Latest / Gladden Longevity Podcast / The Invincible Brain: A Neurologist's Guide to Never Aging - Episode 326
Transcript
- 0:00There are many things that shrink the brain and these factors are often lifestyle related.
- 0:07There are at least five things that can shrink the brain.
- 0:10Sedentary lifestyle, poor nutrition, sleep apnea or insomnia, too much stress, and having a lazy brain, people who don't challenge their brain.
- 0:22One of the things that fascinates me about our brain is neuroplasticity.
- 0:26Neuroplasticity means that our brain has the ability to change and rewire.
- 0:31So for example, when you learn how to balance yourself on a snowboard, or when you learn to stand on a slack line, or when you learn to play tennis, or you learn to improve your
- 0:44vocabulary, or learn a new language, or pick up a new hobby.
- 0:49in all of those things, you're literally forming new pathways in your brain.
- 1:22Welcome, everybody, to this edition of the Gladden Longevity Podcast.
- 1:25I'm your host, Dr.
- 1:26Jeffrey Gladden.
- 1:27And as always, we're here answering the big questions in life.
- 1:30How good can we be?
- 1:31How do we make 100 a new 30?
- 1:33How do we live well beyond 120?
- 1:35How do we live young for a lifetime?
- 1:37And how do we generate and create a 300 year old mind?
- 1:41Today, I'm going to be talking with a doctor, an MD who's also a PhD, Dr.
- 1:46Majid Fotuhi And he is a neurologist.
- 1:51Johns Hopkins and Harvard trained neurologist who has really focused on brain health.
- 1:56And we're going to be talking about brain health.
- 1:58He has a book coming out, The Invincible Brain, has an app, The Invincible Brain, and he has a course about the invincible brain.
- 2:05And so we're going to dive into what actually keeps your brain healthy.
- 2:10uh We go down the rabbit hole on a number of different things.
- 2:12I think if you're interested in brain health, you're going to find this uh informative and uh useful podcast.
- 2:19So Majid, welcome to the podcast.
- 2:21I'm really looking forward to this conversation.
- 2:24You're touching on a couple of areas in your soon to be released book, which we'll talk about, about cognitive maintenance, if you will, avoiding Alzheimer's.
- 2:32And then I'm also curious about conversations around trauma, stress, how they're stored in the body, the impact on biology.
- 2:39So welcome to the show.
- 2:41Thank you very much for inviting me to your podcast.
- 2:43I'm really excited to talk with you, Jeff.
- 2:45Yeah, that's great.
- 2:46So let's start with let's start with your book.
- 2:49I think this is going to be published.
- 2:50You told me in March of this year called the Invincible Brain.
- 2:54And I know you have a very strong background in neurology, Ph.D.
- 3:00and medical degree and residency, et cetera.
- 3:05Why don't you talk to us a little bit about your take on cognitive decline and then what you see are some of the
- 3:13of drivers of it and some of the levers to actually reverse it or prevent it either one.
- 3:20Well, thank you very much for introduction and mention in my book.
- 3:25There are many things that shrink the brain and these factors are often lifestyle related.
- 3:32There are at least five things that can shrink the brain.
- 3:35Sedentary lifestyle, poor nutrition, sleep apnea or insomnia, too much stress, and having a lazy brain, people who don't challenge their brain.
- 3:48Most people think that as they get older, their cognitive functions will decline and they just get weaker and weaker and they just die.
- 3:58What we have come to appreciate is that if you control these negative risk factors, then you're able to maintain your cognitive functions for a long time.
- 4:11With aging, there may be 5 % or 2 % or 3 % decline
- 4:17in cognitive function if you have a healthy lifestyle and do the five things that I recommend and is that a five pillars of brain health, exercise, sleep, nutrition, stress
- 4:30management and brain training.
- 4:32So you were asking what are the factors that cause cognitive decline?
- 4:36Those are the things that was mentioned, mostly lifestyle related and what are the things that we can do to reverse that and grow the brain and those are the five pillars of brain
- 4:44health.
- 4:46Yeah, so let's talk about growing the brain.
- 4:47I think this is a really interesting area.
- 4:49was seeing some stuff recently on, and you may have seen this as well, that people that play racket sports actually live about nine years longer than people that don't play
- 4:58racket sports.
- 4:59And I was seeing something by Daniel Amon, who was talking about that.
- 5:03And the feeling was, is because they're actually activating their cerebellum when they're playing these sports.
- 5:11And he was saying that so many neurons are located in the cerebellum that when you're actually exercising that, that it actually has an impact across the entire brain.
- 5:20And one of the things that we stress here, I'm not a racket sport player per se, although I do mountain bike and run and snowboard and do things like that, is that we really do a
- 5:28lot of balance training, like on different kinds of things that challenge the brain.
- 5:33And it's not just standing on one foot.
- 5:35It may be
- 5:36on a board with a roller under it, or it could be on a slack line, or it could be any of these things that actually challenge your your brain and doing it with your eyes closed
- 5:45also.
- 5:46And then also walking figure eights frontwards, backwards with eyes open and eyes closed.
- 5:51found to be really, really helpful at building proprioception and balance and a sense of fine muscle, fine motor control.
- 6:03And it seems like
- 6:05the kind of exercise has an impact on it, right?
- 6:09So we know cardio, think, um obviously has impact for the brain, but I've come to understand that really balanced training, let's call it that.
- 6:18And you can get that a lot of different ways.
- 6:20It seems to have a big impact as well.
- 6:22I'm curious what your take is on that.
- 6:24As we grow older, we need to maintain a strong core and we need to maintain balance because one of things that happens when people get their 70s and 80s, they have reduced
- 6:34proprioception, increase risk of falls, and when they do fall, they have a hip fracture, they end up in hospital, and that's usually the beginning of the end.
- 6:43Now, you want to work on your core and you want to do balance.
- 6:47It's interesting you mentioned standing on a slack line.
- 6:50There was a recent study that showed
- 6:52And if you take a group of people, do MRIs at baseline, and then have them stand in slack line and maintain their balance, and then two months later, look at their brain MRIs
- 7:01again, you see actual improvement in their brain functions just with that simple exercise.
- 7:07So balance and coordination are functions that heavily depend on cerebellum.
- 7:15The other thing you could do to improve an activity set up by long is to do racket sports.
- 7:20I personally play tennis and I love it.
- 7:23I was just happy to hear that playing tennis is considered a racket sport and can increase longevity.
- 7:29But when you do the racket sports, you're constantly maintaining your attention and a ball and you're constantly coordinating so many of your muscles.
- 7:41think brain training is an important
- 7:43element of those five pillars of brain health I mentioned.
- 7:46And there are types of brain training that activate multiple parts of the brain at the same time.
- 7:53So for example, when you learn to do snowboarding, you have to learn so many things to maintain your balance.
- 8:00It's not easy.
- 8:01It's really hard.
- 8:03And so you are really challenging your whole brain when you learn how to snowboard.
- 8:09And the same thing when you're trying to improve
- 8:12or serve on a tennis, you're improving, you're challenging many parts of your brain at the same time.
- 8:18That's right.
- 8:19Now, I think I think that's right.
- 8:21I think it's I think what what we've discovered and this is true in so many parts of the physiology, right?
- 8:28The bones like to be challenged.
- 8:29The muscles like to be challenged.
- 8:31The nervous system likes to be challenged.
- 8:32The brain likes to be challenged.
- 8:34Right.
- 8:34And yet we kind of are in this comfort society, right, where it's like, well, I'm comfortable in my chair.
- 8:41And I get that but really the key to the key to vitality is really continuing to challenge yourself you know in safe ways incremental ways, but I find it really kind of exhilarating
- 8:51quite honestly to feel yourself get better at something It's really it's kind of one of the joys of life is to feel yourself get better at something whether it's learning
- 8:59medicine or whether it's learning to balance on a slackline or an endo board or You know a BOSU ball or whatever you're working with right so
- 9:06There's a lot of joy that comes out of it.
- 9:08And I think that's something that people miss.
- 9:11They feel like they have to do it because it's like a thing to do.
- 9:14But actually that mastering something, that learning something, that challenging yourself creates so much joy.
- 9:20Then you get all the endorphin rush and you get some oxytocin out of it.
- 9:23You get a lot of other things that are super helpful to us, right?
- 9:25You you make a great serve.
- 9:27You make, you win a match, right?
- 9:28There's a lot of dopamine, a lot of, you know, a lot of joy that comes out of that.
- 9:32So, yeah.
- 9:33One other thing I find is that a lot of people who go their 60s or early 70s, they sort of give up on trying to get better at things.
- 9:42They just get into this slippery slope of saying, well, I'm getting old.
- 9:46I'm not going to do that.
- 9:48And then because they don't do things, they decline more.
- 9:52And because they decline more, they see for a fact that they can't run, they can't play tennis, they can't do this, they can't do that.
- 9:59And they get worse for real.
- 10:01That's right.
- 10:02find it really exciting.
- 10:03You know, I sometimes do triathlons and a couple of years ago I was finishing a triathlon.
- 10:09had done like one mile of swimming in ocean.
- 10:12I had done 28 miles of bikes and then I was doing eight miles of running and I was close to finish.
- 10:19And I saw this gentleman who clearly was in his eighties trying to pass me.
- 10:24And I said, wait a minute, I'm not going to let you pass me.
- 10:27But at the same time, I loved it.
- 10:29that this guy who was about 30 years old at the time or 25 years old, he was passing me.
- 10:35And actually talk with him.
- 10:37And he has such an interesting story to talk about actually.
- 10:40But I think that we need to change people's mindset.
- 10:44Jeff, I think what we need to do, we need to tell people, set aside the old way of looking at aging.
- 10:51We're not getting old, it's advancing our age.
- 10:54And like Shakespeare said, midlife is like a new childhood.
- 10:58This is where you can start having fun.
- 11:01You're done with your 95 job.
- 11:03You're done with your little data obligations.
- 11:06You can learn new things, can travel, you can work on your body.
- 11:10You have more time for exercise than used to.
- 11:13So I think people need to change their view.
- 11:16We need a paradigm shift in the way we look at people in their sixties and seventies and eighties.
- 11:22You know, I'm in my sixties and have a lot of friends seventies and some friends in eighties and my circle of friends.
- 11:28are like you.
- 11:30They may be 70, but they are so active, so engaged, so fun to hang out with.
- 11:37And I feel bad for a lot of other people who are getting to their 70s and they sort of come to appreciate and come to tell themselves and believe that, you know, this is the
- 11:51time you sit by the pool and do crossword puzzles.
- 11:54Yeah, that's right.
- 11:56a football game and drink beers.
- 11:58If that's your idea of retirement and getting old, well, that's how you get Alzheimer's disease.
- 12:05That's the kind of mindset that will definitely get you on that slippery slope of brain decline.
- 12:12The things I told you that shrink your brain, the sedentary lifestyle, lack of brain activity, and not challenging yourself, not eating right, those things.
- 12:22will just continue to erode and shrink the brain and get to the point of Alzheimer's disease.
- 12:27I believe that only small percentage of people, maybe 5%, 7 % have the genes that make them be very sharp despite having done everything wrong or lose their marbles despite
- 12:40having done everything right.
- 12:42Most people, than 90 % of people will not experience cognitive decline.
- 12:47if they do the five pillars of brain health, which I talked about in my book and in my lectures.
- 12:51I personally plan to be 90, be sharp and independent.
- 12:55And knowing what I know, I think there's a very small chance I won't get there.
- 12:59I mean, I may have a car accident, I may do a little cancer or something unexpected may happen.
- 13:05But based on everything I've read in my field, there's no reason for me to be, you know, slow or.
- 13:13not be able to do things in my 80s.
- 13:16Why not?
- 13:17Why not?
- 13:17I have arms and legs and brain and eyes.
- 13:20so, you my vision may be 10%, 20 % less.
- 13:23My hearing may be 10%, 20 % less, but that's not gonna limit me from enjoying life.
- 13:29Yeah, think all that's right.
- 13:31think it's very important when people feel like they're losing something, right?
- 13:38Because I think a lot of people equate aging with losing the capabilities.
- 13:43And I don't do that.
- 13:45I divorced my chronological age from my age, right?
- 13:48I lived young for a lifetime is one of the things that we do here.
- 13:52So I'm 27, right?
- 13:53I wake up 27 and I'll have a.
- 13:55inverse of 27 birthday coming up in February, but I'm still 27.
- 13:59Right.
- 13:59And that's a great it's a it's an amazing mindset.
- 14:01And the reason I bring it up is because if I don't feel 27, then I never say, oh, well, but I'm good for my age.
- 14:09but I'm still able to do so many things.
- 14:11I never say that.
- 14:12I always say, what do I need to do to get back to 27?
- 14:15Right.
- 14:16Because you in life, you only get the questions or the answers to the questions that you're asking.
- 14:21Right.
- 14:21And so if I'm asking, how do I get to 27?
- 14:24There are ways now available to us to get there.
- 14:27Right.
- 14:27And so I think that's a really important mindset around this.
- 14:31my admonition to the to the audience would be to say, if you feel like you're losing something, don't sit there and try to make peace with it.
- 14:39Ask the question of how do I get it back?
- 14:41What do I need to do to get it back and actually come back stronger?
- 14:45And maybe it's maybe it's thyroid medicine, maybe it's hormone replacement therapy, maybe it's.
- 14:50engaging in the proper kinds of exercise that really challenge your brain.
- 14:54Maybe it's adjusting to the foods.
- 14:55Maybe you've got mold in your house.
- 14:57Maybe you've got all kinds of things that could be complicating the situation, but you'll never figure it out if you settle for loss.
- 15:05Right.
- 15:06And so that's I think that's really important takeaway.
- 15:09You're absolutely right.
- 15:10A common thing that happens is that when people get to their 70s, they have hearing loss and they sort of accept it and they don't fix it.
- 15:19And as a result, they don't hear well and they may not engage fully in conversations.
- 15:25And as a result, they may avoid conversations because they fall behind.
- 15:29They can't keep up.
- 15:30As a result, they become more isolated.
- 15:32As a result, they get brain stimulation and as a result, they develop dementia.
- 15:36Many studies have shown that people who get a hearing aid reverse their cognitive trajectory.
- 15:43They were gonna go down and the simple thing, like a hearing aid, will reverse it.
- 15:48The only thing that happen is, you know, a person in their 70s, when you start feeling like, oh, I'm not doing anything, I'm home alone all the time, and then they move and they
- 15:58live in a house near their children and grandchildren, and they hang out with grandchildren more often.
- 16:05right.
- 16:05that interaction with grandchildren makes them feel so much better and their brain functions better.
- 16:11You're absolutely right, Jeff, in that people sort of accept that with aging comes decline.
- 16:18And when there are treatable, reversible things that are happening, they don't address them because they just think it's a part of the game.
- 16:25It's not.
- 16:27It's not.
- 16:28It's not.
- 16:29And that thing, unfortunately, is a secret to longevity that
- 16:34in my experience, most people don't know.
- 16:36You're like one of the few people who have articulated it so well.
- 16:41But you are among the few people who have heard this.
- 16:44I'm the one always telling people that.
- 16:46And I'm so happy to hear from you, being a cardiologist, experience these things.
- 16:51And I love your attitude.
- 16:52And that's my attitude.
- 16:54I think if I have a joint pain, I figure out what the problem is.
- 16:58And I...
- 16:59Figure it out, know, sometimes you need an injection, sometimes you need an anti-inflammatory and you may need a knee placement.
- 17:04Well, do it.
- 17:06Don't, don't, don't miss out because, you know, I was thinking like when you retire, you have a third of your life ahead of you, a third.
- 17:14That's a lot of life.
- 17:16And it's, it's a pity to miss out on a third of your life being miserable and have this doom and gloom approach.
- 17:26It's another important point about if you do have an injury, there's there's kind of a kind of an understanding that, OK, I'll make a hypothetical.
- 17:35Someone's knee is bothering them.
- 17:36Right.
- 17:37And it's like, well, I went to see the doctor and he said, I didn't need a knee replacement, but, you know, hang in there and maybe you'll need one in three years.
- 17:45Right.
- 17:45Maybe you'll need one in five years.
- 17:47And.
- 17:48My approach to that is to say, OK, let's see what we can do to regenerate your knee.
- 17:52Right.
- 17:52I've rebuilt my own knee, you know, through some regenerative technologies that we use here in the in the clinic to where I can do anything I want again.
- 17:59Right.
- 17:59I can run.
- 18:00can snowboard.
- 18:01I can mountain bike.
- 18:02I can, you know, do anything I want.
- 18:04And that's what you want to do.
- 18:05But for other people, their knee is beyond repair.
- 18:09And yet they kind of force themselves to live with it.
- 18:12What they what they don't realize is that.
- 18:14They decline so much, not only physically, but also mentally because of that.
- 18:20And if you need a knee replaced, go get the knee replaced.
- 18:23Right.
- 18:23I've got clients who were big CrossFit people and they tore up their shoulders or they hurt their knees doing it.
- 18:30Right.
- 18:30And we're not big CrossFit fans for that reason.
- 18:33However, once they got their knees done, the knee replacements are so good now they're back skiing, they're doing they should.
- 18:38I should have done this five years ago.
- 18:40Right.
- 18:40And that's what we hear over and over again.
- 18:43So I'm not advocating for unnecessary surgery, but what I'm advocating for is whatever it takes for you to get back on your feet so that you can actually reengage with life.
- 18:52That's what you need to be doing.
- 18:54It's physical or whatever else.
- 18:56Yeah, I'd like to learn outside this about the regenerative knee.
- 18:59I'd like to hear about that.
- 19:01Yeah, no, we do a lot of cool stuff here.
- 19:04So let's talk a little bit about uh trauma also.
- 19:07I know that you have some connection to trauma and how it's carried in the body and stress and making some distinction between those two.
- 19:15You know, we're big fans of this as well in our in our life energy circle.
- 19:18Of course, we talk about mental health.
- 19:21as being so critical because, you know, if you're suffering with anxiety, stress, depression, PTSD, addiction, things like that, it sabotages your ability to engage in
- 19:30life.
- 19:30It sabotages your decisions that you're trying to make and things like that.
- 19:34Right.
- 19:35So from our standpoint, a lot of the mental health issues that we can deal with can have somewhat of a genetic predisposition.
- 19:42There are people that are predisposed to more anxiety or less anxiety, more depression, less depression.
- 19:47But then there's also the traumas that we've all experienced.
- 19:50And then we end up living in reaction to those traumas.
- 19:53And then we normalize that.
- 19:55And now we're living on tilt, so to speak, like a poker player that just lost five hands in a row, right?
- 19:59Everybody knows they're on tilt when they walk in the room, but they don't know it because they've kind of normalized it.
- 20:04And so in our world, one of the goals is to actually really deeply understand the trauma, deconstruct it.
- 20:11understand what we contributed, what somebody else contributed, and then forgive everybody involved, including themselves, to where you can actually heal it.
- 20:18And then you can move to another phase where you actually transcend it.
- 20:21And this is where you actually become grateful for everything that ever happened, because now you have more empathy, more insight, more wisdom, right, that you can share and live
- 20:29your life from.
- 20:30And you become unencumbered by these traumas that you've experienced.
- 20:34That's for us.
- 20:34It's kind of how we think about it.
- 20:36So I'm curious to know how you think about it in your in your own world of.
- 20:40trauma and impact on the brain and things like that.
- 20:43Yes, I have the same approach.
- 20:45In my neurology practice, I saw thousands of patients who came to me with memory loss and brain fog, and many of my patients had different etiologies for why they were having
- 20:57cognitive decline.
- 20:59For some people, maybe the things I mentioned to you, like obesity, centered lifestyle, sleep apnea, but for others, it was a psychological and a trauma-based issues.
- 21:10For example, I had a patient, I never forget her.
- 21:13She was a young woman in her actually 70s, she looked very young.
- 21:16And she was very adamant to improve her memory, which I loved.
- 21:20But one of the things that she told me during our first visit was that she regrets the way her life turned out because 30 years earlier, her parents had died and her brother cheated
- 21:32her of the inheritance of the house they had.
- 21:36Mmm.
- 21:36as a result, she lost a million dollars.
- 21:39And throughout all these years, she always thought about how her life would have been so much better if she had a million dollars 30 years ago.
- 21:49So every day she was thinking about how a million dollar back then would have been like, you know, $5 million now and what kind of house would she would have had, this and that.
- 22:01And then as a part of our brain fitness program where people
- 22:05We help people improve their memory by those five pillars of brain health.
- 22:09We also help people with their psychological health.
- 22:13And so our social worker talked to her about reassessing that something bad had happened to her 30 years ago, and it's a done deal.
- 22:23She can't change it.
- 22:24And it would be a pity that she would miss another 20 years of her life regretting what should have happened, could have happened.
- 22:33And so after talking with her for a few times, then she came back to see me for follow up and I loved it.
- 22:40Her face was bright.
- 22:42She was smiling.
- 22:42She's talking for two.
- 22:43He.
- 22:44I wasted 30 years of my life.
- 22:47I spent so many hours every day thinking about something where I could have just spent that time, exercise more, eat better, be more active, engage with life more.
- 23:00And now I've decided, you know what?
- 23:03It is what it is.
- 23:04I'm just going to let go.
- 23:06And I feel so much lighter.
- 23:08I feel like a burden is off my shoulder.
- 23:11And now instead of going to those repetitive negative thoughts, I can actually think about the future.
- 23:18I can think about, OK, well, I have a great life.
- 23:21Maybe it would have been different.
- 23:22Maybe not.
- 23:23Sometimes money can cause problems.
- 23:25But I have a good life.
- 23:27I have a place to live.
- 23:28I have a car.
- 23:28I'm able to do everything.
- 23:30And I'm going to enjoy the rest of my life.
- 23:32And that change in thinking is the key to overcoming the psychological trauma that happened decades ago.
- 23:40It's very common, and I have seen hundreds of patients who have had issues that happened to them when they were younger, and that has persisted throughout their life,
- 23:51unfortunately.
- 23:53And some of them actually were able to have an aha moment and set aside.
- 23:58And some of them we had to send to a counselor for further evaluation treatment.
- 24:02Mm Yeah, it's a big deal.
- 24:04It's a big deal.
- 24:05Again, she was living in reaction to that for all those years.
- 24:08Right.
- 24:08And it had had an impact on on everything.
- 24:12When she became unencumbered from it, all of a sudden she's light.
- 24:15She's free.
- 24:16She's she can, you know, make her own decisions, do whatever she wants.
- 24:19you know, the interesting thing is that in 30 years, she probably could have made that million dollars back six ways to Sunday if she, you know, thought about it in new ways or
- 24:27whatever.
- 24:27Right.
- 24:28So there's yeah, there's always
- 24:31opportunities out there if you look at the world through opportunistic kind of lenses.
- 24:35And to your point, I think it's all about perspective, really, and gaining perspective.
- 24:40So talk to us a little bit from the neuroscience perspective about how brains work when they're, you know, either ruminating on something or they're in anxiety or reactions to
- 24:53trauma or stress.
- 24:54Talk to us a little bit about that.
- 24:56One of the things that fascinates me about our brain is neuroplasticity.
- 25:00Neuroplasticity means that our brain has the ability to change and rewire.
- 25:06So for example, when you learn how to balance yourself on a snowboard, or when you learn to stand on a slack line, or when you learn to play tennis, or you learn to improve your
- 25:18vocabulary, or learn a new language, or pick up a new hobby.
- 25:23in all of those things, you're literally forming new pathways in your brain.
- 25:28One of the things I find fascinating about cardiology is that you can get, know, the walls of the ventricles can change.
- 25:36And, you know, obviously the lining of the blood vessels can change.
- 25:40These are not hypothetical.
- 25:42These are anatomical changes to the narrowing of the arteries.
- 25:46It's a real thing.
- 25:48and the heart muscle is getting thicker and more fibrotic, it's a real thing.
- 25:52In Harvard Medical School, I remember one session we had in pathology where we looked at hearts and they had put about 50 hearts in trays around the room and our job was to look
- 26:04at every heart and decide what was the problem.
- 26:07Like one was uh cardiomyopathy, one was coronary disease, one was a heart attack and so forth.
- 26:13See, our brain is the same way.
- 26:15Our brain can anatomically change, physically change.
- 26:20A lot of people think that the brain is like an ear or the computer just sits there.
- 26:24It's not.
- 26:26It's a living organ with a capacity to change.
- 26:29And so when you learn something new, when you exercise, you change the anatomy of your brain, you make it bigger and stronger.
- 26:36This is called positive neuroplasticity.
- 26:39Unfortunately, there's this thing called a negative neuroplasticity where
- 26:43when you ruminate over the same idea, then the pathways that you use to ruminate get stronger and stronger and stronger.
- 26:53It's like you spend an hour a day playing the piano.
- 26:56Those pathways get stronger and stronger and stronger every time you practice.
- 27:01And so when you ruminate over something a thousand times or a million times, that pathway becomes so much stronger and it becomes a default.
- 27:10So a lot of people fall into the default, like the lady we're talking about, her default was in that thinking about that.
- 27:18And that thinking over and over again, made connections in a negative way, which then reinforced her behavior.
- 27:27And the good thing about the brain is that these pathways can change.
- 27:31You can modify those things.
- 27:33It's like, you you want to remodel the kitchen.
- 27:35You can literally remodel your brain based on your habits.
- 27:39based on whether you pick up new hobbies, they do things, or whether you take gambling, or you do drugs, or you're stressed or you're not stressed, you literally change the brain,
- 27:53much like life experiences can modify the anatomy of the heart.
- 27:57Yeah, no, I think that's right.
- 27:59For sure.
- 28:00I'm thinking a little bit, too, about certain neurotransmitters, right?
- 28:07So I'm thinking about some genetics as well.
- 28:11So there's a gene called the COMT gene, right, which is basically responsible for breaking down things like dopamine and different catecholamines like that.
- 28:20And there can be a 4x, a four times
- 28:23difference in a person's ability to actually break those down.
- 28:27There are a lot of other genes that can factor in also, but it's interesting that uh when we see that and we see that people are highly stressed and they have a deficiency in their
- 28:39ability to break that down, one of the things that we look at is how, how do we get that gene to turn on and work better?
- 28:45How do we actually stimulate genetic expression at that
- 28:48point, right?
- 28:49So we can use things like magnesium, a cofactor, we can use genistein, we can use other things to actually upregulate it.
- 28:55But then actually the person understanding what their genetics are helps them also to understand, okay, when I put myself in a stressful situation, I'm going to have an
- 29:04exaggerated, potentially an exaggerated response to what's there over what somebody else would.
- 29:09So we do a lot of things related to brain training, where we start to entrain the brain.
- 29:15with things like brain tap to teach people how to go into a theta state or an alpha state to actually lower heart rate variability, calm the entire system so they can go through
- 29:25life really more in a meditative state than in a reactive state, right?
- 29:29And so this is another way to train the brain is to train it from the standpoint of being stress resistant by training it to be calm and then helping people to regain being calm,
- 29:42you know, should they get stretched out of
- 29:44position.
- 29:45So for me, the analogy is this.
- 29:47It's like if you're snowboarding, let's say, or skiing and you're a novice at either of those sports, when you hit unexpected challenges, know, bumps or trees or whatever you're
- 29:58going around, it can throw you off balance.
- 30:00Right.
- 30:01And the goal when you master something, right, when you're a master at skiing or snowboarding, your upper your upper body is not really moving.
- 30:08Your legs are absorbing whatever's there and you're
- 30:11looking far enough ahead that you're, you know, you're navigating.
- 30:14And so you're actually going through rough terrain, but you're unperturbed, right?
- 30:20You're reacting, you're taking appropriate action, but you're not perturbed.
- 30:23You're not thrown off balance and you're not crashing.
- 30:26And I think that's become for me kind of a nice analogy for sort of mastery of our stress nervous system is to actually be able to go through life and navigate the challenges,
- 30:37react in appropriate ways.
- 30:39and yet not get thrown off balance.
- 30:42I think a lot of people sort of feel like, well, I've always reacted this way.
- 30:46I'm just going to compete.
- 30:47Keep reacting this way when somebody says something, well, it's going to, you know, blah, blah, blah, blah, blah.
- 30:52And I think that that is also kind of acquiescing to something that people don't have to acquiesce.
- 30:56You can become a master of actually your own nervous system and how you respond.
- 31:02You can train yourself just like you can learn to ski or snowboard or play tennis for that matter.
- 31:06Right.
- 31:06You can go into a flow state.
- 31:08And it's in a flow state that you now have agency.
- 31:11You probably know this from tennis.
- 31:13When you're in flow, you know, everything slows down.
- 31:15You have complete agency, but you're also very calm.
- 31:18I do that on a mountain bike or snowboard.
- 31:19It's like, I'm in flow.
- 31:20It's like, this is the best thing ever.
- 31:21You can do that in life also.
- 31:24And I think this is something that we stress with our clients that it's uh important to master this because it changes, you know, how you live your life and it changes the
- 31:33experience of it.
- 31:34So, yeah.
- 31:35Yeah, I totally agree.
- 31:37I think the important thing is that you can learn to change your mindset and you can learn to be in that flow state.
- 31:44And one of the best ways to do that is with heart rate variability training, which you mentioned.
- 31:49Slow breathing, like you can breathe six per minute, just breathing in slowly and hold for a couple seconds and breathe out.
- 31:57That alone can really change the level of activity in the vagus nerve, which then can make level activity in the brain.
- 32:03and increase those are theta waves or alpha waves and reduce beta waves and that will put you in a state of mind which you can describe as a flow or be at ease with nature, be at
- 32:14ease with the universe.
- 32:16And so I think you're right on, you're right on, you're totally on target.
- 32:21I agree with everything you said.
- 32:23We need to get ourself in that state of mind and if we have genes like COMT that may...
- 32:30change the level of breakdown of dopamine, neuro-pneumonia, serotonin in our synapses, and as a result may have more or less serotonin or dopamine compared to other people, we can
- 32:40change it.
- 32:41We are all mosaic of different genes, and we have some of the better versions for some genes and not so good versions of the other genes, but if we have the attitude that we're
- 32:52gonna fix things, we can address which part of our lives are not optimal.
- 32:58and then try to figure out based on our current level of knowledge how we can approach and address those.
- 33:04And if there is a solution for it at a scientific level, like know, is magnesium going to help this process?
- 33:11Then do it.
- 33:12If not, then you can go downstream and work on the things that we know can help, such as heart rate variability.
- 33:20And also I think, you know, people think you're either happy or depressed.
- 33:25I've learned that you can learn to be one notch happier.
- 33:28Even the depressed patients, if they set their mind into it, they can learn to be one notch happier.
- 33:34I'm respectful of the fact that it's not easy to just tell people, on, snap out of it.
- 33:39I've seen tons of depressed patients.
- 33:41I know how difficult it is to experience depression.
- 33:43However, even depressed patients can get training to be one notch less depressed, one notch happier.
- 33:51And of course, average person who doesn't have depression
- 33:54can definitely find ways.
- 33:56The challenge is to look at it that way.
- 33:59The challenge is not to look at yourself as a victim.
- 34:01It's a challenge to think of it as the master, as the king of yourself.
- 34:07You are the king of your destiny.
- 34:08And if there are problems, describe them, define them, address them.
- 34:13Not feel, oh, poor me, I don't have this gene or that gene.
- 34:18That really applies to intelligence.
- 34:20A lot of people think,
- 34:21Like other people are smarter.
- 34:23know, a lot of people may think like, you know, look at him.
- 34:26He's a cardiologist.
- 34:27He's invented things.
- 34:28He has, you know, so many physicians working for him.
- 34:33He's just a smart guy.
- 34:34And I'm really not anywhere as good at him.
- 34:36But they don't realize that they have their own forms of intelligence.
- 34:40They may be a good cook.
- 34:42They may be a good handyman.
- 34:43They may be a good comedian.
- 34:45They may be a good therapist.
- 34:46They may be able to connect with people.
- 34:48So everybody
- 34:50has their own package of natural talents, but they can acquire all the other talents that other people have because their talents emanates from their functions in the brain.
- 35:04The parts of the brain called cortex and the big campus generate those forms of talents, skills, intelligences.
- 35:12So anybody can do it.
- 35:14I think some things might take more training than others.
- 35:18But anybody who spent 10,000 hours practicing the same thing over and over again will get really good at it.
- 35:24So people need to have that attitude of the liberated attitude that I can be better at anything.
- 35:31I can be physically young, like 27-year-old.
- 35:34I can be mentally sharp.
- 35:36And if there are things I'm not good at, I can learn how to figure it out to be better.
- 35:40And I will be better at it.
- 35:42And as you mentioned earlier, it's such a joy.
- 35:44It's such a joy.
- 35:46where you get better at something and you say, my God, I got better.
- 35:50Let me tell a little story.
- 35:52A few of my friends were playing pickleball and there were one person short and there was this lady sitting there.
- 35:58She looked at an older lady, 79, and she came to play.
- 36:02And as she was playing, these were people in their 50s and 60s and she was 79.
- 36:06So as they played, she was obviously not the same level as they were.
- 36:11And they were thinking like politely telling her, well, thank you, but.
- 36:14Next time we're okay, thank you.
- 36:16But this lady really got into it and started practicing when she was not playing with them.
- 36:21So when she came back, she would play with them and within a few months she was better than the other ones.
- 36:28And she loved the fact that now she had turned 80 and she was playing better than a bunch of people who were 20 years younger than she was.
- 36:37And they were couldn't believe, so everybody was happy.
- 36:40I think the mindset is important thing.
- 36:42If this 79 year old would have said, listen honey, I need to go on my rocking chair and read my newspaper, this would not have happened.
- 36:50But she took on the challenge to, first of all, be there, be available, be in a community center where people play pick up ball, to be in that situation where she can play pick up
- 37:01ball.
- 37:02And then do accept the challenge, like I can get better, and practice.
- 37:08And then see the results.
- 37:09People need to realize they can get better.
- 37:12See, that's the big problem.
- 37:13A lot of people think it's too late.
- 37:16Yeah, I agree with that 100%.
- 37:18I think, you know, what's interesting is that I think we access joy more frequently when we have a higher sense of agency, right, where we're actually architecting our lives.
- 37:31And I think it's easy to have experienced life and have experiences and have relationships and things that haven't, quote unquote, worked out the way that you might have hoped.
- 37:40and then to identify with that.
- 37:42because of it, you end up feeling somewhat sad.
- 37:46And in some level, you you actually don't even feel safe because you're not sure if the next relationship was going to go well or go bad or whatever.
- 37:55And so you don't you don't put yourself out on the pickleball court, right?
- 37:59Because of that, you don't have the internal safety to feel like I'm to be OK.
- 38:03That's one thing.
- 38:04The second thing is you don't have the agency to say.
- 38:07Yeah, but I'm an architect of my own life.
- 38:09I can do whatever I choose to do and I can have fun.
- 38:12I can create joy doing it.
- 38:13Right.
- 38:14So I think if you're listening to this and you're feeling a little bit stuck, the idea is to give yourself safety.
- 38:21Right.
- 38:21And then understand that you are the only architect of your life and whatever anybody else thinks about you really doesn't matter at all.
- 38:29Right.
- 38:30It's only what you think about you.
- 38:31And so if you if you
- 38:33incorporate a positive view of yourself and then you become the agent of your own change and your own growth.
- 38:38It's like, well, now we're having fun.
- 38:40And the goal, again, is to joy.
- 38:42It's really about.
- 38:43So not about doing, it's about creating joy, how you create joy for yourself and other people.
- 38:48When you're playing tennis, I think you go out there because you know you're going to experience joy.
- 38:52You know, when I do any of the things I do, it's because I know I'm going to experience joy.
- 38:56And I think if you're listening to this, if you want to take the step forward.
- 38:59keep your eye on the prize, which is I'm going to experience joy when I do this.
- 39:03And it's like, oh, OK, it's joy.
- 39:05It's all about joy.
- 39:06It's not about walking on the slack line or playing the piano.
- 39:08It's about joy.
- 39:09OK, well, how do I experience joy?
- 39:11Right?
- 39:12So anyway, cool.
- 39:15Talk to us a little bit about glutamate.
- 39:17This is very interesting neurotransmitter that is an excitatory neurotransmitter that not everybody breaks down as efficiently.
- 39:24Some people have receptors that more responsive to it.
- 39:27Some people make it more readily.
- 39:29Certain foods will increase glutamate levels in the brain.
- 39:32And it can be associated with anxiety.
- 39:35It can also be associated for me anyway.
- 39:37If I have high glutamate foods, it'll cause me to have brain fog, things like that.
- 39:42I know you did some research on glutamate.
- 39:44Do you want to talk about that for a little bit?
- 39:46Yeah, when I was a graduate student at Johns Hopkins many years ago, it's hard to believe almost 40 years ago, I studied the distribution of glutamate receptors in the brain.
- 39:55Glutamate is the main excitatory neurotransmitter.
- 39:58It's a small molecule, which is a messenger molecule that neurons use to talk with each other.
- 40:06And 40 % of the neurotransmitters in the brain are glutamate.
- 40:11The other 40 % are GABA.
- 40:14And the 20 % are the other neurotransmitters, such as dopamine, neoprenorphine, serotonin, adrenaline, epinephrine, and things like that.
- 40:22And so it's exciting to know that...
- 40:26Our brain is made of chemicals, many of which can be modified with lifestyle changes.
- 40:32For example, GABA, which is the main inhibitor neurotransmitter, can be activated with things like meditation that calms your mind.
- 40:41I mean, sometimes people have a glass of wine, which increases GABA activity as well.
- 40:46I don't recommend it, you know, but I think that's one thing that also reduces GABA.
- 40:52Glutamate is the main excitatory neurotransmitter and it's challenging to work with because it's everywhere.
- 41:00It's in the part of brain for vision, for moving, for thinking, for seeing, hearing, touching.
- 41:06And so it's challenging to work with glutamate.
- 41:10We know that too much glutamate can cause toxicity in the brain.
- 41:15So for example, when people have a stroke, that part of brain may die and as a result, when
- 41:22dead neurons are releasing their glutamate, that glutamate then goes and excites the neighboring neurons and the neighboring neurons are excited to death.
- 41:30It's called excitotoxicity.
- 41:32Now there are some things like MSG, which may also increase glutamate and they can really affect your thinking.
- 41:39And so in general, you want to be mindful of things that may affect your transmit levels in the brain, including glutamate.
- 41:45Yeah, that's good for people to know and understand.
- 41:51And GABA really, I think, is great because it does have a calming effect.
- 41:54So things like taurine can increase.
- 41:57GABA and certain other supplements can improve it.
- 42:02GABA Penton can be used.
- 42:04There's microsomal GABA that people can take that may make it into the brain and be helpful.
- 42:09Meditation will improve GABA.
- 42:12This ability to actually master your own nervous system enables you to actually go into more of a GABA dominant state, which helps sleep, which helps calm, which helps
- 42:21relaxation.
- 42:22Anyway, think one of the take home messages here, if you're listening to this, is that your brain is really there for you to play with.
- 42:30can rebuild it.
- 42:32It's like a Tinker Toy thing or Legos, right?
- 42:34You can rebuild your brain.
- 42:36Your brain is not fixed.
- 42:37Your thoughts are not fixed.
- 42:38Your mood is not fixed.
- 42:39Your ability to move through space is not fixed.
- 42:43You can do so many different things.
- 42:44You should start to play with it and then just see how many things you can accomplish.
- 42:49I didn't start snowboarding until I was 45 and I didn't start mountain biking until I was in my fifties.
- 42:54So it's, um, you know, and I pick up new things all the time and I play the guitar on a regular basis and play new songs and write new songs and all this kind of thing.
- 43:02So it's really important to, continue to imagine, to build, to use your brain, to have fun with it.
- 43:09Right.
- 43:10It's super important.
- 43:11Yeah.
- 43:12Yeah, absolutely.
- 43:13Your brain is not fixed.
- 43:14Your brain is not a computer.
- 43:16Your brain is not like your ears.
- 43:17It's not a fixed structure that just decays over time.
- 43:21A lot of people think that your brain is like a computer that sort of gets rusty and old as you get older.
- 43:26No, your brain is a vital living organ like your muscles.
- 43:31And the more you stimulated, the more you take care of your food and what you eat, the more you're mindful of what things increase inflammation, the things that affect your
- 43:41your sleep, the healthier will be your muscles and the healthier will be your brain.
- 43:45And as you said, you have so much control over your brain and you can literally shape the brain to the version you want to have.
- 43:54And the good news is this, it doesn't take years to get there.
- 43:58So we did this program of what we call brain fitness program, which was 12 weeks.
- 44:02And we had a lot of patients in their 70s who had mild cognitive impairment, which is the stage between normal and Alzheimer's disease.
- 44:09And 84 % of them improve their cognitive functions in three months with addressing, you know, when we see patients, we do what's called a brain portfolio where I ask patients 40
- 44:21questions, which then tells me all the little things that may be affecting their brain functions.
- 44:27And then we address the treatable ones, like, you know, they have sleep apnea, we treat it, they have depression, we address it.
- 44:32We have vitamin deficiency, we took care of it, they have a thyroid problem, we take care of it.
- 44:36they were hearing or vision loss, we take care of it and so forth.
- 44:39So we have a list of 40 things we address and then we personalized this 12 week program for our patients and then 12 weeks later, they're you know, GF 2.0, they're like a new
- 44:50person and the same person thought they had Alzheimer's disease, they thought like, you know, I'm just gonna die miserably in five years and then by 12 weeks they memorized 100
- 44:59words.
- 45:01They were just, you know, so many people said, Dr.
- 45:04Futhu, you saved my life.
- 45:06I had a lot of people coming to see me from Texas actually.
- 45:09And people say this was the best thing ever in my life.
- 45:13This program was so successful that we were open seven days a week from 8 a.m.
- 45:18to 8 p.m.
- 45:19We had 25 brain coaches and our office was open seven days a week.
- 45:24I if I added a night shift I would, I think some people would show up.
- 45:28And I think the reason it was so successful is because people could see results within weeks.
- 45:34With 12 weeks,
- 45:35There were clear objective improvement in cognitive tests.
- 45:38But even after three or four weeks, people would realize that we're just getting better and better.
- 45:43And so I'm totally with you in that we need to have a paradigm shift in our field.
- 45:49We need to look at aging through a new lens.
- 45:52Aging does not mean decline.
- 45:54Aging does not mean inevitable cognitive decline.
- 45:58Aging means you have more time to have fun, figure what needs to be done, and do it.
- 46:05Yep, agreed.
- 46:06Well, beautiful.
- 46:06Well, it's been a pleasure chatting with you.
- 46:08How do people find out more about you or get in touch with you or whatever?
- 46:13Sure, I have a website, drfotuhi.com, D-R-F in Frank, O-T-U-H-I.com, drfotuhi.com.
- 46:24And also I have a new app called the Invincible Brain.
- 46:28So my book is the Invincible Brain, and um the app is the Invincible Brain, and it's online course.
- 46:37I'm also...
- 46:38I have a lot of things on YouTube and Instagram and TikTok and X and LinkedIn.
- 46:43Nice, okay, so people will be able to find you, that's great.
- 46:47All right, well, beautiful.
- 46:48Well, thanks so much for being with us today.
- 46:51Yeah, my pleasure.
- 46:51I really enjoyed our conversation,
- 46:53Yeah, it was great.
- 46:54Thanks so much.
- 46:55Thank you, bye