AMA: From Parkinson's to Concussions to Hormones and Beyond

In this episode I take questions from the audience and review the research on a variety of topics.

The concussion we all missed: Using Mike Evans’ hit as a case study, Dr. Z shows why a “minor” concussion can be far more life-altering than a broken collarbone—and how symptoms get rationalized away.

Depression redefined: New findings on excitatory neurons and microglia link mood and inflammation—explaining why exercise, vitamin D, gut health, and targeted nutrition help some people more than meds alone.

Women’s brain health & hormones: How menopause accelerates brain atrophy in MS, which regions are hit (memory, attention, emotion), and why LC/MS hormone testing changes the conversation on safe HRT.

Parkinson’s is rising—here’s why: Environmental exposures (industrial degreasers, pesticides, head trauma, autoimmunity) drive risk—and the practical levers you can control now.

From POTS to “wear-and-tear” knees: Why POTS is a neuro-immune problem (not a single-cause diagnosis), how ultra-processed foods speed cartilage loss, and what emerging evidence says about Boswellia + celery seed for pain, function, and inflammation.

Transcript

Hey, everyone. Welcome to the Ask Me Anything. I'm Dr. Spencer Zimmerman, and I'm going to be covering really nearly any question you have about health. I'm going to focus specifically more on brain health, immune health, and things like that. So while we're waiting for some of the questions to come in, as they come in, I will absolutely address them as I finish up my thoughts. But I also have different research, different things that have happened over the past couple of weeks that has grabbed my attention, where I'm going to share my screen and go over that with you as well. So. All right. So one of the very first things I want to go over when we look at brain health, it's that of concussions. Concussions impact millions and millions of people each and every year. When you look at the research as to what happens when you're diagnosed in the emergency room with a concussion, nearly fifty percent are still struggling with symptoms a year down the road. So it's not this simple, minor little injury that doesn't really mean anything. But being here in the Tampa area, a lot of people are very big buccaneer fans and one of the legends for the team is wide receiver mike evans just got back from injury makes an amazing diving catch so it appears but then when he goes down with the way he lands unfortunately breaks his collarbone but also suffers a concussion and he's down for quite a bit you know it takes him a bit to be able to get up and to get off the field And when he's doing it, he's really, really dazed. Now, one of the reasons why I have this up, it's because when we look at this, right, it says suffers broken collarbone. So this is clearly the emphasis of the articles, the fact that he broke his collarbone. And so then they start in here and they talk about like, okay, um, You know, suffered a collarbone. This is going to sideline him for most of the remaining of the season. He's going to be out two to three months, depending on what type of collarbone fracture this is, whether it's surgical or non-surgical. But he's going to be out for a bit. And then they really just sneak it in here, who also sustained a concussion. Now, I've got a really big issue with this. His collarbone injury is going to be very, very short term. It's going to be a couple months, two to three months. And then it's really going to be as if it never happened. There's no long-term issues that are going to come from this. But when we look at it from a concussion perspective, there are a lot of long-term issues that come with it. from symptoms of chronic fatigue, to poor concentration, to mood issues, depression, anxiety, irritability, to insomnia, to headaches, to chronic neck pain. But then we go to diagnoses such as any type of dementia, specifically Alzheimer's, to Parkinson's, to multiple sclerosis, and many other things that could be a potential thing. So one is definitely a greater threat. And unfortunately, the one that is the greatest threat didn't get the attention it needed but we're gonna watch this play because this is what happened so he's going looks like he catches it and when you see that right it doesn't look right he comes down it doesn't look like it's that bad you know it looks pretty innocent but yet he stays there now When you initially see this posturing that happens, right? He hits. So it was probably right there. His head hits against the ground. Now this is hard because there's many times you're watching sports and you see things very, very similar to that, right? So that gets it. He loses consciousness. Cause I mean, if you can see there, his eyes are basically closed. Now at this point, it drops the ball and then he just stays there. Now this isn't from the collarbone, right? You wouldn't like, yes, you'd have pain and everything with it, but you wouldn't see this, right? You just see that posturing just kind of completely goes flat on that. So big issue that we need to make sure that Concussions are really taken seriously. And this isn't just concussions in sports, because remember, sports concussions are not a top two cause of concussions. The top two causes of concussions are related to falls and then also car accidents. And there's a lot of people who I've seen in car accidents who had a broken collarbone. They had a rotator cuff injury or a labrum injury of some type. And because of that, their concussion was ignored because people start making these logical things, which does make sense, right? When you connect the dots, but it doesn't actually help people out. So what are some of the dots that they're connecting? They're like, well, you know what? They hurt the shoulder. So the shoulder, right? It's kind of pulling. That's going to give you some neck tension. That neck tension is going to give you a headache. The headache is going to make you don't sleep as well. The sleep is going to give you issues with your energy and fog. And then that's why you're irritable. And you can see how you could easily rationalize it away pretty, you know, it doesn't take much to rationalize it away. But this is also very, very dangerous because that is not the right thing to do. So let's make sure that we are not rationalizing away concussions. People are getting the proper treatment that they truly need. So that's, Really, the first story that I wanted to start with is concussions are still downplayed, unfortunately. And until they're no longer downplayed, people just aren't going to take them as seriously as they should. Now, we're going to go through a variety of other things as well. So we just finished talking about everything related to the Buccaneers. Next, let's go on to depression. So depression is one of those things that many people experience, at least at some point in their life. And here was a new thing just came out, as you'll see, October thirteenth, twenty twenty five. First time scientists pinpoint brain cells linked to depression. So there's always been the thought like, okay, depression, SSRIs. Hey, maybe you're just in a bad relationship. Maybe you hate your job. Maybe it's the food you're eating. And you're right. For some people, that's definitely it. But for some other people, that's not really the reason why they have depression in the way they do. So what they did was they looked at a variety of different things and then the So here's what it says, right? They discovered that gene activity was altered in two types of brain cells, a class of excitatory neurons responsible for mood and stress regulation, and a subtype of microglia, the immune cells that manage inflammation in the brain. so it should be really important here that when we look at neurons neurons are the functional cells of the brain it's neurons job they communicate with each other as they communicate with each other you can function the way you need to so this is good mood this is concentration everything in that side okay But on the other side, when we look at microglia, these are immune cells. So as the immune cells, they get activated in different ways. So depending on how they're activated, they either help with repairing anti-inflammatory benefits or they're actually highly inflammatory. And what did they see, right? The immune cells that manage inflammation. And ultimately when you get more inflammation, the brain does become susceptible to depression. And this is where one of the things is, you know, people are trying to figure out what fixes depression, but there's really not one thing when we're looking at what fixes depression. But people have looked at fish oils, right? Some people are like, ooh, I do fish oils at a pretty good dose. My depression isn't there. But then you have other people, they change their nutrition and they don't have any issues. And remember, if you're joining us, feel free to ask me questions. I'm going through different articles and things that have been sent that have provided a lot of interest to me. over the past couple of weeks and we've already talked about Tampa Bay Buccaneers with Mike Evans and his concussion but if you have questions about anything brain health or immune health feel free to ask it and I will address it to the best of my ability but you know once again this is very interesting getting this article when we're looking at depression because Depression is, at the end of the day, it is a neurological and immune system mediated thing. And that's why as people improve their gut health, they're like, whoa, my depression's better. And there's been a lot of research on different probiotic strains that you can give people to help with their depression. Because yes, probiotics, when done appropriately, may help someone's depression. Vitamin D may do it. We know exercise does it. Why does exercise do it? Well, as this article that I'm reviewing talks about the neurons get impacted. Well, when you exercise, your neurons get stimulated to connect better, but also you reduce inflammation. So that's a big, big thing. Now into the next article, we are talking about multiple sclerosis. So with this article, menopause linked to accelerated brain atrophy in women with multiple sclerosis, and they specifically found different parts of the brain that atrophied as a result of menopausal transition. And it's because despite the myths that females only have estrogen to have babies, that that's not true. Like estrogen and progesterone are essential for brain health. And when you don't have appropriate levels, your brain does get it. It does get impacted. And that's why people in perimenopause and menopause, they notice so many cognitive based symptoms and issues. so make sure you're getting that checked now you may be wondering how do i even get my hormones checked well really the best way is blood work okay you get blood work that uses the latest technology now i need to emphasize that latest technology bit because there's different ways that technology is that calculates everything depending on the technology that is used your results will actually vary so what's the most accurate form of testing well it's lc ms so You'd want estradiol, ultra sensitive LC forward slash MS. That's going to be much more accurate than estradiol on its own. Now, when you do total estrogens, right, there's no true differentiation. It's just total estrogens. But the same thing is true when we're looking at progesterone, LC slash MS progesterone. is gonna be more accurate than not. And I can't tell you how many times I see people who they're being prescribed hormones or told they don't need hormones based upon things that aren't overly valid. Then when we look at testosterone, testosterone is another one, free and total LCS forward slash MS as well is what needs to be done. Because once again, we know that when people go, when females go through menopause, there's some accelerated brain atrophy in the, you know, and I think this is important, right? in global gray matter right so gray matter these are your neurons okay so these are the basically you think about your cities that's your gray matter and your white matters the streets that connect everything so everything flows appropriately so we're seeing global gray matter but then they also know the left hippocampus so the hippocampus is the part of the brain responsible for learning and memory specifically for like short memory encoding so Guess what? That's not going to end well. And that may be part of the reason why we see the memory issues. Anterior cingulate, attention, emotional processing. So as it says, ultimately people with multiple sclerosis are likely to have issues. And we know that hormone replacement therapy for most people can be done very, very safely, right? We have estradiol patches that are out there. We have progesterone pill that's bioidentical and the patches are bioidentical as well. so the days of having to say well i can only do compounded or nothing that's not really true and when we look at testosterone you know that there's not as many options for females but that's where compounded does come in and then if people are wondering about pellets i'm personally not a big fan of pellets mostly because you have to commit to it for that time frame and i treat a lot of people who've been over medicated on pellets And reminder, if anyone has questions about the things that I'm going over, just let me know and I'd be happy to review it with you. So we'll absolutely keep things going. Okay. So if you have questions about anything, brain or body health, let me know. I'll answer them. i'm going through it so depending on how you're watching and listening to me you may or may not be able to see the screen of what i'm using but here we go all right next one let's go parkinson's so parkinson's is the fastest growing neurodegenerative condition percentage wise that there is now when we look at parkinson's and the reason why parkinson's increases it's not just purely genetic okay because you either have to believe that we just magically won the genetic lottery or you have to believe there's a lot of things that are triggering our genes to misbehave there's a lot of environmental influences and it's the environmental influences are the ones that really really matter so now this thing know i'm not going to pretend this is new because this is not new at all okay there's been multiple research studies on this but basically there's a industrial decreasing agent trichloroethylene okay shown to increase other stuff right with um Dry cleaners also known to do it. We know that if people live within a certain distance of a golf course, they also have a higher risk. You know, people with concussions have a higher risk. We know people with different autoimmune conditions have a higher risk of Parkinson's disease as well. Okay. Um, Yeah, and you know, things important, because this is, like I said, this is in dry cleaners, but primary use as an industrial cleaner and degreaser, TCE, is found in consumer products, including lubricants, adhesive, sealants, paints, right? And you're like, this is a lot of stuff. A persistent environmental pollutant and known carcinogen, so it's known to cause cancer, and it's found in air, water, and soil, and take years to break down through evaporation. And this is one of those big things. So even once they get rid of some of this stuff, it's not truly gone. It's going to persist. Okay. So ultimately limit your exposures, control what you can control. That's super important when we look at Parkinson's. Now on the other side of the spectrum of Parkinson's, let's go back to childhood. So I treat a lot of moms, a lot of people who have kids. Right. And there's a lot of them who their kids are getting sick frequently and they themselves get sick frequently. Now, there's a lot of reasons why someone can get sick frequently. But this was a newer article that came out at the beginning of the month. They had looked at a meta analysis and they found prenatal antibiotic exposures tied to higher risk of childhood infections. So if you're pregnant and you take an antibiotic, the likelihood that your kid is going to get sick more frequently goes up because this impacts you, but also impacts the development of their immune system. Now they looked at the different types of infections. Okay. They found ear, nose, and throat infections. So anything from ear infections to sinus infections to strep, those all go up as a result of moms who took antibiotics during pregnancy. Now, it didn't show that for respiratory infections, but it did show up for what, in general, we see as the most common infections kids have. And so if we did a little bit better with making sure moms were healthy throughout their pregnancy and really didn't use antibiotics, unless we absolutely had to, that would go a long way in helping kids have the immune system that they should have. But in general, there's even things beyond that, that we can do to help kids have a better immune system because no kids should be getting sick routinely. That's just not something that has to happen. All right, now, because I do treat people who've got autoimmune-based conditions, I get a lot of people who come with different stuff. This looked at prior disease-modifying anti-rheumatoid drugs, okay? And psoriatic arthritis lesions. And ultimately what it says, those who used it and also those who are older age are associated with more severe ultrasound-detected infections. inflammatory and structural changes in psoriatic arthritis. Now this one really, you know, means a lot because these drugs are expensive, right? Like I get people like, Oh, natural health is expensive. You know, it's a couple hundred bucks for supplements or whatever. No, these drugs are And when a study comes out and shows that the arthritis is worse compared to those who basically never used it, that's very head-scratching. Maybe I'm interpreting some of this wrong, but it's like that is head-scratching. That should not be the case when medication costs that much. It should do better for structural changes than that if we're really going to say something's effective. Now to keep our thoughts, and this is kind of where we're going to go with the rest of the time, is along the arthritis. So I did get a question about schizophrenia. When we look at schizophrenia, this is a It's a blend. It's a blend of genetics. It's a blend of neural neurology and immunology. There is some research looking at the role of gut health and inflammation in schizophrenia. And so if I was to write, treat someone's schizophrenia, which, you know, I don't treat a lot of that. I try to get them to optimize all aspects of their health. Like you can't sacrifice your sleep because many people's schizophrenia is You know, they can tip over after certain medication exposures. Specifically, when we start looking at illicit drugs, you know, marijuana can tip people over. There's other things out there that can tip people over to in a schizophrenia. So how do we get the health where it needs to be? Prioritize your sleep. Make sure you're gooding the exercise you need. Make sure your nutrition is good. Make sure you optimize, you know, your vitamin D, your blood sugar. and really take care of the foundational aspects of health. As you take care of those, then doing something where you're maybe doing more with going into gut health and other things like that could absolutely be beneficial. But my stance on going into the deeper, more specialty labs, which don't get me wrong, I absolutely love, cover the basics first and then see what you have left. There are a lot of people, if they really get the basic down, they will do okay. All right. And then just reminder, if someone has other questions, let me know, right? Let me know, put in the chat and I will answer those questions as I see them. And if you have questions about anything else, brain health, you know, our immune health, let me know. Now, as we're talking about psoriatic arthritis, let's just go into regular cartilage. So the amount of people who deal with arthritis and Oh, you know what? I need to get a knee replacement. I got to get a hip replacement. I got to get a shoulder replacement because of my arthritis and I just have no cartilage. It's through the roof. Yes, many of these surgeries are being done one, two, three years before they should. But at the end of the day, they're still likely going to happen unless there's a change. So what can you do, right? Is it this thing where your arthritis is there and it just has to keep going and that you're kind of this innocent bystander and there's nothing you can do? Well, it turns out, according to this article, So July, the answer is no, you're not an instant bystander. So ultra processed food intake was linked to cartilage thinning and knee osteoarthritis. So the more junk food people eat, the faster their cartilage deteriorates, which means, and here's what they said, right? Worse than the outcomes among women, including higher pain scores and thinner knee cartilage. So. that needs to be considered okay if if you have arthritis and no one's talking about your nutrition the times have changed we need to really be looking at inflammation and anything nutrition related and i'm going to keep going on this topic in a moment but i'm going to answer a question so is pots considered an autoimmune disorder This is where, when we really look at POCS, we have to step back and say, what does this stand for? Postural orthostatic tachycardia syndrome. What's the definition of syndrome? So a syndrome is a grouping of symptoms that does not have a true explanation. And that's why we see the same with chronic fatigue syndrome, right? We don't know the underlying process fully for POTS. When I say that, it doesn't mean we don't know how we could eventually treat it. It means like rheumatoid arthritis, it's like, oh, you know what? These are the markers we see in labs. There's these things that we predictably see. With room with pots, we just say, Hey, you've had these set of symptoms for a set period of time, three to six months. It's been there pretty consistently. And we don't have an explanation for why you're there. Now there is a type of autoimmune phenotype of pots. So there's a subset and you can technically have what's called anti-ganglioside antibodies that can cause autoimmune neuropathy okay small neuropathies and that can do it now there are a lot of people who also have pots and they have co-existing autoimmune diseases so i do treat people who have either lupus or they've got rheumatoid and they also have pots now if as you treat their rheumatoid then everything goes away it means it was really just rheumatoid it's not even pots Now that's really getting into the nuances because for me at this point in time, until we get more research, POTS is a set of symptoms where we are looking for a certain thing to happen with your heart rate and no changes to your blood pressure. In which we say, we don't really have a good understanding. Okay. So I hope that answers the questions as to whether or not it's an autoimmune disorder. Now, can autoimmunity drive POTS-related symptoms? Absolutely, all day long. Just like people with immune issues, it will drive. So whenever I look at POTS, I view it as a neurological and immunous issue. So neuroimmunology is ultimately what it is. because it's an autonomic nervous system dysfunction. So it's nervous system, right? Your nervous system actually through your vagus nerve fires down to help control your heart rate, okay? Also fires down to help control your blood pressure. You have baroreceptors that sense changes in blood flow as well. And that all has to do its job appropriately. But if you have inflammation, you have autoimmunity, you have food sensitivities, you have issues with mold, that inflammation is going to go hit certain parts of your nervous system, cause inflammation, and it's going to shift the balance of your sympathetic versus parasympathetic nervous system. Hence, worsening your POTS-related issues. So I hope that answered the question. Once again, POTS is not straightforward. It is very, very nuanced. And that's why if you're in different groups, most people with POTS, they don't get better. Because if you're trying to look for the one thing, you're never usually going to find that one thing that if you address it, magically all of your POTS stuff gets better. but it is finding the three to five things that if you add them up together, that's the significant player for you. So I try to differentiate, is it immune versus is it neurological? And that's based upon the testing as well as really just spending time with people and being able to dissect their history plays a really big, big role. So now continuing, right? So we said ultra processed food drives osteoarthritis and it thins the cartilage faster. So, well, what can we do? So this is a new supplement. Okay. And, and when we look at supplements, a lot of supplement companies do not research their supplements. Okay. What they do is they say, all right, let's go to PubMed. We're gonna look at different ingredients that appear to be good. And then we're gonna throw them together and then we're gonna, you know, see how people like it. And if it's good seller, we basically consider it a great supplement and it's working. And if it's not, then we don't this company. They only have a few supplements at this point in time, and they don't actually release any supplement without doing some degree of studies. So what they did was they used Boswellia serrata and apium gribulins L-extract for knee osteoarthritis and cartilage degeneration. Okay, it tells you how much it was. Right, here's how much it was. And then what were the results? Now the results are pretty cool. So oral administration of the nutraceutical resulted in prolonged symptomatic relief with reduced pain, stiffness, and swelling. Inflammatory and cartilage degeneration biomarkers were decreased in the nutraceutical group compared to baseline and placebo. So some of these markers, interleukin-I, VI, high sensitivity C-reactive protein, tumor necrosis factor alpha, E-Cetrate, right? All of those are down. So you have things that actually shows that it can reduce the damage that's occurring in the cartilage. And then one of the things they noted, though, was there were also things that were increased, which suggested collagen synthesis contributing to cartilage regeneration, which is really, really cool. At given doses for ninety days, there were no adverse effects. So how cool would that be if we could have someone on a supplement that actually reduces inflammation, but also helps to promote regeneration of their cartilage and in some of the imaging that i've seen from these studies you have some increased joint space it'd be really cool to see how this goes over a longer period of time because i would think to true you know you're going to get some initial marker changes but to really get a significant it's like what happens about six months to a year but this is so much better than other things that people are stuck having to do because there's no trade-offs with this, right? There's no trade-offs that we are aware of. Now looking at this other one, okay? So this was the same thing and they looked at this versus NSAIDs, okay? Celery seeds and Boswellia serrata extract demonstrate promising efficacy as a safer and effective adjunctive therapy for knee osteoarthritis. offering pain relief enhanced joint functionality and potential reduction in nsaid usage which is awesome because we know with nsaids there's a lot of trade-offs from what it does to the gut heart and just so many other things so to have something that is non-pharmaceutical and i don't even want to necessarily say non-pharmaceutical right i just want to say non-trade-off like that's what we should really be looking at it's not Drugs are good or drugs are bad. It's more of, well, how many trade-offs do I have to make with my health if I take this? And I think that's my goal as a provider is I want to say, what's the least amount of medication or what's the least amount of medications we need? How do we minimize side effects and trade-offs of anything that we use? And what you'll see when we come down here, You know, the change in mean pain score you see at zero, you know, pretty high up there at a sixteen day, thirty down to a twelve day, sixty down to an eight. We're just rounding up and then day ninety. It's a four like that's pretty cool. You see the same thing. Stiffness score just slowly comes down. Physical function score slowly goes down. I'm not going to really go into this one, but ultimately the amount using painkillers did go down. they're perceived okay of where you got with pain on a zero to ten seven point eight one down to two point five seven what about when you're moving what happens also down down down down So this is really, really cool, right? So we know that by removing ultra processed food and by using one supplement, and one of the cool things I like about this supplement is, as I mentioned, this is one of the few companies that researches, and this was at the dose that they say is a serving size, which is awesome. Because there's a lot of times, even with supplements I use, I'm like, yeah, but one serving size just isn't going to do it. You're going to need like two, three, four servings to truly be therapeutic. And so I always appreciate it when there's actually a pretty therapeutic dose just out the door. So reminder, if you have any questions, feel free to type them in. Let me know. And I will absolutely address those. And for those of you who don't know me My name is Dr. Spencer Zimmerman, and I've got a clinic here in Wesley Chapel, Florida, which is right next to Tampa. I see people who live in the state, Idaho, Utah, where I'm also licensed, and those who fly in. So the things I treat, concussions, POTS, autoimmunity, chronic dizziness, chronic headaches, migraines, and things like that. But it's really about putting together Each person as a individual and not trying to treat them as little pieces that are all disconnected. There's enough of that that's happening in the world. And it's why a lot of people, guess what? They just don't really get the results they would like to have. So last time, if anyone has any questions, let me know. We've covered a lot because we started with Mike Evans. Then we went to multiple sclerosis. We also went to brain functionality with depression. We went to Parkinson's. We went to immune system development. We went to osteoarthritis and really have covered the whole spectrum. Plan is to do more of these. probably close to a weekly where I will grab different articles that hit my inbox, put them together like this, but then also as more people join, have more questions, answer things as well because getting your health back it's tricky it's hard and there's more confusion now than ever and i see a lot of people yanked in all these different directions and you can only know what questions to ask if you get the right experience Okay, because outside of it, you're like, well, I think I'm asking the right question. It's like, well, sometimes you are and other times it's not. But you need the experience. And by being able to get some different thoughts, right? Challenge the way people approach stuff. So I hope everyone enjoyed this. And until next time, I'm Dr. Z, located right here in Tampa, Florida. I'm a dual licensed nurse practitioner and doctor of chiropractic. where I focus primarily on brain health. But really, it's about connecting everything because the brain doesn't live in isolation. So I will see everyone next time.