The Empowering Neurologist Podcast

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Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available! Discover how to protect your brain and future health - grab your copy today at https:/www.braindefenders.com.
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Why do some people feel exhausted, mentally foggy, metabolically unwell, or simply older than they should even when their routine laboratory results are considered “normal”?
That question is at the heart of this episode of The Empowering Neurologist, featuring functional medicine practitioner Dr. Will Cole, coauthor with Dr. Josh Axe of Heal Your Cells: Reversing the Irreversible.
Dr. Cole and Dr. Perlmutter explore the idea that long before disease becomes obvious, dysfunction may already be developing at the cellular level. This concept takes on particular importance when we consider the brain, which accounts for only about 2% of body weight but consumes roughly 20% of the body's energy at rest.
The conversation examines how seemingly separate factors including metabolic dysfunction, chronic inflammation, poor sleep, environmental exposures, physical inactivity, and prolonged psychological stress can converge on the same cellular systems and ultimately influence brain health.
00:00 — Why Your Cells May Be Aging Before You Feel It
03:44 — Meet Dr. Will Cole
04:50 — What Is Cellular Dysfunction?
09:25 — Why Healthy People Can Still Develop Disease10:32 — The Environmental Factors Affecting Cellular Health
15:47 — Why Mitochondria Are Central to Health
16:37 — How Mitochondrial Dysfunction Drives Inflammation
19:57 — How Much of Aging Can We Actually Change?
20:47 — The Connection Between Mitochondria and Insulin Resistance
25:43 — Mitochondria, Microglia, and Brain Inflammation
29:28 — Why There Is No One-Size-Fits-All Diet
32:03 — Training Your Cells to Become More Resilient
32:46 — What Are “Adversity Mimetics”?
35:51 — Why Intracellular Health Matters
36:32 — Why Conventional Medicine May Be Missing Cellular Dysfunction
37:58 — What Do We Really Know About Peptides?
40:16 — Is Ozone Therapy Worth Considering?
42:30 — Ozone and the Science of Cellular Resilience
43:41 — What Is Therapeutic Plasma Exchange?
45:38 — Who Might Benefit From Plasma Exchange?
46:45 — The Everyday Habits That Support Cellular Health
51:35 — Your Cells Are Responding to the Choices You Make
Dr. Will Cole is a leading functional medicine expert specializing in thyroid health, autoimmune conditions, hormonal imbalances, digestive disorders, and brain health. He is the host of The Art of Being Well podcast and a New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum, and Gut Feelings.
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Connect with Dr. Will Cole
Website: https://drwillcole.com
Instagram: https://www.instagram.com/drwillcole
LinkedIn: https://www.linkedin.com/in/drwillcole
Facebook: https://www.facebook.com/doctorwillcole
Podcast: https://open.spotify.com/show/6z1lJ5dfKNHwGGQPOFTc7E
Apple Podcasts: https://podcasts.apple.com/us/podcast/the-art-of-being-well/id1539535133
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Connect with Dr. David Perlmutter, MD
Website: https://www.drperlmutter.com/
Instagram: https://www.instagram.com/davidperlmutter/
Facebook: https://www.facebook.com/DavidPerlmutterMD/
YouTube: https://www.youtube.com/@DavidPerlmutterMD
X (Twitter): https://x.com/DavidPerlmutter
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🧠 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! Discover how to protect your brain and future health - grab your copy today at https://drperlmutter.com/books/brain-defenders/.====What if one of the most important windows for protecting women’s brain health happens decades before Alzheimer’s symptoms ever appear?On this episode of The Empowering Neurologist, we explore the growing conversation around women, hormonal transition, and long-term brain health with two guests bringing very different, and deeply complementary, perspectives: Emma Heming Willis and Dr. Nicole Beurkens.Together, they examine a critical question: Why are women disproportionately affected by Alzheimer’s disease, and what role might hormonal changes play?00:00 Intro04:47 The First Signs of Bruce Willis’ FTD06:37 Receiving a Diagnosis With No Roadmap08:08 Emma’s Journey From Caregiver to Advocate10:18 How Understanding the Brain Can Reduce Fear12:06 From Brain Fog to Brain Health15:45 Why Women Face a Higher Risk of Alzheimer’s17:44 The Missing Conversation Around Brain Health21:37 Building Brain Health in Your 20s and 30s24:16 It’s Never Too Late to Support Brain Health26:53 Why Connection Matters for People With Dementia30:01 What Happens to the Brain During Perimenopause35:53 The Debate Around Hormone Replacement Therapy38:34 Why Does Frontotemporal Dementia Happen?40:11 Modifiable Risk Factors and Alzheimer’s Prevention44:43 Teaching Kids Brain-Healthy Habits46:40 Why Mainstream Medicine Is Missing the Brain Health Conversation50:48 Empowerment vs. Blaming Patients53:04 Alzheimer’s Is a Disease of Decades56:19 The One Thing Every Woman Can Do for Her Brain56:50 Emma’s Message to Families Facing Dementia58:29 From Fear to Empowerment====Emma brings the perspective of lived experience. As the wife of actor Bruce Willis, who was diagnosed with frontotemporal dementia, she has experienced the realities of caregiving firsthand. Rather than stepping away from that experience, she has used it to advocate for caregivers and women’s brain health. She is the co-founder of Make Time Wellness and the author of The Unexpected Journey, which combines personal experience with practical guidance for navigating the challenges of caregiving.Dr. Nicole Beurkens brings nearly three decades of clinical and nutritional expertise. A licensed psychologist and Board-Certified Nutrition Specialist, Dr. Beurkens focuses on the intersection of brain function, metabolism, nutrition, and lifestyle—and how these factors can influence long-term neurological health.___________________________Instagram: https://www.instagram.com/davidperlmutter/Website: https://www.drperlmutter.com/Subscribe to our channel:https://www.youtube.com/channel/UCDRl_UAXxbHyOOjklnA0dxQ/?sub_confirmation=1

🧠 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. ====We dig into why 94% of US adults have some metabolic dysfunction, how the body can enter a full stress response with no psychological trigger, why GABA supplements work for some people and not others, and what that reveals about gut health. 00:00 - Introduction00:06 - The Sympathetic Spiral of Doom01:04 - Brain Defenders: A New Way to Think About Brain Health03:25 - Welcoming Dr. Scott Sherr04:42 - Why Stress Has a Metabolic Component Most People Overlook06:00 - 94% of Adults Have Metabolic Dysfunction07:00 - Mitochondria 101: Why Some Cells Have Thousands and One Has None07:58 - Insulin Resistance08:50 - Toxins, Infections, and Other Roads to Metabolic Breakdown09:28 - How Mitochondrial Stress Triggers a Stress Hormone Spiral10:47 - The Cell Danger Response13:49 - Brain Defenders: How Mitochondrial Dysfunction Polarizes Microglia15:22 - Stress Without a Stressor: How Metabolism Alone Can Trigger Fight-or-Flight16:01 - Straws on the Camel's Back: Situational vs. Metabolic Stress17:01 - GABA, the Brain's Brake Pedal, and Why Oral GABA Doesn't Work18:20 - 40 Hz Light Therapy and Cognitive Decline21:00 - GABA vs. Glutamate: The Balance Behind 80% of Brain Signaling22:17 - The Depression-Serotonin Myth and the Real Role of GABA23:04 - Why GABA Supplements Stop Working Once You Heal Your Gut24:18 - Kava, CBD, and the Amanita Mushroom Compound That Calms the Brain25:06 - How to Know You're in Sympathetic Overdrive Without a Wearable26:16 - 70,000 vs. 120,000 Thoughts a Day: The Stress Math27:33 - Recovery Is the Real Marker of Resilience28:05 - Heart Rate Variability Explained29:22 - Why Going From the Gym Straight to a Cold Plunge Backfires30:07 - How to Actually Use Your HRV Data (Trends, Not Absolutes)31:21 - 3X4 Genetics: Your DNA Isn't a Verdict33:16 - Why Dr. Perlmutter Quit Drinking Wine34:13 - The Apollo Device and Its Impact on HRV35:20 - Blue Light, Melatonin, and the Sleep Routine That Actually Moves the Needle35:46 - Turn Off the News: How Constant Stimulation Feeds the Sympathetic Spiral39:22 - Interleukin 6, AMP Kinase, and the Inflammatory Signals You Actually Need39:29 - Hyperbaric Oxygen Therapy and Mitochondrial Biogenesis42:00 - Why Timing and Sequencing Matter More Than "More Is Better" With HBOT43:08 - The Aviv Clinic Research on Oxygen Delta and Blood Vessel Growth44:01 - Methylene Blue: The Redox Cycler That Boosts Energy Without the Crash45:14 - Why Liquid Supplements Fall Short and What to Use Instead46:20 - The Problem With Relying on Coffee for Energy47:00 - Methylene Blue as a Historic Antimicrobial: From Malaria to WWII48:09 - Glyphosate, Rotenone, and the Environmental Toxins Destroying Complex One49:14 - The Gut-Brain Connection and Sympathetic Activation50:09 - The Gut-Brain Connection and the "Soft Kiss" Typo Story53:08 - Why Sitting Down to Eat Actually Matters53:52 - Healing the Gut First: The Fastest Path to Calming the Brain54:37 - Psychedelics as a Tool to Break the Sympathetic Spiral57:06 - Mitochondrial Medicine as the Common Denominator58:14 - 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. ✉️🌱====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