Welcome, welcome, welcome to Armchair Expert, Experts on Expert. There is an old friend coming by. He is jockeying for most frequent guests. He is, and he's up there.
He's in a dead heat maybe with Sedaris. Dr. Sanjay Gupta, what a sweetheart from Livonia, Michigan. That's always going to make me like him more than everyone else.
Yeah, and he's one of those guests we have where we just start talking, and it's so interesting. Yeah, and he can pretty much tell you about anything in the health sphere, and touch down on the most exciting topics. In fact, today we go over Alzheimer's, the weight loss drugs. We talked about marijuana.
Marihuanica, yeah, everything under the sun. And he has a new documentary out on May 19th on CNN called The Last Alzheimer's Patient, and we talk a lot about that. Of course, Sanjay is a neurosurgeon with a practice, and CNN's chief medical correspondent. He has a new season of his podcast out now, where we get your podcast called Chasing Life, The Science Behind Happiness.
Who wouldn't want to know about that? Please enjoy our sweet, sweet friend, Dr. Sanjay Gupta. He's an old transfer.
He's an old transfer. He's an old transfer. How are you? Just about a gym.
Yeah, sorry. I'm touching my breath. No solid. Hi, it's good to see you.
You too, in person. In person, back in person. I've been offered all the drinks. I got my drink, yeah, good.
You don't need a coffee or anything? No, I'm good. Tell me about your coffee intake. I do a cup a day.
Oh, your whole life? My whole life. Wow. Never liked it.
It's so tempting to stereotype when we have two Indians in the room. Yeah. Because Monica was very late after the caffeine, too. Yeah, I also hated it.
Oh, that's weird. You're two of only five people I know that came to it that late. Well, the thing is, I drank caffeine. I just didn't like coffee.
Oh, tea. Okay, so you had soda or whatever. I had soda. I had tea.
Coffee just did not taste good to me. And it was really weird, because everybody that I know, especially in the medical world, they all drink coffee. Coffee is not to me. Multiple cups a day.
Did not like it. And then my wife started giving it to me during the pandemic. Giving it to you like it was medicinal. It was.
I was getting up at 4.30 every morning. Right, trying to stay on top of all that. I make my calls to the other side of the world before they go to bed. And I need a caffeine.
And I got this good coffee. Purity, I don't know if we're supposed to talk about brands. Yeah, we're there. It's a good, clean coffee.
What makes it unique? The other stuff, I feel like I can always taste chemicals in the back of it. I get that chemical aftertaste in my mouth. But Purity is just clean.
I want to try it. I am fully addicted to Starbys in the same way I was addicted to Camelites. Like, it's my religion. And people even point out, like, you know, it's overly cooked and burnt and blah, blah, blah.
I'm like, yeah, whatever it is. You don't taste it. It's perfect for me. Everyone has their own palate.
Now, once you like it, because, okay, similarly, grow up with my grandparents. Percolator, Livonia. I remember. Yes.
No fruit township. But all my summers in Livonia. And that Percolator went all day long. The big coffee pot.
So it smelled so good. And I wanted to like it for so long. And it was terrible, as you were just describing. And then one day, it was delicious.
Ha, just clicked. Don't you think that is one of the weirdest phenomena with your taste buds? It doesn't surprise me that we are constantly changing. That our taste buds, our microbiome, what we like, what we don't like, what we find sweet or palatable changes as we get older.
Frankly, it may change even day-to-day or month-to-month. We have that much sort of dynamic changes in our body. So it doesn't necessarily surprise me. Yeah.
By the way, you look ripped. Can I just tell you? Please, tell me all day. I mean, I'm just saying.
Okay, to put off some of that compliment, I literally just walk upstairs from the gym. So this is as good as it's going to look for the next two days. Is it just for me? Of course I do.
You're bringing the brains. I've got to bring the bra on. You're eating the yang. You guys got both.
I just want to say I've been really looking forward to this. Us too. This is the fourth time. Yeah, that's a bit.
You're one of our best. You may have tied Sedaris with this episode or maybe one behind. Probably one behind. He's four or five.
I'll be back next week. I gotta be. In fact, you should just come back at four and just be back to back. You're investigating enough things that I'm sure we could fill two hours with any number of topics.
So before we even get into that, what fascinates me about your role is you're also in show business. And so you do publicity tours. Like, here's what I thought. I walked out of the gym and I saw a really nice Escalates in the driveway.
And I said, oh, that's Sanjay. Sanjay definitely has a driver that CNN provides because he is also expected to go out and promote the show. In a lot of ways, you're like an actor that would travel around and do press tours. Yeah, you know, it's funny.
I've never thought of it that way. That sort of stuff was always sort of the add-on. And frankly, I'm not even really promoting anything. You guys provided this wonderful invitation.
And as soon as I saw it, I just jumped at the opportunity to be here. I'm not just saying that. I'm trying to think, am I promoting something right now? Well, yes.
May 19th, you've got The Last Alzheimer's Patient on CNN. I'm very excited about that. You have a podcast of your own, Chasing Life. You have a couple of forthcoming documentaries you're making that are of great interest to me.
One in particular, the weight loss drugs. I want to talk about that. I just got back from Copenhagen. Oh, you did?
Yes, the federal government two days ago signaled that they're going to pretty much declassify weed or reschedule it. You're going to be allowed to talk about that. Drop it down in the schedule. Tylenol level.
Tylenol with codeine. Still controlled. So it's not recreationally going to be different than what it already is. There's so many states that have it recreationally.
But it's a big move. Something we've been talking about for a long time. I think it can be medicine. The culture and the science, the collision of those two around cannabis is one of the most fascinating things that I think I reported on.
Just how it all comes together. Yeah, and there's also some geopolitical historical ramifications of it. We're generally not leading this as a country. We're pretty conservative.
And it's kind of shocking that we will potentially be joining a handful of countries globally out of hundreds of countries that actually might be criminalized entirely. And that's not generally our position either. It's not. And even this rescheduling, to be fair, we'll still have this federal versus state dichotomy.
There still may be problems in certain places for people to access this as a medicine, traveling with it across state lines. That's boggled my mind that you could use it as a legitimate medicine for your child with seizures in California, but potentially be criminalized for the same thing in a different state. So this doesn't necessarily address it because it's still a controlled substance. Yes, but I think we would both recognize the very well-worn pattern of this, which is most states started with a medical use clause, which then grew into recreational use.
Fuck it, we're here, let's talk about marijuana. We have now a pretty robust data set. I don't know how many years it's been, but I believe Colorado's going to be coming up on maybe a decade or something of having fully recreational legalized marijuana. That's right.
And so I imagine we have a good sense of what the impact of that is, good or bad, plus and minus. Look, you can even go further back to prohibition because that provided some really interesting data on what happens when you actually, in that case, deregulate something. You do see usage go up for a period of time, but ultimately it probably sort of balances out to where it was before. So there's not this huge clamoring all of a sudden for people to just start taking it.
People who wanted it before, recreation probably got it. Yeah, exactly. People who use it as a medicine and felt criminalized for using it as a medicine. By the way, I'm not just saying that.
I think that not only can it work as a medicine in certain situations, I think what really struck me is that sometimes it's the only thing that can work. Give a couple of examples. This seizure disorder known as Draves, D-R-A-V-E-T-S. So it's basically just seizures that are happening all the time for young children.
Intractable, they're called. And there was a little girl who first captured my attention on this because I wasn't that sold on it being a medicine, but she was a young girl named Charlotte Figgey. Well, let's be clear. A lot of people are worshiping it as a cure-all from like the 1900s.
So there's a lot of bogus stuff you have to weed through. That's the challenge in so many areas. Yeah, it sounds all of these things. I think it's one of the hardest parts of my job, frankly, because people want to see black and white where they should rightly see gray.
And the idea that, well, you said it was going to be a cure-all, a panacea for everything. It's not that. Therefore, it's useless. Well, that's not right either.
So to be nuanced in this area is challenging. And you kind of know you're doing it right as a reporter if people on all these different sides are throwing barbs at you. They all hate you. I think you're on to something.
I got it. I don't know. They sometimes may see a visual thing where they see sparkles in front of their eyes. Sometimes they have a strange taste in their mouth.
That's a common one. You taste metal in the back of your mouth. Oh, God. I'm going to be so hyper-alarm.
She's very angry on you. No, they were both at night. So I don't know what anything was. And I was with friends.
The first time I didn't know what it was. I just woke up like at four so disoriented and in a ton of pain. And I peed in the bed. I'm a proud of you for keeping that in.
He's a doctor. He's seen it all. I've urinated in the bed. Natural emission of the urinary type.
That's not common for me. So I thought, what's going on? I went to the doctor the next morning. They did a urinalysis.
And then they were like, oh, your kidneys are fine. Everything's fine. You're fine. And I was like, well, okay, I guess.
And they gave me a steroid shot for like the pain. That was it. And then a year later. Did you get a scan of your brain?
No. They didn't even begin to think this could be neurological. They were just like, oh, something weird. You laughed them out.
Yes, you drank too much. Probably. I peed in the bed. I see you a thousand times a week.
I was like, I did. But then the second one. And this is crazy. I was on this date.
A first date. And of course, I bring up that I had peed in the bed a year ago. First date. I go all in.
And he said, I don't mean to scare you, but it kind of sounds like you had a seizure. Because he himself had had a seizure. And I had never heard that or thought of it. So I was like, huh, weird.
And I asked my doctor. I said, hey, that thing that happened a year ago. Could that have been a seizure? And she said, there's no way for us to know at this point.
A week later, I was with Kristen and two of our other friends in New York. And I haven't. So they saw it. They returned to bed, thank God.
Yeah. Got it. They were cut costs. Two to bed.
A bunch of millionaires still saving money. You got to applaud it. Seizure prophylaxis. She was watching it.
And they observed the whole thing. And I went to the hospital. I was like, that's what's happening. And did they scan you then?
Then they did. And everything's fine. I had peed the bed too, but it was alcoholism. If I peed the bed again, it's probably that.
Is that on your list of topics? Peed the bed? I just wanted to tell you that people peed the bed and invite you to share us. Yeah, if you want to share us.
I mean, I definitely peed the bed. I think I was like two years old. 300 a week. That's crazy.
And so, by the way, if your child is having 300 seizures a week, I have to imagine you are absolutely open to anything. Right, that was the thing. So, you know, she'd put this baby in the baby Bjorn and just feel her seizing all the time. Can you imagine?
And they tried these medications and they're told the medications can be cardiotoxic. They're so powerful they could actually stop her heart. So, it was terrible, terrible choices for a mom. Are they muting out neural activity in certain areas?
That's right. Essentially shutting down your parasympathetic? They're basically stunting all these pathways in your body. That's how they work.
And that could have an impact on the heart as well. So, she tries CBD oil. And she says, an hour goes by. Five hours go by.
A day goes by. And Charlotte does not have a seizure. She'd be crying at that point with gratitude. Yeah.
That's how it started. And the publishers of Charlotte's Web would be on board with this one. Yeah, I hope so. Helping a lot of kids.
Oh, man. Yeah, so, that's the medical use. There are numerous ones that have been documented and are legitimate. Now, what are the more social outcomes?
And have you even looked at kind of the broad data? One of the things that's been observed that I'm aware of is where marijuana is legalized, alcohol consumption dips. And that's interesting. So, in a harm reduction model, even if marijuana is not ultimately beneficial, but we weighed against maybe decreased alcohol consumption, which we know is bad for many reasons, you know, you've got to have this very nuanced approach to evaluating what's good or bad for society.
And I'm really curious where we're at on all of it. I mean, so that's one positive thing that's been observed. There was really interesting data that came out of Colorado initially looking at opioid use specifically. And they found that opioid consumption went down.
That is wow, huh? Part of it, I think, has to do with the fact that people do use marijuana for pain. You were getting this alternative to opioids because there weren't a lot of opioid alternatives. We've done seven documentaries on this.
The last one we did was specifically looking at the use of cannabis in seniors. And it was really for what I sort of called the triad of aging. So, you're older and you're fine, you're healthy. But the three things that seniors complain about the most, sleep problems, generalized aches and pains, and mood.
So, oftentimes, because we live in such a medicalized society, you might be prescribed pain medications, antidepressants, and Ambien. My dad, who's 80 years old, was prescribed Ambien. Oh, boy. Terrible drug.
Do you operate the farm tractor? No, but it's so scary to take Ambien. Yeah, it's not a good one. I'm going to go out on a limb.
He fell and falls are a huge problem. I love the fact that it was never studied on women and come to find out it's twice as potent in women for whatever reason. I mean, the idea of how we run trials for both women and children in this country. But the idea that cannabis could be used for the nuisances of aging is really interesting.
Well, this is kind of a cure-all, actually. Yeah, I mean, people were reporting much higher quality of life scores. I spent a fair amount of time in Europe looking at how they're using cannabis in different places in Europe. And what is interesting, in Israel, for example, they are looking at the use of cannabis for what they call behavioral abnormalities associated with dementia.
So people who get dementia oftentimes have serious behavioral problems. They wander. They may sometimes become violent. They get scared.
The option a lot of times is antipsychotic drugs, which basically is for a zombified people. They have good data now using cannabis for that. So there's all these different things that are coming about. And to your point earlier, we're behind on this.
Israel is probably the world leader on this. Obviously, other countries, Netherlands, they've been doing a lot of research for some time because they've had such wide use. But we're starting to see the benefits, I think, in ways that we had not seen before. And it's not just an alternative for some of these conditions.
For some people, it's the only thing that really works. And we have a really arbitrary hierarchy with what's right or wrong to take. So an antidepressant, an SSRI inhibitor designed in a lab is somehow preferable to marijuana. And I'm not team marijuana.
I also think it gets a little nauseating, you know, nature cares all. But it is this interesting to look at why we select. Yeah, why do you think it was illegal in the first place? Coming out of prohibition, I think, frankly, just culturally, they needed another target.
And I'm saying this in part because when you look at the history of that time frame and you look at the data around cannabis, it wasn't that they said this is problematic. What they said was we don't have enough data to actually render a decision one way or the other. So let's just classify it, schedule it, in this case, as a schedule one substance. It also correlated nicely with all the government's known nuisances.
So your beat poets, black folks, hippies, anti-war movements. Oh, they're really sawing something out there. I thought it was like a scream. I was like, sounds like you have a weird ring on your phone.
You notice that I keep going back and forth between marijuana and cannabis. Marijuana itself is considered a perturbative term. That was designed to sort of diminish it even further. Or devil's cabbage.
Yes, exactly. The well-known phrase. But cannabis as an actual scientific term is what scientists will often refer to it as because they think of it as a compound that can be medicinal. A rebrand.
A rebrand, yes. Of course, we called it weed for the documentary. So I don't think we were doing anybody anything else. You should just call it grass.
So I'm conflicted. I kind of have to force myself to look at it in a harm reduction way because I think people are going to use stuff. I also think there's kind of some pandemic anxiety. I think it over-indexes in some groups.
And it really pairs up nicely with groups that are inheriting a lot of generational trauma. So I think it's really useful. And also, I don't think people should be dodging reality at all times with external substances. So I'm conflicted.
I don't think it's an overall great arc for everyone to be medicated on cannabis. So it takes a very, very precise and nuanced evaluation of it. I agree with you on that. We run the risk of creating the same problem of over-medicalizing like we have with pharmaceuticals.
I will say this, though, that after 10 years of really looking into this, we all carry these CB1 and CB2 receptors in our bodies. The cannabinoid? Yeah, the cannabinoid receptors. Yeah, cannabinoid receptors.
You have it in your brain. You have it in your gut. People who have inflammatory bowel disease, for example, will sometimes find tremendous relief with cannabis. I think as a species, we cohabitated and co-evolved with this plant.
So for most of our existence, we probably had constant activation of these receptors in our bodies. Over time, we started to lose that, especially as the substance became increasingly maligned. So the idea that you would stimulate what are natural receptors in your body as humans did for most of our existence. I don't know what that means overall, but I think it's interesting.
So to your question, are we over-medicalizing or are we actually creating a homeostasis in our bodies that did exist? If you talk to folks in Israel who, again, have been doing this sort of work for a long time, and you ask them a simple question, how does this work? Why would it relieve pain? An opioid, we know why it relieves pain.
It targets these new receptors, things like that. Blocks receptors. Yeah, here, the idea that you create a homeostasis and you allow the body to sort of heal itself in some ways I think is interesting. The body sleeps better.
It experiences less pain, it experiences less mood, abnormalities, whatever it might be. He likened it to sort of a flywheel. You know, in a flywheel, you get going, and that pretty much goes. You know, you get a little tap every now and then, but it's going to go.
Could cannabis sort of be doing that for our bodies? That's what they think. By creating a positive inertia. By stimulating receptors that we all have in our bodies.
These receptors exist for what? We do create a compound in our body known as anandamide, which is probably the closest thing to cannabis that stimulates these receptors, but we only make a certain amount of that. And so the idea that you need to supplement as you get older because you make less of it, it's like anything else. Could you think of this like another hormone?
Yeah, I supplement my hormones. Do you? Well, yes. I'm open to criticism.
But yeah, testosterone. Did you get your levels checked? Yeah, yeah, yeah. And then I adjusted them.
They were low. They were low. And specifically, my free testosterone was really low. My overall was moderately low, but my available testosterone was quite low.
And I started taking it six years ago and absolutely love it. What did you experience? Most significantly, and this podcast is bizarrely a product of it. I had a movie, it came out, it didn't open well.
I was in maybe like a three or four month kind of depression over that, a reevaluation. What am I doing? And I was mostly focused on, I think I'm done. I think I'm going to retire.
I think this was a fun ride, and I think I'm going to. I don't know. But of course, women have it too. But mostly, it's the get up and go do the thing that will get you status hormone is what it really is.
So that could be aggression if you're in a very aggressive society where status is determined by aggression. If it were a status derived from philanthropy, you'd become the most philanthropic person. So it is the hormone that makes you chase whatever thing. So for me, it brought me back to maybe my 30-year-old appetite for my hobbies and work.
Wow. And then additionally, yeah, I can have more muscle mass, I burn fat more. I love it. Were there any downsides?
Yeah, initially. And I think I was interviewing Andrew Huberman, and he made a suggestion. So yeah, there's some pretty predictable side effects where you can get water retention. I had that a lot.
I didn't have any skin stuff that you can have. And he basically just said, split your dose and just do it more often. So you're not getting these peaks and valleys of it. If you can kind of just stabilize it, you actually won't have any of those side effects.
And I changed to that a few years ago. And yeah, now I would have no idea. There's zero side effects. Over time, your testicles get smaller because they're not producing testosterone anymore.
So if I was very vain about my testicle size, maybe I would. I would call that a big guy. You can tell the gym who's using testosterone. I would call everyone's testicles.
Do you have a stance on it? Are you anti or four? Well, I just had my levels checked. And they were normal.
But my DHEA level was a little low. You probably had that checked as well. Yeah, I supplement. And it's interesting.
The reason I had it checked was mostly for my brain. Is this a result of doing your Alzheimer's? Yes. I went through an entire preventive neurology visit.
In Boca Raton? Yeah. Richard Isaacson is the guy who did this. And I got to tell you, even as a brain guy myself, it was super fascinating.
I think what really jumped out at me is, first of all, because there's not a biomarker for brain health. I think if you look at heart health, you can say cholesterol, blood pressure, calcium score, ejection fraction, all these things. With brain health, the joke goes, if you ask 10 neurologists to define a healthy brain, you'll get 11 answers. That's a very good joke.
That's also scary. People don't really know. But the idea that we now are very comfortable saying we can prevent, predict, and treat heart disease, and that came about over the last 60, 70 years. We're sort of getting to that point with brain health now, where even though we can't say here is the test that definitely says whether your brain health is good or bad, we know that we can predict, prevent, and treat brain problems.
And one of the things that Richard really pointed out to me was a simple equation of doing a DEXA scan of your body and seeing how much bone, how much muscle, and how much fat you have in your body and where that stuff is located is highly predictive of future dementia. Oh, wow. And so someone like me, I work out every day, but I do not put on a lot of muscle. And one of the most challenging things for me is to put on skeletal muscle.
So your core, you'd get to the point where a preventive neurologist would say, in order for your brain health, you need to put on more muscle. Part of it might be self-inventing with DHEA, in my case. Another thing might be is I do a lot of hikes with my dogs, and now I always wear a rucksack when I do that. Yeah, there you go.
A rucksack leading to brain health. That's not what I would have expected. No. Well, have you read Outlive?
Yes. And he's big on that. Yes, it's everything. And so I read the book.
I guess I'm almost all in on it. Am I writing that? This is a bit of a paradigm shift where we weren't looking at the brain as the result of your metabolic health. Right.
We were kind of looking at it and going like, oh, there's this blood-brain barrier, and it's this own thing, and maybe what you eat. You know, like, we love to think of it as so separated. We always have. There's your brain, and then there's almost the rest of your body.
And it's got a barrier between it and the rest. We fail to recognize how part of the system it is, and that really your metabolic health is the greatest predictor of your mental health and your brain health. The most evidence behind brain health is exactly that. How long has this been?
To me, that felt like, oh my God, what a revelation. I'm only like a year and a half into thinking that way. When I started my neurosurgery training, I finished in 2000. Even at that time, the idea that you could create new brain cells, that was sort of considered very fringe thinking.
We learned in biology, when we went to college, that the brain cells didn't go through mitosis. There were somatic cells, and then there were these gray cells that never went through mitosis. And maybe that's not true. We can create new brain cells throughout our entire lives.
Wow. So I think I'm learning that this minute still. Oh, wow. This is huge.
This idea of neurogenesis. It's a relatively new construct, but I think that it's pretty widely accepted. We started to see this in animal studies initially. We started to see it only in certain areas of the brain, including the hippocampus, which is responsible for memory, short-term memory at least.
And I think part of the issue was we didn't ever look at the healthy brain. We only looked at the brain when there was a problem. There was a tumor, and there was trauma, something like that. And when your brains had a fair amount of plasticity, so they could sort of recreate pathways.
But the idea that you could actually create new brain cells is still a relatively new way of thinking about this. One of the most evidence-proven ways to do that was through physical activity. Whoa. It was even a specific kind of physical activity.
This was interesting, because when you work out really intensely, you can create a lot of what is called BDNF, brain-derived neurotrophic factor. That's like the miracle growth. It's so sexy when you say these words. You don't think that they just roll right off your tongue.
You guys like this stuff. Oh, we do. I know. That's why I like talking to you guys.
Brain curves. Okay, BDNF. Brain-derived neurotrophic factor. Kind of like miracle growth for the brain.
You can't eat it. You can't inject it. You have to make it. The best way to make it is through activity.
And here's the thing. Interesting little nuance is that when you're intensely active, you're also making a lot of cortisol. The cortisol can be a bit inhibitory to the BDNF, as was explained to me. So the best type of activity for your brain is probably brisk activity without creating too much cortisol.
So blasts of short duration? Short duration or just even longer duration, but less intense. Brisk walking, for example. Oh, okay.
Everything I'm reading now is like you should really be building in some really elevated heart rate blasts within there to increase your max VO. Very important for overall metabolic health. Very important for heart disease. There's some nuances with the brain.
That's what's sort of interesting. I think the general thinking was what's good for the heart is good for the brain. And it's a general rule. I think that's right.
But when it comes to activity, brisker activity versus intense might be better for the brain. The way we eat, you know, everyone knows sugar is bad for you. When your body consumes too much energy in the form of sugar, your body will sort it. That's considered very evolutionary.
When the brain sees too much sugar, the receptors are much more narrow. So they'll accept a certain amount of blood glucose. And after that, they'll just sort of turn off. So you could be stuffing your body and starving your brain at the same time, which I think is really interesting.
Like it's protecting itself. It's protecting itself from a very high blood sugar. There's these little things about the brain that we're learning that are different. On some level, it's really intuitive.
Like when you just think of your heart and your cardiovascular system is a hydraulic system with fluid running through it. And you think of increasing the pressure at times and really forcing all of that fluid to move and circulate. There's something very intuitive about that preventing buildup and blockage and all these things. It's interesting that you don't just intuitively apply that to your brain too.
I guess because the way it's been positioned is this other thing that's not hooked to the rest of everything. It's always been seen as something different. But this amyloid buildup that Alzheimer's patients seem to exhibit in fMRI scans, can we think of that amyloid is similar to any other kind of plaque you'd be building up in your cardiovascular system? It appears to be a remnant of something.
So to the extent that coronary artery plaques, for example, are reflective of remnants of cardiac disease, I think there's a similarity. What is different here is that there are people who have a lot of amyloid plaque in their brain and have no symptoms. Oh. If you had a lot of plaque to the point of blockages, for example, in your coronary, you're most likely going to have symptoms unless you develop so many ancillary blood flow workarounds.
Exactly. So we don't know still if you have a lot of plaque and don't have symptoms. I think that's suggested that plaque is not the whole story here. Maybe it's part of the story.
And so many of the drugs that we worked on for a long time were just designed to get rid of plaque. It's so hard to know, right? Is plaque a symptom of an underlying thing? That's really what we need to attack?
Some people have suggested it might even be associated with brain infections. So the plaque actually helped prevent or protect the brain against infections early in life, maybe. Maybe corridor off an infection or surround or encapsulate? Pathogen, right.
Whatever it might be. Or it's just some sort of remnant of something that happened in the brain. It could be an indication of the aftermath of something as opposed to being predictive. And even when you took away the plaque, like they have these great drugs, these monoclonal antibodies, which are good at reducing the amount of plaque, but so-so.
It doesn't equal. No. Armchair expert, if you dare. Okay, so we are into your special.
That's coming up. The last Alzheimer's patient. Yes. What happened when you went?
What was the whole thing? I gotta tell you, it was a bit scary. You guys should do it. You should do a podcast on this.
You don't even do the brain scan, or rather the body scan. I did the full body scan recently, and Mike was like, I don't think I want to know. My grandpa just died and he had dementia, and so I am hyper-aware that I might get it. If I can prevent it, I'd want to.
Yeah, and I think, again, up until recently, there wasn't the belief that you could. Just like we thought about heart disease 67 years ago, you're either going to get it or you're not. There's not much you can do. That's how we thought about the brain.
There's a lot you can do. I think what was interesting, when I went for it, the variety of testing. So I did do a sort of poor man's DEXA scan to get an idea of how much visceral fat, but I also went through very sophisticated cognitive testing. So to give you an example of a few other things, draw a three-dimensional cube right now.
Draw a clock that says the time is 1110. I'm going to give you 30 words to remember now, and in five minutes, I'm going to ask you to repeat as many of those as you can. Oh, God. Can I tell you something shallow and terrible about myself?
I took such pleasure in watching you get some of those questions wrong. Like, you're working on a little iPad, and you're hitting these buttons, and sometimes it's a red X, and I'm like, oh, it's not because you're anxious. Well, I'm definitely anxious. I get nervous.
I'm nervous now. I'm a nervous test taker. I'm confident that you don't get every question right on every test you take. Are you playing connections?
I'm nervous now. I get nervous before everything. Do you guys get nervous? Yeah, I do.
You don't get nervous. It's context-dependent, for sure. When I interviewed David Letterman, my idol of my whole childhood, yeah, I'm nervous. Because you're afraid you might not leave a good impression?
The value I have placed on what his approval would mean to me is such heightened stakes that I can't help but want that so bad. He is a father in that way. Here's somebody I've worshipped. If he even alludes to the fact that I'm doing a good job or I'm all right, that's going to be incredible.
That's really sweet, actually. Yeah. We should all, you know. Yeah, I care.
Yeah. I mean, the fact that you pointed out that I got those questions wrong is going to haunt me now. I mean, you know, you weren't really nitpicking on that edit, because if you were looking over, you're like, show the ones I guess. Right.
No, but here's a little insight that I learned about myself with this cognitive testing. So the words, you've got 30 words to remember. Now, it's not just how many words you remember. It's how quickly you remember them.
And which of the words did you remember? I gravitated away from words. I gravitated away from words with B's and D's in them. Whoa.
Never realized this about myself. And first thing Richard asked me when he sees me, he goes, do you count on your fingers? And I said, yeah, I always count on my fingers. I do this.
He goes, anyone ever tell you that you probably have dyslexia? What? I'm about to be 55 years old. No one's ever told me this.
Welcome to the club. Do you do this? Do you do these and D's? I'm a hardcore dyslexic.
Really? Oh, you didn't learn to read the fifth grade. Interesting. So you knew that early on.
I do. You developed strategies presumably to address it. I don't get distracted by my story, but I don't think so. I'm in charge of creating the words.
That was an interesting thing where I wanted to write. So now I was incentivized to learn them, whereas before I wasn't. But it magically happened. I don't know how.
I'm not sure it was from some technique they knew about in the 80s. It would be interesting if you took this test now to see if you've just overcome that. I observe it constantly, though. Numbers, you know, I still have lots of jumbling and my pronunciation's pretty rough, I think.
The B and D thing, that's interesting. I still do this. Wow. I still do this.
I'm holding up a B and a D in my hand. I just quickly check myself. Yeah, you definitely have it. Like, which direction should it be pointing?
The circle? Is that what you're saying? And look, that's even hard for me to say really quickly. That's a D.
And your left hand makes a B. Audience, if you put your first finger and your thumb together and the remaining three fingers up in the air, that's what we're talking about. Yeah. By the way, it works well at dinner parties, too, because bread drinks.
Oh, I like that. Oh, I like that. This is the first time I've ever seen a B. No, is that my bread or is that the guy next to you with bread?
Now you know. But what I would argue, why I'm quick to agree with this very light diagnosis of dyslexia for you. When I got labeled dyslexic at UCLA, when I had to go back and get re, you know, to get extra time on tests and stuff, you have to go through a very long eight-week evaluation thing. And once I did that, it was very comprehensive and very obvious.
One other element I would say supports this diagnosis is I think in place of being able to get information from the written word, you develop a very, very, very good memory for auditory stuff. Your recall for words becomes really strong and your ability to consume and digest and hold on to information you've heard gets very high. And I think you have that. That seems very clear to me that you have that.
I think so. I think my enunciation is good. I'm older than you are, but once I started typing, I think it obviated a lot of the problem as well because I just knew where B and D was on the keyboard. And I never think about it each time.
But I don't write freestyle very much at all. Okay. Do you? Yeah, every morning I write with my left hand.
You don't find it challenging. I do. I hate it. But I have to journal.
It's like my commitment. But free writing as opposed to just typing. Correct. It's probably a very good exercise.
It probably is, yeah. And I've been doing it for 20 years. It probably helps with spelling and all of this stuff. It is.
I've become such a technophile with that because now I've got everything set to the maximum parameters. It'll fill in the words for me. Yeah. It'll fix the spellings for me right away.
So it's one step short of just thinking it and then it's right, which is next, I think. Yeah. Yes, very close. Okay.
So when you did this barrage of tests, you discovered perhaps you're just like, that's an interesting outcome and then one of other things. Because if I were you, I would go into a pretty optimistic. You live a very healthy life and you exercise a lot. Yeah.
If you think of our health care system as a sick care system, which I think it is, in that case, I'm doing pretty well because I'm not sick. 95% of the doctors probably look at all my results and say, you're fine. There's nothing to do here. But I think in the spirit of prevention, to the extent that it's reasonable, you're not going to go crazy in terms of cost, but there were several places that I could be optimized.
I eat very healthy, but my omega-3 to omega-6 ratio is not very good. At points in my life, I've taken fish oil, but then have become less enthralled by the data, less compelled by it. I have this supplement. But my doc is like, you have to flip that ratio, the omega-3 to omega-6 ratio, and here's the data to show you why that's going to be beneficial.
DHEA, wearing a rucksack. There's another thing, the longest nerves in your body are the ones that go to your feet. Most people do not pay any attention to their feet and how their feet move. You wear shoes, I got these shoes on.
Which, by the way, my daughter helped design these shoes. Oh, that's nice. They're from here in L.A. They're adjustable.
So he suggested toe spacers for me. Wear toe spacers 10 minutes a day, which will really help activate these nerves, the longest nerves in your body that go to your feet. So these are not expensive things to do. Yeah, you can cram toilet paper in there.