is just one of the 12 modifiable risk factors to prevent the disease. Larson speaks to the dozen modifiable risk factors that were presented in a 2020 report of the Lancet Commission and they include: less education, hypertension, hearing impairment (between the ages 45-65 hearing loss is the biggest modifiable risk factor), smoking, obesity, depression, physical inactivity, diabetes (type 2 leads to a two-fold increased risk of developing AD), low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution.
“There is no inevitability about this condition,” he says of the loss of cognitive functioning. “I was reading the numbers. There's a 1/3 drop from 2000 to 2016 in the rates of dementia in North America and Europe. We have reached a point where people are better educated, socio and economic indicators have improved. We're not doing the same stuff our parents were doing as far as health. We realize we need to exercise, and not smoke, and not drink a bunch of alcohol.”
On the other hand, Dr. Larson worries that dementia is increasing in less-advanced, industrializing societies that adopt some of the unhealthier aspects of the Western lifestyle.
Some of the choices that people can make to diminish the risk of Alzheimer’s, besides engaging in physical exercise, are controlling weight and blood pressure; treating or protecting against diabetes; quitting smoking; moderating alcohol consumption; and addressing hearing loss and perhaps even vision impairment.
"A lot of the things that reduce the risk of dementia and Alzheimer's disease are the things that improve health and well-being in older people,” points out Dr. Larson, who recently retired. But individuals should not wait until they approach old age to adapt to a healthy lifestyle. The earlier they begin, the more likely they are to diminish the chances of losing cognitive function.
Dr. Eric B. Larson was executive director of Kaiser Permanente Washington Health Research Institute (KPWHRI) and vice president for research and healthcare innovation at Kaiser Foundation Health Plan of Washington. A general internist, he was a professor of medicine at the University of Washington in Seattle. He recently retired from full-time work, but continues to be active in the field of geriatrics and works part time at the University of Washington’s Department of Medicine as a professor of medicine.
Dr. Larson began at the University of Washington as a fellow in 1975 after graduating from Harvard Medical School. He served as medical director at the University of Washington Medical Center and was associate dean for clinical affairs from 1989 until 2002. Dr. Larson joined Group Health (now Kaiser Permanente) in 2002 to lead the Center for Health Studies. His research on aging includes a longstanding collaboration between Kaiser Permanente Washington and the University of Washington called the Adult Changes in Thought (ACT) Study. With colleagues from University of Washington and Group Health, he received a demonstration grant from the National Institutes of Health to establish a model Alzheimer’s disease registry in 1986. This morphed into the landmark Adult Changes in Thought
Dr. Lisa Broyles - Love Up Your Liver
Keeping your liver clean is yet another way to boost your cognitive longevity and enhance the likelihood that your brain stays sharp as long as possible. Though many people pay little attention to the liver and have scant knowledge of what it does, this vital organ performs many critical roles in enabling the body to continue functioning. Most significantly, it rids the bloodstream of harmful toxins.
“Your liver is vitally important,” explains Dr. Lisa Broyles. “It removes toxins and chemicals that are dangerous for us from our blood and gets rid of them.”
Dr. Broyles, a certified functional medicine doctor who is specially trained in preventing and reversing cognitive decline, says that people should pay attention to the liver and take steps to detoxify the organ if it is struggling to perform its many functions. Among those functions, besides detoxifying the blood stream, are producing and regulating the level of cholesterol, regulating sex hormones, storing sugar when the body needs it, tending to the body’s immune health, and guarding against blood clotting.
When the liver is having difficulty in its effort to remove bodily toxins, it can lead to such problems as migraine headaches, autoimmune disease, cancer, lupus, and arthritis.
The liver must be clean, Dr. Broyles says, if it is to effectively do its job.
“I do think that every six months, ideally, everyone should do a liver and gallbladder flush, and followed by some colon hydrotherapy, both before and after,” she recommends. Dr. Broyles says that a number of companies offer liver cleansing approaches and kits.
She talks about three phases of liver detoxification - oxidation, conjugation (making toxins more water soluble so they excrete into the intestines and leave the body), and transportation where toxins are broken down (to assure a healthy gallbladder).
The food you eat and the medicines and vitamins you take can all enhance — or in some cases hinder — the the way the three phases clean the liver of its toxins. For instance, Tylenol can shut down the process of liver conjugation, according to Dr. Broyles. She points out that genetic make-up also plays a role in liver detoxification; each person is different and testing can help determine the right steps to take in cleaning the liver.
Dr. Lisa Broyles, MD, is trained in the Bredesen Protocol, a personalized program to prevent and reverse cognitive decline. It is estimated that nearly 50 million currently living Americans will die of Alzheimer’s disease if effective prevention and reversal are not implemented–almost 100 times more than have died of COVID-19. Mainstream medicine would have you believe that it can’t be prevented, is untreatable, and progressive, with most patients not surviving beyond three to eleven years post-diagnosis. But we are learning that the disease is a pathology of multiple causes that is preventable and even reversible in the early stages through the kind of holistic and individualized approach prescribed by the Bredesen Protocol. A certified functional medicine doctor with an interest in holistic/integrative medicine, Dr. Broyles is transforming medical care in rural North Carolina. Addressing the underlying causes of disease rather than simply treating symptoms, Dr. Broyles uses a systems-oriented, holistic approach that engages both patient and practitioner in a therapeutic partnership. The result has been a palpable rise in health IQ and wellness in the community she serves. “People are hungry for this kind of patient/physician collaborative care. They want to take charge of their well-being. They want to feel empowered. Too often, though, the insurance system in America limits choices for physicians and patients alike. Functional medicine represents a fundamental paradigm shift from symptom suppression to an integrative body/mind approach to optimal health,” said Dr. Broyles. Hoping to help more people than her limited practice c
Dr Jeffery Galvin -Secrets to Getting Young Again
If you aspire to live a long life, don’t wait until you are 60 to pursue it, advises Dr. Jeffrey Galvin, director of the Vitality Medical Wellness Institute North Carolina. The earlier you begin living a lifestyle aimed at longevity, the more likely you are to reach your 90’s and beyond in health, he suggests.
“How do we build vibrant, healthy 90-year-olds?” he asks. “We start with 30 and 40-year-olds, maybe 50-year-olds.”
Galvin anticipates technologies, just over the horizon, that will radically extend human life. And current research (on mice and other animals) seeks to remove a body’s degraded cells and replace them with younger ones as a vehicle toward longevity.
But Dr. Galvin’s practice, the Vitality Medical Wellness Institute in Charlotte, NC, is not just trying to enable patients to live longer but also to enable them to be healthier as they age. “The idea is you want to stay healthy and performing really well for a long time,” he says.
Dr. Galvin wants to optimize peoples’ performance as long as possible and lessen the decline that often precedes death. He thinks it better to live to 90, and have just two years of decline rather than endure decades of decline even while living longer.
Another reason to strive for a healthy life sooner rather than later, he says, is that the life-prolonging technologies to become available in a few years won’t be accessible to the unhealthy. But,“If you're 75 and you're in top shape, then you're going to absolutely be eligible for those therapies."
He laments that most doctors treat disease and symptoms to manage decline but don’t show interest in patients’ overall health. He doesn’t blame the doctors themselves — “The system is not set up for you to be healthy,” he asserts.
Major causes of death — strokes and heart attacks, cancer, Alzheimer’s — must be minimized in advance. That entails evaluating family history and personal risk factors, testing for disease markers and planning how to uproot these potential seeds of death. “It really is important to do this testing and look at people's baseline health,” Dr. Galvin says. "We reverse chronic disease, because you can't really optimize until you get rid of all the underlying problems.”
Jeffrey Galvin is the medical director and founder of Vitality Medical Wellness Institute. He is board-certified in emergency medicine and obesity medicine. He served as a major in the United States Air Force, specializing in trauma and emergency care. After completing his military service, he settled in Concord, NC, with his wife and three children. With over 25 years’ experience working in some of the busiest emergency departments in the country, he has cared for over 50,000 emergency and trauma patients.
Dr. Galvin has extensive training and experience in functional medicine, hormonal optimization, fitness, nutrition, genomics and epigenetics, and brain peak performance. He is an expert biohacker experienced in nootropic use, peptide therapies, heart rate variability training, and sleep hacking. His goal is maximizing human performance, reversing chronic disease and optimizing overall health.
Dr. Galvin founded Vitality Medical Wellness Institute in 2010. It was born out of frustration with modern medicine’s focus on treating symptoms of illness, not the underlying causes. The Institute seeks to change the paradigm by which the medical establishment trains doctors to treat chronic medical problems with medication while ignoring the root origins of disease. Dr. Galvin believes that by focusing on nutrition, fitness, hormonal optimization, and permanent lifestyle changes, health can be optimized. By utilizing this approach his patients are able to reverse chronic medical conditions, lose weight and maximize performance. At the same time risk of future disease is minimized.
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My grandfather passed from Alzheimer's. After seeing the Chris Hemsworth show, Limitless, I’ve been on a quest to learn more about how I can prevent Alzheimer’s.
I searched for podcasts and was so happy to find this one. Jane is a great host and is very knowledgeable. Great guests with the latest information on the disease and things you can do to prevent it. I couldn’t be happier to discover it. I feel more hopeful that I can make changes in my life to prevent this disease.
The Best Brain Health Podcast
Jane has the best group of guests and she asks all the right questions. She had her own memory issues and in addition her parents had issues too, so she has lived this nightmare. Also there are no annoying commercials in this podcast, so in a few minutes you hear the latest cutting edge info. Thanks Jane!
We’ve just listened to the first episode of Cutting Edge Health and it’s mind blowing. Who knew there was so much deep, integrated, non traditional but rigorous research going on in the field of cognitive decline? Jane Rogers is taking us on an important trip into our own health and the power to improve it. Thank you!