Reversal of Alzheimer’s Disease with Dr. Heather Sandison: Rational Wellness Podcast 317

Dr. Heather Sandison discusses How to Reverse Alzheimer’s Disease with Dr. Ben Weitz.

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Podcast Highlights

3:05   The most recent drugs for Alzheimer’s disease that have recently been approved, including Aducanumab, that remove beta amyloid from the brain, do not actually make patients better and may make them worse.  I did a podcast with Dr. Bredesen in episode 271 where we discussed that the landmark study that supposedly showed that the amyloid plaque that was seen in the brains of  Alzheimer’s patients in the landmark paper in Nature in 2006 that was so influential in influencing this whole amyloid hypothesis of Alzheimer’s disease, that these images were falsified. Dr. Sandison said that she wishes for all the patients and the families of those out there who are suffering with a loved one who has dementia that there was a pill or an IV that would just make the nightmare go away.  Unfortunately, despite the billions of dollars that have been spent on this problem and despite the uncountable hours of really smart researchers who have been working on the concept, they have been barking up the wrong tree.  The two most recent drugs approved are Aducanumab and Lecanemab they both cause brain swelling and brain bleeding and at most they make you get worse at a slower rate. They might keep your mom in memory care longer. But your goal should be to have your mom improve and get out of memory care.

7:02  The great news is that we have an alternative, which is the precision medicine/Functional Medicine approach pioneered by Dr. Dale Bredesen.  Dr. Sandison is working on a book called Reversing Alzheimer’s that will be published in June 2024 by Harper and she has just published a paper using this Functional Medicine model in the Journal of Alzheimer’s Disease:  Sandison H, Callan NGL, Rao RV, Phipps J, Bradley R. Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline. J Alzheimers Dis. 2023 Jun 19.   This paper is similar to the one that Dr. Bredesen and Dr. Kat Toups published in the Journal of Alzheimer’s in July 2022, but Sandison’s trial used patients who had more severe cognitive decline and she got similar results. Toups K, Hathaway A, Gordon D, Chung H, Raji C, Boyd A, Hill BD, Hausman-Cohen S, Attarha M, Chwa WJ, Jarrett M, Bredesen DE. Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project. J Alzheimers Dis. 2022;88(4):1411-1421.  Bredesen used patients who had a MoCA (Montreal Cognitive Assessment) score of 19 or better, while Sandison took participants with a MoCA scores between 12 and 23. This showed that this Functional Medicine approach can work with patients with more severe cognitive decline.  While the Bredesen study lasted nine months, the Sandison study only lasted six months. They were both pilot studies with 23-25 patients.  The Sandison study saw 73.9% of our participants improve their cognitive function, while the Bredesen study saw 84% improvement of cognitive function.  The key thing to focus on is that this Functional Medicine approach did not just slow the decline of cognitive function as these super expensive drugs did, but patients actually got better and had improved cognitive function! 

11:33  While we might not yet be seeing a significant change in attitudes among conventional doctors or among insurance companies, who essentially control the healthcare system in the US, the Journal of Alzheimer’s Disease is highlighting Dr. Sandison’s paper in their annual periodical. And things will have to change because there are a massive number of people in the baby boomer generation who are approaching the age at which the risk is higher and there might be so many with Alzheimer’s that the cost of caring for them will overwhelm the healthcare system. The cost in paid care from Medicare was $300 billion in 2020 alone and the estimated cost of unpaid care for children and spouses who are not being paid for caring for someone with dementia in 2020 is another $200 billion.  The cost of Dr. Sandison’s Functional Medicine care program averages $19,000 for six months, while the average cost of a memory care center is $12,000 per month, so if you can delay going into a memory care center, it makes sense to invest in seeing a Bredesen trained doctor. 

26:50  Insulin Resistance and the Ketogenic Diet.  Dr. Sandison recommends a ketogenic diet, which reduces insulin resistance and allows the brain to use ketones for energy instead of glucose.  She wants them to have a ketone level in their blood over one millimole per deciliter.  She finds that the patients who do the best are the ones who dive in fully who follows a ketogenic diet and commit to change their lifestyle. They’re taking supplements, getting rid of toxins, getting on hormones and changing their diet, changing their exercise routine, prioritizing sleep, meditating and balancing their stressors and getting into activities that are fun and cognitively engaging. Dr. Sandison recommends for patients with cognitive challenges following a  ketogenic diet and being in ketosis for 3-6 months and then add some season fruits and some squashes and more starchy veggies like beets and carrots and some sweet potatoes, quinoa, and legumes, but not ever going back to eating pasts and breads.  For prevention, she recommends doing keto for 4-6 weeks every 3-6 months.  Dr. Sandison recited a story about a patient who’s daughters brought him in and followed the ketogenic diet and he started remembering all his grandkid’s names and the names of the animals on his farm.  His son came into town and he started eating pizza and ice cream and hanging out with his family and by the time they left, he couldn’t remember their names, couldn’t remember the farm animal’s names.

41:07  Nutrients.  Among the most important brain-supportive nutrients are vitamin D, citicholine, and B vitamins.  Dr. Sandison also likes a nootropic called Qualia Mind from Neurohacker.  She also recommends bacopa, rhodiola, and amino acids like taurine and threonine that support neurotransmitters. She recommends 3-5 gms per day of EPA and DHA from omega 3 supplements. Coffee berry, gingko, lion’s mane, gingko, and huperzine are all important brain nutrients.  She also recommends probiotics, which can help with generalized inflammation and mood and sleep, all things that can affect cognition. Dr. Sandison has a colleague who did a PhD project to determine how to get probiotics to colonize the gut and the things that can help are to take a lot of probiotics, so she recommends taking 100 billion CFUs with a variety of different strains and to take them with food.  Recommended products include Xymogen ProbioMax, Designs For Health, Klaire labs, spore based probiotics, and a Garden of Life product.   

45:15  Hormones. The first question that some might ask is taking hormone replacement therapy for a women in her 60s or 70s safe, since the Women’s Health Initiative in 2001 seemed to indicate that it was not?  But the impact of this WHI study was overblown and there were many problems with this study, including that they used oral conjugate equine estrogen and synthetic progesterone and not bioidentical hormones.  There was a Finish epidemiological study that found that there was a reduction in your risk of dying of cancer if you initiated hormone replacement therapy, whether it was estrogen alone or estrogen plus progesterone in your 50s, 60s, or 70s.  (Mikkola TS, Savolainen-Peltonen H, Tuomikoski P, Hoti F, Vattulainen P, Gissler M, Ylikorkala O. Reduced risk of breast cancer mortality in women using postmenopausal hormone therapy: a Finnish nationwide comparative study. Menopause. 2016 Nov;23(11):1199-1203.)  There’s another study in the UK that shows that hormones reduce all-cause mortality. There are also French trials.  Dr. Sandison mentioned often recommending Estrogen, progesterone, testosterone, pregnenolone, and DHEA.  Obviously, each patient’s risks should be taken into consideration, including her cancer risk, whether she is BRCA positive, etc. When it comes to cognitive decline, hormones can be very helpful. She feels that hormones are very protective of your bones and your brain, no matter when you initiate them.



Dr. Heather Sandison, is the founder of Solcere Health Clinic and Marama, the first residential care facility for the elderly of its kind. At Solcere, Dr. Sandison and her team of doctors and health coaches focus primarily on supporting patients looking to optimize cognitive function, prevent mental decline, and reverse dementia by addressing root causes of imbalance in the brain and body.  She was awarded a grant to study an individualized, integrative approach to reversing dementia and is a primary investigator on the ITHNCLR clinical trial.  At Marama, Dr. Sandison has created an immersive residential experience in the lifestyle proven to best support brain health. She understands that changing your diet, adding nutrients, creating community and optimizing a healing environment are all challenging even for those will full cognitive capacity. The website to her clinic is Solcere.com.  The website to Marama is Maramaexperience.com.  

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.



Podcast Transcript

Dr. Weitz:                            Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. To learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.

                                                Hello, Rational Wellness podcasters. Today, I’m excited to be talking about how do we prevent and reverse Alzheimer’s disease with Dr. Heather Sandison. Alzheimer’s disease is the most common form of dementia and the most common neurodegenerative disease, and the numbers are increasing. It’s crucial that we make some progress on preventing and treating this horrific condition. But conventional research has not been all that fruitful and is centered on the role of beta amyloid protein plaques that are found in the brains of most patients with Alzheimer’s disease.

                                                Now we know that the leading drugs for Alzheimer’s not only don’t make patients better, but actually shrink their brains, making them worse. What can we do? Well, functional medicine may have an answer. Dr. Heather Sandison is the founder of Solcere Health Clinic, where she and her team of doctors and health coaches focus primarily on supporting patients looking to optimize cognitive function, prevent mental decline, and reverse dementia by addressing root causes of imbalance in the brain and body. She was awarded a grant to study an individualized integrative approach to reversing dementia. As a primary investigator on the ITHNCLR clinical trial, it’s great. We need more research on functional medicine approaches. Dr. Sandison also founded Marama, which is the first residential care facility for the elderly that utilizes a functional medicine approach to improving cognitive function by helping residents to change their diet and lifestyle and make the other changes necessary to promote better brain health. I know, for sure, from watching my mom having been in a memory care facility, that the conventional memory care facilities do nothing to help clients other than take care of them and charge you more.

                                                Dr. Sandison is also the host of the Reverse Alzheimer’s Summit, and this is in its third year. She also hosts the Collective Insights Podcast where she works to share what’s possible for those suffering with dementia. Dr. Sandison, thank you so much for joining us.

Dr. Sandison:                     Thanks so much for having me.

Dr. Weitz:                           That’s great. I’d like to focus most of our discussion today on natural things that we can do to help patients, but perhaps you might want to make a comment on some of the latest data on these beta amyloid removal drugs have been coming onto the market for Alzheimer’s patients, the most recent of which is Aducanumab, and maybe comment on this whole amyloid hypothesis and focus on the development of these drugs. For those who are not aware, part of the controversy about these drugs came to light last year, and I did a podcast with Dr. Bredesen in episode 271, where we discussed that the landmark study that showed that amyloid plaque that was accumulating in a brains of Alzheimer’s patients that was in nature in 2006, that was so influential in this whole drug research on the amyloid hypothesis that the images in the paper were actually falsified to make the point.

Dr. Sandison:                     Yeah, it’s really frustrating. There’s a really phenomenal book by a gentleman named Karl Herrup called How Not to Study a Disease: The Story of Alzheimer’s. Essentially, my comment on the medications is, I wish I that for my patients and for all of the families out there suffering with a loved one who has dementia, that there were a pill or an IV or something simple that would just make the nightmare go away. That’s just not unfortunately the reality. Despite the billions and billions of dollars that have been spent on this problem, and despite the uncountable hours of smart, really intelligent people’s time that had been thrown at this disaster, we’ve been essentially barking up the wrong tree. You’re absolutely right. There was this paper that was published in 2006 in Nature that I wouldn’t say it was like this seminal paper, but it was one of those ones where in 2005, everybody was scratching their heads questioning this hypothesis that beta amyloid plaques were the problem, that they were the evildoers that were causing dementia.

                                                In 2006, this connection became essentially what we thought was more real, that there was more of a connection between cognition and amyloid plaques. Well, the issue that really came out of that is that it amplified the funding. When everybody was questioning themselves going, “Maybe we should look in other directions and look at modifiable risk factors or at something else causing dementia,” they doubled down on this hypothesis that was going nowhere. What we see with you mentioned aducanumab, there’s actually one that has come out even since then called Lecanemab that’s slightly less risky in terms of brain swelling and brain bleeding, but these are the types of… Unfortunately, it doesn’t work that well, let’s start there. Then secondly, there are a bunch of issues with the side effects, including brain swelling and brain bleeding. These super expensive drugs that essentially prolong a torturous process, I think there’s an ethical consideration right there.  It’s like, do you really want your mom in memory care longer? Because all these drugs do is essentially, they draw out the decline process. A lot of people might say, “Yes, absolutely. I just want my mom around longer.” But for a lot of people, they might go, “She’s barely here and she’s not enjoying life. I don’t want to do that, especially for $56,000 a year, plus all the doctor’s visits to make sure that she’s not having brain swelling and brain bleeding, plus whatever else comes with it.”

We have an alternative, which is the great news. There is hope. I’m actually working on a book called Reversing Alzheimer’s with Harper, and that’ll be published in June of 2024. But before that, in August, the clinical trial that you referred to is going to be published in the Journal of Alzheimer’s Disease. We’re really, really excited about that coming out this summer in 2023. Thank you. It has been-

Dr. Weitz:                            No, we need more research in journals for functional medicine on all these topics.

Dr. Sandison:                     Essentially, this paper is very similar to the one that Dr. Bredesen, who you interviewed as well who… He supported my friend Kat Toups, she was the primary author on that. It was published also in the Journal of Alzheimer’s Disease in July of 2022. Our trials are very similar. They took 25 participants and did a nine-month intervention of this Bredesen approach, and they took participants with a cognitive decline that was down to a MoCA score of 19. A MoCA score is a way that we can put a number on how severe someone’s dementia or cognitive decline is

Dr. Weitz:                           MoCA score stands for Montreal Cognitive Assessment, right?

Dr. Sandison:                     Exactly. That’s right. The Montreal Cognitive Assessment, it’s a single worksheet that you can do with… Typically, there’s a tech in someone’s office. There’s also the Mini-Mental Status and the SLUMS test.

Dr. Weitz:                           By the way, the MoCA test is the one that Donald Trump bragged about the fact that he got a good score on…

Dr. Sandison:                     Right. This is where you draw a clock, you copy a box, you name some zoo animals and you tell everyone what day and time it is, and maybe you are-

Dr. Weitz:                           Then that all qualifies you to become president.

Dr. Sandison:                     Well, and it gives us, as clinicians, it gives us a 30-point scale, so that we can put a number on how severe someone’s decline is. A perfect score is 30, anything over 26 is normal. Then once you go down into the low 20s, this is measurable cognitive impairment. Then when you go into the teens, this is also measurable impairment of course, but other people are starting to notice it. This is when things start to, and everybody’s a little bit different, but either spatial awareness, a short-term memory, ability to do math, recall names, that is starting to be affected.   Once we’re down into the low teens below 10, this is severe cognitive function. A MoCA score of around two is almost non-verbal, so really severe. We can basically put this on a scale, and that’s the utility of having a worksheet like the MoCA score. Dr Toups and Dr. Bredesen, in their paper that they published last year, they took people with a MoCA score above 19 and then watched what happened and measured what happened. In our trial that’s about to be published, we took 23 participants, about the same number of participants, and we took them through a six-month intervention, so it was a little shorter than their nine-month intervention, and we took participants with MoCA scores of 12 to 23, so more severe cognitive decline, and we got very similar results. With Dr. Toups, her paper, they had 84% of participants improve their cognitive function, and we had 73.9% of our participants improve their cognitive function.

Dr. Weitz:                           Awesome.

Dr. Sandison:                     Yeah. As you might imagine, we had more severe patients and we didn’t have quite as much time, so we got slightly about 10% fewer improve their cognitive decline. But when you look at that, compared to these super expensive brand new drugs on the market, and especially when you can compare them to the old drugs, with those guys, they’re not getting improvement, they’re getting a slowing of decline.

Dr. Weitz:                           In March, a new review of all these drugs was published showing that actually you get increased shrinkage of the brain, so actually patients are getting worse.

Dr. Sandison:                     Then we didn’t do any imaging in my trial, unfortunately, we will in a follow up, but Dr. Toups, they show that you actually get an increase in gray matter volume, and then you also get a reduction in the slowing of the hippocampal volume that’s normal with aging. Your brain is shrinking less fast, your cognition is getting better, which I think should be the standard. What we want is an improvement in quality of life and in cognition, and that’s what we see when we basically take all of functional medicine and throw it at the brain.

Dr. Weitz:                           Are you starting to see a change in attitudes yet among either conventional doctors or the public in general? Is the word starting to get out or not yet, that functional medicine can have a significant impact on helping patients with dementia?

Dr. Sandison:                     Yeah, I think we’re about to see, I feel really, really fortunate and honored, just so privileged because the Journal of Alzheimer’s Disease is highlighting my paper in their annual periodical. They are attempting to set the course of research around Alzheimer’s disease and really reset the course of research. My hope is that things will change. Now, here’s the issue. It has to, because this is a desperate situation, not only for families, but for Medicare. There are a massive number of people who are approaching the age at which the risk is higher. The baby boomer generation is about to be in that unmodifiable risk category of advanced age, and there are so many of them that there essentially won’t be enough people to take care of those who need it with Alzheimer’s. The cost of this is absolutely unbelievable. The cost in paid care or Medicare is over $300 billion in 2020 alone.

                                                Now, the cost of unpaid care, so all of the adult children and spouses who are not being paid to care for someone with dementia is over $200 billion in 2020. These numbers are just absolutely astounding. I mean, the number of people in the US right now, it’s about $6 million people who have been diagnosed with Alzheimer’s. But I’ll tell you this, there’s a whole lot that haven’t been diagnosed, because they don’t want to go to a neurologist, because they think, “They’re not going to help me, and the only thing they’re going to do is take away my driver’s license,” so a bunch of people go undiagnosed, and that number is just getting bigger. Around the world, it’s between 50 and 60 million people who are suffering with Alzheimer’s. Even if conventional medicine or the conventional press doesn’t want to start changing the narrative, we have to, we absolutely have to.

Dr. Weitz:                           It’s going to be so difficult because of the way insurance companies control the healthcare system that to start paying for functional medicine in a way that allows functional medicine doctors to survive, it was so far away from that. I mean, the insurance companies have been increasingly paying doctors less and less and not being willing to reimburse doctors for time at all. It’s going to take a major paradigm shift as long as insurance companies are deciding what happens to healthcare dollars.

Dr. Sandison:                     Well, also, you mentioned senior living, right? We need a change in that industry. We certainly need a change in the medical industry and insurance and that racket. We need a change in the food system.

Dr. Weitz:                           Oh, 100%.

Dr. Sandison:                     In society in terms of isolation and the time spent on screens, there are huge systemic and societal changes that we really need. Yet, here’s the math. Dr. Ben, it costs about $12,000 to have somebody in memory care. For our trial, we budgeted $25,000 for each of our participants, and we never use that much. If you can set aside, let’s even say, I think the person who spent the most, all the IVs, all of the doctor’s visits, all the labs, all the supplements, all the medications, the most spent of all of our… And he was really sick. Of all of our participants was $19,000. You can go through that in two months of memory care. Even if you can delay going into memory care, it makes sense to invest in seeing a Bredesen-trained doctor.

Dr. Weitz:                          100%. It will just do our part to make sure things change in the right direction. Let’s get into how do we help patients? When you have a patient you suspect of having some cognitive problems, where do you start? Which cognitive tests or tests do you like to run?

Dr. Sandison:                     Yeah, yeah. Pretty much now the only patients I see are patients with cognitive decline. Where we start is a thorough intake, because many of these people are at the last quarter of their lives, let’s say, and hopefully the last third, they’ve still got lots to look forward to. There’s a lot to discuss. They have a lifetime of health history to collect. In my first visit with them, my goal is to get to know them, to understand them, and also to understand the dynamics in their family. What can they afford, quite frankly? What are they able to do? Can they do all the testing? Even if they can’t, are they going to have the support at home to potentially get on a ketogenic diet? Which we see as being really, really helpful. It’s not the only diet that’s great for the brain, but it certainly is very, very helpful when we see a ketogenic diet really helping cognition.

                                                Are they going to have support with that at home? If you have a spouse who’s got cookies lying around, this is just a non-starter. Are they going to be supported in getting exercise and getting social interaction and getting outside and maybe help with stress management? What does that look like? Are adult children are spouses involved or are they on their own? I’ll tell you this, we’ve worked with several health coaches. Health coaching, I’ll just say right now, my stance on health coaching is it is the best investment you can make. It is the best bang for your buck because the foundations of health, diet, exercise, sleep, stress management, these things are your 80-20. They are the 20% that you’re going to change, the 20% of the money you’re going to spend, and they’re going to get you 80% of the benefit.

                                                If you’re just trying to out supplement this, I can’t help you. Working with a health coach is really like, that’s the foundation. The icing on the cake is going to the doctor and getting all the labs done. That can be really, really helpful, especially if we identify something like toxic burden or something like that. But when I’m first working with a patient, I’m trying to identify, what’s going to work for them best? I want all that data. I love to do $3,000 in labs. We basically aim to do that. Again, we go back to this investment makes sense. Cognitive decline is in your family. If you are concerned about Alzheimer’s because your brain doesn’t work the way it did 5 or 10 years ago, what Dr. Bredesen calls it is a cognoscopy. You might’ve heard him say this.

Dr. Weitz:                           Of course. Yeah.

Dr. Sandison:                     I love it. It’s so catchy, right? Because there’s all that emotion associated with a colonoscopy, but for your brain. It does just what a colonoscopy does for colon cancer, we’re doing for cognitive function. We’re saying, How likely are there things there, like the polyps in your colon? Are there polyps in your brain? So to speak, right? Are there toxins? Are there nutrient imbalances? Are there inflammatory markers or infections? What is going on that might affect every neuron in your brain, and how well it communicates with the others so that you can remember that person’s name or where you parked your car or where you left your keys? All of these little things so that you can continue having conversations with your loved ones into your 90s and beyond. That set of labs is really important. That is where I start.  Well, I start with understanding what’s going to work for this family. Do they need health coaching? Are they able to do the foundational pieces? If not, how do we get them the support that they need? Then I typically do some nootropics, omegas, some probiotics, some vitamin D, and then we order all the labs. I also recommend Kirtan Kriya, I mean, there’s a long laundry list. Is it okay if I just go into these things?

Dr. Weitz:                           Sure, yeah.

Dr. Sandison:                     Okay, great. We recommend Kirtan Kriya. It’s a meditation practice. It’s the Sa Ta Na Ma, and there’s a lot of great research associated specifically with Kirtan Kriya meditation and Alzheimer’s and other related dementias. Great for caregivers because caregivers for someone with dementia are anywhere from two and a half to six times the risk of being diagnosed with Alzheimer’s later on in their life. Caregiving increases of stress, you don’t eat as well, you don’t sleep as well, you don’t exercise as much because you’re caring for someone else.

                                                My recommendation whenever I’m working with caregivers is you got to get on this too. You need to be on this plan with the person you’re caring for. Do the Kirtan Kriya with them, do red light therapy if you can with them. Change up your exercise so that you’re getting strength training, aerobic and potentially contrast oxygen therapy and maybe dual task where you’re engaging both your cognitive function. You’re on the edge of what you can do cognitively and physically at the same time because you get way more cognitive benefits when you do both of those things together.

Dr. Weitz:                           What was that last thing you were talking about, cognitive and exercising while you’re playing chess, or what is it?

Dr. Sandison:                     Yeah, great question. Dual task exercises, if you look this up on YouTube per se, it’s a little newer, but we’ve seen it in Parkinson’s clinics, TBI clinics, stroke patients. This is a really helpful way for neurogenesis, to promote neurogenesis. What you’re doing is you’re finding that edge where you’re engaged cognitively and you’re engaged physically. For some people, if they’re struggling with cognitive decline, this means a class, a Zumba class, maybe a Pilates class, a yoga class where you’re being cued by an instructor to bring your right arm down to your left hip, something like that, it takes some effort for you to keep up cognitively. Now, if I go to my Pilates class that I’ve been to three days a week for the last five years, I’m spacing out. This is not engaging me cognitively.

Dr. Weitz:                           It’s going to be something new and novel.

Dr. Sandison:                     Exactly. Ballroom dancing comes up. This is something that’s been associated for a long time with cognitive function and improving that and protecting it. There’s a bunch of pieces here to the activities that you might think about doing if you are concerned about your brain health. I think of them like checkboxes. All right. Does it involve exercise? Yes. Ballroom dancing, yep, checks that box. I’m going to be physical. I’m going to get my heart rate up. Does it involve cognition? Yes. I’ve got to remember the music and the steps. I’ve got to remember these pieces and put them together. Check, yes, cognitive function. Is it social? Social isolation is one of the known risk factors when it comes to dementia, and certainly through COVID, we saw the ramifications of that on people’s cognition. Check, yep, ballroom dancing, check the social box. When you start putting these things together, I like to add being outside, communing with nature.

                                                There are a few other boxes that we can add here, but ballroom dancing certainly checks a lot of them. If you’re thinking about taking on a new sport or a new hobby, how can you do all of that? That’s a way to make this feel a little more approachable. It can feel like a full-time job to do all of these things. But if you can start the Venn diagram where you’re doing multiple at once is really helpful.

                                                I have some patients, I had this really sweet patient. She would go for walks with her granddaughter and her granddaughter would quiz her. She was a nursing student focusing on holistic nursing, and she was really interested in nutrition. She would quiz her on the ketogenic diet, and then she would also quiz her on her grandchildren’s birthdays, something really emotionally important to her grandma. They would basically just go on these walks together and talk about nutrition and talk about the grandkids, and she would get these little quizzes. What I do is I will have a podcast in when I’m running or rowing, and I will stop Peter Attia and I will go back and I will think through like, “What did he just say? What did I just learn?” I will stop Andrew Huberman and be like, “Okay, what is the mechanism of…” Blah, blah, blah, whatever he was talking about. That’s how I do it.

                                                I find that those things stick a little bit better. Having fun when you’re doing these things too also is there’s a great article in Cognition Today that explains the importance and the mechanisms of why it’s so important if we want to learn and create these new connections, these new neurons and synapses in our brain, then we have to make it fun. We’re going to do so much more if we’re in a rest digest and heal state and that parasympathetic state, we’re going to learn so much more than if we’re in a stressed out state. This is just as true for toddlers and grade school students and college students as it is for seniors who are battling cognitive decline.

Dr. Weitz:                           You mentioned Peter Attia. I’m going to bring up cardiovascular. I heard Peter Attia say recently that you should get your ApoB level below 40, that you need to drive that down as low as you can, and that is the only way to reverse, eliminate cardiovascular disease. It has no effect on brain function, because the cholesterol, by using statins and PCSK9 inhibitors and other drugs, were only affecting the cholesterol that’s produced by the liver that goes into the bloodstream and the cholesterol in the organs like the brain is produced in the brain.

Dr. Sandison:                     I’m not an expert on all of that, and I’m certainly not a cardiovascular [inaudible 00:25:44].

Dr. Weitz:                           Just trying to create a bit of controversy here.

Dr. Sandison:                     I have respect and trust that Peter Attia has a good resource for that, a good reference. What I have seen clinically is that patients who have cholesterol levels-

Dr. Weitz:                           Yeah. All the studies that have been funded by big pharma say that statins are perfectly safe and have no negative effect on brain health.

Dr. Sandison:                     What I’ve seen clinically is that patients who have cholesterol levels below 150, it’s [inaudible 00:26:15]… Total cholesterol, yeah. It’s really hard for them to heal. Wound healing is more challenging. Depression and anxiety are more prominent. I remind patients that cholesterol is the backbone of your stress hormones and sex hormones and required for healing. Driving that number down is not without risk. I trust and respect Peter Attia. I haven’t read everything that he has, so I will leave that there.

Dr. Weitz:                           How important is insulin resistance for Alzheimer’s prevention?

Dr. Sandison:                     We recommend a ketogenic diet. I recommend a ketogenic diet, not forever, but for somebody struggling with cognitive decline, I recommend-

Dr. Weitz:                            Now, how do you characterize the ketogenic diet?

Dr. Sandison:                     We have a handout. It’s a keto diet guide, and our goal is to have patients measure a blood level over one millimole per deciliter of ketones. That’s our target range. Mild ketosis is 0.5 to 0.9. Really what I would love to see my patients do and the patients who do best, first of all, the patients who do best, they dive in fully. They’re not dipping their toe in the water here. They are really committing to changing their lifestyle. Yes, they’re taking the supplements. Yes, they’re getting rid of the toxins. Yes, they’re getting on the hormones, and they’re getting on the diet. They’re changing their exercise routine. They’re prioritizing their sleep, they’re meditating and balancing their stressors, and they’re getting into activities that are fun and enjoyable and cognitively engaging. They’re doing all of it. Now, I take that back. They’re not necessarily doing all of it, but they’re doing the majority of it.

                                                They’re really, really making meaningful change, because you’re not going to get out of this doing… We’re asking for a miracle. We’re asking to reverse Alzheimer’s and reverse the cognitive decline on the way to Alzheimer’s. That is a miracle. It’s not expected. It’s not what we typically see. To get that reward, you have to put an effort. Again, I wish there were a single pill or an IV that we could take. Ketogenic diet, what I recommend is three to six months in ketosis, one millimole per deciliter. What I do in prevention mode, I don’t have a family history, but I love this stuff, I live this stuff. I’m in ketosis right now. I’ve been in ketosis for about three weeks. I had come back from vacation and it was time. Every three to six months, probably quarterly, I get into ketosis for four to six weeks. For my patients with cognitive decline, I recommend three to six solid months in ketosis.

                                                Now, it’s not going to happen, right? Nobody’s going to stay there for three to six months. You’re going to have some accident where you taste something. I mean, I had this happen the other day. I was at a friend’s house and I made tea, and I thought their almond milk was unsweetened and it was sweetened. I tasted it immediately, but I then felt later that I was kicked out of ketosis. I could feel the difference. It’s going to happen. You just get right back on the horse and get back into ketosis. Then when you’re not ketosis, what I recommend is not going back to processed foods, because we know that is a modifiable risk factor for Alzheimer’s and dementia, is the consumption of highly processed foods, and so not going back to the pastas and the breads. But when you come out of ketosis to add your whole foods, your seasonal fruits, your squashes and your more starchy veggies like your beets and carrots, and the other things that are going to raise your blood sugar but that aren’t highly processed, maybe some rice, maybe some quinoa, certainly lentils, beans, legumes.

                                                Those are also great things to add when you come out of ketosis. Then again, if you are cognitively declined, you’re going in and out of ketosis. You’re increasing your metabolic flexibility. To get to the succinct answer to your question about insulin resistance, this is critically important, because as we age, even if you don’t have diabetes, we all have some degree of insulin resistance as we get older. That means that more sugar hangs out in our bloodstream. We can’t use that insulin as effectively to get sugar into the cells of the brain or wherever. That sugar can become very toxic. Glycotoxicity is one of Dr. Bredesen’s types of Alzheimer’s.

                                                Also, insulin itself can become toxic. What we want to do, I mean, the human body just amazes me, that we can just switch fuel sources. We can go from using carbohydrates, sugar, glucose, you can use those interchangeably to using fat or ketones for fuel. What we see is the brain actually prefers that. There are very rare times that both ketones and glucose are available to the brain to use as fuel. When we’ve seen that, they’ve measured, the brain will pick up the ketones before the sugar, and also it burns cleaner. I interviewed Dr. Steven Gundry for my summit recently. He has some really interesting mechanisms that he’s proposing for why this burns so much cleaner and what’s going on with the change in our metabolism when we move into ketosis. But where the rubber meets the road, what I see clinically is that people perk up.

                                                We had a patient, he had a bunch of kids, and one of his daughters brought him in and got him into ketosis. It was fantastic. He did great. He started remembering all of his grandkids names, and he started remembering the names of horses and cows and cats and dogs and the farm animals around where they lived in this rural area. Before, he couldn’t remember the word horse, the word cow. He gets into ketosis, starts remembering the names of his grandkids and the names of the animals. His son comes into town and those grandkids, they want to have pizza, and they want to eat ice cream, and they want to hang out and watch TV with grandpa. By the time they left, he couldn’t remember their names, couldn’t remember the farm animal’s names. We can see what happens and people can feel it. I certainly feel, I wake up at 5:00 AM ready to get out of bed when I’m in ketosis, I drag myself out of bed between 6:00 and 6:30 when I’m not. We can see and feel the differences.

Dr. Weitz:                           And so, do you recommend the clients measure their blood ketone levels? What about doing the breath ketones?

Dr. Sandison:                     Oh gosh, this is another one of those. I wish they worked. We haven’t been able to get the breath ketone meters to work consistently. Same, urine. Urine can be helpful, but it doesn’t seem to be as consistent after about a month in ketosis. The blood ketone levels really are the most consistent and the most accurate in my experience. I would love if somebody could prove me wrong and show me one that really did work that didn’t require a finger prick. What I’ve used and many of my patients coaching clients have used is a-

Dr. Weitz:                           Continuous glucose monitoring.

Dr. Sandison:                     Glucose monitoring. Thank you. You can see me pointing at my tricep. That’s like the Libre.

Dr. Weitz:                           You’re talking about CGM.

Dr. Sandison:                     Yes. That they’re inversely related. If your blood sugar is up, your ketones are down. When your blood sugar is down, your ketones are up, typically. What was most helpful for me was the way I felt. I could tell, okay, I’m in ketosis, and then I could double-check myself and say, “Okay, what’s my blood sugar at? Oh, well, if it’s 97, I’m probably actually not in ketosis. If it’s down at 72, yep. I’m probably in ketosis. Also, I love to drink matcha. Andrew Weil has these great matcha products. I drink his matcha, and there’s one that’s an adaptogenic blend. On the back of the label, it says zero carbs, zero sugars. But when I drink that one, my blood sugar spikes. I’m not saying they put anything in it. Everybody just has a different metabolism. I can’t tell you how many times I’ve had patients, a husband and wife getting into ketosis, and she can stay in ketosis, eating zucchini all day long, and he gets kicked out. I had a patient come in and tell me they could eat white rice and stay in ketosis, which makes no sense at all.

Dr. Weitz:                            If there’s adaptogenic mushrooms, like [inaudible 00:34:40] mushrooms, that actually have a fair amount of carbohydrates in them.

Dr. Sandison:                     Yep. My recommendation, don’t just rely on the labels. Mostly eat things that don’t have labels. Everybody’s an individual. Your metabolism is different. If you’re going at this, measure.

Dr. Weitz:                            I wanted to mention, I like to try to hit on a few of the controversial things, when it comes back to cardiovascular health, there’s a marker for cardiovascular health that’s been talked about a lot recently, and it’s called TMAO. This marker is something that can be measured that shows that you have an increased risk of clotting and heart disease. TMAO comes from eating red meat, eggs and supplements that contain choline or L-carnitine. Many of us in the functional medicine community have been using choline as a very important brain supporting nutrient. How do we square these two?

Dr. Sandison:                     As I mentioned, I don’t recommend that anybody’s on a ketogenic diet forever. My recommendation from this ancestral health diet or this concept that maybe we should approximate more of our hunter-gatherer ancestors diet, the consistent thing about what our ancestors ate 100,000 years ago was inconsistency. I’m not recommending that somebody be in ketosis for the rest of their lives. I’m recommending that they switch it up and eat seasonally and that you watch these levels, watch these lipid levels. We have most of our patients who get into ketosis, and this is a very plant forward ketogenic diet. This is not eating bacon and eggs and cheese all day every day. This is cruciferous veggies and leafy greens and avocados.  I have an egg allergy, so I can’t even have them. Lots of people have, they have a dairy allergy, so they have to work around that, but it still works, and you’re not doing it forever. Watch the fricking labs. If it’s not working for you, we got to figure something else out. Maybe more fiber, maybe some amla or berberine, something to make this work for you so that you’re not increasing your risk. There’s a lot of options there, and everybody’s different. Most people that we have get into ketosis by the time they hit month six, their lipids are coming down, because they’re using them for fuel. You’re using fat for fuel, so those lipid levels are normalizing. In the first six weeks, they’re definitely raised.

Dr. Weitz:                           Yeah. TMAO is a little bit different than measuring lipids, but what about supplements that contain choline, [inaudible 00:37:44] choline, other forms of choline? I am not a believer in this TMAO marker. There’s too many problems with it as far as I’m concerned, but I’m just wondering.

Dr. Sandison:                     I associate TMAO with gut bacteria, so I don’t know. It sounds like you’re associating… It was something different than I’m. [inaudible 00:38:05].

Dr. Weitz:                           Stanley Hazen from the Cleveland Clinic has pioneered it as an important marker for cardiovascular health and recommends measuring it. Then typically, this is a sledgehammer that can be picked up by vegans to tell everybody who’s eating meat why they shouldn’t eat meat. But that’s my take on it. I think it is the case that only certain people are going to turn choline or L-carnitine into TMAO depending upon your gut bacteria. It may be that this is actually a marker for an unhealthy gut, but it is being used in parts of the cardiovascular world as a way to measure cardiovascular risk, a little bit different than LDL and some of the other markers.

Dr. Sandison:                     Got you. Yeah. For cardiovascular risk, we’re looking at Lp-PLA2, which typically indicates some inflammation in the gums and can come from oral health. If I see that elevated, I’ll refer people to a biological dentist. We look at ApoB and Lp-PLA2 and sdLDL, homocysteine of course. TMAO, we run. I don’t typically see it really abnormal, so I haven’t focused on it a ton. My response to the vegans is, you’re absolutely right on the environmental front all day long, I’m not recommending the best health for the environment or for the planet. What I am recommending is what I have seen clinically be the best healthy diet for your brain. Now, I am a strong believer that if you’re eating, if you’re consuming animal products, they should be organic, they should be grass-fed. If it’s salmon, it should be wild, even though the salmon fisheries are shut down completely right now, it’s really frustrating, and that you shouldn’t be on this diet forever, that you should [inaudible 00:40:08].

Dr. Weitz:                           What’s that? The salmon fisheries are shut down right now?

Dr. Sandison:                     I’m so bummed. The wild Alaska salmon that I usually eat from May to October is unavailable this year because the salmon fisheries are closed.

Dr. Weitz:                           Really? Why are they closed?

Dr. Sandison:                     I don’t even know that much detail. I just got sad and walked away from the butcher.

Dr. Weitz:                           Well, you can still get it frozen.

Dr. Sandison:                     You can get it frozen. Yeah. The point here though is, you’re not going to be on this forever. Measure your labs. If you’re vegan, it’s really hard to do a healthy vegan ketogenic diet. It’s really, really hard. You’re going to be nutrient-deplete. I don’t recommend doing that for long, if you’re going to do it. Then if ketosis is something you’re willing to experiment with, then go back and forth between the plant-based diet and a ketogenic diet. While you’re on the ketogenic diet, have a little more of the animal protein and have it be well-sourced.

Dr. Weitz:                           Okay. What are some of the most important brain-supportive nutrients?

Dr. Sandison:                     Well, we talked about a few. Vitamin D certainly is a signaling hormone that supports neurogenesis and synaptogenesis. I mean, you talked about citicholine. I use a nootropic called Qualia Mind from Neurohacker, and that has a lot of the ingredients for a nootropic that essentially it’s a stack of good quality nootropic supplements. You’re going to need your B vitamins, you’re going to need the basics, your B’s. Then what we can do, in my mind, I’m like, “Do we want to talk about the signaling stuff?” Which is hormones, because not really a supplement, it’s not really a nutrient? Because hormones-

Dr. Weitz:                           Why don’t we hit the nutrients first and then we’ll go to hormones next?

Dr. Sandison:                     Okay, great. There are a bunch of different nootropic blends out there. I chose Qualia Mind, because it was formulated by friends of mine to be frank and their geniuses. I also have watched it really, really, really help people. I felt the benefits of it. That’s why I’ve used it.

Dr. Weitz:                           I’ve been using Brain Vitale that Kat Toups recommended, actually.

Dr. Sandison:                     Oh, yeah. I mean, there’s a bunch of them, and I think Kat’s probably recommending some of the ones formulated by Dr. Bredesen, but they look pretty similar. You mentioned choline. Choline is a often in here, bacopa, rhodiola, taurine, threonine, amino acids that are going to support neurotransmitters. I’m looking because I have-

Dr. Weitz:                           Omega 3s. Yeah.

Dr. Sandison:                     Usually, I do omegas separately, because you’re not going to get enough omegas from some combination of nootropics. Your omegas, it’s really important that they don’t become rancid, so keeping them maybe in the fridge or something. I do omegas on their own, and I recommend people get three to five grams of EPA/DHA a day. But then coffee berry, you mentioned lion’s mane, ginkgo, huperzine, these are all things that can be seen in these classic nootropic formulas that we use. Then, I mean, we’ve already talked about the gut-brain connection potential with the marker that you’re running. I can’t connect it to that, but I put everybody on probiotics because I have watched that significantly change generalized inflammation and mood. Mood is really the biggest thing, but also sleep, all things that are indirectly related to cognition.

Dr. Weitz:                            Is there a certain type of probiotic for this particular issue that you find beneficial? Or do you rotate probiotics or?

Dr. Sandison:                     Yeah. My recommendation to my patients is 100 billion per dose, take them with food. I know the wisdom from the elders was to take them before bed or on an empty stomach. I have a friend who she got her PhD in functional gastroenterology, I guess.

Dr. Weitz:                            Yes.

Dr. Sandison:                     She said that her PhD project was how to get probiotics to colonize the gut. It was a whole lot of them, as much variety as possible and with food. This makes sense, because they’re going to hitch a ride on the food when the stomach acid is at its lowest through the gut and then potentially colonize the intestines. I just recommend people rotate them. Some brands I like, I mean, I love the Xymogen ProbioMax. Designs for Health has a good one. Then Klaire Labs has great ones. The spore-based ones are really popular. Those help some people. Oh, Garden of Life is one that’s really easily accessible, and I see patients get great benefit from that.

Dr. Weitz:                           Cool. Let’s get into hormones. Hormones like estrogen, progesterone, testosterone. Then of course, is it safe to place, say, a woman in her 70s on hormone replacement?

Dr. Sandison:                     Yeah, great question. I would add pregnenolone and DHEA to that list. I think of five primary ones.

Dr. Weitz:                           Estrogen, progesterone, testosterone, pregnenolone, and DHEA.

Dr. Sandison:                     Yeah. Let’s chat about the women first. Is it safe? There’s a Finish trial, epidemiological study, of nearly half a million Caucasian women in Finland, and it showed that there was a reduction in your risk of dying of cancer if you initiated hormone replacement therapy, whether it was estrogen alone or estrogen plus progesterone in your 50s, 60s, or 70s.

Dr. Weitz:                           Interesting.

Dr. Sandison:                     Huge, huge dataset that showed that adding hormones actually reduced your risk. Now, there’s another study out of the UK that shows that hormones reduce all causes of mortality, hormone replacement. There are French trials as well. The Women’s Health Initiative study, I think, was very overblown by the media. I mean, there was a New York Times article recently about this that explained what happened, and we’re seeing more and more of this.

Dr. Weitz:                           Well, one of the theories about that was the timing hypothesis, which was the idea that the reason why these women had an increased risk is because they didn’t start the hormones immediately after going into menopause. They waited 10 years. And so that’s a risky thing to do.

Dr. Sandison:                     Well, and also perhaps those women had other comorbidities, and so there’s a lot of variables in there.

Dr. Weitz:                           They weren’t doing bioidentical hormones and… Yeah, yeah, yeah, yeah. Lot of problems with that study.

Dr. Sandison:                     Yeah, I see hormones being… It’s like I can see a wilted flower come into my office and they get on hormones and they perk up. It’s a dehydrated plant that’s been watered. It’s just wild to watch. Let’s consider the cancer risk. If you’re BRCA-positive and you haven’t had a mastectomy and a full hysterectomy, which most of the patients I’ve seen that are BRCA-positive, I’ve seen an older population, they’ve already had that done. Then if you have a history of cancer, then there’s a different risk-benefit analysis. If you have a significant family history of cancer, there’s a different risk-benefit analysis. But if you have a strong family history of cognitive decline and you have cognitive decline right now, you have osteoporosis, you have heart disease, I don’t see two sides to that really anymore. It’s just way too protective of your bones and your brain, no matter when you initiate.

Dr. Weitz:                           You’ve talked a little bit about exercise. What would be the full exercise protocol? You mentioned things like activities like dancing, but what about weight training, cardiovascular exercise, balance training, things like that?

Dr. Sandison:                     Like diet, my recommendation is mix it up. You want to get enough, and I refer back to the Framingham trial that showed so much cardiovascular benefit exercise is going to increase blood flow to the brain just at the simplest level in terms of mechanism. Your aerobic exercise is going to do that. Best strength training is going to increase muscle mass, which is going to increase those [inaudible 00:49:04] or the endocrine signaling that’s going to come from the muscles to the brain to promote, again, synaptogenesis and neurogenesis. We want to optimize for both of those things. I mentioned the dual task. In an ideal world, you’re getting about 200 minutes a week of moderate to vigorous exercise, and this is 220, the number 220, minus your age, and then you can multiply that by 0.5, and then 0.75 or 0.7. I’ve seen a little bit different things, but basically you want to get about 50 to 80% of your max heart rate is where you’re in that moderate to vigorous.

                                           Another thing I’ve heard people say that’s just much simpler than doing the math is you want to be breathless several times a week. You want to be out of breath from exertion. 10,000 steps a day, when I’m talking to patients, it totally depends on where they’re at. I’ve had patients who won’t get off the couch to go to the mailbox. Just walk around the neighborhood for five minutes, and that is an improvement. I’ve had other patients who are exercising too much that it’s a stressor. They’re doing triathlons every six months. It’s too much, and it’s probably basically creating an adrenal burden. We have to back off. But in an ideal world, what you’re doing is you’re getting a mix of things, dual task exercise that includes strength training and cardiovascular exercise about 200 minutes a week. That engages both physically and cognitively.

                                                Then if you can add contrast oxygen therapy, and this is where you’re going from concentrated oxygen to 8% oxygen. What we breathe in normal air is about 20% oxygen. You go up to 80% and then down to 8 or lower percent of oxygen. That creates a hormetic effect where the body is essentially stressed. In that you have vasodilation, you have detox pathways kick in, you have cytolytic events where you get rid of those old senescent cells. You have an increase in mitochondrial density per cell over several months of doing this. Those are things that if you have access to a contrast oxygen therapy device-

Dr. Weitz:                           What is a contrast oxygen therapy device?

Dr. Sandison:                     Yeah, pretty simple. We use a Schwinn Airdyne, it’s like a bike with the arms. Some people will use a treadmill, other people will use even just like a rebounder. You want to be able to get that cardiovascular effort and be stationary. I use a rower, and so I’m always dreaming that this will happen, but there’s tubing and stuff. What’s happening is there’s an oxygen concentrator, just like any other oxygen concentrator. These are pretty easy to come by, but that’s hooked up to a reservoir, a big bag of concentrate, where the concentrated oxygen will collect so that you can use it while you’re exercising.  Then you have a mask on, and that mask is connected to a tube, then connected to your reservoir, and you can flip that tube open and closed. When it’s open, you’re on positive oxygen. When it’s closed, you’re on negative. When you’re on negative, you are getting vasodilatory effects. You’re basically being starved of oxygen while you’re sprinting typically. Then you recover on the positive oxygen. You take those dilated vessels and you’ve flushed them with highly oxygenated blood, and you recover there and you go back and forth for as many times as you can for 20 minutes.

Dr. Weitz:                           Is this something that you control manually?

Dr. Sandison:                     Yeah, exactly.

Dr. Weitz:                           Okay, interesting. That’s a way to get oxygen. Is that an alternative to hyperbaric oxygen or ozone?

Dr. Sandison:                     Yeah. Yeah, definitely different from ozone, but I would say an alternative to hyperbaric is different, but yes. If you talk to the guys that created these contrast oxygen therapy devices, they would say one 15, 20-minute session on a contrast bike, riding a bike with contrast is going to be worth 31-hour dives. That’s probably an overstatement from the guys that created this and really believe in it. But it’s also, from what I’ve seen, probably not far off. Your dives, you’re very passive. You’re in a chamber, and most people, what they have access to is a soft chamber. There’s Israeli studies about hyperbarics for Alzheimer’s. They’re using hard chambers that cost millions of dollars to build that nobody here has access to.  We’re not talking apples to apples when we talk about a soft chamber that goes to 1.4. We’re talking about something really, really different. The soft chambers, you’re totally passive, you’re lying there. Great if you can read a book or do something, but your ears have to be able to tolerate it, you need to be able to communicate. For somebody with severe Alzheimer’s, this is not an option. Some people are claustrophobic, not an option. I mean, the mask is a whole situation on the contrast side that not everybody can tolerate, but contrast, you’re getting the pressure and you’re getting concentrated oxygen, but you’re not working, so you’re not getting as much delivery of that oxygen.

Dr. Weitz:                           There’s a number of devices that have been designed to stimulate the brain. I think you mentioned red light. There’s a purple light. People are using various other types of devices, electrical devices, to try to stimulate the brain to promote brain health. Which of these do you find or any of them do you find beneficial?

Dr. Sandison:                     Yeah. The red light therapies we definitely see people have benefit from now, have they been-

Dr. Weitz:                           Is this the one where they put the helmet on? Is it that one?

Dr. Sandison:                     We use V-Lite at Marama, and that’s what I recommend to patients. This is in that mid-600, mid-800 wavelength. This, it works on the cyclooxygenase enzyme around the mitochondria. It improves the mitochondria’s ability to create ATP. It basically makes that process more efficient, and so you have an increase in energy production in the cells, which Dr. Bredesen has proposed that it’s an energy deficiency that essentially causes Alzheimer’s. Our beta amyloid plaques and our tau proteins, although they might be associated, certainly there’s some relationship, they are the results of that. Then you have all these other causes for why there’s a depletion of energy.

                                                If we can do something like use a red light to increase our ability to create energy or switch to ketogenic diet, increase our ability to create energy, then we have a better fighting chance. That’s what we understand is going on with this pretty specific spectrum of red light. There’s two. Then 1070 nanometers, there’s some research around it as well. 20 minutes once a day, we have patients who when they do the alpha, they’re much less anxious, so we can use it for that. Then gamma is more specifically for memory.

Dr. Weitz:                           Okay. Have you found peptides to be beneficial?

Dr. Sandison:                     Yeah. Yeah. Clink, Cmax, Cerebrolysin, those are the typical ones used for cognitive decline, specifically. What I find with Clink and Cmax is that often it’ll be a little bit of a win. People will feel a little boost, and then it plateaus and goes away. I typically don’t have patients on it super long-term, but they’re great because you can do them intranasally, so they’re easy, you don’t have to inject anything. Whereas cerebrolysin, you really need to inject, and it’s much harder to come by. We do that by IV, probably in higher doses than most people do. But that’s what I’ve seen work best. Then I’m a huge fan of BPC and TA1 and Matsi. There’s lots of them, [inaudible 00:57:24]. Love peptides. Sometimes they’re hard to get, sometimes they’re really complicated to get. We do what we can there and help people in ways that are appropriate with those.

Dr. Weitz:                           Cool. You have this Marama Center for assisted living. Maybe you can tell us a little bit about that.

Dr. Sandison:                     Yeah, sure. Absolutely. What happened was I had patients coming into my office getting better with cognitive decline, the Alzheimer’s. Then people started asking me, “Where do I send my loved one? I have an uncle and I can’t take him in. I’m in the sandwich generation caring for my kids and managing my household and trying to keep my full-time job and my marriage together. I can’t do all of this for my loved one. Where can I send them?” I realized that there wasn’t a place that existed. I asked around and thought, “How hard could this be?” And ended up creating this new concept, senior living facility, that’s very much based on what we’ve been talking about. It’s an organic ketogenic diet in a non-toxic environment. We use organic sheets and mattresses and all that. It’s a social environment, so everyone’s engaged.

                                           Then the activities from sunrise to sunset and beyond are all about enhancing cognitive function. We have the LiVO2, the contrast oxygen therapy, we’ve got the V-Lite. We’ve got Biomax. We’ve everybody in engaged in Pilates, or excuse me, probably not Pilates these days. There has been some in the past, but now it’s yoga and meditation and dancing. We’ve had hula dancing classes and pets that come and go. Then sleep is really prioritized in terms of light and noise in the house, it’s really important to us that our residents can get really high quality sleep.

                                           Then the residents, they are expected to get better by the caregivers. Part of it is about how the caregivers interact with them. They’re expecting them to improve. They also are helping them with all of their crazy supplements and hormones and everything they’re on, and they understand why and how important those are. Then they are engaging them in ways that are really inspired by a woman named Teepa Snow positive approaches to caregiving. Then also through how to speak, which is very much about diffusing and creating a very loving, fun, playful, relaxed environment so that they can really optimize cognitive function that way.

Dr. Weitz:                           That’s so great. I’m glad that you set that place up. We really need more places like that.

Dr. Sandison:                     Thank you.

Dr. Weitz:                           Maybe you can tell listeners about some of the programs, if by the time this runs your summit will be over, but they could order the summit. I think you have some training programs available as well, maybe for practitioners or?

Dr. Sandison:                     Yeah, yeah. Actually for caregivers. People who are caregivers, caring for someone who has Alzheimer’s, the Bredesen approach, I can’t tell you how many people have walked into my office withholding a Bredesen’s book, [inaudible 01:00:37] and Post-It notes and notes in the margin telling me how much benefit they got just from that. Even more patients walk in and they say, “I read the book,” or, “I listened to the podcast and I get it, but just tell me what to do. How do I implement this?”

                                                And so, that’s what we’re trying to do across my entire spectrum of offerings, basically, is get you and caregivers, people who are looking to prevent, people who are caregiving, and even people who have severe Alzheimer’s, we’ve seen them get better now. They don’t necessarily go back to work, but they get better. They improve their quality of life. Our goal is just to make Dr. Bredesen’s protocol more accessible. We have coaching, we have evergreen courses, we have one-on-one coaching, we group coaching. There’s everything from the Evergreen course to Marama, which is a full immersive residential experience. We hope there’s something for everyone who’s on that spectrum and suffering with this, and it can all be found at drheathersandison.com. Just drheathersandison.com.

Dr. Weitz:                           Awesome. Thank you so much, Dr. Sandison.

Dr. Sandison:                     Ben, it’s been an absolute pleasure. Thanks for having me.




Dr. Weitz:                           Thank you. Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would certainly appreciate it if you could go to Apple Podcasts or Spotify and give us a five-star ratings and review. That way more people will discover the Rational Wellness Podcast, and I wanted to let everybody know that I do have some openings for new patients so I can see you for a functional medicine consultation for specific health issues like gut problems, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity and take a deeper dive into some of those factors that can lead to chronic diseases along the way, that usually means we’re going to do some more detailed lab work, stool testing, sometimes urine testing, and we’re going to look at a lot more details to get a better picture of your overall health from a preventative functional medicine perspective.  If you’re interested, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at (310) 395-3111, and we can set you up for a new consultation for functional medicine. I’ll talk to everybody next week.


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