The Hidden Cause of Alzheimer's That 94% of People Aren't Addressing with Dr. David Perlmutter

Dhru Purohit (0:00)

Dr. David Perlmutter, welcome back to the podcast. When it comes to brain health, one of the biggest challenges we have today is that we're actually focused on the wrong enemy. What are we focused on, and what should we be focused on when it comes to Alzheimer's, dementia, Parkinson's, and other neurodegenerative diseases?

David Perlmutter (0:21)

I think that what Western medicine has done, and it's really been a disservice to all of us, is compartmentalized all of these diseases. Saying that there's something very unique about these diseases. There certainly are in terms of how they present. We know that Parkinson's is basically a movement disorder where we get rigidity and we get tremor. Alzheimer's is more of a cognitive issue, frontotemporal dementia, progressive supernuclear palsy. We could go down the list. But the part that we've missed, but now we have fully embraced, is that there is one unifying mechanism that underlies all neurodegenerative conditions. Can you imagine one mechanism involved in everything that we're seeing go wrong with the brain? It's breathtaking. You're smiling because, you know, who knew?

And it really goes kind of against the grain of my training because as a neurologist, we learn what is unique about this disease and that disease. The reason we learn why they're unique is because there are unique patented approaches pharmaceutically to treating each and every one of them.

And the idea though is that the treatments for these diseases focuses on their manifestations, on the smoke. And now we recognize that the fire that is underlying all of these conditions is exactly the same and it's an issue related to the immune system of the brain. And I'm going to say this several times in our time together. Who knew? For me at this stage of my life, to recognize that everything has converged on this unifying principle for what makes a good brain go bad across all diseases is exactly the same. Different manifestations, I get that. You mentioned as we were chatting earlier that you interviewed Dr. Ray Dorsey, who talked about how in Parkinson's, he calls it a man-made disease because it's related to exposure to toxins that target a certain part of the brain. But guess what? It targets the immune system in that part of the brain that makes dopamine, that manifests as Parkinson's disease. The same immune, what we call dysregulation or screw up, if you will, happens in Alzheimer's in all the neurodegenerative conditions.

That is fascinating for a person like me at this stage in my life, because it unifies everything that I've talked about for years. Many of our topics that you and I have conversed about over the years, the microbiome, gluten, high carbohydrate diet, refined carbohydrates, all converge on one thing, how they affect the microglial cells. We're going to use that term a lot today. Those are the cells of the brain's immune system that become changed from being supportive to being destructive, from being friend to being foe. That's a unifying theme across every neurodegenerative condition that you can think of.

Dhru Purohit (3:09)

You actually say in the book that microglial cells, these key cells that are part of the immune system that you're talking about, they're actually maybe even more important than neurons when it comes to brain health. And of course, we all know that neurons are important. But what do you mean by that?

David Perlmutter (3:26)

Well, neurons have been getting all the attention for years. We don't want our neurons to degenerate. That's for sure. But the degeneration of neurons is way downstream.

What happens first is loss of synapses, the connection between neurons. That's easy prey for the microglial cells. So when these microglial cells, our brain immune cells shift from being, we call it M2 supportive to being M1 destructive, the first target are the synapses, the connection. So loss of connectivity. Secondarily, then the work courses of the brain, the worker bees, if you will, are threatened and are destroyed. So really what's in charge here are these microglial cells, the immune cells, and ultimately that makes sense because our entire immune system is really doing so much more now that we realize it than just being on guard and the firemen staying in the firehouse waiting for something that the immune system would do, like an infection or trauma or a stroke. They're actually involved in upkeep, in keeping the brain healthy and functional all the time.

Yeah, they shift in their configuration when there's a threat. But they're always involved in maintenance, in nurturing our synapses and neurons, and really allowing us to grow more synapses and neurons to build a better brain. The important concept that we're going to unpack today is that we control that. Our lifestyle choices determine whether those microglial cells are working for us or they've turned our backs on us. That's what's so empowering.