Can Cognitive Decline Be Reversed? Early Signs and How to Protect Your Brain

All right, and we're live. Uh, sorry everyone for the delay. Just some tech issues, but we're all we're all good now. Um, we're going to wait for people to roll in. While we do that, we're going to do some intros, some fun disclaimers, all that. So, uh, if you're new here, this is the MedMatrix podcast where we go live multiple times a week talking about um, everything health related, functional medicine, how to take control of your health. Um today we're going to be talking about the early signs of cognitive decline and how to prevent that, how to stay as mentally sharp for as long as possible using some pretty fun strategies. Um I'm joined here with esteemed Colin Reernard, a functional medicine PA. Uh Colin, why don't you give a little background on kind of, you know, your experience, how you got into functional medicine for those who may not know you. Sure. Yeah, I'm uh thanks Cole. I'm glad to be here. I'm one of the lead clinicians um at MedMatrix. I have a pretty unique background. Um, I have a background in chiropractic medicine, also in natural medicine. I practice medicine at MedMatrix as a PA. Um, I'm multiple board certified as well as fellowship trained in functional medicine. So, I've been doing this a little over 10 years now. Um, between all of us in the clinic, I think we have like over 50 years experience in functional medicine. So, it's pretty cool group of people um, from a clinician perspective. But yeah, I specialize in hormone health, uh, weight loss, longevity, gut issues, thyroid, uh, pretty much a lot of things that people struggle with, complex chronic illness. So, um, talking about cognitive decline is something I deal with almost every day with patients. So, I think it's a really good topic for us today. Yeah, 100%. Cognitive decline is like one of those things, too, right? If like you're phys it's like one of the most important parts of your health, right? like if you're physically not there um but but or I guess if you're physically there but you're not mentally there anymore it doesn't doesn't really matter. So cognitive health almost comes above everything when it comes to what's important, right? Um so quick disclaimer before we get into kind of the nitty-gritty today is uh none of this is medical advice. This is really for this webinar, the podcast is for educational purposes only. If you want medical advice uh feel, you know, you can you're welcome to enroll as a patient with Med Matrix if you're interested in doing that. You can go to our website medmatrixusa.com and uh just click apply and talk to a patient coordinator and this episode. So, uh why don't you give us like a background column like what causes cognitive decline? Is it like one thing? Is it a bunch of things? Like what's what causes it? It's often a bunch of things. And I think what we need to kind of address too is what is cognitive decline? kind of like what that means. So, um, a lot of times I think people think of cognitive decline as older individuals like the geriatric population. Um, and also thinking about cognitive decline as people that may have neurocognitive disease like Alzheimer's, dementia, Parkinson's disease. Um, so cognitive decline is is really linked to a lot of different things from poor sleep, chronic stress, um, uncontrolled diabetes or even pre-diabetes, blood sugar regularity. Um, so there are a lot of root causes, but a lot of people kind of think that cognitive decline is really something that, like I said, shows up later in life, but there's a lot of early signs of this. So I think it's I think talking about this in the podcast is going to be important so people can understand what that is. Um but yeah, a lot of a lot of the things we see as cognitive decline are really systemic issues that go on for many years, uh lack of sleep, really chronic stressful environments, um people that struggle with hormonal deficiency or hormonal decline. Also, blood sugar regularity, like I said, if you're pre-diabetic or have metabolic syndrome, a lot of issues there, uh we see as related to cognitive issues, for sure. Interesting. Let's um let's dive into like some of those things you mentioned because you mentioned a lot that goes into like that can affect cognitive decline. One of the things you said um was blood sugar and diabetes. So how does blood sugar um and is when you say blood sugar is this like um everyone like is this something that only applies to like diabetics or is this like most people are going to like what like let's talk a little bit more about that like how does blood sugar affect cognitive decline? Well, so everybody has blood sugar, right? You have blood glucose. Um, and when people have sort of blood sugar irregularity or if we want to call it insulin resistance or the body's inability to control the blood sugar, which could lead to a pre-diabetes or a diabetes, um, a lot of that is dietary, poor lifestyle, um, eating the wrong food. So, blood sugar dysregulation really affects the way the brain is fueled. um because we really need uh blood sugar as energy for our brain and when there's dysregulation and dysfunction there it can affect the way the brain functions. So in theory what you're dealing with is a dysfunctional brain in relation to sort of the food of the brain, right? So if you're not feeding the brain in the appropriate way, then it's not going to function correctly, which could affect things like neurotransmitters, which are the chemicals in the brain that make you feel good and make you happy. Um, and then there's also blood sugar that can affect inflammation in the brain. So someone that has insulin resistance or pre-diabetes or blood sugar regularity, it's a very inflammatory problem in the body. So that type of process, that inflammation can affect the brain tissue directly. So if you think about say you fall and bust up your knee, right, or something and it's red, it's inflamed. You know, people know what inflammation is kind of on the outside cuz if they, like I said, bump something, you have a sports injury, you know what that feels like. So think about that same kind of physical change on say your skin or something from an acute injury in the brain, right? If there's that inflammatory process, that swelling in the brain, it's going to not function well. So something like blood sugar irregularity over say x number of years, decades in a person that causes low levels of inflammation in the brain causing very slow uh potential neurokcognitive decline. So we often and we've said this on the podcast many times that what you do today in whatever age you are will affect who you become in say 20 30 years. So people that struggle with poor sleep, chronic stress, pre-diabetes, now maybe their 30s, 40s, 50s, say when they're 70, 80, that's when those issues of their younger years will affect them in older years. So we often talk about neurocognitive change as starting 20 to 30 years earlier than it actually appears. And that's one of the reason one of the main reasons why we see this blood sugar regularity inflammation. Yeah. Okay. So yeah. Yeah. Because a lot of people think cognitive decline is something that just shows up earlier like sorry later in life but you're saying that it can actually start show up a lot earlier. So what are like some signs that you might see in like you know your like 30, 40, 50y old patients um who might be kind of exposed to early cognitive decline like what what how might that be showing up now if that makes sense. Yeah. So, some of the most common early signs people might already experience with cognitive decline that they brush off as sort of quoteunquote normal is um a lot of people have brain fog, but that's a really tricky symptom. I'll be honest, because brain fog can be a lot of things and a lot of people have brain fog that might be normal because they just work in life. So, um then all there's also sort of a slower level of thinking. People aren't as quick. I have a lot of patients that will say, "I'm not as like sharp. I can't like kind of bring it bring it out really quickly. Um, forgetting names, forgetting words. Um, it's on the tip of my tongue kind of sensation. Like I I I know what I want to say, but I can't say it. Yeah. Um, and then also people that struggle with multitasking issues or difficulty with focus. Um, we just had a great podcast uh last week with my colleague Dr. Rose about ADHD and how that kind of affects things. And so many of us are kind of ADHD now because of all their technology and phones, but difficulty focusing over a long-term period is another sign. Um, losing your train of thought sort of in say a mid-sentence or mid task. Um, people will often complain to me about their work is being impacted. You know, I I can't I have presentations I have to do for work and I struggle with that or I have tasks and projects that I'm struggling to get done. And then um some people will talk about a decrease in their creativity or their logic or their reasoning. So the thing that the thing that we try to stress is some of these symptoms are normal for people as just you know we get tired right life is tough. We all work and we have busy lives. So your brain gets tired. But what we're trying to really convey to people from a neurocognitive perspective is this is a this is stuff that's going on long term. This isn't necessarily isolated instances. Um, and it's not necessarily a normal thing if it's something that's prolonged over time or it's progressively worsening or you're just not able to kind of catch up with yourself mentally. So, that's how we try to educate patients on some of these symptoms. Cory. Yeah. So, a lot of the things you said was really interesting. You talked about like feeling like not as creative or not as sharp or words, you know, getting stuck at the tip of your tongue. Um, which is interesting. I want to make a point here. It's like though like if you went to your maybe normal doctor with like kind of some of those issues, they might be like, "Okay, and like right, right." [laughter] They might not look at like like that might not actually like they probably wouldn't care too much about like that as an issue, right? Can you kind of talk about the contrast between like how like functional medicine looks at like things like that opposed to like how conventional medicine like in that contrast? Yeah, I think it's really important to highlight from a functional medicine perspective aging and cognitive decline because as functional medicine practitioners, especially me, uh, and I know my colleagues too at MedMatrix, we look at things from a way of optimization and longevity, right? We're trying to live as long as we can, as healthy as we can, as prosperous as and optimal as we can physically and mentally, right? when you introduce a concern in the sort of standard medical model of care, not that this is good or bad, I'm just kind of making a point. Um, a lot of it, depending on your age, is well, you're just getting older, quote unquote, you know, or you have a lot of stress or well, like for example, a couple days ago, I had a patient, a a female, she was in her mid-4s, she's she has a few young kids and she was kind of experiencing some of this. um is it cognitive decline? You know, not sure. But she's having some brain fog and just feeling tired mentally. And her primary care doctor was like, "Well, you have three kids, so of course you're going to be tired, right? It's sort of I feel like with instances like this, especially cognitive stuff or feeling tired mentally, if you're not 70, right, which would sort of trigger a neurocognitive exam to to kind of understand if you do have something like an Alzheimer's or dementia, if you're say in your 40s or even 50s, you're maybe too young for neurocognitive disease. So your your doctors might sort of push that aside as trying to trying to come up with a reason. Well, you work a lot or you have kids or you're getting older. Okay, that's that's not really an answer. And so many of my patients that struggle with with brain fog or cognitive dysfunction or issues with word capture, memory, they're told like, "Oh, well, you're in your 40s now." Oh, like it's just just happens, right? That's I I just feel like it's so ridiculous, right? That the medical community at large, not everybody, you know, I'm not saying that, but as a whole, sort of puts in people's ear that it's normal to feel the effects of aging in your 30s and 40s. And if you think about that, right, if we sort of stop and think, and this is what patients are starting to do, and this is where functional medicine is coming in and sort of filling in the gaps, people aren't accepting that anymore. They're coming to us and saying, "Well, I saw my doctor. I'm having a lot of brain fog. I'm just not thinking well. I'm not performing at work. They tell me I'm getting older, and I just don't accept that." So, that's where we come in. That's the functional medicine advantage. And we say, "Yes, I don't accept that either for you. What can we start to look for that will be driving this um to fruition?" And that's really the difference is trying to be proactive about this versus just trying to come up with a random solution to what the medical community thinks is a nonpr but is actually a problem. Yeah. Okay. Yeah. Great. So now like what does that actually look like? Like how does that look differently from a um like what you're actually doing inside the inside your practice? Like patient comes in and they're like saying, "Hey, I have brain fog. Like I don't feel as creative. I'm not as motivated anymore. Like what are some of the things that like you actually start to look at and a and questions you start to ask to actually like, you know, make make change? Well, we ask a lot of questions when we're evaluating a patient for any condition, including cognitive issues. Um, and that's just the functional medicine sort of way because we're trying to identify what sort of lifestyle um variables are affecting things. We're trying to understand um what dietary effects are having on on people. We're asking about people's stress, about their job, about their situation, right? Are you married? Do you have kids? Um, how are you sleeping? That's a big thing. Um, we had a we've talked about sleep on the podcast so much. And if people aren't sleeping or Yeah, I sleep three hours a night. Been that way for years. It's sort of like a hard stop right there. You know, how can we expect your brain to work if you don't sleep? Yeah. So, uh, we start to look at some of these lifestyle pieces from a patient and all these variables and then we really dive deep into the biomarkers, the objective, right? the blood sugar like we talked about, the nutrition markers, the inflammatory markers, the hormone markers, and you start to paint a picture of, okay, this patient's not sleeping, they're not eating well, they've got a really stressful job, they're vitamin D deficient, they're vitamin B12 deficient, they're maybe permenopausal or low testosterone. You put all this together in this little soup, right? this puzzle and that's the functional medicine advantage is putting this all together and then it's sort of presenting it back to the patient to say well of course you don't feel good you know how would you how would you you know all these things are going on um so that's really the the way we excel at med matrix from a functional medicine perspective is putting together all those pieces that are not investigated otherwise uh for for most patients um because those are really the important things and if people like I said if people aren't some of the basics like diet, sleep, their stresses to the max, you sort of have to have a hard stop and I I do I get kind of real with people and it's a little tough love and to say listen we have to improve these big variables or it's going to be really hard to get you better um you know if you're not eating if you're not sleeping. So yeah, versus say, you know, in the conventional medical setting, there might be a similar conversation. Um, and a patient might tell their doctor, "Yeah, I'm not sleeping." And the doctor rightfully will say, "Oh, well, that's a huge problem. Here's a sleeping pill. Again, I'm not I'm not faulting that. Not saying it's good or bad, but has it solved a problem. I'm not sure it has, right, for a long-term solution anyway." Okay. So, sleep has kept coming up as far as like it seems like the most important things, the cognitive decline. And I know Totally. Like I talked to I I've hear from a lot of patients and a lot of them come to us because they're not sleeping well or they're coming to us and then you later find out like that they're not sleeping well. So um just curious actually how many of new patients that are coming to Med Matrix um are not sleeping well when they go first come to us? Uh well there's I'm just one of a few of our clinicians in the practice. So, I I'll I'll speak for them because I we talk all the time and I sort of know what our patient population looks like, but the number of people that don't sleep that come into our practice are a good amount. I I would say as a new patient, I would say almost I would say more don't sleep well than actually do. I don't know what the percentage is necessarily. It's definitely at least 75%. threearters of my new patients um are having some level of sleep disturbance and whether that is related to say say in females that are permenopausal or menopausal where their hormones have started to shift um decline in certain sex hormones in women can significantly affect sleep. Yeah. Also sex hormones in men if your testosterone is low it will affect your sleep. So there's definitely um a good number. I I don't I don't have too many that are like, "Yeah, I sleep great and everything's fine." That doesn't happen very often. Yeah. Right. Especially when they first come in. So, um why is like why is sleep so important and so closely tied to like cognitive health and like cognitive decline if you're not sleep. Yeah. Sleep is so important when it comes to cognitive decline and the sort of the impact over time really on cognitive decline because when you sleep very deeply um your brain detoxifies. uh we call it the glimpmphatic system. People have probably heard of lymphatic system. It's sort of the the body's waste plumbing to get rid of waste and toxin. You have a similar system in your brain, but it's specific to the brain in the way it functions uh physiologically. So when you are in deep sleep, your your brain is almost like going through the rinse cycle in the dishwasher or like your washing machine, right? Put your brain in the washing machine overnight and kind of rinse away all the toxins of the day and everything that's been going on. If you're not sleeping, then your brain is not um cleaning itself. So, you know, we do things for our bodies every day to clean ourselves, right? We shower, we bathe, we brush our teeth, we wash our hair, we do things to clean our bodies, [snorts] but no one thinks about, well, how do I clean my brain or other parts of my body? And sleep is how we clean our brain. So, you can have um issues with memory. Uh because when you sleep, memory consolidation occurs. Um sleep dep sleep sleep deprivation over a long period of time can lead to poor focus and brain fog. And also we talked about inflammation a little bit earlier. Poor sleep or lack of sleep is a significant driver of inflammation in the brain. So you can get a lot of toxin buildup. Um and people kind of we live in a world especially in the United States. I mean culture is different across the world in terms of how we take care of ourselves as humans but in the US for the most part depending on maybe where you live um this drive to do and go at a very high level is is sort of a cultural part of a good amount of people in this country anyway. [snorts] So there are people especially um depending on the type of work they do or their lifestyle that I've seen as patients that feel that they just can hack the sleep part like I don't need sleep or I have three businesses that I run and I'm responsible for XYZ and I've never slept a lot because I have a lot to do and Right. Yeah. They just sort of think that they can push through and then these are the people that are doing this kind of hacking on their body in their 30s, 40s, 50s. They're the ones that in their 60s and 70s will end up as Alzheimer's dementia patients because they they sort of tried to skate by by hacking the body in a bad way and not giving it what it needed. So, that's really where we see the decline. And it's our job in a functional medicine clinic like Med Matrix to educate people to say, "Whoa, you got to stop, right? you're on the road to destruction if you continue to do this. Um that's part of our job as educators. So sleep's a big one for every everybody. Yeah. And it's something we discuss right from the beginning. When you become a new patient in the clinic, uh we talk about sleep. All the clinicians talk about it. It's one of the most important parts of our intake is talking about that lifestyle factor. Yeah. What's like the um what would you say like the minimal amount of sleep that you would need to get to like be kind of in the clear of like or at least not encouraging cognitive decline if that makes sense. Yeah. The um the research on your age and tonight the thing about sleep really is you really need um the deep sleep. So if you're not getting deep sleep, so if you're not sleeping enough, you're not going to get the deep sleep that you need. So if you're sleeping say four hours a night or something, the amount of deep sleep is going to be highly reduced. So um I'm pretty sure deep sleep you need like 2 to three hours. I'd have to look up the the the data, but it's a few hours at least of deep sleep. So that's why you need like eight 7 to n hours of sleep to achieve that number of deep sleep because your sleep cycle goes through different period, you know, you go through a different phases of sleep. It's not all deep sleep that when you're sleeping. So that's it's um you know younger younger people adolescence need more sleep because of their brains and their brain is growing and all of that stuff. So there's a lot of there's a lot of sleep that's needed for people. What do you think is a bigger impact on kind of like neuro health, brain health and preventing cognitive decline, sleep or nutrition or stress? Oh gosh, what's the bigger of the three? That's a really hard question, Cole. Um [sighs] stress, chronic stress really affects the body and it really affects the brain. Um let's talk about that. How does chronic stress affect the brain? Like what like let's define chronic stress for example like um I work a lot. I'm also training for like an Iron Man. Is that chronic stress or is that like healthy stress? Like let's talk about let's talk about that. Stress is really subjective, right, to a person. And I think there's an amount of stress that people put themselves through that they that is ve that they is very healthy as you said um like there are healthy stressors right like I work out I do bodybuilding right you're training for an iron man physical exertion is very healthy stress on the body but I think people can very easily identify when their stress levels are unhealthy because they lose the ability to understand how to like make it work for them. They are kind of as we as we say burning the candle at both ends. Yeah. Right. They're they're not able to function. They're they're lives are starting to be impacted. They're lacking the ability for self-care. They're lacking the ability for proper and they're not sleeping. [snorts] Uh oh. Colin, you there? Right. I address crossed a threshold cognitive performance. Um, if you're joining us live, let us know if you're having these tech issues or if you're hearing Colin clearly or if I'm the issue because right now Colin has disappeared. Oh, there he is. Colin, you there, man? Yeah, I'm here. Okay, you just cut out. We just lost you for like 15 seconds. I don't know if everyone Oh, lost him again. Hey, if you're watching this live, uh, help me out in the comments. Let us let me know if you can still see and hear me or if you can still see Colin. Um, we have someone on the back end who runs these, so hopefully she's figuring that out right now. Um, yeah, let's get some comments going. I feel like I'm all alone in a room right now. Feel free to ask me questions about Med Matrix and how we help patients while we wait here for uh Colin to rejoin us. Looks like we have about like 20 people here between Instagram and YouTube. No one. Okay. Oh, here we go. Okay. Thank you, Kathleen. Appreciate the feedback. Um Leah, who is our backend person, is working on it. Oh, hi guys. Where's Colin? Colin has exited and is going to re-enter. Um, this is weird seeing myself on all these screens, all these lives. Um, but we've notified them that he's l he's we've notified him that he's lagging on our end and we're just going to try and fix that. So once he pops back in, we will react. Yeah, thank you. Hopefully it's hopefully it's shortly. Uh, but we'll still keep it at the hour time. Here he is. There we go. I'm here. All right. And we're back. Sorry. I don't know what happened. Little intermission. I hope everyone [laughter] Sorry about that. Oh, good. All right. I think we we were talking about um stress and how that affects cognitive decline. Yeah. Sorry everybody that's listening live. I don't know what happened. My I don't know. But um yeah, so as I was saying, I think it's really hard to kind of piece apart like a chronic stress, a food, a sleep issue because they kind of all go together. I think chronic stress can sometimes be an overlying issue for people when it comes to some of these other lifestyle things because when you're living a lifestyle that is not in line with taking care of yourself well if you're not giving the time for sleep for proper nutrition um then those other things are going to suffer. So like a perfect example of that I think is I hear from patients all the time is well I don't eat well because I don't have time. Well okay why don't you have time? Well, uh, kids, uh, I'm at work all the time. I I don't have time to meal prep. I I know I should, but like I just, you know, so life, whatever we want to call that variable, stress, whatever, responsibility, life for people starts to accumulate in such a way where they start to neglect these basic self-care uh, tasks and then sleep starts to go, right? I'm not sleeping as well. I'm not sleeping less. And then I start to eat and less and then you know the stress gets higher and you try to push yourself right take on more job responsibilities take on another job take on more this more that and it's like I said these people that are trying to perform at a very high level and there's performing at a very high level but then there's kind of tipping over the edge and you're just kind of you know falling without a parachute. So, those are the people that we see a lot in the clinic at MedMatrix is you've kind of gone over the edge and you don't know how to come back from it. Um, and they're brain foggy. They're they're not performing at work and they really don't know. They know they need to reel it in, but they don't know how. What are some of your favorite like a like I guess question a are there any like specific like blood markers or tests that you can like uh subjectively run and say like okay like we can see this on like your your blood work that this is happening and also like if either way like what are some of your favorite strategies to like get people back on track? Well, blood markers are a lot. You know, we see inflammation markers. We see nutritional deficiencies. We see effects on the thyroid. We can start to see blood sugar regularity. Um, all those types of tests we run in the initial panel for patients when they join as a new patient at MEM Matrix. But we do see a lot of this stuff objectively. And I think this is where it starts to hone in for people is they know they need to do better, but then they come to us and we we sort of lay it all out on paper. It's like, yeah, it's there. You're pre-diabetic or you're even diabetic. You're nutritionally deficient. Your cortisol is really high, which is a stress hormone, or it's really low. Um, your inflammation markers are high. So, we we sort of can see this objectively, but um some of my favorite sort of approaches for for getting this kind of back on track is it it sometimes take a little bit of tough love. I I don't know how to say it any better, but it's really hard for me as a clinician to and I I know my colleagues at Med Matrix will agree with me. It's hard for us as functional medicine providers to have patients be disconnected from themselves or disconnected from their care. Um we're we're not, you know, going to just give pills for people to sleep better or, you know, pills to just, you know, magically improve everything. It's really you have to you really have to be responsible and proactive about your health. So patients that join the clinic um as new patients really need to understand that their health is really driven by their proactiveness. And that's a big thing we talk about in the initial stage of care. That's a big thing for me is like listen you've got to make some change. We've got to change your diet. We've got to change the way you live. Got to change your sleeping habits. And it's not an overnight thing. But it's it's recognizing from a patient's perspective that you have to do these things or it's not going to really work. So that's how we that's how we get started. That's how it has to happen. Yeah. Just one step after another, right? Yeah. Yeah. Sort of one foot in front of the other. And a lot of patients are just ready for a change and they know they need to do it, but they don't know where to start. And that's totally fine. That's what our job is, is to lay it all out for them and say, "Listen, this is how we're going to start and I'm here to be your accountability buddy and help you through it." Uh, so you know how to start. Yeah. But it's all it sounds like it's a lot of just the simple you there. Oh yeah, I'm here. You're You broke up for a second there, Cole. I don't know. I was just saying it's just it's just a lot of the simple things is kind of what you were simple things. Yeah. Yeah. Um and I think a lot of the patients, you know, patients also do love the kind of more fancy things we can do. So like what are some of those things when it comes to like tools that like can also help patients that you you like to use whether it's um supplements or even things like peptides or other like hormones? Like what are some of the other tools that are very helpful? We use a lot of tools. Um, from a functional medicine perspective at Med Matrix, we have so many tools. Um, I I often talk about, you know, the overuse of medication. Um, just because that's a sort of standard medical practice is when you have a problem, you just get medicated for it. But we are not anti- medicine at MedMatrix. I want to make that very clear. We do prescribe medication um that's appropriate, but we're often prescribing things in a different way. um could be medication in a different form or different doses of things but often using other types of medication um as as like hormone replacement for example that's a medication but it is something that is used much more routinely in sort of a functional medicine space so something like that is really important using a lot of supplements using a lot of herbs botanical medicines um IV therapy you know we do in the clinic some people are just dry they're dehydrated or their nutrition deficient. All right, come in and get a B12 shot. Come in and get a shot of vitamin D. Come in and get an IV, right, of of some B vitamins, some nutrients, just something to kind of like boost you up and and kind of get the blood flowing and get your brain turned on. Um, peptides are a great thing, as you mentioned, we use a lot of peptides in the practice that can target um energy and mitochondrial support and um um things like regenerative and repairative processes. So there's a lot of tools we use and um the tools are to be used. It's almost like a 50/50, right? The patient has to meet us halfway and we'll meet them halfway. So we can give sort of our our stuff, all of our tools, but as long as you're meeting us too in the middle. We can't give everything and you do nothing, right? You have to do some change. You have to make some dietary change, some lifestyle. We help you do that. We we teach you how. But um it's a 5050 relationship. It's a it's a synergism that that helps people relearn how to basically live their life um using the tools. So that's great. Yeah, it's cool. Let's talk more about that because there's a lot of like fluff out there. I mean, you go on Instagram nowadays and it's like every other ad's like the the new supplement is going to like fix all your problems. So like what are some of like the most you mentioned nutrients, you talked about nutrition, you mentioned supplements. So what are some of your favorite like supplements when it comes to like staying mentally sharp, nutrients that are important to kind of like monitor? One of the most common things I see for people that have cognitive decline or chronic fatigue or brain fog from a nutrition perspective is being deficient in vitamin D. Vitamin D is really really important for your uh for fatigue, for brain function, also immune system function. But I've had people with vitamin D totally in the toilet. And um obviously that's not necessarily the only intervention we make. But uh something like that is really simple. You know, come into the clinic and get a shot of vitamin D, start on a really high dose quality supplement, and give it a couple weeks. Uh and people are kind of their brain just kind of turns right back on. I've had people that have vitamin D really, really deficient. I get them in the clinic, they do a a shot of say a high dose of vitamin D as an injection and right away, oh, I'm like, I slept so good last night kind of thing or I was like so sharp that next day. So, it's sometimes really basic and I and sometimes it sort of surprises us because like how did you go so long without knowing this? No one checked this. Um, but people don't. Um, so we that's what we do. Um, but yeah, really basic stuff, basic B vitamins, um, things like magnesium people are deficient in because again, this can come from poor diet, right? You're just not eating or you're eating one meal a day because you're stressed to the max, you don't have time. So your basic nutritional markers and your nutritional mark um, your basic nutrients and vitamins are low. We see that on labs and that's sometimes where we start in combination with maybe some other things. But it's like you got to get these nutrients better in order to start improving things. So those are some really basic stuff. There are also certain herbs that we use that can help regulate like your stress hormones that can help regulate sort of your sleep cycle, your sleep rhythm. Um we use herbs like things called adaptogens that can help with regulating your cortisol and your stress response. So there are a lot of really cool things that we do and this is all training that we've all had. Uh this is not stuff they teach in in medical school or any type of conventional medical training. This is all stuff we've learned. Um you know I [clears throat] took classes and seminars and read books and became board certified and all these other things. So these are things you just don't get in the traditional medical sense. Um and the other thing I want to make note of is all these interventions that we're using for cognition or sleep improvement or whatever it is, they're all heavily studied and heavily researched. You know, we we pride ourselves at Med Matrix on practicing evidence-based medicine. So, it's not something that we're just pulling out of the clouds. This is all stuff that is heavily researched and heavily um understood from a medical perspective that's appropriate for people. So, great. Yeah. But those are some things we do just really routinely. Some of the basics is is the best way to start. Yeah. Yeah. I think that's I I mean go a little off topic here, but I think that's a really good point to bring up that it is evidence-based. I think there's there's so many like functional medicine, holistic medicine, natural medicine, right there and there's longevity medicine. There's all these different terms and not a lot of people like know what it actually is. So sometimes people think it's kind of like woo woo but in reality it's like functional medicine is as evidence-based as it gets, right? Yeah. Yeah. It's a great actually idea for a podcast maybe in the future is kind of defining some of these terms, what they mean, h how we how we use them, you know, what they mean for patients, what they mean for clinicians. Um, yeah, it might be a great discussion to have so people understand it a little bit better because you're right, there's all these kind of terms and they're kind of sexy, right, for people to use. It's very buzzy. It's social media drives this a lot, but what does it actually mean? Yeah, it's a good point. Yeah. And it's also kind of different, right? because it's like, you know, you go to a cardiologist, like you kind of know what you're going to get, right? But if you go to a functional medicine practice, it's like literally every single one's going to be a different experience. So, it's like, you know, you got to be make sure who you're working with is legit. Um, but Okay. Yeah. Yeah. So, real quick, you also talked about peptides. I know a lot of people are interested in peptides. And then you mentioned specifically peptides that work on the mitochondria. So, let's unpack that a little bit. So, first off, like in simple terms, like what is the mitochondria? How does that affect brain health? And then like um we'll dive into like peptides and like how they they can improve mitochondria function. So mitochondria is a part of the cell. So the very basic building blocks of all your tissues. The mitochondria is where energy molecules are made. So specifically something called ATP. Um probably people might be like oh yeah I remember that from high school biology or something. Yeah. But basically this is a very reductionist way of how your body sort of energizes itself. So when people struggle with a variety of issues uh whether it's complex chronic health issues, chronic fatigue syndrome, chronic stress, um you name it, there could be some level of mitochondrial dysfunction. So basically at a cellular level, your body's cells are not able to produce the energy that it needs to function. So if you're trying really hard to do your dayto-day and your energy cells are not making energy, it's going to be really hard for you to do that. So when we talk about mitochondria, we really are talking about uh as I said, how the body fuels itself. So if people are struggling with brain fog, cognitive dysfunction or just cognitive decline in general, um mitochondrial support is always something we want to think about because if the brain is not making energy, not able to utilize energy from a basic physiological cellular perspective, that's a problem. Um so we there are there is some there are various ways to kind of test for that. We don't always do that because it can be kind of costly and you know it's not it doesn't always change the change the treatment plan but um there are ways that we can try to approach mitochondrial dysfunction using certain peptides using certain herbs botanical medicine supplements um to try to help kind of turn on that energy production factory that's in all of your cells. So very very important to address for almost every patient uh because when people are tired mentally, physically, cognitively there's it's probably very safe to assume there's some level of mitochondrial dysfunction. Interesting. Okay. And then talk about so like what are like some of like the mitochondrial peptides and how do they work? So one of the most the um one of the most common ones that I like um is something called Mi. Um and again I'm not providing medical advice for anybody so this is just educational but um Matsi is a peptide that directly affects um metabolic health. So it can can specifically target insulin resistance which we talked about a little bit earlier and regulate your blood sugar. Um there is some studies that show that M actually um improves physical capacity. um endurance and then sort of your lifespan. So it kind of um almost doesn't mimic exercise but it sort of improves how much capacity you have for exercise. And then um there's a lot of new research on Matsi about how it can protect the cells from oxidative stress. So specifically what that means is the cells get damaged from uh physical stressors. So um this can lead to met metabolic decline and you know age related decline. So there's like a longevity piece to this too. But there are a lot of there are other peptides that we use for for energy. But but this one I do love a lot because it sort of acts as like a master switch for um the metabolism. So it's pretty cool. Yeah. There's certain herbs um that can [clears throat] be used to power energy. Um something like NAD is really common or the precursors to NAD which is NR and NMN. Yeah. Uh there are a lot of different cool things that we use. So and and the thing that the thing you mentioned this earlier, Cole, which is really um really cool, but you talked about sort of how all this stuff is being advertised sort of in social media and it's kind of all over the wavelengths of Instagram and all of our social media platforms. So people do try to sell these things, you know, for patients. Companies are trying to promote all these supplements and, you know, for your energy and blah blah blah. They're great. They do work. But I want to make it clear that if people are struggling, right, and we think there's mitochondrial dysfunction, we think that there's energy issues, people are struggling physically, mentally, cognitively, taking a supplement to improve that without addressing all the other underlying baseline issues is going to be hard for you to get better. And that's where these, you know, influencers on Instagram or Tik Tok or these big supplement companies, they'll make a ton of money because they're selling you this pill that will help with energy technically, right? The ingredient is has been proven to do that. But again, people aren't eating well, they're not sleeping, they're nutritionally deficient, all that stuff. If that's not improved as part of the treatment plan, you could unload all the peptides and supplements in the world. it's not going to make a huge difference. You have to use these things in conjunction with those other pieces. So, that goes back to my my comment earlier to say like it's a 50/50 or if the patient's not doing their role and we're not doing it equally, it's it's not going to work. So, you have to you have to satisfy those basic things for patients to start being able to use some of these other tools successfully. Yeah. Okay. Um it's really important. Yeah. Yeah. One one tool that I don't think we've mentioned yet, but like everyone knows it as like the the brain supplement is uh omega omega 3 and six. Can you talk about a little bit about that? Like how like if you take your omega-3s every day, like are you not going to get Alzheimer's 100%? Like what like what's the real real battle? So, it it's really it's not that simple because there's a lot of different it's very multiffactorial in terms of how something like an Alzheimer's is develops, but um omega-3 fatty acids, particularly DHA and EPA, sure, maybe people have seen those on their supplements or online or something, but they're really crucial for brain health. So, basically, they support the cell membrane. So the cell we've talked about has this like outer wall um that holds everything in the cell and it's made of these fatty acids. So if you don't have enough fatty acids in your diet um then it can be really hard for your cells to kind of turn over and make new cells because it doesn't the raw materials are not there. So they really really importantly support the cell membrane. They importantly um improve neuronal communication or how the nerves communicate with each other. So your brain is just this collection of all these different nerves together and um without enough fatty acids they can't connect and make and make connection um and and transmit messages and things like that. So yeah um that's a really important part and then also omega-3s have very um potent anti-inflammatory properties. So we talked about this earlier um where inflammation can directly affect the brain like physically how it works. So, omega-3s can have an anti-inflammatory effect, but again, if you're trying to supplement omega-3s on top of a really bad diet, yeah, it's not going to work. So, you've got to start doing that work plus doing the the supplementation. But, yeah, I use omega-3s and probably almost everybody. It's uh it has a lot of benefit, not just cognitively. Yeah. And how this is kind of a odd question, but like how important is like consistency in all this? Because like I know a lot of people like they try to do on their own like they'll take their supp they'll take they'll buy omegas, they'll take the bottle, they'll like get good sleep for a couple weeks but then it's like and then another week goes by and then you know they're they're drinking on weekends and then like not sleeping well and then like they didn't they didn't reorder their supplement. So like what like yeah how much does how important is consistency in all of this? uh consistency, and this is probably another great podcast episode topic, but consistency is extremely important for patients to get better because if you think about um how long it took the patient to feel unwell, it wasn't overnight for almost a lot, you know, a lot of people that struggle with chronic health issues. So, to expect them to expect themselves to get better in a week is not going to work. So when I talk to patients, especially in the beginning phases of care, I try really hard with everybody to be very transparent about their expectations to say, "Listen, this can take six months. This can take a year, if not longer." Um, and that's why it's really important for them to understand that the 50/50 relationship is so important. So, these are the things I'm going to do, right, as the clinician, these are the things I need you to do, and we're going to talk every few weeks, every few months, whatever that is, to start checking in on each other and holding each other accountable. So, the consistency is extremely important. Yeah. For anything, right? You go to the gym once, you're not going to notice a change. You go to the gym twice or a week, you won't notice a change. After six months, you'll notice a change. Right? After a year, you'll notice a change. You're probably experiencing this with your Iron Man training, right? Yeah. You do it once, nothing's going to happen. Um, it's just like learning a new task, right? You do it once, you're not any better at it. You've got to do it over and over again. So, we educate patients all the time that this is really a uh change in the way you live, the way you function, the way you exist in your space, your home, your job, your relationships, your family. And it just has to be that way. And if people aren't ready for that, that's fine. Totally fine. But that's really what it needs to come down to. So, we do that so well at MedMatrix from a functional medicine perspective because we understand how to guide people through um where I think the traditional medical community just doesn't know how to hold patients accountable and how to bring them through a treatment period over a period of time to change their life. So, yeah, that's a great point. Consistency is so important. Yeah. Yeah. No, I mean, well, I mean, it's kind of like obvious like you're kind of like, well, duh, right? But like the reality is like it actually like doing all these things like taking the right supplements consistently eating well consistently getting good sleep, exercising like in the midst of like you know your job, your family, like social life like it actually is really hard and like that's one of the reasons like I love like being a because I'm obviously I I work at my matrix I'm also a patient like you it's like you kind of get regiment like you go in it's like you know two hours every three months like you spend on labs and a provider visit and then you got like your provider assistant who just takes takes care of like making sure all your supplements arrive at your door and if you're doing any medications like those show up, you get like you know nutrition lifestyle plans and it just makes like the consistency very easy because like honestly to like stay on top of all those things like is challenging, right? And I think like a lot of people like they want to do the right thing, they try to do the right thing on their own, but they don't. It's just like the follow through is that's kind of the hard part. Um really hard. Yeah. So we're we're getting to the 50-minute mark. So, we're going to go through some we're going to do a patient case study and then we're going to start doing some Q&A. So, uh looks like we've had a pretty small but fantastic crowd with us today. We have like 15 20 people like kind of sticking around the whole time. So, um drop some comments guys on like questions you have, clarification you want on certain things we've talked about and we'll answer those live. Um don't don't leave us hanging here. And then while we wait for you guys to do some comments, uh let's let's do a patient case study, which is something fun we always do. So, why can't Yeah. If you could like think of a patient that like specifically relates to just like um cognitive decline or brain fog that kind of came in and um yeah, like what what you did with functional medicine. Yeah. And this it it [laughter] for me it was pretty straightforward but not straightforward in any way for the patient I don't think because they didn't understand the connections. But this was a um patient I saw probably six months ago, five months ago maybe. Um and he Oh, Cole, your video dropped off. I don't know if you can still hear me. Keep going. I'll figure it out. Yeah. Um so patient I saw about 6 months ago uh came in and he already had been diagnosed with diabetes. So, uh, he was on multiple medications for his diabetes and his diabetic markers were not able to get better. So, his primary care doctor was sort of on him all the time. We got to increase your medicine. We got to increase and he was just kind of done like I don't want to keep increasing my medication. I don't want to keep incering any offering me any type of resolve. So, he wanted help from me sort of like, okay, what do you think? I've had diabetes for 20 years. I can't get it better. You know, and he was doing all the right things. He was exercising. His diet was not that bad. He, you know, there's always ways to tweak diet, but it wasn't a traditional like, yeah, I eat like crap kind of person. He was on top of it. He was putting in the effort. So, um, on top of ma managing his complex health concerns, one of his his major chief concern was fatigue, just all over the place. um physical, mental and he works I don't remember the exact title of his job but he works in maritime work something he's an engineer on um some sort of maritime vessel whatever that you know I'm not sure some of the specifics and forgive me if those listening are related to this I don't know um I'm ignorant to that stuff but um he was starting to really have a decline in his ability to work because he had a very high cognitive function u a high level of function at his job as an engineer on this on this um boat. So he was responsible for a lot of things, really struggling when we did his intake and going through all of this stuff and he was sleeping well. I mean, it was everything. Everything was not too bad, right? But it's cognitive decline. Really, really bad cognitive decline. So when I educated him about it, it's like, okay, well, you have really bad cognitive decline probably because you're diabetic. That's probably part of it. And he recognized that. But it's like, I'm doing all the right things from a diet and lifestyle perspective. Why is my diabetes so bad? And then if it's making my cognitive issues bad, right, it's sort of snowballing. He was he's 57, something like that. Um, his testosterone was in the toilet. Totally in the toilet. I think it was like 203 or something. So for those that know or know anything about hormones in men, um, testosterone is like 300 to,200 in a normal range. It should be about 700 to 900 optimally. His was like 2011 or something. Yeah. Yeah. So it's like Okay. your testosterone is really low. Testosterone in men is going to significantly impact cognition number one. And there are studies that show men that do suffer from neurocognitive decline like Alzheimer's dementia have low testosterone. There's a correlation there. Um not necessarily saying that treating Alzheimer's and dementia is with testosterone, but there's a clinical correlation in the literature. Y so his testosterone being low was affecting his mental ability and also his body's ability to regulate his blood sugar. After 6 months on testosterone replacement, he was as sharp as the tack at work doing all the good things and his blood sugar improved so much that we had to talk I had to talk to his primary care doctor to say, "Hey, he's having hypoglycemia episodes or episodes of low blood sugar. we got to take him off of some of these meds. So, he was on three medications to manage his diabetes. He went down to like one at a very low level within six months and it was really really remarkable. Um, so he was really happy about the the diabetes. He was totally totally thrilled. He's like, "You don't even know been dealing with this diabetes thing for so long. Why did no one ever tell me this?" And I was like, "I don't know." But then just from a performance perspective because like I said he had a very high level performance job cognitively as an engineer. Um so getting that back in a few months was really life-changing. So really cool case but it was it kind of like it wasn't like a direct relation. And it was like, okay, we have to figure out all the tools and the pieces to kind of link it together, but this is how functional medicine works, right? It's like you come in with a chief concern and we have to try to Sherlock Holmes it and say, "How is this all related together?" And we have to investigate and try to put the pieces together. So if he had never come to us, he may have he may have succumbed to a neurocognitive disease in later life because of the diabetes being bad, it effect on the brain, the low testosterone's effect on the brain after a while. I'm not saying he he won't, but it's much more unlikely now that he'll have neurocognitive decline when he's say 70 or 80 years old. Um, so it was a really really cool case but but not not something that is uh overly visible say in the medical community. Not as recognized as um linked together. So cool guy. Yeah, that's still so exciting, man. I must I mean it must feel really cool for you too just as a provider to like be able to help people like that. That's so fulfilling and even like I'm like so happy to like it's awesome here all the time. it becomes sort of second nature to us as functional clinicians because this is just the way our brain works. So when we do this stuff, you know, I do it all day, right? Day after day, hour after hour, I see patients all the time. And you know, it's it's tons of positive stories and life-changing stories. And sometimes I do, and I'm not trying to say this to toot my horn, that's not what we do. That we don't have egos as clinicians at Med Matrix, but we sort of get lost in the fact that we do this routinely because patients come in and they'll say, "Why, like this guy, I've had diabetes for like 15 years. Why has no one told me that I should have my testosterone optimized?" I'm like, "Dude, I I couldn't tell you." And he's like, "Yeah, but you sat with me for literally 30 minutes, went through labs, and said, "Uh, this is your problem. I've been to multiple specialists over 15 years. How How does no one?" And it's like, I I don't know, but it's just like it's almost like I brush my teeth every day and I, you know, do all these things routinely. It's just such a routine part of how we treat people. Um, and I we forget that this is not the norm. Yeah. um we we forget all the time. So we have to kind of reel ourselves back in and say people are not used to this type of health care. Um but we do it so routinely every day. So it is really cool, really rewarding. It is. It is so exciting. Well, thanks for the story. That was great. I'm sure other people appreciate it. All right, guys. We got like two minutes here. So, and we got no questions. So, you guys are kind of like [laughter] you're letting us down. I'm kind of sad. Oh, be nice to the listeners. Maybe we maybe we've done such a good job. I said this to Dr. Rose the other day on the podcast. We had no questions. I said, "Well, we just did a really good job." That's a good way to say we answered everybody's questions. We were really insightful and really articulate, so we have nothing. There's nothing else to say. Okay. Well, at least give us like a thumbs up, guys. [laughter] I need I need a little bit more reassur reassurance um than calling here, but got to have confidence. Yeah. All right. Well, if we don't get any questions here in the next minute, let's we'll wrap up. So, yeah. I mean, if um that was that was an awesome episode. That was so so much fun. I learned a lot. Um, if you're watching this live and you're interested with working with us as a patient, you can go to medmatrixusa.com and um, apply to become a patient there. Um, oh, there we go. We got one. Thank you, Kathleen. Thank you, Lynn. Oh, yeah. Looking forward to more. Yeah, I'm a new patient. Just had blood work. Um, yeah, thanks guys. Excited to meet you, Kathleen. Thank you, Lynn. Appreciate it. Yeah, we talk to each other, right, Cole? And we don't know like are people even listening to, you know, so it's nice to [laughter] hear. making sense. Thank you guys. So yeah, um and to you know share this with friends like spread the word. It's like again like you know Colin was talking about that guy who came in who um could have like lived the rest of his life and like kind of suffering you know not enjoying life and uh health is so important and that's what we try to do here. So um yeah that that that's it for today's episode. If you're interested in learning more becoming a patient you can go to medmatrixusa.com and get started there. Thank you everyone. Thanks everyone. Thanks.