#398 Reversing Alzheimer’s and Neurodegenerative Conditions with Dr. Heather Sandison, ND

This week on The Less Stressed Life, we're talking about reversing cognitive decline and optimizing brain health with Dr. Heather Sandison, author of Reversing Alzheimer’s. As a naturopathic doctor and founder of the first memory recovery residential program, Dr. Sandison shares the six root causes of neurodegeneration—and how you can bring the brain back into balance at any age.

We’re talking about reversing Alzheimer’s and neurodegenerative conditions (although it is so much more). From toxins to stress to nutrition, this empowering episode offers real hope and practical tools for preventing and even reversing memory loss. Whether you're supporting a loved one or thinking ahead for your own brain, this is one conversation you don't want to miss.

Dr. Sandison's free Keto Diet Guide can be downloaded at: https://www.drheathersandison.com/
In that website people can also watch all her content and read her blog

KEY TAKEAWAYS:

• The six root causes of cognitive decline (and how to assess them)
• How toxins and stress quietly sabotage brain health
• What your ApoE4 gene does—and doesn’t—mean for your future
• Signs of early cognitive decline most people miss
• What Dr. Sandison’s clinical trial revealed about reversing Alzheimer’s

ABOUT GUEST:
Dr. Heather Sandison is the NYT bestselling author of “Reversing Alzheimer’s The New Toolkit to Improve Cognition and Protect Brain Health”. She is a renowned naturopathic doctor specializing in neurocognitive medicine and the founder of Solcere Health Clinic, San Diego’s premier brain optimization clinic, and Marama, a residential program turning memory care into memory recovery. She has dedicated her career to supporting those suffering with dementia and is the primary author of peer reviewed research published in the Journal of Alzheimer’s Disease. She is excited to shatter common misconceptions about Alzheimer’s and share what she has learned about keeping your brain sharp at any age.

WHERE TO FIND:
Website: https://www.drheathersandison.com/
Instagram: https://www.instagram.com/dr.heathersandison/

WHERE TO FIND CHRISTA:
Website: https://www.christabiegler.com/
Instagram: @anti.inflammatory.nutritionist
Podcast Instagram: @lessstressedlife
YouTube: https://www.youtube.com/@lessstressedlife

SPONSOR:
Thanks to Jigsaw Health for sponsoring this episode! Struggling with dry, cracked hands? Try their Alaska Cod Liver Oil for omega-3s + vitamins A & D to support skin and immune health. Use code LESSSTRESSED10 at JigsawHealth.com for 10% off—unlimited use!

WORK WITH CHRISTA:
I've streamlined my proven method to help you get to the REAL root of eczema and food sensitivities—without the overwhelm. Join the program at christabiegler.com before doors close!

Transcript

 [00:00:00] Dr. Heather Sandison, ND: these six components of brain health are toxins, nutrients, stressors, structural issues, signaling and infections.

[00:00:09] When we can create more balance in that our cells heal. 

[00:00:14] Christa Biegler, RD:  I'm your host, Christa Biegler, and I'm going to guess we have at least one thing in common that we're both in pursuit of a less stress life. On the show, I'll be interviewing experts and sharing clinical pearls from my years of practice to support high performing health savvy women in pursuit of abundance and a less stressed life.

[00:00:44] One of my beliefs is that we always have options for getting the results we want. So let's see what's out there together.

[00:01:02] Alright, today on the Less Stressed Life, I have Dr. Heather Sandison, who is a New York Times bestselling author of Reversing Alzheimer's, the Nuke Toolkit to improve cognition and protect brain health. She's a renowned naturopathic doctor specializing in neurocognitive medicine and the founder of sre, I hope I said that 'cause now I forgot how to say it. Health Clinic, San Diego's Premier Brain Optimization Clinic and Murma a residential. Program Turning Memory Care into Memory Recovery. Super excited to talk about that. She's dedicated her career to supporting those suffering with dementia and is the primary author of Peer reviewed research published in the Journal of Alzheimer's Disease.

[00:01:37] She's excited to shatter misconceptions about Alzheimer's and share what she's learned about keeping a brain sharp at NEH. Welcome Dr. Sandison. 

[00:01:44] Dr. Heather Sandison, ND: Thank you so much for having me. It's a pleasure to be here. 

[00:01:47] Christa Biegler, RD: Yeah. Alright, so I'd love to stop, jump in with a story. And I was listening to you on other podcasts and I didn't hear this yet, so I wanna hear why Neurocognition and Alzheimer's became your thing.

[00:01:57] How did you get here? 

[00:01:59] Dr. Heather Sandison, ND: It was really one of my early patients. I was a skeptic. I came to this as a skeptic, but I had heard my mentor, Dr. Dale Bredeson, speak at conferences, and I was really intrigued because what he said made sense, even though I had never seen it happen. I'd never seen someone with neurocognitive decline.

[00:02:15] I never seen someone with Alzheimer's improved. And I had been told over and over again, like many doctors in training, many medical professionals in training, there was nothing you could do. And that to suggest otherwise was actually to do harm. And to give people false hope. So I, took that as gospel for a long time.

[00:02:33] And then when Dr. Edison started presenting at conferences, he was explaining a con, a conceptual framework of basically saying. What is at the causal level? Can we, where can we intervene to create more balance in the system to help neurons thrive, to help the brain thrive? And how can we take out all the junk?

[00:02:51] And that, to me, it like made sense. I was like, yeah, the body is designed to heal. Of course this can be possible. But again, I didn't have any confidence 'cause I had never seen it before and I was still skeptical. So I came back to my clinic after being trained by Dr. Bredesen. And it was patients who showed me that this was possible that it was a woman named Arlene.

[00:03:11] She came in with her husband. She was very severely vented. She had a MOCA score of two out of 30. So a perfect score on this one page test is a 30 out of 30, 26 and above is normal. It's okay. We don't have to remember everything all the time. That's normal. But we should remember most things where we are, how to draw a clock, how to copy a cube, remember some words.

[00:03:34] And she only got two things right? I could see that she was cognitively processing. Her the questions right, and her answer to them. But by the time she could get the answer out, she had lost the words and she could answer with yes or no. But really that was the extent of her ability to engage in conversation.

[00:03:53] Her handwriting was really cramped and small and at an angle it had been affected by this disease. Her, obviously her relationship with her husband, she was completely dependent on him, and yet I could see this like bright shining, beautiful soul in there. She had this huge smile and she was dressed in this floral, bright floral print, and she had this black leather studded bag and you could just see that there was so much of her, even though she was having trouble in conversation.

[00:04:21] And she went home and I went through the motions. I'll just be honest. Like that day I went through the motions. I did what Dr. Bison trained me to do what I'd been trained in naturopathic school to do. We looked at her nutrients, we looked at her toxins. I recommended she go see a dentist and get amalgams out and get root canals.

[00:04:36] I. Fixed. I recommended she get on bioidentical hormone replacement. We talked about lifestyle things like getting on an organic ketogenic diet, about ballroom dancing, about walking and getting more exercise about optimizing for sleep. There were so many things that I recommended she do thinking, gosh, this is really overwhelming.

[00:04:54] I don't know how I would do this with good cognition. She and her husband, they just went home and they did it all. They had the confidence that I needed, right? They put, they had read Dr. Bison's book, the New York Times bestselling book from 2017, the end of the Alzheimer's, and. They did it and six weeks later, she came back and her MOCA score had gone up to a seven.

[00:05:14] She had gotten her hand by writing back. She was a school teacher and she had this like big looping, beautiful handwriting I could imagine on a chalkboard and on a whiteboard. And she had it back. And when I looked at the two MOCA scores six weeks apart, one was a two and one was a seven.

[00:05:27] Now this is not supposed to be possible, right? That's what I've been told over and over again. My first response was, we must have done this wrong. Like the, this isn't to me it was just like, does not compute, right? And I look at her husband and he's no, she's different. Like our life is different.

[00:05:44] And from that moment on, it was really like. How do I do anything other than tell as many people who as will listen, that there is hope for this disease, that there are not only is it false and inaccurate to say there's nothing you can do for this disease. But there's actually an overwhelming number of things that can be done.

[00:06:07] And so it's a really a matter of navigating those and figuring out which ones are gonna benefit you the most from an individualized perspective. And I know your background being in nutrition and lifestyle. It's the biggest things come down to what we put in our mouths. How much stress we're under and what our relationship with that stress is.

[00:06:25] How much sleep we get, what time we go to bed, and then how much movement we get and who we surround ourselves with. The communities that we're in and those things are free, right? Like we have lots and lots of support for people who want more handholding and more precision based approaches, but there is so much we can do to optimize cognitive function at any stage.

[00:06:44] Christa Biegler, RD: I think we align a lot. And I have a question that may take us into this next piece. So you said your mentor was Dr. Breen and he, obviously, his thing is also Neurocognition and Alzheimer's. And how did you end up with a mentor in that space, if that wasn't something you were doing a lot of or.

[00:07:02] I'm just curious how you ended up with him specifically. If that was his thing. And and I wanna just underline something that was very human of you, and this is for all of us, is that we seen as always believing, and so we all struggle with skepticism if we have not experienced it yet.

[00:07:16] And so its just healthy. 

[00:07:18] Dr. Heather Sandison, ND: Yeah, exactly. Yeah. As we should, right? We don't wanna be vulnerable to being, victims of fraud, like all of these things, right? And we don't want snake oil. We want something that actually works. And I think one of the takeaways, hopefully from this conversation is it's not easy.

[00:07:31] It's an invitation into something actually really challenging to change our lifestyle, to change our behavior. It can cost money, right? It is more expensive than what's going to be available at your Medicare doctor, right? And not everybody has access to that, and that's part of my life's work is to increase that access.

[00:07:49] But there's so much that can be done. The things that are less expensive require more effort. And it doesn't work if you don't do it. We've seen that also over and over again. If you can't implement, then it doesn't work. You don't get the benefits. So it's how do we create environments?

[00:08:06] How do we get that accountability? Accountability buddies is how I think about it now. It's like how do we get that person on our team who's gonna cheer us on and hold us accountable and make sure that we are implementing? How do we set ourselves up for success? 

[00:08:18] Christa Biegler, RD: For sure. 

[00:08:19] Okay, so Dr. Bison talked about how do you go upstream and bring in balance, and I heard you talk about something on a different podcast that I feel very in tune to, which is that all symptoms come from imbalance.

[00:08:31] So bringing the body back into I balance is how you reduce symptoms overall. And so I don't wanna spend all of our time on this, but I do think that it's relevant to run through some of these. Systems or more so categories of imbalance of how these are some of the ways that you help people put into buckets.

[00:08:48] Some of the things that can be out of balance and how, because it can feel like a lot. And so when you put it into categories, it makes it feel easier. So will you talk about some of those categories, which is somewhat what your mentor had shared too, right? Where it was like, yeah, it makes sense that things are outta balance and that's how the body starts to respond differently.

[00:09:04] So will you tell us about those categories? 

[00:09:05] Dr. Heather Sandison, ND: Yeah, and this is also an answer to the question around how did I end up with Dr. Bison as a mentor? 

[00:09:09] Christa Biegler, RD: Yeah. 

[00:09:09] Dr. Heather Sandison, ND: So one, I wouldn't go away. Like I think I just kept popping up in his space. And so like finally we were introduced but I was doing a lot of his work before he knew who I was.

[00:09:19] And the reason what brought us together, he's a, he trained at Duke and Caltech, like at some of the and UCSF and some of the best institutions in the country for medicine. And is a neurologist is trained as a neurologist and I'm a naturopathic doctor, so how did our paths intersect through functional medicine.

[00:09:36] And functional medicine is a version of naturopathic medicine and it's this perspective that the body has the ability to heal. And what we're looking for is to create homeodynamic balance. So we accept that the body, the brain is imperfect, but also a very complex system that we have a reverence for.

[00:09:54] Like I am never fully gonna understand how the brain works, right? But understanding that still every day I wanna learn a little bit more, right? So that we can get a little bit closer to approximating our understanding to reality. And in that there's this fundamental idea that. In any complex system, what we're looking for is, again, that homeodynamic balance.

[00:10:14] Things aren't gonna be the same at 8:00 AM as they're at 8:00 PM or the same at eight years old as they are at 80 years old. But there's a rhythm to things. There's a sense of what's going to keep that dynamic system whole and functional so when we have imbalance too much too little in the wrong place or at the wrong time.

[00:10:30] We create imbalance, and this can be applied to any complex system. Government systems, financial systems, education systems, any complex system out there, A house plant, right? Is a living organism complex. What's going in, what's coming out? Is it in balance? So the six components of brain health, how we categorize this and how we start to like check boxes.

[00:10:49] Okay, I don't have to worry about. Stress, but I do have to worry about my diet. I don't have to worry about sleep. I sleep great, but I do have toxic exposure, right? This is how we start to say what of are of these components, what of these pieces apply to me as an individual, but might not to my neighbor, might not to my spouse, these six components of brain health, I would argue, are the causal level factors when it comes to neurodegenerative disease. Not just Alzheimer's, but even when we're thinking about Parkinson's, macular degeneration, frontotemporal dementia, the litany, the list of neurodegenerative diseases. So these six components of brain health are toxins, nutrients, stressors, structural issues, signaling and infections.

[00:11:32] When we can create more balance in that our cells heal. 

[00:11:37] Christa Biegler, RD: Yeah, totally. Let's talk about toxins for a second. Mycotoxins, heavy metals and chemical toxicities. . I would love to hear about that in practice, what you have seen, because you are dealing with a condition that is. What I would consider more severe. And when we see things that are more severe, sometimes we see more significant testing results. And so I'd love for you to share some of the things that you've seen with dementia.

[00:12:01] 'cause we hear this like hubbub a little bit. And actually I think about, when I think about neurodegeneration, something that is really after my heart is the prevalence of cancer now. And actually let me step back for a second before we talk about those toxins, will you just tell us about the prevalence of neurocognitive?

[00:12:16] Issues in the population currently. Out of curiosity. 'cause I was going to talk about this relationship potentially to cancer, but then I remembered, oh, cancer is one and three, it's gonna be one and two. What about neurocognition or neurocognitive decline? What is the prevalence there? 

[00:12:31] Dr. Heather Sandison, ND: Yeah, so there's about 6 million Americans, 50 million worldwide.

[00:12:35] That number is going up very quickly. And the big thing I think with Alzheimer's and dementia as we age, is that it's not just the patient that's affected. So if there's five, 6 million Americans that are affected, but that have a diagnosis of Alzheimer's or dementia. That takes a caregiver with them, a spouse, an adult child, someone else or multiple other people are having to quit their jobs or go down to part-time or somehow accommodate this very stressful disease.

[00:13:04] And cancer is similar, but it feels finite. Cancer treatment of the nineties is not what we have today. Even people are diagnosed with stage four cancer and they go through treatment and. Many times they get better. They're thriving, they feel healthier than they have in a long time.

[00:13:15] It's really incredible. I think yes, incidences going up and there's lots and toxins I think are a big part of that. And I think that's true with dementia there whenever we see someone, Dr. Bison, he's always quick to raise this. I was just go on a phone call with him and he's oh, this person is a OE three three.

[00:13:32] They don't have genetic predisposition. They're relatively young. This is atypical. Look for toxins. Look for toxins. And I also think it's a place where the conventional world has really not caught up. There's clearly that toxins cause cellular damage. They throw things out of regulation, right? This is a primary cause.

[00:13:54] So when we see cancer and dementia, thyroid issues. Even hormonal imbalances, autoimmune disease, all of those are secondary. Those are responses of the body many times in an attempt for the body to get back into that homeodynamic balance. Amyloid. Beta amyloid that in the conventional world was thought of as the cause of Alzheimer's for many years.

[00:14:17] We can get rid of amyloid. We're really good at that now. Billions of dollars have gone into making drugs that get rid of amyloid, but it doesn't help cognition. Amyloid is antimicrobial. Amyloid is part of the. The brain's response when there are infections or toxins, it's a part of a neuroinflammatory response and it's there to protect us.

[00:14:37] So that's a secondary level, right? We where we wanna focus, where we have the most fun is at this primary causal level. If we can get rid of the toxins, less amyloid is generated. 

[00:14:49] Christa Biegler, RD: Yeah. So I was wondering about with these specific toxins, what were some of the test results you've seen? Just because I work with a condition that has a lot of toxic burden as well, and when I've done some of the total tox burden tests the results are hit or miss. But I feel like you have a better client population to see more interesting things. So do you wanna share anything that you've seen that's been crazy or interesting that kind of floored you a bit? 

[00:15:12] Dr. Heather Sandison, ND: Yeah. In our clinical trial, every single person had toxins.

[00:15:17] When we're looking at a population that's over 65, generally, and by the time you've been around this planet for a lifetime, right? You have had the opportunity to collect a lot of toxicity, and we see that we see that older people generally have higher toxic burden. It's very rare for me to see someone over 65 without some significant level of metals, molds, or chemical toxicity.

[00:15:42] Christa Biegler, RD: Yeah. Very interesting. 

[00:15:43] What about toxins having an affinity for the brain? What is that about? 

[00:15:48] Dr. Heather Sandison, ND: Yeah, so certain things like mercury, mercury is a very neurotoxic, whereas lead gets stored in boats now lead is associated with iq. Don't get me wrong, lead will cause a problem. But Mercury is particularly neurotoxic.

[00:16:02] And I think that there's also, the toxins are gonna wreak havoc. You mentioned cancer. Many of the same cancers that are neurotoxic are carcinogenic. And or immunosuppressive. So when we look at these, I think what we're looking to do is not point at one and say, that's what caused my dementia, or that's what caused my cancer.

[00:16:22] Although sometimes, especially if there's a dose response, right? If you have a really high dose or a long exposure, we can make those connections. But what we wanna do is reduce the total toxic burden, and Dr. Bison uses this phenomenal analogy of my brain is on. If you think of your brain as a country.

[00:16:39] And you're that brain, that country is at war. You're not building infrastructure, you're not building the roads and schools of your brain, the synapses of your brain. What you really wanna be doing is taking all that resource, so all that great food that you're eating, all those supplements you're taking potentially, and you wanna put that resource into resolving the war, to fighting, the infection, to getting rid of the toxin.

[00:17:02] And once we've done that, once we've resolved that, so once those mycotoxins are down or those metals are down, those chemical toxins are down, or we stop being exposed to them. Then we free up more resource. Right now we have more glutathione to act as an antioxidant. We have more B12 to help reduce our homocysteine, to help us with neurotransmitter balance.

[00:17:23] We have more amino acids. All that resource that we have, we can now free up and shift it towards that regenerative state, which is where healing happens. It's so fun and exciting, right? But when we're wrapped up in a war, it's just common sense, right? You don't wanna be building new infrastructure, new connections.

[00:17:41] What you wanna do is get up and over that and free up resource. 

[00:17:44] Christa Biegler, RD: Yeah, totally. And when I think about detoxification for these different, I. Things heavy metals, chemicals, mycotoxins, et cetera. I think about all the resources that they use up, which is what the analogy really tells us. It's like you don't have the opportunity, so how do you remove some of this strain on your country that is the brain, right?

[00:18:04] To allow it to free up these different resources. And I think about nutrients, I think you said nutrients was one of the six. I think it was the six categories and I think about how nutrients are a big deal in stress and stress depletes nutrients in general. And I'd love to, for you to share you, you had a blip there about how neurodegeneration isn't really just affecting the person having the neurodegenerative.

[00:18:26] Decline, but also the caregiver. And I wanna come back to genetics a little bit as well, but I wanna talk about stress on the brain and what happens when you have stress on the brain, and then how that impacts caregivers as well. 

[00:18:37] Dr. Heather Sandison, ND: So physiologically we see that high levels of cortisol, sustained levels of cortisol, this is that amped up, right?

[00:18:43] We're running on adrenaline. That picture shrinks the hippocampus, the memory center of the brain. Now the amygdala, kinda this emotional center of the brain and the hippocampus, the memory center of the brain. They are right next to each other. Geographically, they are right there next to each other.

[00:18:57] You cannot separate them. So when we sleep, this is actually really important. When we sleep, the amygdala and the hippocampus work together to help us process memories. We rinse the amyloid through the glymphatic system. We rinse other toxins to the glymphatic system.

[00:19:13] We rinse the cortisol out of the system, right? We get rid of things that can become toxic and build up, but we also, we get this emotional in our deep sleep and our REM sleep. We basically take the bite out of the emotional experiences that we had the day before, and if we skip that step, then when we get reminded of that awful conversation we had yesterday, or fighting with our partner or yelling at our kids or whatever it was, or being frustrated with the person we're caring for, it has the same emotional kinda resonance.

[00:19:41] It's still amplified if we haven't had that chance to process it through our subconscious and at night while we're sleeping. That plays sleep plays a huge role. Food plays a huge role in our stress levels and our nutrition, right? It's gonna be the backbone, enough protein is gonna be the backbone of our neurotransmitters at how much sugar we have.

[00:19:58] And if we're on that sugar rollercoaster of spikes and drops and getting hangry, that's gonna have a huge impact on our stress levels caregiving. I'm so glad you asked this question because we see in the literature that. People who serve as care partners for someone with Alzheimer's or dementia are anywhere from two and a half to six times more likely to be diagnosed with dementia later in their life compared to someone who never serves at a as a care partner.

[00:20:21] This is a huge increase in risk. And so whenever a patient comes in, I am looking at their caregiver just as much as I'm looking at the patient to adopt these lifestyle interventions to protect their brain. 

[00:20:34] Christa Biegler, RD: And often the caregivers are, might be spouses, not always, right? But it might be a spouse.

[00:20:39] And so there's not shared genetics in a spouse, right? 'cause they got those genetics. And you mentioned a PO before the gene that may. Give you some details about Neurocognition. In fact, I'm gonna have you define what you mean by that, because not everyone is familiar with a POE. And so you said your mentor had said, Hey this person is not positive for a PO three.

[00:21:01] I think it's a, you'll explain in a moment, so it's atypical, look for other causes of this neurocognition, but talk about the influence of genetics on neurocognition versus environment and will you speak to a PO three? 

[00:21:16] Dr. Heather Sandison, ND: So going back to our framework, this is under structure. So this is our molecular structure, not a macro structure of can we get oxygen to the brain?

[00:21:23] Can we get blood to the brain? Have we been hit over the head by a baseball bat? That's our macro structure. Our molecular structure is this genetic predisposition, so A POE again. Okay, you said as. US listeners up for this, but just hang on with me for a minute. I'm gonna, and if you wanna get out a pen and paper and write this down, it's a POE or A-P-O-E-A-P-O, apple Potato Orangutan Elephant.

[00:21:48] And then a POE. You get one from mom and one from dad, and there are three possibilities. So you're gonna end up with two copies. Of either a two, three, or four. So you might be a two, three, you might be a three, four. You might be a four. Four, you might be a three. Three. And the general population, so get rid of genetics.

[00:22:10] The population at large has a 13%. Chance of being diagnosed with dementia or Alzheimer's in their lifetime. So 13% risk is our sort of average across if you have one copy from mom or dad of a POE four. So say you're a three four, your risk goes up to 30%. So basically, a third one in three, if you have two copies, if you have a POE four four status.

[00:22:37] Your risk goes up to well over 50%. And there was a nature paper in the past year that essentially suggested that you were destined to get Alzheimer's at some point in your life. So this is really terrifying and it's also very empowering. So I had patients say 10 years ago who would. Ask me like, why would I wanna know that?

[00:22:59] It's just gonna keep me from sleeping. That's not gonna be good for my brain. I'm just gonna have anxiety. And I really understood that perspective. Then now, there's so much that we can do. There are so many decisions that we can make along the way that will help to preserve our brain health and prevent and delay, and yes, even reverse cognitive changes when they start to happen.

[00:23:22] I highly recommend that my patients get a POE. We run them on everyone. And I recommend that their children get it too, because if I have a 20-year-old or someone even younger than that and they're thinking about different careers, I'm gonna discourage someone with an A POE four four status from high contact sports, from shift work.

[00:23:44] So from going to nursing school or becoming a ER doctor or a firefighter. They're, they need to protect their sleep. Yeah. They need to make sure that their brain is getting all the support and none of the detriment. And that's more important for them than Yes. A spouse or a neighbor, someone who's not genetically related and doesn't carry that risk.

[00:24:04] Christa Biegler, RD: Yeah. I haven't. Done genetic work or genetic interpretation for several years because I didn't like the way we were doing it. So I'm just curious in clinic, what does that look like Now in clinic? Are you doing like a swab in the cheek and then can you just check a POE the reason I ask is because there seems to be a.

[00:24:22] My brain can't always wrap my head around it from the way we used to do it, which was a couple hundred dollars to, sometimes people say, I got the genetic workout for breast cancer and it was like thousands and I'm just like confused about how that actually works in clinic. Will you talk about that for a second?

[00:24:37] Dr. Heather Sandison, ND: Yeah, and I had a similar experience. I stopped running like big genetic profiles and running like Raw 23 and me data through and all that stuff. I wasn't getting enough benefit in a lot. I found it was detrimental to people, right? They were really attached. I have this mutation. I'm like no. This is a variant.

[00:24:52] Like everyone's unique and or I can never take methylated B vitamins, right? Always have to do this. And I'm like, there's a lot you're a genetic miracle just because you're here. And so I think remembering that a OE four actually protects us. So if you are exposed to a brain parasite, you want to create that inflammation in the brain faster.

[00:25:10] If it just, it depends on the context. Our ancestors had a POE four. Most commonly. And now three is most common because our world is different. 

[00:25:19] How do we do the genetics? We just do it on a LabCorp panel or we actually run a lot of Cleveland Heart Lab or Vibrant America, and we just add it to our panels.

[00:25:26] So it's in the blood draw. They don't need much, we don't do a buccal swab. It's not separate. And the only genetics, I tend to run our A POE we used to do a little M-T-H-F-R, but I've really moved away from that because again, that attachment to this variant, this mutation. And I wanna do things that are going to affect my treatment plan.

[00:25:45] And when there's a difference in a POE status, if someone has that risk, I wanna work harder and faster. Yeah. Than if somebody doesn't have that, or, there's this atypical picture. I'm gonna look at things a little bit. 

[00:25:56] Christa Biegler, RD: Yeah, I mean it makes sense. It's very logical that people would wanna have that information for what you're working with and for my experience also, it was actually just a little too overwhelming when it's actually, let's just address everything in the current lifestyle and all of these other very similar buckets to what you described.

[00:26:11] Let's work with those. Actually curious about how, since you're running it on everyone or most people. How often is there the 30% and 50% predisposition in your population? Not that you have to gimme a solid, perfect answer, but I'm just curious. Is it like, is it even 50%? 

[00:26:29] Dr. Heather Sandison, ND: Oh, not in the general population, but in my, I see mostly people who are able E four positive.

[00:26:33] Christa Biegler, RD: Okay. 

[00:26:33] Dr. Heather Sandison, ND: Because they're, that's why they're coming to me, right? Yeah. 

[00:26:36] Christa Biegler, RD: Yeah, so , you have quite a spectrum, then you have prevention. Those people who know that they're a POE four positive and as well as those that are more progressed, I'm guessing. 

[00:26:46] Dr. Heather Sandison, ND: Oh yes. It's a luxury when we get to see prevention patients, of course.

[00:26:50] And typically what a lot of what happens, right? Is we have, mom comes in and mom is struggling with cognitive impairment, and sure enough, she's a fourfour, right? So now the daughters where we have this luxury of prevention, they're in their fifties or sixties or forties even, and they're in, they clearly have one copy.

[00:27:06] Do they have, the question is, do they have one from mom and dad? They have genetic risk, how can we get ahead of that? And then even sometimes looking at their kids what are the teenage or the 20 something year old kids? What is their risk and how can we get ahead of any neurodegenerative disease?

[00:27:22] We find, again, in the science 18 year olds who are a four four positive are have an. Cognitive disadvantage compared to those without. So it's affecting cognition even in in like late childhood. This is wild. This was a surprise to me. 

[00:27:39] Christa Biegler, RD: What would be some of the symptoms and I was gonna tuck this one in later, but since you bring up 18 year olds, have a cognitive disadvantage.

[00:27:46] What are some of the things that maybe they see, and we'll say this from a perspective of, it doesn't mean you're gonna have Alzheimer's if something like this is there, but it's like awareness can be powerful if you take it in the right context. So is there anything to say about that of early signs of things?

[00:28:01] Dr. Heather Sandison, ND: Yeah, so I think what you wanna look for. 

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[00:29:19] Dr. Heather Sandison, ND: One is subjectively not everybody's aware of their cognitive decline. Sometimes it's the daughter or the spouse who starts to notice. Totally. But for those of you who are having that experience of five years ago, I would've remembered that neighbor's name.

[00:29:31] Even though I don't see them every day. We've lived across the street from 25 years and. I should know that name, right? Like word recall is an early sign, spending more time looking for misplaced items around the house, the keys, the wallet, the phone, the purse, leaving a purse at a restaurant more regularly.

[00:29:48] That kind of thing is an early sign. Also changes in judgment. So where. These are 65 plus our baby boom regeneration. They're at very high risk for fraud. And getting that phone call that says you need to wire money or you need to go down to Walmart and get the gift cards and like that whole thing.

[00:30:05] Or this toll one is really common and it's really easy for. People in that age category who aren't as tech savvy and who maybe have lost a little confidence in their cognition, they're really prone to that. So having hearing like, oh, mom or dad became a victim of fraud.

[00:30:22] Hopefully they don't take everything. That comes up here and there also, managing calendars, so missing appointments and that sense of overwhelm is an early sign as well. So where mom or dad or spouse used to host Thanksgiving dinner, no problem, they would look forward to it. Or they would host the 4th of July party every year or birthday parties, or they would plan travel like, oh, she always put our Europe trip or our trip to the lake.

[00:30:47] She was the one who managed all the flights and the hotels and the car and whatever needed to be planned. And now she's not doing that. Now that feels too overwhelming. That's definitely an early sign. So these executive function tasks around planning and execution, when we start to notice that's shifting, that can be a red flag Now.

[00:31:08] The sooner we get started, the better, right? The earlier we intervene in the disease process, the younger someone is, the better our chances at getting reversal and when we can prove reversal, which we have, when we've shown that we can improve cognition of people who have disease process going on.

[00:31:26] Then I hope that what it does is it inspires people to take action in terms of prevention, right? What we want this to translate into is don't suffer at all. Don't get any of these symptoms. Take action before to protect your brain. 

[00:31:38] Christa Biegler, RD: Yeah. And also say a lot of those symptoms are things I see with other, because the buckets you gave, right?

[00:31:44] Infection, toxicity. I think nutrients, et cetera, are actually common categories for lots of things, lots of systems as well. So I just will share that that there's many opportunities. And I may ask you like, some of these, I'm gonna come back to like bioidentical hormones, like your client, Arlene.

[00:32:01] With time there's cognitive decline there, so I wanna talk to you about that. But before that, since we're talking a little bit about prevention and early stage. You had a question about what kind of testing is maybe available through your primary care that might be covered by insurance.

[00:32:15] That might give you some indications of things. 

[00:32:18] Dr. Heather Sandison, ND: Yeah. Dr. Bison has a great list, and you can actually just order the testing directly through him through apollo health.com. There's a long list there that, it's in my book, I think. I don't know if it serves us. I think it's better to link to a resource than to go through all of those.

[00:32:34] But essentially you're looking at a complete. Blood count. A metabolic panel, hormone panel, thyroid panel nutrient status of like vitamin D and some B vitamins, homocysteine inflammatory panel, an advanced cardio lipid metabolic panel that also includes fasting insulin, a urinalysis. And so that's generally what's in there.

[00:32:53] I probably left some things out and there's lots of detail in what those panels are. So that typically is covered by insurance. Now, of course, if you go to some managed care organizations, they're gonna say, no, we don't wanna do that. I also, I recommend everyone, anyone suffering with any cognitive impairment for any reason, get a sleep study because sleep has such a big impact on cognition.

[00:33:15] So that's an important one to get ahead of. I also. Working with a provider is really helpful really important and helpful, but I don't want anyone to be discouraged because they don't have a breent. The upper echelon of this is Right, find a Breent provider who you can work with, who's near you, who you can create a relationship with, and then do the precision medicine piece.

[00:33:33] It's expensive. It really is, and I think piecemealing it together with someone else is challenging. Now you can do it with the books, you could do it with Dr. Bison's book and with potentially with my book, but. If you feel like you're hitting a wall when it comes to finding a provider that can help you with this, go back to the most important pieces.

[00:33:50] The foundational pieces are gonna be diet, exercise, sleep, and stress management. Yeah. And we can get so much benefit from those things. And I would even say, especially if financially you feel strapped, don't worry about that other stuff until you have those foundations in place. Yeah. And then go that.

[00:34:06] Christa Biegler, RD: That's such a good point. 

[00:34:07] Dr. Heather Sandison, ND: On the cake with the doctor. 

[00:34:08] Christa Biegler, RD: Yeah. There's always, I think there's just an option for every person and for every budget. And as you said, the things that cost the lease are sometimes the hardest to implement. So start there. And that's why you said make a foundation and even all the labs that you listed off would be things that if I was doing a really comprehensive lab panel, that would also be included.

[00:34:27] And so there's. I say that because success leaves clues, or you should find common threads of truth throughout different conditions even. So even though we're gonna put the lens of neurocognition on those labs those can serve you in other places. And that actually takes me to some other questions that come up when we talk about neurocognitive decline.

[00:34:45] Some people call Alzheimer's type three diabetes. What would you say to that? 

[00:34:50] Dr. Heather Sandison, ND: Yeah, so this is that nutrition. Going back to our framework, we're talking about nutrition. Essentially what's going on as we age, all of us, regardless of diabetes status, we are not as good at turning sugar into a TP or that fuel that our brain, our cells run on.

[00:35:07] We don't do that as efficiently. I. It's because of insulin resistance, even resistance just to the glucose, and that creates a lot of oxidative stress, a hallmark of aging. The body is incredible. We're like hybrid systems, right? We can flip the switch and we can run on ketones. And so I recommend that more or less anyone experiment with getting into ketosis in a metabolic ketosis.

[00:35:29] And just see what it feels like for your brain, for your mood, for your sleep, for everything, for inflammation, what it feels like to be burning fat for fuel instead of sugar for fuel. That's that ketogenic state. You can also add exogenous ketones, so type three diabetes. Essentially what we're saying with that is in Alzheimer's, the brain does not have enough resource.

[00:35:49] So going back to that, my brain is done, right? It's you're sending all the weapons or you're sending all the infantrymen, but they're not connecting to actually win the war. You're not actually creating the resource that you need to get up and over those humps, and so you don't have the ability to find that name or remember where you put your purse down.

[00:36:06] The brain only takes up 2% of body weight, but uses 20% of energy expenditure every day. It is a very energy hungry organ. So we have to give it enough resource. Now that's gonna be oxygen. It's gonna be nutrients, but of course it's gonna come down to what is the fuel that we turn into a TP and we have options.

[00:36:26] It doesn't have to be sugar. 

[00:36:28] Christa Biegler, RD: Yeah, and I'll just mention from a very light perspective, very intelligent people. We skip. Nourishing ourselves, 'cause we are busy. And so I just acknowledge that's like actually a human issue that we sometimes struggle. And you do need energy for those synapses to fire.

[00:36:45] That's like the normal order of operations. When before the brain is turned on for using fat for fuel instead of sugary fuel. Then it's a little different conversation about timing and those pieces. But just at the, when we're starting with foundations, before we get fancy, are we even.

[00:37:01] Nourishing our brain, et cetera. And I just say that because everyone who's listening to this podcast is brilliant. And I did find that over time, brilliant people. We still have to talk about sleep and we still have to talk about basics sometimes, right? Because it's easy to glaze past the basics for something I.

[00:37:17] Shinier 

[00:37:18] Dr. Heather Sandison, ND: such reminders. I say this stuff all the time and it's still a practice for me to get to sleep on time, to get to bed, to make sure I've got the right food in my fridge so that Yeah. I'm nourished. Yeah. The day, 

[00:37:29] Christa Biegler, RD: yeah. It takes, it's like 

[00:37:30] actually 80% of life right there. 

[00:37:34] Dr. Heather Sandison, ND: Life is set up.

[00:37:35] Society is set up so that it's easy to grab a burger and fries, and it's easy to stay up and binge watch the latest show. I think it's set up. Society's not set up in our best interest for health. 

[00:37:47] Yeah. It's set up for somebody to make money. 

[00:37:49] Yeah. 

[00:37:49] Christa Biegler, RD: Yeah. 

[00:37:50] So there have a couple more things as we start to wrap up, but you brought up.

[00:37:55] Oh, you have a brain parasite and so we'll put this under the infection category, I would assume. And I've heard lots of interesting stories about brain parasites that I never talk about on the podcast. And I wanna hear about any comments you have about this because there may have been someone that heard you say that. A while it felt like I was seeing all these videos online of people pulling things outta the, they were like, someone had a headache forever and then they did brain surgery. It was other countries and they're like pulling a worm out. And I bring, I just wanted to talk about this for a second because I don't feel that this is something that shows up in testing easily.

[00:38:30] And you mentioned it, and I would love to hear any comments you have about infections as a whole. What are common infections that you see in neurodegenerative? And since you mentioned that, you probably can't go to your provider and say, can you test for this? So if you'll just Yeah. Share anything.

[00:38:45] Dr. Heather Sandison, ND: I don't think it's 

[00:38:45] necessary to, for most people to test for brain parasites. Now, if you're going to Papua New Guinea, so I mentioned this in the context of a POE four, four or versus three, three. And, our ancestors who didn't have access to clean water and parasites have been on this earth as long as we have as have fungus and bacteria and viruses. And so we've been co-created in that in this environment with them. So when we are a OE four four, our brain will mount an immune response, an inflammatory response faster than if we're three three. That's just how we're designed and back. 150,000 years ago, 200,000 years ago, that's what we wanted, right?

[00:39:26] We wanted, we didn't live for 80 years. We lived for maybe 40 years and we wanted to mount this inflammatory response in our brain. We weren't worried about dementia. Fast forward to now, it's a very different state of the world. We have access to clean water. We don't, we have shoes. We have a really different lifestyle, but infections still trigger this inflammatory response.

[00:39:48] Now there's more common infections that are more closely linked to dementia, Alzheimer's than parasites. So I wanna focus on those because they're also. Actionable. So one is the human herpes viruses. HSV one, herpes simplex one, which causes cold sores. We see in studies that people who more aggressively treat that are less likely over time to be diagnosed with Alzheimer's.

[00:40:12] Now if you have a traumatic brain injury, it can actually reactivate that virus. Which can lead to even more neurodegenerative the inflammatory response that leads to, that can impact that neurodegenerative disease process. We also see that, shingles. So this is from another herpes virus.

[00:40:28] This is varicella. This is the chickenpox virus that many of us had as children. Or we, somebody, some people have been vaccinated, but we see that adults who are vaccinated for shingles have a 20%. Reduction in risk of being diagnosed with Alzheimer's or dementia over the next seven years. So there's definitely a relationship between herpes viruses and how our brain, the inflammation that is created in our brain. And this makes sense because those viruses are stored in the nervous system. Another one that's less kind of I guess we don't connect the dots maybe as easily, but is page vallis.

[00:41:03] , the bacterias that are associated with gingivitis gum disease also trigger neuroinflammation. They also trigger cardiovascular risk, so they can create vascular spasms and inflammation in the arterial lining, and they can lead to more neuroinflammation. Another infection is Lyme. Lyme in the co-infections associated with Lyme have neurological manifestations that can involve memory loss.

[00:41:28] So understanding those, we screen for those. We wanna understand if they're there and treat them aggressively, prevent them, right? Sometimes it's as simple as flossing your teeth every day or using a water pick or co like oil, pulling. Something to help with gum health. The other one is CID and this is a pretty different mechanism.

[00:41:48] This really has much more to do with the structure. It's vascular supply. Are we getting blood flow to the brain? And covid creates a more hypercoagulable state, so the risk is more associated with clotting and endothelial health. So we come at that from a little different direction when we're supporting someone who's had that post covid cognitive impairment.

[00:42:07] Christa Biegler, RD: Yeah. Did you see a very significant trend upwards in the last, I don't know when you started this work? How long ago was that? 

[00:42:13] Dr. Heather Sandison, ND: Yeah, 

[00:42:14] 2017. It's definitely something that we talk to a lot of people about, but there's tons of people who have. You know who never got it or it doesn't really seem to be related.

[00:42:24] In terms of time. But then a lot of people who do, I got Covid for the third time and I was out and my cognitive function has never recovered. That's a common, that's a common story, but it's not everybody. 

[00:42:34] Christa Biegler, RD: So 

[00:42:34] you've referenced several times your mentor and the Bredesen protocol, and then you also had a paper, I don't know when your paper came out, and I think the book came out this last year-ish.

[00:42:45] Dr. Heather Sandison, ND: Yeah. Book was out in June of 2024. The paper was published. Our paper was published in August of 2023. 

[00:42:50] Christa Biegler, RD: Awesome. 

[00:42:51] Okay, so I wanna hear a little bit about results with Reversing Dimension neurocognition, which is what these things speak to. You have a lot of data, so tell us a little bit about that.

[00:43:01] Dr. Heather Sandison, ND: Yeah, so in our clinical trial, we recruited participants who had MOCA scores from 12 to 23. So normal is 26 and above perfect is 30. When we're in that 12 to 23 range, we are in measurable cognitive impairment. Some of that's more on the mild side, but we're going more towards the direction of dementia and diagnosed Alzheimer's.

[00:43:20] And what we saw was that after a six month intervention, as I was trained by Dr. Bison. We saw that 74% of our 23 participants improved and we had statistically significant increases in the mean across all participants in MOCA scores. The Montreal Cognitive Assessment in Cambridge, brain Sciences in memory, and overall composite cognition in quality of life and in sleep scores.

[00:43:44] And we had improvements in. All the battery of testing that we did through Cambridge Brain Sciences. Not all of it was statistically significant, but all of it improved in, in terms of focus and attention and the other things that we were measuring cognitively. This is great news now that came a year after Dr.

[00:44:00] Breen and his group led by Cat Tubes. They published a paper also in the Journal of Alzheimer's Disease in July of 2022. Very similar trial. They had a nine month intervention, whereas we had a six month intervention. They took 25 participants where we took 23, and they took participants who were not as severely declined.

[00:44:18] They had MOCA scores of 18 and above, and what they showed was that 84% of their participants improved. 

[00:44:25] Christa Biegler, RD: That's pretty exciting. 

[00:44:26] Dr. Heather Sandison, ND: Really exciting. Now, these are feasibility trials, right? The critique is that there's not enough people in there. A hundred percent agree. And but that's where we start, right?

[00:44:33] Is with, is this feasible? Can we do a complex intervention with a cognitively impaired population? The answer is yes. Yeah. And we get outcomes. We get statistically significant outcomes. Now, people enroll in this trial. They're interested, part of our eligibility screening with, are you willing to make these changes?

[00:44:50] And you could argue that this isn't adaptable to everyone, but I think the more people know, right? What would you do to save your cognitive function? 

[00:44:58] Christa Biegler, RD: Yeah. I'm not gonna rely on one pill to save this cognitive function. And that's the challenging charge in front of you, is even having, as you said, if we go back to Arlene's story at the very beginning, you gave them a long list of opportunities and they.

[00:45:12] Went to battle. They, maybe that's not the right phrase, but they took action, right? And so it's yeah I would say, we talk about this a lot on the podcast we're driven to change something from inspiration or desperation. And this is, these are desperate times in this scenario, right?

[00:45:26] And so it's like you're likely to be, there are people that want this, right? Because the alternative is not good no matter what. Yeah. 

[00:45:33] Dr. Heather Sandison, ND: Also, you don't have to do all of it, right? Yeah. So what we saw is that people who dive in fully, right? Like I see this over and over again. The people who take the bull by the horns and they go for it, they're, I have higher confidence.

[00:45:46] The people who have support, they have a caregiver who's enthusiastic and on their team and wants this for them. They get, I have more confidence there. And even that being said, it's like there were lots of people in our trial who never got into ketosis. But they still improved. They were willing to make some changes.

[00:46:03] So maybe they didn't fully restrict carbohydrates enough to get into ketosis, but they did change what they were eating. They stopped eating the cake cookies, and they had less pasta and rice, right? And they added more vegetables, but maybe they didn't fully achieve ketosis, right? So you can make changes.

[00:46:20] Even small changes, if they're sustainable, are gonna have an impact on the trajectory of your health over time. 

[00:46:26] Christa Biegler, RD: Yeah, and I just wanna acknowledge, because we won't really have time to talk about it, but I just wanna acknowledge how amazing it is that . You are part, you've started, I don't know all your role, but this residential care facility, so that way people can just go and get in and do the interventions around that.

[00:46:43] And remember, it's been years since I interviewed Dr. Terry Walls who wrote a book about multiple sclerosis, but at the time they were doing something similar because people, sometimes struggled with, they'd never done some of this stuff before. And and you were like, Hey, it's actually straightforward, like for someone who's familiar with it, it's this isn't actually that, that difficult, but I'm.

[00:47:00] It's such a lift to do, to create in-person things, I just am saying kudos. And that actually brings me to my last question when I hear you on other podcasts, and I am looking at the variety of work that you're doing. You have a challenging the optimistic client base, and you are bubbly and you have.

[00:47:20] What seems to be, to me, a very healthy headspace. And so the question is really how are you taking, and I know this is a loaded question, but it's a good last question. And so the question is really how are you keeping your brain healthy in all of the ways? I don't mean just physiologically, but just for your like mental health, et cetera, managing all these things and these, like this kind of big charge that you have.

[00:47:43] Dr. Heather Sandison, ND: I feel so fortunate because I have purpose and meaning in my life, and I see a lot of other entrepreneurs who really don't have that, who often feel empty with what they're doing and they're chasing an exit or this or that, and I get so much fulfillment from the people I get to talk to like you, but also just I get to ask every.

[00:48:03] Patient that I meet, like what brings you joy? And I get to hear those things like, it's so fascinating and interesting. I get to learn like these intimate details of their lives and hear from these really cool people who've done incredible work in their lifetimes. And it's just such a privilege.

[00:48:19] So I think that, like I just have the. Best job, and I get to be super creative and come up with these solutions and people have trusted me. And I, it's just yes, there's a responsibility, but I like, feel so privileged that I get to do it. And then I also, I wake up in the morning and I drink my matcha with my lions man and my MCT, my collagen pattern in it.

[00:48:41] And then I meditate for 30 minutes. And then I start my day and I try to get to bed at eight 30 every night, which I know sounds like total Grandma. But then I can get up early and I feel rested. And if I jump on the computer after dinner or after I put my daughter to bed, I will be up until 12 or 1:00 AM working because it never ends, right?

[00:49:00] So I have to be like, Nope, I'm going to bed and I'm gonna put my. And also I feel it right when I'm jet lagged, when I haven't gotten enough sleep. I'm not me, I don't have the patience or creativity. I'm not the best version of myself. So I feel like I owe it not just to myself, but to everybody I'm working with.

[00:49:16] Christa Biegler, RD: Yeah. I love it. Where can people find you online or learn more about your work? 

[00:49:20] Dr. Heather Sandison, ND: Yeah, dr heather sandon.com. It's S-A-N-D-I-S-O-N. 

[00:49:24] Christa Biegler, RD: Yeah. Perfect. Very straightforward. Thank you so much for coming on today. 

[00:49:28] Dr. Heather Sandison, ND: Thank you so much for having me, Christa. It's been a real pleasure.