Well, six o'clock, I think we're good to go. I really appreciate you guys coming out today. I know it's a beautiful day, and we're not getting a lot of those lately, so I appreciate you taking the time to come out and learn a little bit more about brain health. This is a topic that I'm really passionate about, and I see a lot of patients who are suffering with cognitive dysfunction. And it's just running rampant through our society, and there's a lot we can do about it. And that's what I'm hoping you can get out of today's talk, is just how we can change the trajectory of Alzheimer's and cognitive decline by some lifestyle therapies, as opposed to looking for the quick fix with the pill. Because there's been a lot of money spent on research for Alzheimer's pharmaceuticals, and it keeps coming up short. So what we're finding through Dale Branson, which we just mentioned there in that book, the end to Alzheimer's, is he's doing a lot of really cool research that's showing that with cognitive decline in Alzheimer's, they're actually reversing cases of Alzheimer's through a functional approach, which means we're going to talk a little bit more about that as we go through the talk, but by addressing why Alzheimer's is happening, as opposed to just trying to stop it with a pharmaceutical. And that's what we're trying to get into today. So my name is Seth Osgood, and I'm the founder of Grassroots Functional Medicine. And I just, again, appreciate you being here. So I wanted to kind of put this home with a quick video just to put everything into perspective. It's a really cool video that's on the web. Just about two minutes.  Well, yeah, oh my god. Now, where'd you think he was? You're OK, though, right? Well, you're OK, Graham. Graham, you're OK.  Here, give me the hand. We do the hand holding. Listen up. Fritz and Fritz, you know his name, right? Fritz? Yeah.  I do. Before you come. No, you've been living with us for two and a half years. And before that, you came up to our house every weekend for about four years. You took me out there. We did, Pete and I. You came to stay at our house every weekend until you couldn't live alone anymore, and then we moved you in permanently. So you used to know every day. You used to know every day. You just forgot. You forgot today. What did he die from, honey? Well, probably heart failure. He had Alzheimer's disease, but when people die in their sleep, they usually have a heart attack. So he probably had a heart attack in his sleep. He was still living. Well, if he was living, he'd be by your side. Well, I thought it was wrong. You're stuck with me, lady. Yeah. Fritz, but I'm better than nothing. Oh, my God, honey. I'm better than nothing, eh? So the unfortunate truth is that this is the reality for a lot of people, and the number is growing. In fact, every 65 seconds someone in the United States is diagnosed with Alzheimer's. And, you know, in 2018, it was estimated there was almost 16 million cases, but this number is estimated to increase significantly over the next few years. In six years, it's going to increase. They're estimating by 29%. And then by 2050, we're looking at 14 million cases. So going from 5 million to 14 million by 2050, it's pretty significant. And again, there is no, at this point, there's no known cure or no effective treatment from a pharmaceutical standpoint. So we have to start digging outside of the box and thinking about this a little bit differently. It's the sixth leading cause of death right now. And beyond the emotional and the physical tax that it has on our society, there's a huge economical burden as well. As you can see, the cost in 2017 is 175 billion for Medicare and Medicaid. And that's expected to jump to 758 billion by 2050 again. So just, you know, it's getting out of control and it's going to hurt our economy as well as our life. As you can see, the risk for Alzheimer's increases as we age. You know, 65, 10% risk that goes to 25 by 75, and 50% risk of Alzheimer's and dementia by age 85 years old. So, you know, the problem is is that this doesn't just happen. This isn't something that pops up when you turn 65 or pops up when you're 75 or 85. It's a slow progression. So there is a lot of symptoms, subtle symptoms, that you can start to recognize that, you know, years and years before you get the diagnosis and we need to take action. That's where we need to start making changes to optimize and reduce our risk. So a lot of these symptoms, I mean, how many people know people who or maybe you're suffering yourself trouble remembering things, difficulty making decisions, problem solving, you know, slower thinking, mixing up words. This is happening to us more and more as we age and unfortunately it just gets thrown off as a normal part of the aging. Now of course, some of these things are okay to get worse. That's when we have to really start taking it seriously. The truth is that a lot of times, you know, these are not just natural part of getting older. These are red flags. These symptoms are foreshadowed on what may come. And of course, there's a lot of factors that can put you at an increased risk, which we're going to talk about today. But, you know, we have to, again, start taking action sooner. And if you do, your body can heal. The research is starting to show this. And to Alzheimer's is doing some really fabulous research in actually showing Alzheimer's, you know, holding and then actually regressing by taking this holistic whole body approach. And that's what we're going to talk a little bit more about today. But the reality is, you know, the sooner you act the better the outcome. So, you know, you can sleep. You can think clearly in the old age. You can hold onto those cherished memories. You can be only present for you and your family and improve your brain health as you age. And that's, these are the things we need to be thinking about and working towards as opposed to just accepting the fact that we're getting older. So just a little bit about myself. So I grew up in, not too far from here, Corinne Vermont, Chelsea Vermont, not too far from here. And I was raised on an organic dairy farm, a parent's own dairy farm. And I grew up in a household where everybody had issues. Five out of the six of us were diagnosed with irritable bowel syndrome. And that was our norm. My mom was the one who suffered the most. She's the one that was like a lot of my patients who had been to multiple doctors and had, you know, just, was trying to find some answers and was just giving this blanket diagnosis of IBS and was told that hey, this is your norm. This is what you're going to live with the rest of your life. Just rely on some of these medications. And this is life. So that's what we grew up doing, just living with, you know, IBS, irritable bowel syndrome.  So what changed is, you know, when I was actually getting ready to graduate from school, I got a phone call from my mom. She said, hey, you're not going to believe this, but I just went and saw a doctor. She practices what's called functional medicine. And my IBS symptoms are gone. I feel I'm completely better. So I'm thinking to myself after just completing conventional training, well, what did you take? Because I want some of that, too. So I asked her what she took and she said, I didn't take anything. I actually changed my diet. She put me on an elimination diet and she found out that I was allergic to several foods. So I was skeptical because I was at the mindset that we needed a drug to treat every ailment, but I was desperate at the same time, and sick of being sick. So I went on the same diet and found out that I had food sensitivities and my symptoms were gone and my brother and my sisters did the same thing and their symptoms went away completely. Guess what we were allergic to? Or guess what we had problems with? Dairy. Dairy. So we grew up on a dairy farm and what was frustrating about that is, number one, I had never been taught that foods could cause problems with gut health. And the second thing, it was just frustrating to me that nobody really asked the question about what we were eating. And I always tell people, when you bring your animal for the vet, the first thing they ask is, what are you eating? But yet when we go in, nutrition is at the very back of the list when it comes to, you know, chronic disease or health issues. So I was, at that point, I was just intrigued by this concept of functional medicine and neurovein at first and that's where I'm at today. So today what I'd like to do is tell you a little bit more about what functional medicine is and how it varies from a conventional approach. We're going to talk about neuroinflammation which is a big piece of Alzheimer's and cognitive decline and then we're going to talk about four root causes of cognitive issues. Of course, there's many, but and seven's natural strategy that you can use to boost your brain health. So have you guys heard of functional medicine? Have you guys heard of functional medicine? So, you know, functional medicine... Hi, I'm on in. So functional medicine is a little bit different than the conventional model. You know, conventional medicine is absolutely phenomenal when it comes to acute care. So if you have an emergency, if you have an acute problem, you want to be in the hospital because the care is second to none. But where we're falling a little bit short is when it comes to preventative care and product disease management and that's where functional medicine is trying to fill some gaps. So functional medicine is geared towards trying to figure out why. That's really what it's about to do. Why are people getting sick? Why are these diseases starting? Where is this inflammation coming from? And by addressing the why we see some really amazing results because, again, the body can heal as long as you're fueling it with the proper fuel and removing the triggers that are causing inflammation. The other big difference with what we do is it requires a partnership. This isn't simply you need to take a pill and you're done. It requires work and it requires lifestyle change and it requires dedication on your end. But the result is health and that's what we're looking to really achieve through the functional approach. Anybody know who this is?  Einstein is really an interesting story. Obviously he was a super smart guy known for his intelligence. One of the things that a lot of people don't know is that when he passed away a researcher I think his name was Thomas Harvey actually stole his piece of his brain to study it. Einstein knew that he was going to be sawed after and he wanted to be cremated. He didn't want anybody to be playing with his parts and studying his parts.  He lost his job and he lost his reputation for it. But there was some very interesting findings. So what they theorized back in that time frame was that he would have a lot more neurons. He would have a lot more electrical cells to increase activity to contribute to his intelligence. But when they compared his brain to the average human brain the neurons were the same. There wasn't a significant difference. What they found is that he actually had more glial cells in the area of his brain that was involved with critical thinking.  Another one of those things that were they just thought it was there didn't really have much of a role just help things together. He actually played a very significant role with overall brain health. It plays a role with development with metabolic function with neuronal health and then with intelligence as well. So a lot of the things we're going to address today and talk about can actually be beneficial or be harmful to the glia and this contributes to neuro-information which is really at the root of a lot of cognitive decline issues. Another key concept to really understand here is what a healthy set of neurons look like and what the neurons of an Alzheimer's brain look like. So as you can see on the left here everything is very clean those these extensions from these neurons they send electrical impulses they communicate with one another but over here on the right you see that these neurons are blocked by different things and these are called tangles, tau tangles and beta-amyloid plaque and those are two hallmark signs of Alzheimer's. The problem is you can't really see those unless you're doing an autopsy. So originally I thought, you know, let's try to create a drug that will fix this that will stop the the beta-amyloid that will work on these neuro-figurative tangles and again they came up with a drug that when they did address those problems that the problem was still there, Alzheimer's was still there. What we now know or what they're learning about is the fact that the body is putting these beta-amyloid plaques around the neuron to protect it from damage. So it's not although the plaque blocks the signals and causes neuronal issues in death it doesn't, it's not the root of Alzheimer's. The root of Alzheimer's are the problems that cause this plaque to form. So by getting rid of the plaque it doesn't do anything. We have to think about why is the plaque there and how do we prevent that and how do we optimize the body so it can break it down. So beta-amyloid plaques and cow tangles.  So when you have an issue with your brain, whether that's Alzheimer's or whether that's Parkinson's or whether that's MS or whatever is going on with your health you're not going to feel pain.  What you feel or what you know and how you know something's happening is by your symptoms. So the symptoms are what we have to be cognizant of these are what we have to look out for these are the red flags that tell us if something's going on that is triggered by neuro-inflammation. So neuro-inflammation is the big player that causes destruction of brain cells and problems with cognitive functions. So there's different levels of neuro-inflammation here. As you can see with mild neuro-inflammation a lot of us have been here. Brain clogs, low thinking, reduced endurance, sensitivities to chemicals and foods. A lot of people with brain inflammation, they walk down the cleaning aisle, the grocery store and it's just too overwhelming for them. They have to leave because it's just too much stimulation. Now if you step off into the moderate category that's where you really have problems with depression and sleepiness and irritability you know the lethargy the increased demand for sleep where you need more and more sleep but you still feel fatigued, you still feel tired and then of course there's the severe where the symptoms get much more scary, right? Call them a delirium seizures and some people will have a mixture of all of these. So let's dive into some of the causes of cognitive decline because these are things that you can address to help optimize your risk. So one of the big things is inflammation. Now inflammation is one of your body's natural processes to help it heal. So when you cut your hand, you're going to get inflammation and that's going to recruit the cells and recruit white cells and red cells and platelets and different parts of your immune system so that healing can occur. Now inflammation is supposed to be acute. The problem is when it's a chronic issue, when it happens for a long period of time, that's when tissue damage and destruction starts to occur and so we need to be thinking about the things that cause inflammation and that can be a whole host of different things which we're going to go over a little bit more today. So one of the things that contributes to inflammation is infections. And what is one of the more common affections that we run into here that in the upper or in the New England area that's running rapidly out there calling all over the place Lyme disease. So you've got to watch out for Lyme disease because that's a big one these days and unfortunately I was just talking to somebody today, you know we grew up not too far from here and when I was a kid we didn't have any ticks, you know, we didn't have to worry about it but now I'm literally picking ticks off my kids every week. You know, so it's great. We live in Norwich where it's really bad but we're picking ticks off our kids all the time and even last year I tested several of them and they were negative and this year they're positive. So you can send the ticks in to be tested and it's a great idea especially if you've been bitten but it's something that we have to be careful of because these infections can be a big problem not only in the Q-phase but also in the product page and you can have, you know, more than just Lyme disease, there's a lot of co-infections for ticks, you can get things from mosquitoes and from fleas, you know, you can have gut infections, you can have fungal infections, you can have parasitic infections. There's a lot of bugs and critters out there that will tax your immune system and cause inflammation throughout your entire body including in your brain. And there's been several studies where they've actually looked at Alzheimer's brains and found Lyme disease inside the brain. So along with other viruses like M.C.M.R. and different bugs. So we have to be cognizant of product infections and we have to, again, work to strengthen our immune system that is key. And then deficiencies and imbalances is also very important. And this is looking, so when you're looking at deficiencies you're looking at nutritional deficiencies which is a big, you know, we do nutritional testing on almost everybody and I haven't found a patient yet who's not deficient in something. So, you know that this is, the key part of this is fueling the body for what it needs to heal. So if you don't have those right nutrients, you know, if we're not consuming the right foods or we have gotten balances that are inhibiting absorption of nutrients then it's going to set us up for failure in that healing process. And then imbalances are important too, specifically we're looking at cognitive-defined hormones play a big role. So that's something that we'll talk a little bit more about. And then toxins. So for those of you who don't know, unfortunately our world is toxic, right? And there's only so much we can do about it, but you have to protect yourself against toxins. This is key. And this can be mold, that's a big problem around here. I've seen a lot of people who suffer from mold toxicity. So, you know, especially with the basements and the humidity and the airtight houses that we're finding now, one water leak, small water leak, can lead to a big mold issue. So you have to be careful and you have to, you know, really seek this out and make sure you're taking care of it because mold is toxic to your brain. We also know that there is toxins in our food, right?  But even though organic stuff, you got to be careful when you need to clean it because it's sprayed with water that's often contaminated with, you know, different pesticides or herbicides.  So if you are in the habit of using Roundup around your house, do not do it. That is horrible. There's so much research coming out showing how life, say, or Roundup is linked to all sorts of cancers and chronic diseases. They're even finding, you know, life, say, in the cord blood of infants. So it is coming from mom and it's going to baby. Our infants, as soon as we come in, it's when we're toxic.  So we're going to talk about ways that you can minimize your risk and reduce your toxic load. One of the big toxins to talk about when it comes to cognitive dysfunction is alcohol. So alcohol is, you know, a lot of people drink alcohol and there's some research suggesting that there is benefits for certain things. But when it comes to cognitive decline or brain dysfunction, we know that it's inflammatory and it's not your friend. So if you have any sign of cognitive issues, you really need to cut out the alcohol. It might make you feel good in the short term, but realistically in the long term it does lead to inflammation.  You know, that is not good.  And then I have to mention before round up, you know, this is the stuff that is no good and it's a huge problem in our society and it's everywhere. You know, it's in the brain, it's in the soil. You know, so that's you just got to be really careful. So let's jump into some of those strategies to help your body heal and improve brain health. I wanted to tell you guys, so on that sheet I handed around, we've got a brain I made a guide for you, which we've got a... Oh yeah, I think you're over here. There's a link on the bottom there, but I made a guide to make it so you can bring this home and read more about it and more tips on how to be successful.  So I encourage you to share this with your friends, you know, share it with your family and really start incorporating some of these strategies because they can be a game changer. They can be a game changer.  So the first thing is optimizing your diet. This is the most inflammatory component of most people's life as their nutrition. Unfortunately, our food is bombarded by processed foods and excessive carbohydrates, unhealthy fats, nutrient deplete food, so we have to be figuring out what diet is best.   Anything is possible, so you really have to individualize it and you have to figure out what diet plan is going to be right for you. But what we know is that eating a lot of, you know, a plant-based diet with lean protein and healthy fats is really what you want to be sticking to and of course you want your food to be as clean as possible. Ideally you want it to be organic and for those of you who don't know, there's a great resource called the Clean 15 and Dirty Dozen on EWG.org and that is a website that's really good for a lot of health tips but what it, that Clean 15 and Dirty Dozen is telling you what 15 foods you can get away with, typically not buying organic and which 12 foods you always want to buy organic because they're the highest on the entire EWG.org EWG.org Yep, it's a great, and they got all sorts of resources on there, environmental working movement. So one of the things that I like to start people on to really figure out what is, what foods are problematic for them is an elimination diet and depending on where you are in your journey, there's different levels of aggressiveness but there's various benefits to doing an elimination diet, you know, again the fact that there's no calorie restriction in your toxic burden, you're eating foods that are high in phytonutrients and you're reducing inflammation so sometimes we'll put people on a strict elimination diet and sometimes we'll get rid of one or two foods and that's okay, you have to do what works for you but you want to start somewhere if you're going to eliminate three foods, the top three you want to get rid of for a short period of time or whatever, whatever when you decide to do is, you know, sugar sugar is very inflammatory, gluten dairy and I know a lot of people hear about gluten but I tell you, it is a big problem for a lot of people but you don't know until you get rid of it completely and then add it back in but you know, some people need to get rid of you know, nuts and seeds and nightshades and lagoons and various other things that can be inflammatory but I highly recommend at least doing some form of elimination diet if you haven't because it can be a game changer so many conditions I've seen improve or completely vanished by simply eliminating some inflammatory foods and I think a lot of it I don't think it's that the food was causing the big problem, I think that it's just another trigger of inflammation that increases the inflammatory load and the more, think of it as a bathtub that just overflowing and the more we can drain out that water with different mechanisms, the better we're going to be for it, the healthier we're going to be and the less inflammation we're going to have but elimination diet is very powerful. When we're looking at brain health we want to focus in on healthy fats and nutrient dense foods so a lot of people have probably heard about the ketogenic diet. Now the ketogenic diet is again one of those sexy diets out there right now everybody's doing and talking about and I don't think it's good for everybody and you have to be careful when you do get on the ketogenic diet and watch your lab guys, watch your liver, watch your inflammatory markers, watch your liver function but when it comes to cognitive dysfunction and brain issues it can be a game changer so this can be really good when it comes to Alzheimer's or cognitive decline, you just got to work with somebody to help you tweak it and make sure everything looks good because there's nothing out there that's perfectly safe, you want to make sure balance is key and then another question I always get are what are the top supplements or nutraceuticals that I need to take for brain health and because I know a lot of people literally come into my office and they'll have a grocery bag full of supplements you know and that happens a lot because people just want to feel better and they read about supplements and they see the benefits but you can go crazy and you can go broke taking supplements so what you want to do is figure out an individualized routine that works for you and when it comes to brain health there's a couple of things that you can look at so according to the research these are some of the supplements that are the top players when it comes to cognitive decline resveratrol and curcumin which is derivative of turic you guys have probably heard of that these are excellent when it, the polyphenols when it comes to brain health essential fatty acids you know DHA is a better fat for cognitive dysfunction but DPA is really good for inflammation and immune function so make sure you're on a good fish oil but more importantly make sure you're eating the foods that are high in these fats so we call it if you're not eating fish if you're on a non good question yeah yeah so I have a lot of patients who are vegetarians or vegans and if we are trying to supplement them we look at numbers to see where they're at but if they need supplementation a lot of times I'll use an algae based supplement that works really well they just need to take more of them where you need to be but it does get the job done but you want to remember the smash fish okay smash fish are high in omega so salmon mackerel sardines and herring those are some really good ones that are high in the omega 3 that you want to focus in on and then short chain fatty acids this is kind of a new cover to the field things like butyrate and these come from actually your gut flora when you eat resistant starch foods things like you know raw oats, tiger nuts green bananas, plantains potatoes that have been cooked and cooled those are all resistant starch foods and what happens is your good flora will gobble them up and as a byproduct it puts off short chain fatty acids which play a, they're like fuel for the cells in your gut they play a big role with gut health but they're also crucial for brain health and then magnesium you can't get enough magnesium that's good stuff when it comes to you know brain health there's a supplement called magnesium 3 and 8 that crosses the blood brain barrier and it's really good for brain inflammation and then anti-oxidants like glutathione glutathione is also very good at clenching oxidative stress and inflammation short chain fatty acid, do that be like MCT? no, that's not a great question short chain fatty acids are butyrate, acetate, and propranate so they either get them from a supplement or you get them from eating resistant starch foods so say they're getting these cool potatoes cool potatoes yeah and so you cook raw oats raw oats like you put in this movie they're a great resistant starch tiger nuts a lot of people don't know what tiger nuts are but those are a great resistant starch and they're a good snack so it's not a nut it's actually from a root but it's a good snack that's quick and you can get tiger nut flour as well that works bananas that are on the green side you don't want the ripe bananas full of sugar you get them a little on the green side they're better resistant starch plantains as well if you just google you know there's a bunch of them out there but those are the things that really help optimize your gut health and they're great for brain health as well raw oats as in rolled oats yes, yes yes, you got it wrong resistant starches resistant starches and then the other question I have magnesium what was the supplement magnesium freeening now there's all sorts of different magnesium I'm a horrible spelling T-H-R-E-O-M-A-T-E I think is what it is so there's various forms of magnesium some are really good for your brain some are really good for bowel movements some are really good for muscle aches and then magnesium freeing it is really good for the brain but with magnesium too you can't overdo everything so there's nothing that you can just take a bunch of and be completely safe you have to get your levels checked with magnesium freeing it works really good for sleep as well because of its calming effect so the reason where this picture is coming from is anybody have heard of type 3 diabetes? yeah some people are calling Alzheimer's as type 3 diabetes because the strong association between diabetes and cognitive decline in brain issues so when you're a diabetic this happens for various reasons but one, there's a lot of inflammation a lot of oxidative stress is inflammatory so you have small vessels inside your brain so when those become damaged just like that can happen in your kidney or in your heart you can get reduced blood flow when you have reduced blood flow you can have many strokes and that can lead to cognitive decline so diabetes is no joke that is one of the things that we have to be aggressive about treating and getting under control and beyond just taking a medication to make your numbers look good you have to make the lifestyle changes that actually fix why the problem is there to begin with because just making the numbers look good is not necessarily changing the inflammatory response so you want to again take that whole body approach what numbers do you talk about? for diabetes checking your blood sugar depends on where your numbers are at but some people have diabetes or pre-diabetes or insulin resistance so this enzyme here is called insulin degrading enzyme why this is important is because its primary job is to break down insulin what else does this do? it also breaks down beta amyloid plaque so remember that previous slide that showed Alzheimer's brain with the tangles of how tangles in the beta amyloid plaque well this enzyme actually helps break down the plaque which is awesome again the body is just such a magnificent design and it can fix itself the problem with this enzyme is that it can't do two things at once very efficiently so when you have diabetes and your insulin levels are high and one of the jobs of insulin is to help mobilize sugar into the cells so it doesn't cause problems with various things that it does but when you have high insulin because you're eating a lot of carbohydrates or high sugar diet you use all of your insulin degrading enzyme to break down the insulin and there's not much left over plaque so again it's just that blood sugar under control is super important another big thing you need to focus in on is reducing stress now who's not stressed these days everybody's stressed for one reason or another but there is legitimate pathological changes that happen in the brain from increased stress one of the areas that gets affected is your hippocampus which is important for memory so one of the big problems with Alzheimer's is losing your memory so high stress we've all experienced this when you're under high stress you have more of those brain parts so we need to be careful about monitoring our stress not only being reactive to it when it's high but being preventative deep breathing, meditation, prayer acupuncture, massage go out and go for a walk sit in the grass and around and the other thing is getting out of toxic relationships you know if you have a job that you hate and it stresses you out you need to do something different if you're in a relationship that is horrible and you're stressed out every time you're around your friend or your spouse you need to fix that whether that's counseling or whether it's getting out these toxic stressors will destroy you and we see this not only with cognitive decline we see it with auto-immunity we see it with cancers we see it with all these things they're through this major stressful event and now they're sick and that's not coincidence something is changing with your physiology from that stress response it suppresses your immune system it wears down your brain destroys your gut there's so many negative things for stress how that stress causes so you need to address that make that a top priority and that's probably one of the hardest things for people to change the exercise regimen which is awesome but sometimes people will not fix the stress they'll improve to their full extent because of that it needs to be on the top of the list that's usually the reason why people get sick so we need to make that the top priority to get you better sleep is another big one stress is not just emotional it can be physical it can be toxic that same response will follow for multiple reasons but sleeping is huge you need to get enough sleep at least 7 to 8 hours listen to your body and do what it needs ideally we want to be adopting a healthy sleep hygiene so many people are on sleep medications nowadays just to go to bed but there's so many things you can do naturally to optimize this one of the biggest things, shut your phone off so many people are addicted to their phone all night long it's right by their bed it's going off, the alerts are on and then you've got wifi and emfs there's various things there that are concerning but shut your phone off shut your screens off at least a couple hours before you go to bed and set yourself up for success you can put some blue light glasses that are really effective to helping your brain calm down you can meditate or pray or be brave before bed there's so many things and those basic maneuvers you know it may be a little bit challenging at first can be really effective how do you measure the quality of your patient? that's a great question so there's all sorts of ways to do that now and there's not a perfect method in all honesty some people will wear the fit bits or the different tracking devices which I think have some value then there's sleep studies that you can do now where you can actually do an at home sleep study the sleep studies in the sleep centers I just don't really agree with those because it's not a good environment to get restful sleep but now you can actually do those sleep studies at home so in all honesty though it's talking to the patient and asking them and asking their spouse or their partner as well just to gauge where they're at and people are usually pretty good about it but as far as how they're sleeping and the quality of sleep it's a little bit tricky blue light glasses you can get them on amber or amber glasses they've got like a tinted lens so the blue light from screens like on your phone or your computer doesn't weight your brain up like it would if you were just looking at it do you wear them when you go to bed? you wear them before bed I believe that we're supposed to be rising and setting with the sun so at night when the sun is going down that's what you would want to put on your blue light glasses if you're going to watch TV or if you're going to do some kind of work where are you getting them? Amazon, you can get them on Amazon they're actually not very expensive blue light glasses so you're saying where they're just when you're looking at screens I think it's good in general unless you know I think it's great around the house too because a lot of people have their lights on we're trying to get the brain to calm down so even a little bit of tint and you can set your phones to have blue light not that I encourage you to be on your phone but there are settings so it dims at night as opposed to bad so this is another cool finding in the recent years it's called the lymphatic system so originally we thought that the lymphatic system which is an important part of a immune function in drainage or toxins wasn't in your brain it was just throughout your entire body but they recently found that not too long ago that it's actually in the brain so this is where the glia which are those cells I talked about before detoxify and cleanse themselves this is a big part of that so if we are going to this is the most active it's at night when you're sleeping so that's why again we have to be prioritizing sleep if we want the brain to recover we need to get a rest of the night so we can figure out how to make that happen and then movement we are a sedentary society we are at work all day at the desk and just as guilty as anybody you're sitting down and consulting with patients all day but you have to make extra time to get up and move and exercise so exercise has so many different things for the brain and this is all backed by research so it increases neuro-tropins like BDM the BDMF which is important for cell repair and recovery it decreases inflammation and restores real cells and it enhances neuroplasticity and neurogenesis so it enhances the communication between neurons and the routes that they take and there's proven evidence that again it reduces cognitive decline so we have to make exercise part of our daily routine I always tell people when all of my patients there's five things that need to happen for you to get well you need to eat the right food you need to sleep, you need to move you need to relax and we need to focus on detox and we'll talk a little bit more about that but if you're not addressing those foundational elements a lot of the other stuff doesn't really matter as much so you're going to get so much more benefit and so much more recovery and quicker recovery by prioritizing those foundational five things so when we're looking at exercise with cognitive decline we know that there is the right amount high intensity training is one of the more beneficial things for brain health but you can overdo it so you hear a lot of people doing CrossFit where they probably shouldn't be doing CrossFit or some of these high intensity interval trainings and they wear themselves out so you've got to work with somebody to figure out what's the best routine what's the best plan of action for you where you're getting benefit but you're not over training and losing the benefit from what you're doing and then balance hormones so hormones, there's various hormones and a lot of people have hormone imbalance so you've got adrenal hormones you've got thyroid hormones you've got sex hormones all of these things need to be looked at and they need to be evaluated because they're very very important for again for your body to fight for your body to heal and your body to recover they actually did a study they found that women when they had their ovaries removed before 40 had twice the risk for developing all cycles so we know that estrogen and the testosterone and the progesterone there's a benefit to these hormones they just have to be balanced appropriately that's not saying everybody needs to go out and get out of hormones but there's ways that you can even optimize those naturally but again we know specifically estrogen and testosterone even in women there is benefit to the brain and the best benefit for immune function and I have a lot of people a lot of women specifically who get sick with autoimmune conditions with various other conditions that's just again goes to show how important those hormones are to balance and then we need to focus in on again detoxing and I know I talked a little bit about this before but this is such a big big piece of the puzzle one of the things we need to detox from or make sure we're evaluating for that often gets overlooked are heavy metals do you guys see this movie? this is the mad hatter mad has a hatter does anybody know where mad has a hatter came from? exactly these hatters used to use mercury to take fur off the skin and what they found is a lot of them went crazy so the mercury and the neurotoxicity that it caused caused all sorts of bad things to happen and it caused neuro inflammation which leads to cognitive decline so they coined that term mad as a hatter and it's still around today so we have to be thinking about heavy metals and evaluating our environment because we do have them a lot of people have mixed metal amalgams where there's actually mercury in their mouth from the fillings and we call them silver fillings which sounds really nice and friendly but there's more mercury in there again we have to be aware of that some people have a problem with it and some people don't but if they're leaching out in your system they can be toxic we get metals from certain supplements there's metals in water with this but you have to be thinking about it and looking for it because what we're trying to do are fill those gaps and plug those holes that are triggering and implement inflammatory response so what do we do when we're dealing with detox I always tell people there's what you need to do, you need a pee you need a poop, you need a sweat and you need a breathe that is how you remove toxins from your body pee, poop, sweat, and breathe so we need to stay hydrated we need to be constantly voiding you want to be too dark, you want to be too clear but you want to stay hydrated a good rule of thumb is half your weight in ounces so if you're 160 lbs you want to be drinking at least 80 lbs of water a day that's a good rule of thumb or settle very depending on the person but half your weight in ounces so if you you just have to be constant watch your urine to make sure it happens but hydration is a big problem for a lot of people that's how you flush your system that's a very important again, gut health, you guys have probably all heard about the importance of gut health we know how crucial the microbiome is now we're learning more and more every day you need to have a healthy gut to have a healthy body so pooping is important I talk to some people and they'll say that they have a bowel movement a couple times a week I'm like oh my gosh that's crazy you need to be moving your bowels pooping steaks is what I tell people it's one to two times a day if you're not doing that you need to dress that you need to change that because that's one of the big ways again you eliminate toxins from your body do you say a snake? pooping a snake a long round soft snake so if you look online there's a thing called a Bristol school chart which is a chart that tells you how you should be pooping essentially but it goes from being the rabbit pellets which is really constipated to being liquid which is diarrhea you want to be somewhere in the middle and that's a good reference it has a good rule of thumb to check out so make sure you have a healthy gut if you have gas, if you have bloating if you have constipation or diarrhea that needs to be addressed you need to fix that especially if you're dealing with cognitive issues or any chronic health issues a lot of people don't know this but 80% of your immune system resides in your gut which is a pretty awesome design because again most of the junk we put in our body comes through our mouth it also controls 90% of serotonin production which is very important for mood and for energy a lot of people when they're depressed or have anxiety they're put on SSRI which recycles the serotonin in their body so it's higher but if we fix the gut a lot of times the mood improves as well so we have to be focusing on the gut and also again it's important for the digestion of your nutrients and a lot of times when we have a leaky gut probably people have heard that kind of leaky gut when you have a leaky gut or intestinal permeability which is backed by research it's just not a fruit root term when you have a leaky gut you often have a leaky brain so those two are always talking to one another and a lot of times when you eat a food that's not good for you where you feel gassy and bloated you feel like in your brain you feel tired, you have brain fog you just don't feel well and the systems are connected which is why we have to look at the big picture and not just focusing on individual systems or individual specialties every time we address something in the body we have to be thinking about what is the consequence what is the reaction that's super important so get the right testing this is also important I kind of mentioned this before with the supplements again you can go crazy broke with the supplements so if you get the right testing you want to talk to your doctor about some of these things and see if you can get some clarity on what's really going on because otherwise you're going to be just struggling chasing your tail and going after the wrong thing there's a chance you might hit it but when you're dealing with cognitive decline or you're dealing with brain health issues you want to jump on this thing as fast as you can you want to get the right information so you can make the right steps for the outcome possible so again looking at your thyroid looking at your hormones looking at your nutrients looking at your inflammatory markers looking at your gut health all of this stuff can be really helpful to get you to the best health possible can I ask a question? you said before that deficiencies are important to the doctor what deficiencies do I look for? that's a great question so the basic ones that you want to look at vitamin D, vitamin A vitamin D omega 3 fatty acids magnesium those are some of the more common ones that you can look at you're really looking at anti-oxidants which come back oxidative stress which is a big piece of cognitive dysfunction there's lots of different things you can look at is there a panel that you like that covers the most? it's tricky because we do a lot of different tests because there's better tests for different deficiencies you know we use actually organic acid tests that's urine tests for nutrient deficiencies because that does more than look at what's in your blood it's telling you what's happening more so on the cell level because just because it's in your blood or just because you're consuming high amounts doesn't mean you're absorbing it intracellularly which is what you really need to know that's where you get the most benefit but there's a lot of different ones you can do what is the inflammatory marker? that's a good one so a great inflammatory marker there's a bunch of them out there as well but a basic one that you can look at is high sensitivity C-reactive protein or high sensitivity CRP ESR is another great inflammatory marker which is sedimentation rate and then there's various markers that you can look at even from basic blood channels which we call acute phase reactants and that's just a fancy way of saying when you have inflammation they're going to be high so like for example platelets will often go up and that's in a CVC when you have a lot of inflammation or ferritin which is a great marker for iron storage will go up when you have a lot of inflammation so even some of these basic labs are going to be useful in Brenneson's book there's like 36 and he goes in with the shelf exactly that's a great resource that ends all Alzheimer's so there's a lot of stuff in there just finding a doctor who's going to work with you and help you order those tests and then there's more advanced functional tests that can do like looking at oxidative stress markers and gut inflammation markers and various things you can look at and that's a great resource looking at what he's got in the book and end to Alzheimer's do you work with all these tests? yeah our patients are typically free sick so we really do a lot of testing to get a good understanding of what's going on to get them to that endpoint faster so just to kind of recap some of this stuff you know what I really hope you take home from this is that you've got to jump on this even later when you're dealing with this you still can make progress but we have to shift our mindset from waiting until it's there and then addressing it to preventing it prevention is key so if you're seeing some of these subtle symptoms of cognitive decline whether it's the memory lapses or the brain fog or difficulty finding words or you're not able to perform at work you've had some of these things to maximize your brain health and reduce your risk for deterioration prevention is your strongest defense you don't want to procrastinate and I always tell people less than optimal is not normal so don't accept I hate you're just getting older you're just getting older that's not acceptable that's giving up in my mind you want to be thinking about why this is happening when you're 99 years old you can improve your health but you've got to make changes you've got to do something different your body can heal and again if you just fuel it with the right nutrients you can remove those triggers as Bredesen talks about in his book I think there's 36 different holes that he talks about you need to look at everybody's got different holes everybody needs different treatment it's not a standard process most medical treatment plans where you do this, you do this it doesn't work, you do this, you do this you have to be individualized because that's where you're going to get the best results because we shouldn't be going around from doctor visit to doctor visit when we're in our later years we should be enjoying our life we work hard that's what you want to be focused on is being healthy you want to be there for your grandkids you want to see your children grow up you have to make the changes that you need to make because it's possible so again every 65 seconds someone's diagnosed with Alzheimer's you don't have to be that statistic but to make, to beat this thing you have to start making changes because what you should be who's happy? we want to be happy up until the last days of our life that is what is important so remember this guide, check it out and just some tips in there on how to eat cleaner how to detoxify your home which is huge and how to optimize your sleep and your mindset I really really appreciate you guys coming in and hanging out I know it's a beautiful night out there and it's just inspiring to see people wanting to increase their knowledge increase their education because that is what's going to change the future of health it's you guys so again I'm just really grateful for that and I'll be coming back in the future hopefully but does anybody have any questions? what do you think about the there's a lot of apps out there for free I like those I use those quite often actually with my patients I just told two about it today luminosity is what I typically refer to so remember we exercise our body to keep our muscles strong keep our circulation moving efficiently we also have to exercise our brain find things that you love some of those apps are really good about enhancing memory enhancing the the firing of those neurons and that's what's going to keep your brain going pick up new things that you love learn to play an instrument play memory with your children your grandchildren do different things that's going to stimulate your brain and some great technology out there too to help you do that great food awesome I'll have to read that so if I came to you as a client you wanted to do a whole bunch of tests are all these tests going to be covered by Medicare? actually so it depends right so it depends that's a good question because it is an investment with the testing but believe it or not the best insurance to have which is awesome is Medicare for a lot of these tests a lot of them get 100% coverage which is great not all of them but Medicare does give really good coverage like the nutrition profile gets covered, the stool test gets covered there's various things, Medicare is great they're moving away with a lot of the stuff which is awesome whereas some of the other insurance companies aren't that good so I've got a location in Burlington and in West Lebanon in New Hampshire you do have a question for Elizabeth? can you just open up? IDX drive? for the elimination diet how long do you have to eliminate the food? at least I tell people 30 days so 30 days is a good starting point the research somewhere between 3 weeks and a month before your antibody levels come down enough to where you're going to get a response that's sufficient when you reintroduce the food so if you cheat on an elimination diet even a little bit you're not going to have that exaggerated response if you do have an inflammatory food that you put back in so it is important when you do an elimination diet be strict if you have 100% we're ideally 30 days I think this is a good starting point so you see how you feel after the 30 days and then you put the food back exactly and see how you feel then? there's different ways to do it but what I recommend is you eat the food just a small amount and then you wait a couple of days to see how you feel without the food so you eat it and kind of load your system and see how it reacts if you have any change of symptoms from your baseline where you were going into the food reintroduction then you know that that food is not your food right then it doesn't mean you have to be out of it forever but you want to eliminate it at least until you keep your gut in a better place and then once your symptoms settle down there's a nutritional profile going back to this blood test so urine tests there's different ways you can do it so there's various testing you can look at blood, urine some people even look at hair there's various ways to test I use urine and blood a lot because I find it more reproducible but everybody's different and then just tell me what you're lacking yes it tells you what you're deficient in you know again and what we always want to push is the foods that are high in those nutrients because that's where we want to get you sometimes we use supplements in the beginning to get your levels up but the goal is to always be getting your nutrition from food just you know and so sometimes it's hard to do yes yeah we didn't really get into that so probiotics are very interesting because I think there's still the juries out on what's the best for each person so we just don't have the answers yeah you know I think again getting back to the foods that are fermented you know the prebiotics, the resistant starch food I always think that that is your best bet some people are just in the place where their gut's not helping you out to tolerate certain prebiotics or resistant starches but I personally like to rotate into different things I'm a big fan of spore forming probiotics which are soil based typically but there's a lot of stuff we just got to be careful because the supplements they're all created equal they're not regulated so you just got to make sure you know you know I always recommend getting them from like a compounding pharmacy or directly from the manufacturer because you don't know how long they've been sitting you don't know the environment they've been sitting in you just got to be careful but rotation if you don't know if you're doing different ones it seems like you feel is a good play but again getting back to the food is always the priority I have a friend who's in her late 70s and she was part of a drug study same story at Dartmouth Hitchcock and she didn't know at first if she was in the CBO group where she was getting the drug but she a couple I think a couple of days into the study she realized that something was different with her brain and she went through the study and then she found out later that she was getting the drug that they were experimenting and it turned out to be an amino acid and without going into a lot of deodorant, serum, S-E-R-I-V and she had had a lot of brain fog problems I mean difficult whatever the tests are done she was told in no uncertain terms the last time I spoke to her Alzheimer's had gone away I have a lot no wisdom in the computer but it seemed to be there's more to it anyway it's interesting though because not with Alzheimer's actually I had a patient from Dartmouth who was on it for Lyderics disease they were doing some research and I didn't see the end result but what's interesting about it is that it's an amino acid it was just an amino acid but with that said she's on a strict protocol getting 40 minutes of diet whatever the tests are that determine that Alzheimer's has gone it had gone away so really it's diagnosed mainly based on clinical presentation so that's what they're saying though people are getting better they're improving their cognitive function they're improving their memory by taking this whole body approach and honestly we don't know what works for everybody but we do it all just because when you're losing your memory or you're losing your cognitive function you want to take that full out approach to get better so the exercise of the sleep, the nutrition the supplements that's what reticent is seeing again focusing on each person as an individual and taking a very comprehensive approach to getting people better and it's very intriguing we're learning so much we still will be learning for years and years nobody has all the answers so that's what you've got to do just try I have this problem where I take anything like energy and just recently I took plankton and after about two days of taking it my brain just my brain just I just lose it it's hard to say there's a fine line between detoxing and a reaction you just have to be careful your body but just from doing algae it's hard to say but detoxing does make you feel kind of crummy for a little while we call it a home timer reaction where you're mobilizing junk or endotoxins it can cause a little bit of inflammation which can make your current symptoms a little bit worse but how you know it's a detox reaction is that it should get better but if it doesn't get better within a week or two then it's probably more like reactions to a second I literally can't function I can't ask a case I can't go out of the door and remember where I'm going yeah MCT MCT oil it's great for the brain healthy fats and medium change triglyceride that's where the MCT comes from but I do it every day I think it's great and it's good brain fuel so where the ketogenic diet works for cognitive functions we know that the brain it functions much more efficiently mitochondria which are the energy power cells that function more efficiently when they use ketones or fuel as opposed to the sugar and ketones come from your body breaking down fat for energy at that point though you have to have low sugar you have to have a low carb diet so your body says hey there's not quite enough sugar here there's not enough carbs here to keep me going so we're going to start burning fat for energy and that's where the keto diet comes into play but you got to be careful with it because it's not for everybody so you're saying that taking coconut oil in the internal is good but what about the whole thing that local health that hardens therefore it's bad yeah no I don't think so I think coconut oil again there's no blanket answers here because everybody is unique everybody's different saturated fat which is from coconut can be inflammatory for some people but it can be beneficial for others so that's where it's important to use your markers and look at your inflammation and see how it reacts to your body I mean it's the same with drugs right one person will do amazing on a pharmaceutical the next person will be in the hospital with a reaction so everything's individualized you just got to tread lightly and go slowly and see how your body reacts because there's no perfect treatment for anybody but I do think medium chain triglycerides as long as it's not messing up your lipids your inclinations are good my breakfast is MCT oil, collagen and coffee and you know Rache coffee I love it and it's good and I stay full until the morning so there's a lot of things you can do to run off of fat and feel in your body and it brings more efficiently I have been using lion's mane and I do find that when I run out I'm my memory gets worse so mushrooms are kind of up and coming too you're hearing a lot more about mushrooms and I think there's a lot of benefit there's a lot of good research between lion's mane and Rache and some of these other things yeah shaga, you know that's everywhere Rache coffee so they actually made coffee now that has real coffee organic is what you want but it has Rache mushroom in it which is anti-inflammatory lots of new stuff with mushrooms that they're putting in or sigmatic is a good brand that's a great brand or sigmatic another one is organo gold you just got to get their organic blend but for sigmatic I really like them did you say oh yes, yes so like if my can't get fit and the tick is in Gorgia we're not sure if it was just there or not it will set it off to tick to tick testing it is called drawing a lake on the name it's like I think it's something like tick test you know it's out of Massachusetts there's one other Massachusetts and they're really quick it's 50 bucks to test a tick and some of the main co-infections like Labesia it's a great thing to do because that's really helpful from a treatment standpoint so if someone comes into my clinic and they are bit by a tick and they're symptomatic and if we have that test we know what funds we need to be looking for and testing it for as opposed to running the whole gamut of tests so it's a great thing to do oh Shagonda, if I think if it can feel good how long is it? I can't give you any medical advice but I do utilize Shagonda in my practice but it's a nice change some people do react to it so you have to be careful especially with autoimmune issues just got to see how your body reacts but it's a great adaptogen it does help exactly, so it's an adaptogen in the sense that it's supposed to help you when you're stressed or whether you're low it's just kind of a balancing I just first of all want to thank you for coming out because my grandfather died of it, my dad is 72 he has it, and I'm 42 and there's doctors like yourself, function medicine practitioners who can't actually heal people I started with End of Alzheimer's Dale Bredesen, his repo protocol is amazing there's a couple other doctors in books that are very helpful he has a book called You Can Fix Your Brain he's all over Facebook and social media, and it's really helpful and then have you read Genius Widzik by Max Lugendale no, I haven't, is that good? really good Hyman's got some good stuff out Pearlmutter's another great book Brain Brain, wheat bellies another good one there's different books have you heard of him? yes, but if you get audible, I'm a huge audible fan I'm always listening to books for whatever it is, a month, 10 bucks a month you can just get book after book and there's so many good books out there that really can expand your knowledge and understanding all of this stuff and I would encourage you, from a functional medicine standpoint, another great book is called The Disease Delusion by Jeffrey Bland that's a really good book just talking about where healthcare is at what happened to get people healthy again and I think it's just good to spread the word on that book because it's just such good information Jeffrey Bland this is a question that I wanted to ask you in the beginning sure my understanding is you cannot tell if someone has Alzheimer's or not they're dead in the exam frame that's why it's a clinical diagnosis that's typically what it is because looking at imaging, there's subtle clues on an MRI when you're looking at volumetrics of the size of your hippocampus for example which is suggestive but truly Alzheimer's that's where you know definitively they're doing a biopsy and looking for the tangles and looking at the baby amyloid but there's subtle the clinical presentation that's why even when someone gets an Alzheimer's diagnosis you still want to do a comprehensive evaluation make sure that that's what it is but sometimes just like with everything once you get a diagnosis it's kind of left alone okay that's what it is we're not going to look any further but just like with autoimmune and MS and different things you want to be thinking about just making sure you're not crossing all your T's and dotting all your I's so you're not missing them and then there's head injury head injury is huge so again when you look at if we're calling it a decline in general or any neurodegenerative disease is concussion in head injuries so that's where you just got to be careful with kids and sports and stuff you got to be proactive with protecting them because it's a big deal it's a big deal that sets off a whole cascade of information that can hang around I talked to a lot of people with other disease processes where the trigger was an injury traumatic brain injury so take care of your body take care of it now so we can protect it any other questions guys so they I would say maybe you don't have Alzheimer's but you may have a head injury you may have a head injury but the head injury I forget what it's called a concussion TBI and traumatic brain injury there's different levels of that because that can mess you up in various ways a lot of people with head injuries guess what they get, gut issues too I was just wondering if you don't have Alzheimer's history is important too history is really important we talked to people for 80 minutes at our first visit just going from history from birth up in the present day and trying to paint that picture of what's happened when symptoms started and what some of those triggers might have been but history is super important so take care of your doctor make sure you're well informed I just want to go back to the ball I'm just wondering about that how much of a factor is that more so mold is a big issue exactly for a lot of people it's like lime I personally feel a lot of times when you go to a lime doctor they see lime and you go to a mold doctor so you need to keep an open mind and even look at the big picture again, history is important when things change did you start getting sick when you had that roof leak or did you get sick when you moved to that new apartment that history piece is important do you feel better when you go on vacation as your health significantly improved so that matters but there's also testing that you can do on yourself there's actually a cool test you can do at home it's a VCS test it's a visual contrast screen and you can get that at survivingmold.com it's like $15 now this, I want to start off by saying this is not a perfect test so if it's positive you don't want to freak out and think you have a mold issue but I use this a lot in the clinic as a first step because what we know with mold and biotoxins is that they bind to your optic nerve and that can affect your visual contrast, not peculiarities of contrast differentiating different shades of gray so if you fail this test it means you have a problem of contrast which could suggest some kind of biotoxin illness in mycotoxins from mold which are volatile gases mold certain molds produced from water damage buildings can contribute to that but other things can as well so just because it failed doesn't mean you have a mold issue but that's a good starting point and then there's urine tests that you can do there's allergy profiles you can do but that's not a mold issue if you don't have to have one it's a disaster as far as remediation goes and you want to be 100% sure that that's an issue if you're going to go down that or not 100% you can't be but pretty sure sorry one more question let me stay excited so let's say I brought my dad to see you 72 like what type of, do you have any patients that have cognitive lines? but it's not always, I have a lot of patients I have one today with Alzheimer's new diagnosis but there's various stages too so I get a lot of patients in that 40 to 60 range where they're struggling cognitively they may not have a diagnosis yet but they are definitely heading in that direction so let's say at 72 like what you do the assessment and you run all the tests like one or two things that he could start doing that could start to tip the ties the big thing is that moving in planetary foods is huge getting rid of all processed sugars, all processed junk really focusing on a plant based diet high on fat, lean protein, I think that's essential exercise, very very important working with a trainer it is worth the investment to work with a professional to figure out what you need to do because I'm guilty, I don't know what I'm doing at the gym that's why I have a trainer that tells me what I need to do and I go and do it because my time is valuable just like everybody else's so I want to make sure that when I go I'm getting something out of it so working with a trainer or at least someone who's going to be able to help you develop a routine being proactive with that is important and then again looking at nutrition, looking at inflammation, doing like some of these brain activities and exercises all of that's really important to you now do you walk a lot of occupations along with the nutrition or is there a nutritionist or anything that you sort of because I kind of head over the nutrition fees and make the initial suggestions and then when you have a nutritionist and a health coach in our clinic that help walk them through that and then of course we're always regrouping every single appointment I'm asking people about the five foundational five because those are essential, you know you've got to sleep you've got to eat, you've got to relax you've got to move, you've got to detox and you I think I've been on your site before there's insurance doesn't cover you know unfortunately so what would like a six month engagement cost so I don't think I can actually talk about that you're unfortunately in education you know so everything's on my website everything's on my website any questions guys? sorry man any questions? no? you guys are awesome I really appreciate you thank you thank you if you haven't signed in yeah that would be cool if you wanted to hear from us so if you you can hop in here by itself it breaks down to the start very quickly whereas when you feel it now it becomes more resistant so it travels through the intestine further before it starts to get broken down I don't know for sure but I'm here