The Empowering Neurologist Podcast

🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter's newsletter at: www.drperlmutter.com. ✉️🌱====Dr. Perlmutter's groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com.What if everything you've been told about Alzheimer's, that it's caused by sticky plaque building up in your brain, is missing the real story? In this episode, Dr. David Perlmutter makes the case that the true driver of neurodegeneration isn't plaque at all. It's your own brain's immune cells turning against you.For decades the field blamed beta-amyloid protein for Alzheimer's. Perlmutter walks through a mechanism reshaping the science: the dysregulation of microglia, the immune cells that can either protect your brain or actively destroy it depending on how you live.We dig into the chilling Parkinson's case where contaminated heroin froze patients like statues and revealed immune cells still attacking the brain decades later, why the same self-perpetuating inflammation shows up in CTE, long COVID, and PTSD, how your gut and blood sugar flip these cells into attack mode, the 14 metabolic risk factors that could prevent up to half of dementia cases, and the MIT-pioneered 40 Hz light and sound therapy that slowed cognitive decline and stabilized brain volume in human trials.00:00 - Introduction00:22 - The Plaque Theory and Why It's Incomplete00:32 - Meet the Microglia: Your Brain's Immune System00:57 - Supportive vs. Threatening: The M1/M2 Switch01:43 - Why This Underlies Nearly Every Neurodegenerative Disease02:35 - The Frozen Patients: A Parkinson's Mystery at Stanford03:06 - Contaminated Heroin and the MPTP Discovery04:09 - How a Mitochondrial Toxin Destroys Dopamine Cells05:46 - Microglia Still Attacking Decades Later06:27 - The Self-Perpetuating Inflammatory Cycle07:21 - The Same Pattern in CTE, Long COVID, and PTSD08:08 - Paraquat, Pesticides, and Parkinson's Risk10:45 - What Flips Your Cells Into Attack Mode11:57 - Leaky Gut, the Microbiome, and Your Brain13:59 - Imaging Threatening Cells in Living People15:44 - Immunometabolism: Why Brain Cells Change Function18:05 - 14 Risk Factors That Could Prevent Half of Dementia18:41 - The Breakthrough: Reprogramming Your Microglia21:19 - Don't Wait for Symptoms: Intervene Early22:56 - The Toolkit: Diet, Exercise, Fasting, Sleep, and More25:26 - 40 Hz Gamma Frequency: MIT's Pioneering Technology26:20 - Light Flicker Studies and Beta-Amyloid Reduction27:38 - Human Trials: Slowing Cognitive Decline30:28 - Stabilizing Brain Volume on MRI31:10 - Conclusion: You Are the Architect of Your BrainDr. David Perlmutter, MD is a board-certified neurologist and Fellow of the American College of Nutrition whose work sits at the intersection of neurology, nutrition, and preventive medicine. He received his M.D. from the University of Miami School of Medicine and completed his neurology residency there before entering private practice in Naples, Florida. He serves as Director of Neuroscience Research at Bryan Therapeutics and sits on the Editorial Board for the Journal of Alzheimer's Disease. A six-time New York Times bestselling author published in more than 30 languages, his books include the #1 bestseller Grain Brain, Brain Maker, The Grain Brain Whole Life Plan, Brain Wash, and Drop Acid. His next book, Brain Defenders: Harness the Power of Your Immune Cells to Protect Your Brain for Life (Avery / Penguin), focuses on microglia and is scheduled for publication in August 2026.___________________________Instagram: / davidperlmutterWebsite: https://www.drperlmutter.com/Subscribe to our channel:/ @davidperlmuttermd

🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱 Thank you to our sponsors:EVY - https://www.optoceutics.com/perlmutter and the code perlmutter26 will be auto-applied to your order to get $200 off & free shipping (90 days risk-free). 3x4 Genetics - https://3x4genetics.com/DrPerlmutterfor a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations. ====
Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com. ====What if the gene you've been told to fear isn't actually a verdict on your future, and the disease you're racing to treat has already been silently progressing for two to three decades before anyone notices? In this episode, Dr. Jonathan Fellows joins me to challenge how we think about Alzheimer's risk, diagnosis, and treatment, making the case that early detection and lifestyle intervention matter more than the medications most people pin their hope on.
Dr. Jonathan Fellows is a neurologist with more than 25 years of clinical experience and serves as the Director of the Alzheimer's Disease and Memory Disorder Center at the Michigan Institute for Neurological Disorders, part of Corewell Health in Farmington Hills, Michigan, the largest private practice neurology group in the state. 00:00 - Introduction00:39 - Brain Defenders: A New Way to Think About Brain Health02:59 - Welcoming Dr. Jonathan Fellows03:51 - Why Neurology School Doesn't Teach Prevention05:27 - Inside the Michigan Institute for Neurological Disorders07:44 - Starting the Conversation When a Family Gets the Alzheimer's Diagnosis08:00 - Apraxia and the Real Warning Signs of Cognitive Decline09:00 - Why Amyloid Alone Doesn't Equal an Alzheimer's Diagnosis09:55 - The Centiloid Score: Measuring Amyloid in the Brain11:21 - Blood-Based Biomarkers and the Rise of P-tau 21713:19 - Elevated P-tau 217 at 40: A Wake-Up Call You Can't Ignore13:32 - Habits in Your 30s and 40s vs. Disease in Your 60s and 70s16:53 - 40 Hz Light Therapy and Cognitive Decline18:53 - Why Not Every Amyloid-Positive Patient Should Get Anti-Amyloid Drugs21:00 - Alzheimer's Drug Therapy Today vs. Where MS Treatment Stood in the 90s23:59 - Why Early and Presymptomatic Detection Matters25:21 - Will Anti-Amyloid Drugs Be Pushed to Presymptomatic Patients?25:39 - What We Know for a Fact About Lifestyle and Disease Progression26:27 - A Real Patient Case: When to Say No to Anti-Amyloid Drugs28:30 - APOE Explained: The Gene That Changes Your Alzheimer's Risk31:49 - 3X4 Genetics: Your DNA Isn't a Verdict33:47 - How Exercise Can Offset APOE4 Risk34:10 - APOE4 Is Not Deterministic — and Saying Otherwise Is Malpractice34:51 - Down Syndrome, Presenilin, and the Truly Deterministic Cases35:42 - ARIA Risk and Why Europe Restricts Anti-Amyloid Drugs for APOE4 Carriers38:00 - Where Anti-Amyloid Drugs Still Fit in Treatment39:14 - Current Clinical Trials at the Michigan Institute39:49 - Programmable Microglia: The Brain's Immune System Explained41:01 - Good Twin, Bad Twin: How Microglia Switch From Protector to Threat42:09 - Beta-Amyloid as an Antimicrobial Defender? Rethinking the Enemy Narrative42:49 - Insulin Resistance and the Brain-Metabolism Connection43:41 - The Diabetes Epidemic Hiding in Plain Sight43:58 - The Rainbow Lunchbox: A Preschooler Who Got It Wrong and Right44:49 - Why a Third of Americans Are Pre-Diabetic and Don't Know It46:30 - Closing Thoughts ___________________________Instagram: / davidperlmutter Website: https://www.drperlmutter.com/ Subscribe to our channel: / @davidperlmuttermd

🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱
Thank you to our sponsors:
EVY -  https://www.optoceutics.com/perlmutter 
and the code perlmutter26 will be auto-applied to your order to get $200 off & free shipping (90 days risk-free).
3x4 Genetics - https://3x4genetics.com/DrPerlmutter
for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations.

====

Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com.
====
What if Parkinson's isn't the genetic lottery we've been told it is, but a largely man-made disease driven by what we breathe, eat, and walk through every day? In this episode, Dr. Ray Dorsey returns to the podcast for his third conversation, this time to make the case that Parkinson's, ALS, Alzheimer's, and the rising tide of brain diseases sweeping the modern world are not inevitable inheritances but environmental consequences we have the power to change. Dr. Ray Dorsey is the Director of the Center for the Brain and the Environment at the Atria Health and Research Institute, where the mission is to identify the root causes of brain diseases from autism to Alzheimer's so they can be prevented. He is the co-author of Ending Parkinson's Disease and author of the new New York Times bestseller The Parkinson's Plan, which lays out a new path to preventing and treating one of the world's fastest growing diseases.

00:00 - Introduction: The Smoking Gun of Modern Brain Disease
00:42 - A New Way to Think About Brain Health: Brain Defenders
03:03 - Why Parkinson's Is Pretty Much Preventable
03:21 - Welcoming Dr. Ray Dorsey
04:36 - The Big Thesis: Parkinson's Is a Man-Made Disease
05:24 - What Defines a Man-Made Disease
05:59 - From 6 Cases in 1817 to 11.8 Million Today
06:53 - The Lung Cancer Parallel
07:22 - The PD GENEration Study: 87% Have No Genetic Cause
08:35 - Why Rising Cases Prove It's Environmental
09:55 - TCE and Perc: The Dry Cleaning Chemicals Linked to Parkinson's
11:08 - Glyphosate, Paraquat, and Mitochondrial Damage
15:13 - Practical Steps to Lower Your Exposure
16:58 - Sponsor: 40 Hz Light Therapy with EVY Light
18:58 - The South Dakota Cluster: Living Next to Cornfields
20:25 - Paraquat: Banned in 70 Countries, Still Used in the US
22:54 - Chlorpyrifos and the IQ Drop in Children
25:38 - The Audacity: Why 1 in 31 Kids Have Autism
26:10 - Pesticides in Breast Milk and Across the Placenta
30:00 - Misfolded Proteins and Loss of Smell as Early Warning
32:25 - Air Pollution: The Hidden Driver of Neurodegeneration
33:46 - The $50 Billion Economic Burden of Brain Disease
35:00 - Dr. Langston's MPTP Discovery: The First Environmental Cause
37:00 - Microglia, Mitochondria, and the Inflammation Cascade
40:30 - The Diabetes-Parkinson's Connection
42:00 - The Parkinson's 25: Practical Steps in the Book
47:30 - Carl's Story: Parkinson's at Age 17 from a Golf Course
50:00 - Why Golf Courses Could Spray Less
51:30 - Secondhand Exposure: You Don't Have to Apply It
53:00 - Soccer Players, ALS, and Heading the Ball
55:50 - Michael J. Fox, CTE, and the Multiple-Hit Hypothesis
57:30 - Resources: Environmental Working Group and Non-Toxic Neighborhoods
1:00:30 - The Mission of Neurology: Asking Why
1:01:30 - The Rising Tide of Brain Disease
1:03:30 - The Lancet Report on Modifiable Risk Factors
1:04:43 - Closing Thoughts
___________________________
Instagram:   / davidperlmutter  
Website: https://www.drperlmutter.com/
Subscribe to our channel:
   / @davidperlmuttermd

🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱
Thank you to our sponsors:

EVY -  https://www.optoceutics.com/perlmutter 
and the code perlmutter26 will be auto-applied to your order to get $200 off & free shipping (90 days risk-free).

3x4 Genetics - https://3x4genetics.com/DrPerlmutter
for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations.

====

Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com.

====

What if the future of medicine isn't a smarter doctor, but a thinking partner that can hold your entire biology in mind at once? In this episode, Dr. Don Brown joins me to make the case that AI in medicine isn't a replacement for the clinician. It's an ally capable of seeing patterns no human brain could hold together on its own.

Dr. Don Brown is a physician, computer scientist, and serial entrepreneur whose last software company sold for $1.4 billion in 2016. He returned to graduate school in his mid-50s to study biotechnology at Johns Hopkins, founded Lifeomic in 2017, and now leads Bioscope, a platform that uses AI to integrate a patient's entire biological picture into one dynamic view of health.

We dig into why fragmented medicine fails at prevention, how Bioscope ingests the whole genome, microbiome, epigenome, and medical records into a single synoptic view, the real case where AI flagged arsenic toxicity in a patient misdiagnosed with restless leg syndrome, and what it looks like when AI personas begin guiding patients through their own protocols in real time.

00:00 - Introduction 
00:53 - A New Way to Think About Brain Health: Brain Defenders 
03:18 - Welcoming Dr. Don Brown 
06:46 - From Physics to MD to Software Entrepreneur 
09:01 - Back to Grad School at Johns Hopkins 
10:35 - The Lifeomic Years: Cancer Care in the Cloud 
12:34 - The Spark Behind Bioscope 
15:27 - Building the Ultra-Secure Health Data Repository 
16:26 - 40 Hz Light Therapy and Cognitive Decline 
18:26 - The Epigenome: Why Your Genes Aren't Your Destiny 
19:32 - Decoding the Microbiome and Mitochondrial Genetics 
22:25 - What AI Actually Does With Your Health Data 
23:39 - The Synoptic View: Borrowing From Aviation
26:36 - The 15 Dimensions of Health 
29:23 - Why the Patient History Still Matters 
30:23 - Inside the Bioscope Interface 
31:38 - A Real Case: AI Catches Arsenic Toxicity 
33:13 - Personalized Brain Health: 3X4 Genetics 
35:10 - The Driverless Car Moment for Medicine 
37:07 - Marketing to Concierge Physicians 
40:33 - How Patient Data Gets Into the System 
42:30 - Image Analysis and Specialized AI Partners 
45:33 - The Biggest Misconception Patients Have About AI 
47:14 - Meet Lumina: The Physician's AI Persona 
48:00 - Cairo and the Future of AI Health Coaching 
50:13 - Different AI Personas for Patients and Physicians 
51:39 - Why Concierge Doctors Are Mobbing the Booth 
55:00 - Closing Thoughts

___________________________

Instagram:   / davidperlmutter  
Website: https://www.drperlmutter.com/
Subscribe to our channel:
   / @davidperlmuttermd

🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱Thank you to our sponsors:EVY - Go to https://www.optoceutics.com/perlmutter to get $200 off & free shipping (90 days risk-free). 3x4 Genetics - https://3x4genetics.com/DrPerlmutterfor a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations.====Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com.====What if your anxiety, brain fog, and burnout aren't mental health problems, but metabolic ones?In this episode, Dr. Robin Berzin joins Dr. David Perlmutter to make the case that the brain and body are not separate systems, and that treating them as if they are is costing millions of people their health.====00:00 - Introduction00:46 - Brain Defenders: A New Framework for Brain Health03:00 - Welcoming Dr. Robin Berzin05:23 - Why Smart, Motivated People Still Feel Terrible08:37 - From Columbia Med to Founding Parsley Health12:15 - The Problem With 15-Minute Appointments and Stacks of Prescriptions14:37 - What Is Functional Medicine, Actually?17:07 - Precision Medicine: Treating the N of One19:45 - How AI Is Changing the Doctor's Ability to Connect the Dots22:41 - State Change: Shifting Your Mind Through Your Body25:35 - Why Anxiety and Depression Start in the Body27:09 - 40 Hz Light Therapy and Cognitive Decline29:43 - Exercise, Sugar, and Nutrient Deficiencies as Mental Health Levers32:30 - SSRIs as a Tow Truck, Not a Destination34:16 - Psychedelics and Trauma: Tools in the Toolkit36:01 - Metabolic Flexibility and Why Losing It Wrecks Your Hormones38:04 - Sleep, Wearables, and the One Night That Breaks Your Metabolism40:37 - Continuous Glucose Monitors as a Mirror for Your Choices42:19 - 3X4 Genetics: Your DNA Is a Roadmap, Not a Verdict44:37 - Alzheimer's as Type 3 Diabetes: The Metabolic Brain Connection46:21 - The Lab Work Your Doctor Isn't Ordering49:22 - Fasting Insulin, Heavy Metals, and the Tests That Actually Matter51:14 - What's Next: AI, Wearables, and the Future of Functional Medicine53:56 - If You Feel Stuck: Own Your Biological Data55:34 - Closing Thoughts====Dr. Robin Berzin, MD is a functional medicine physician and health tech entrepreneur leading the push to bring root-cause, precision medicine into mainstream healthcare. She earned her MD at Columbia, completed internal medicine residency at Mount Sinai, and trained in functional medicine under the field's top practitioners. Before medicine, she produced the Oprah and Friends Dr. Oz Radio Show, and she later worked in health tech during med school, sharpening her understanding of how digital platforms could expand access to personalized care.Today, she is founder and CEO of Parsley Health, the only national functional and longevity medicine clinic in the U.S., delivering virtual care across all 50 states plus physical clinics in NYC and LA. Under her leadership, Parsley has grown to nearly 30 clinicians and 40 health coaches and nurses, treated over 50,000 patients, and built a team-based, insurance-accessible model that puts functional medicine within reach beyond the wealthy. She also sits on the medical advisory board of Whoop.She is the author of State Change, which challenges the divide between mental and metabolic health and offers a practical framework for transforming mood, energy, and cognition through the body. Her work is widely featured across major health and wellness media, and she is recognized as a defining voice in the future of preventive, personalized medicine.====Instagram: / davidperlmutterWebsite: https://www.drperlmutter.com/Subscribe to our channel:/ @davidperlmuttermd