The Empowering Neurologist Podcast

Why Exercise May Be More Powerful Than Any Alzheimer’s Drug with Dr. Majid Fotuhi | E210

🧠 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). Fresh Pressed Olive Oil - https://www.getfresh389.com For a complimentary bottle of one of the greatest olive oils I've ever discovered. 3x4 Genetics - http://3x4genetics.com/DrPerlmutter for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations. ==== Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com. ==== If you’ve followed my work for any length of time, you know that one of the central themes we return to on The Empowering Neurologist is this: your brain is far more adaptable, resilient, and improvable than conventional wisdom ever allowed us to believe. This week, I’m thrilled to share a conversation with someone who has spent more than three decades proving exactly that. Dr. Majid Fotuhi, neurologist, neuroscientist, Harvard- and Johns Hopkins-trained physician, and now author of the new book The Invincible Brain, has dedicated his career to helping people reclaim their cognitive potential. His message aligns powerfully with the philosophy behind my upcoming book, Brain Defenders: that the trajectory of your brain is not predetermined, and that meaningful change is possible at any age. In our interview, we explore the groundbreaking ideas that shaped The Invincible Brain. Dr. Fotuhi lays out why intelligence is not fixed, how memory can be strengthened through surprisingly simple practices, and why Alzheimer’s disease is not the single, linear condition we once imagined, but rather a complex “soup” of abnormalities with multiple entry points for intervention. ==== 00:00 Intro 01:44 Choices influencing brain trajectory and resilience 04:25 Redefining intelligence beyond IQ 08:20 Synergy of memory and habit change 13:09 Challenging genetic determinism with epigenetics 18:00 Ad Break: Optoceutics 20:23 Alzheimer's as a metabolic and inflammatory soup 29:45 Ad Break: Fresh Pressed Olive Oil 38:04 Exercise and metabolism in brain health 43:45 Ad Break: 3x4 Genetics 49:38 Brain training and five pillars of brain health 54:55 Mindset as key to becoming a superager ==== Dr. Majid Fotuhi earned his PhD in Neuroscience from Johns Hopkins University in 1992 and his Medical Degree from Harvard Medical School in 1997. Currently, he serves as an adjunct professor at the Mind/Brain Institute at Johns Hopkins University, while also teaching at George Washington University and Harvard Medical School. With 37 years of experience in teaching, clinical practice, and neuroscience research, Dr. Fotuhi has pioneered a multidisciplinary approach to enhancing brain vitality and cognitive performance at any age. His groundbreaking “Brain Fitness Program” combines a comprehensive baseline “Brain Portfolio” assessment with 12 bi-weekly brain training sessions. This program targets lifestyle optimization and cognitive stimulation to improve memory, focus, and overall brain health. Dr. Fotuhi’s program has delivered measurable success for patients dealing with memory loss due to aging, concussions, and ADHD, as documented in several peer-reviewed journals. ___________________________ 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

Toxins Rewrite Your Genes (And Trigger Brain Disease) with Dr. Sarah Marzi | E209

🧠 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). Fresh Pressed Olive Oil - https://www.getfresh389.com For a complimentary bottle of one of the greatest olive oils I've ever discovered. 3x4 Genetics - http://3x4genetics.com/DrPerlmutter for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations. ==== Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com. ==== On this episode of The Empowering Neurologist, I’m joined by Dr. Sarah Marzi, a neuroscientist at King’s College London and a principal investigator at the UK Dementia Research Institute, whose work is transforming how we understand neurodegenerative disease risk. Dr. Marzi’s research focuses on gene regulation in the human brain, particularly within microglia, the immune cells that orchestrate inflammation, synaptic pruning, and repair. Her studies show that genetic risk for diseases like Alzheimer’s is concentrated not in protein-coding genes, but in regulatory regions of the genome, epigenetic switches that control immune behavior in the brain. This conversation with Dr. Marzi is not just about disease. It’s about agency. Understanding epigenetics helps explain how lifestyle, environment, and immune balance can influence brain destiny. It’s science that empowers prevention, resilience, and hope. ==== 00:00 Intro 03:12 Epigenetics and Neurodegenerative Disease 04:49 Why Alzheimer’s Is Not a Single Gene Disorder 09:18 Protein Aggregation and Brain Cleanup Failure 10:55 Microglia vs Neurons in Alzheimer’s 19:04 Blood Brain Barrier and Inflammatory Signaling 20:39 ApoE Genetics Explained 23:37 Human Microglia Transplanted Into Mouse Brain 30:02 Vitamin D Receptor and Protective Gene Programs 38:18 Environmental Toxins and Parkinson’s 44:59 C1q Activation and Synapse Loss 49:33 Why Substantia Nigra Is Uniquely Vulnerable 51:39 Paraquat, Mitochondria and Converging Toxic Pathways 53:00 Epigenetic Memory of Toxic Exposure 54:09 Histones and Gene Regulation in Alzheimer’s 57:41 Oligodendrocytes as a Hidden Player 59:32 Why Single Target Drugs May Fail 01:02:10 Detecting Disease Through Blood and Machine Learning 01:04:41 Can Lifestyle Modify Epigenetics ==== Dr Sarah Marzi is a Senior Lecturer in Neuroscience at King’s College London and a Group Leader at the UK Dementia Research Institute. Her work focuses on how our genes and environment change cellular processes in the brain and can predispose us to neurodegenerative diseases such as Alzheimer’s, Parkinson’s and motor neuron disease. An expert in epigenetics – the chemical switches that turn genes on and off – Dr Marzi uses cuttingedge genomic techniques on human brain tissue as well as cell and animal models. Her team combines these experiments with advanced statistics, bioinformatics and AI to map the earliest molecular changes that make brain cells vulnerable to disease, particularly in immune cells of the brain called microglia. This work aims to reveal how both genetic variants and environmental exposures, including pesticides, contribute to disease risk and to uncover new avenues for therapy. ___________________________ 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

Optimizing Fertility: What Actually Moves the Needle with Rachel Swanson | E208

🧠 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). Fresh Pressed Olive Oil - https://www.getfresh389.com For a complimentary bottle of one of the greatest olive oils I've ever discovered. 3x4 Genetics - http://3x4genetics.com/DrPerlmutter for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations. ==== Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com. ==== On this episode of The Empowering Neurologist, I sit down with one of the most influential voices in modern nutrition and women’s health, Rachel Swanson, MS, RD, LDN. Her new book, Trying! A Science-Based Plan to Optimize Your Fertility, is poised to reshape how we think about fertility, moving it out of the narrow confines of hormone-focused conversations and into the broader landscape of systems biology, metabolism, environmental exposure, and cellular health. Swanson’s work begins with a powerful premise: fertility is not a mystery, and it’s certainly not something women should feel powerless about. Instead, she argues, fertility is a measurable, improvable expression of whole-body health. And her book provides the first integrated blueprint to understand and support that health. The conversation starts with the microbiome, which Swanson calls the “mission control headquarters” of fertility. Who knew that our gut bacteria were playing an important role in determining fertility? Drawing from her book, she describes how the gut, vaginal, and even oral microbiomes create the biochemical environment that influences hormone balance, inflammation, implantation, egg quality, and partner sperm health. What makes this book, and this podcast episode, so compelling and empowering is Rachel’s rare combination of scientific precision and heartfelt dedication to women’s autonomy. She refuses to oversimplify fertility into quick fixes or fad-driven advice. Instead, she offers deeply practical strategies rooted in peer-reviewed research and years of high-level clinical practice. ==== 00:00 Intro - Rachel Swanson04:38 Fertility as Whole-Body Health11:37 Metabolic Health Comes Too Late18:48 Ad - EVY21:17 The Microbiome as a Foundation of Health27:28 PCOS Is a Metabolic Disease, Not Just Hormonal35:15 Ad - Fresh Pressed Olive Oil37:07 Menstrual Products and the Vaginal Microbiome40:41 Inflammation and Metabolism Drive Fertility49:06 Ad - 3x4 Genetics50:26 Personalized Fertility Over One-Size-Fits-All56:16 Closing Thoughts ==== Rachel Swanson, MS, RD, LDN, is a registered dietitian and one of America’s most sought-after nutritionists, known for optimizing human performance through science-backed, personalized care. Her clients include celebrities, professional athletes, and Fortune 500 executives who trust her expertise in concierge medicine and private practice. Rachel is a highly principled, intellectually rigorous, and passionately empowering expert, whose communication and sentiment are consistently driven by a profound conviction in her book's unique, holistic framework as the transformative solution to outdated and fragmented fertility advice, reflecting a deep commitment to women's health and autonomy. ___________________________ 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

Unlocking Immortality? Exploring The Bold New World of Gene Therapy with Elizabeth Parrish | E207

🧠 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). Fresh Pressed Olive Oil - https://www.getfresh389.com For a complimentary bottle of one of the greatest olive oils I've ever discovered. 3x4 Genetics - http://3x4genetics.com/DrPerlmutter for a special offer when you sign up to decode your genetics and get personalized, science-backed health recommendations. ==== Dr. Perlmutter’s groundbreaking new book, Brain Defenders, is now available for pre-order. Discover how to protect your brain and future health - reserve your copy today at https://www.braindefenders.com. ==== Gene therapy is no longer a distant promise, it is rapidly becoming one of the most disruptive technologies in medicine. And few figures embody the urgency, controversy, and pioneering spirit of this field more than Elizabeth Parrish, CEO of BioViva and widely recognized as the world's first self- engineered "GMO human." In this episode of The Empowering Neurologist, we dive deep into her bold vision to treat aging not as an inevitable decline, but as a disease that can be targeted, modified, and potentially reversed. Again, treating aging as a disease. Her journey into genetics began with a simple but profound realization: the diseases that kill most of us, including Alzheimer's, cardiovascular disease, cancer, and overall frailty, are rooted in the biology of aging itself. Instead of waiting for late-stage decline, she argues that medicine should intervene upstream, correcting the genomic and cellular faults that accumulate over time. This perspective led her to take an extraordinary step: undergoing experimental gene therapy on herself in 2015, outside traditional regulatory frameworks. ==== 0:00 Intro 3:16 Treating Aging as a Disease 12:16 Launching a Radical Biotech Company 15:49 Why Telomere Length Mattered Most 18:51 Fear at the Edge of Experimentation 24:19 Ad: Optoceutics 26:08 Alpha-Klotho, The Longevity Gene 30:02 Why Alzheimer’s Still Has No Cure 32:21 Mitochondria at the Center of Brain Health 36:04 Ad: Fresh Pressed Olive Oil Club 39:04 Keeping PGC-1 Alpha Switched On 42:43 Tracking Telomere Length Year After Year 47:11 Ad: 3x4 Genetics 48:37 Myokines and Whole-Body Health 51:48 Glutathione Deficiency and Neurodegeneration 1:00:20 Closing Thoughts ==== Elizabeth (Liz) Parrish, MBA, is the Founder and CEO of BioViva Sciences USA Inc., a pioneering biotechnology company committed to extending healthy human lifespan through advanced gene therapies. Under her leadership, BioViva is developing next-generation combinatorial gene treatments powered by its proprietary CMV delivery platform, positioning the company at the forefront of therapeutic innovation. An accomplished entrepreneur, author, and visionary thinker, Liz is one of the leading global voices behind the Best Choice Medicine (BCM) initiative—a regulatory framework aimed at accelerating access to genetic therapies worldwide. She is deeply involved in international scientific education and has delivered keynote talks at major conferences and institutions, including WIRED, TEDx, and numerous other high-profile venues. https://www.instagram.com/lizlparrish/?hl=en https://bioviva-science.com/ ___________________________ 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

The Power of GLP-1 Agonists: Personalized Medicine for Weight Management - with Ashley Koff, RD | E206

🧠 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 Use code perlmutter26 to save $200 & get free shipping on EVY (90 days risk-free). Fresh Pressed Olive Oil - https://www.getfresh389.com For a complimentary bottle of one of the greatest olive oils I've ever discovered. ==== 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. ==== In this week’s episode of The Empowering Neurologist, I sit down with registered dietitian, personalized-nutrition pioneer, and longtime friend, Ashley Koff, RD, to explore what may be one of the most misunderstood areas in all of health: weight, metabolism, and the pursuit of sustainable well-being. As the founder of The Better Nutrition Program, Nutrition Course Director at UC Irvine’s Integrative Health Institute, and faculty member at IFNA, Ashley brings a depth of clinical and practical insight that few can match. Her new book, Your Best Shot,  tackles one of the most talked-about questions of our time: Is the GLP-1 shot your best shot—or not? But this is far from a book about medications. Instead, Ashley reframes the entire conversation around personalization, body-ecosystem thinking, and the liberating shift from perfectionism to her signature philosophy: better, not perfect. In our conversation, Ashley explains why most people aren’t struggling with a lack of knowledge, but rather an overwhelming flood of it, something she calls “INFObesity.” She discusses the Switch Framework she developed to help individuals identify the key metabolic levers that matter most for them, and she shares compelling patient stories that demonstrate how real transformation happens when we align nutrition and lifestyle choices with our unique biology. What emerges is a far more hopeful, empowering narrative about weight-health, one that acknowledges the complexity of modern life while giving us practical tools to navigate it. If you’ve ever felt frustrated or confused by the conflicting messages around diet, GLP-1 medications, metabolism, or weight-loss strategies, this episode is an essential listen. It offers clarity, compassion, and a science-based path toward truly optimal health. ==== 0:00 Intro 3:39 Misinformation in the world of weight loss 8:28 Calories in vs calories out 12:52 The importance of satiety related hormones 18:10 The experiment of GLP-1 24:49 Ad: Optoceutics 26:37 GLP-1 agonist drugs and the brain 37:16 Ad: Fresh Pressed Olive Oil Club 40:27 GLP-1 and mental health 50:02 Disconnect between food policy and obesity solutions 55:09 Conclusion ==== Ashley Koff, RD is the founder of The Better Nutrition Program (BNP), the Nutrition Course Director for UC Irvine’s Susan Samueli Integrative Health Institute's Integrative and Functional Medicine Fellowship, and a faculty member at the Integrative and Functional Nutrition Academy (IFNA), where she teaches “An Integrative and Functional Nutrition Approach to Obesity and Weight Management.” She is also the author of the upcoming book, Your Best Shot (Harper One, January 6, 2026). A practitioner for over 25 years, Koff is leading a transformative movement in personalized nutrition, turning “better, not perfect” choices into practical, sustainable strategies that deliver real health outcomes. Through patient stories and personal experience, she shows that optimal health is not just possible—it’s essential to living your fullest life. Koff has been recognized as one of CNN’s Top 100 Health Makers, featured in InStyle as “Hollywood’s Leading Dietitian,” and has been selected as Westin’s Global Nutrition Ambassador.