Episode 65: Keeping the Brain Healthy with Dr. Mary Kay Ross

Dr. Robert Rountree:

This is the Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements, and lifestyle approaches to good health. I'm Dr. Robert Rountree, Chief Medical Advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them, and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease.

Dr. Robert Rountree:

Hi, everyone, and welcome to the Thorne Podcast. Hopefully, I'm saying welcome back to the Thorne Podcast. Joining me this week, we have a wonderful guest, my colleague Dr. Mary Kay Ross who's an MD and the chief medical officer Thorne. Her work is grounded in functional medicine. And her special interest I guess you would say is in brain disorders. Which includes dementia, Alzheimer's disease, neurodegenerative disease, traumatic brain injuries. All things to do with the brain, although she's very well rounded in medicine, as she will tell you. So the brain just happens to be one of her many interests. So it's great to have you on Mary Kay. Why don't you tell our listeners a little bit about your background? I know you worked for years in emergency medicine, etc. How did you get from medical school, to emergency medicine, to Thorne?

Dr. Mary Kay Ross:

Leaps and bounds. So I've been practicing medicine for a little over 20 years. And I was in the emergency room for 10, and actually on faculty, and loved teaching, and being very involved.

Dr. Mary Kay Ross:

I got out of emergency medicine because I became sick. And when I became sick, I realized quickly that conventional medicine didn't have the answers for me. So I hightailed it over to IFM, The Institute for Functional Medicine. And that's where I trained. And I really trained, it was fascinating, but initially I was training just to heal myself, and then I became completely involved in functional medicine. And I've never looked back. Because it made me very aware that in medicine, acute medicine, it's great. Conventionally, we treat strep throat with an antibiotic and it works. But that for chronic illnesses, it doesn't work. So I've had a practice of my own since 2012 called the Institute for Personalized Medicine.

Dr. Mary Kay Ross:

And then I became involved with Dr. Dale Bredesen. I became his chief medical officer in 2016 and moved to Los Angeles, California, and worked there for several years with him. He sold his company. And when he did, I was invited to come to Seattle to work with Dr. Leroy Hood and Dr. Nathan Price. And I opened the Brain Health & Research Institute in Seattle. And there, we focused mainly on neurodegenerative diseases, but a big focus on Alzheimer's disease, and doing research, and working with the scientists.

Dr. Mary Kay Ross:

Nathan Price has since left the Institute for Systems Biology and moved to Thorne. And that's where I was invited to follow. And I'm now just moved to New York as of Monday.

Dr. Robert Rountree:

From South Carolina?

Dr. Mary Kay Ross:

From Georgia.

Dr. Robert Rountree:

from Georgia. Oh, you're in Savannah, right? Yeah.

Dr. Mary Kay Ross:

Exactly. So we went from Seattle back to Georgia, and then from Georgia to New York. And there, I've taken the position as chief medical officer at Thorne. And we are currently working very hard on a brain program. So it's very exciting and working closely with the science team.

Dr. Robert Rountree:

So you just move from Savannah, Georgia to New York. Tell us about what you're doing at Thorne.

Dr. Mary Kay Ross:

Right. So we have been working, actually I've been working with them for about six months now. And we're building a brain program. What that looks like is a multimodal program. See, we realize that medicine has really failed as I've alluded to with chronic illnesses. So Alzheimer's disease is one of the illnesses in our country and around the world that the drugs have all failed. So we've had over 450 failed drug trials. And we also have ADUHELM, which is the new drug that was just recently approved by the FDA.

Dr. Robert Rountree:

What, $60,000 a year?

Dr. Mary Kay Ross:

Yes, it's 58,000 a year per patient. And it actually is not working. It's not working well. The efficacy was never really proven. A lot of the scientists that were on that board had to review ADUHELM, felt that it really didn't show the efficacy that it needed to be approved. But it was approved I think at any rate, because everybody's trying so desperately to do something about this awful, awful disease.

Dr. Robert Rountree:

So people are desperate and they're ready to take anything, even if it doesn't do that much?

Dr. Mary Kay Ross:

Absolutely. Alzheimer's disease today if you go to a neurologist, you're very likely to be told what a horrible disease it is that you have, and to get your affairs in order. There's very little that can be done.

Dr. Mary Kay Ross:

So we feel with a multimodal program, we are looking at many different things that could help reverse or halt the disease. We really think the biggest bang for the buck is going to be in prevention initially. But we're hoping down the road, some of the things that we're learning will be to be applied to people that have the disease and hopefully help them and benefit them.

Dr. Robert Rountree:

But even if somebody is officially diagnosed with Alzheimer's, not just mild cognitive impairment, there's still hope for them?

Dr. Mary Kay Ross:

There is hope. Absolutely. And we feel and I have seen first-hand that when you apply this program to people with Alzheimer's disease, as long as they're not really far along with it, they really get benefit. And it can actually halt the progression. And they will regain some of their cognitive function. And then, they'll be able to continue their life. They have to stay on the program. This is not a cure. It's more of a management approach, but it definitely seems to make a big difference in their lives.

Dr. Robert Rountree:

And is there a lot of overlap in the kind of things you're discovering, the kind of interventions you're coming up with, and interventions you would use for traumatic brain injuries or other brain disorder? Say people with brain fog. They don't 'have a disease,' but they're not experiencing optimal brain function. Are you seeing a lot of similarities?

Dr. Mary Kay Ross:

We do see similarities. It's really interesting. What we're doing in building this program is we're working with two different artificial intelligence programs right now. So we're building a basic program that is only going to get better. It's a machine learning program. And really, I've had a big hand in giving them the information that they're using to build it.

Dr. Mary Kay Ross:

The other program though is fascinating. So they have, actually, this is a platform that has been built around digital twins. So they've taken a population, digital population of millions of people. And then they're able to run the scenarios. So with the brain, they've had to build this. So this is new. And they've literally taken all of the research papers in different areas. And it's not all around the brain. Has to do with cardiovascular health, metabolic health, all kinds of different disease processes. And they've looked at how this affects our premise of what we're focusing on the brain.

Dr. Mary Kay Ross:

We've learned so much. We've learned that this disease develops from a cholesterol imbalance if you will in the brain or dis-homeostasis. And that it's so important in the brain to have that balance. And cholesterol is the key. And this feeds into why the apoE4 person, which is the gene that gives you the higher risk for Alzheimer's, why they have more problems than other people. For example, apoE2, which actually helps protect you.

Dr. Robert Rountree:

Protect you.

Dr. Mary Kay Ross:

We are now learning enough to completely understand that mechanism. We've learned so much about the differences between males and females. So when I worked with Dr. Dale Bredesen, we learned that estrogen is so protective for the brain and very important. .But we didn't necessarily understand of the differences between males and females, why females have higher numbers of Alzheimer's disease. And then the men seem to do well. But we now understand that it all has to do with cerebral profusion, and estradiol, and how the females can make it longer. They have a higher cerebral profusion rate, and then they fall off quickly. And their curve really does just drop off after menopause. So it has everything to do with the estradiol. Whereas men have a lower cerebral perfusion rate all along, but then they hang in there later. Interesting.

Dr. Robert Rountree:

Some people would say, "Well, that explains a lot of thing about men."

Dr. Mary Kay Ross:

That's funny. Yeah. But it's really interesting. It's sort of an aha moment. I'd always heard Dale say that amyloid isn't really the cause of Alzheimer's, but now we know it and we understand it so much better. It's a compensatory response.

Dr. Robert Rountree:

And yet all the drugs, most of the drugs that they've tried, including ADUHELM are focus on amyloid, getting rid of amyloid. Amyloid blockers, monoclonal antibodies, things like that. So that explains why the drugs don't work.

Dr. Mary Kay Ross:

That's exactly right. So it's really interesting. And we understand more about statin drugs and why they are not good for the brain, but yet there are some studies that show that they're very good for the brain. And both are actually true. So if you don't have memory problems already and you're worried that you may develop them, then a statin drug might be a great thing for you. We feel like it'll carry you out another 10 years before you would develop memory problems. Whereas if you have a permeability of the blood brain barrier and you take a statin drug, suddenly a molecule that wouldn't normally fit into the brain area will be able to. Then it's not good for you. So does that make sense?

Dr. Robert Rountree:

Yeah. So we're getting into, it's a much more nuanced approach than statins are bad or statins are good.

Dr. Mary Kay Ross:

That's exactly right.

Dr. Robert Rountree:

And that's what you mean by the using an artificial intelligence model is being able to parse these things out to use, I guess we're calling it precision medicine.

Dr. Mary Kay Ross:

That's exactly what it is. It is precision medicine, and we're making it very personalized. And the goal is this. So in the very, very beginning, which is where we're at today, the artificial intelligence platform that's more of the machine learning platform will be able to assess the data from individual patients and come up with a program. As it does it, it will get better, and better, and better at it. However, we will have this other program with the digital twins called Embody that will be able to be much more focused, much more personalized, and actually can build a digital twin of the patient and run scenarios using different supplements, different medications, and see really what it is that that individual needs to be able to offset the disease process.

Dr. Robert Rountree:

So the digital twin in a way, it's like an online avatar, right?

Dr. Mary Kay Ross:

That's right. That's exactly right.

Dr. Robert Rountree:

Your avatar. And you try treating the avatar, or you give the avatar certain interventions. And you're able to predict how the person might respond based on how their avatar responds. Am I understanding this?

Dr. Mary Kay Ross:

That's right. And Bob, it'll give us the opportunity really to save a lot of time with people. We'll be able to do these scenarios very, very quickly, and really kind of cut to the chase, give them the most precision medicine program for them to support them with their specific needs.

Dr. Mary Kay Ross:

And these programs will be merged. So these two artificial intelligence platforms probably around the third quarter of this year will actually be merged. And we will also be able to do this with other of disease models as well.

Dr. Robert Rountree:

Well yeah, I was thinking you could use this for anything that's chronic. I mean, you could take somebody with multiple sclerosis for example, and create a digital twin and say, "Well, this drug would be ideal for you, and this one wouldn't." Or maybe fish oil would be good for this person and not so beneficial for somebody else

Dr. Mary Kay Ross:

That's exactly right. And I believe actually that a lot of the MS work has already been launched as well and is in the works. So I think it'll be fascinating. And you could do cardiometabolic disease. You can look at the genetics. I mean, all of that information is important. It all goes into the program. So it'll be great. And when they're merged, I really believe it's something that we haven't had available before. And this is something initially that's launching that doctors will be able to utilize with their patients. But ultimately, the goal is direct to consumer. So maybe not for someone with Alzheimer's disease, that would be a big lift. But somebody who's worried about it where we can really make a difference in the prevention aspect.

Dr. Robert Rountree:

Well, I was thinking about people that participate in sports like football, contact sports where they get a lot of head injuries. I mean, it would be nice to know first of all, if an individual ball player is at risk cause of their genetics or something else. And then what you might be able to do to mitigate that risk.

Dr. Mary Kay Ross:

No, you're absolutely right. That is going to be phenomenal. We actually are launching a study on brain fog. And we'll be looking at TBI as well, and post-COVID, and post-chemo brain. But I think it's really interesting. So there's a lot of tools that are available today to evaluate those people. And really, if we can hone in and give them a very precision, personalized program specifically for them, I think it's going to go a long way. That's a big problem for the athletes.

Dr. Robert Rountree:

And can you just say a little bit about what kind of tools you'll be using? Is it a simple blood test, or is it brain scans, or genetic testing? All of the above. I mean, I know that Thorne currently offers a biological age test for example. It's a fairly straightaway forward set of blood markers that we use, but the machine underneath it all to interpret is actually pretty elaborate based on Dr. Price's work. So is there something similar to that that you're using for assessing brain health or risk of brain disorders?

Dr. Mary Kay Ross:

For the brain fog study specifically because it is research, we're really trying to look at everything. We'll be using an EEG, so a qEEG. We'll be using volumetric MRI and functional MRI, which I think is really cool. And then for the biomarkers, we're trying to look at everything honestly. So we are actually going to look at phosphorylated tau, we're going to look at amyloid. We are going to look at everything that we can, genetics as well.

Dr. Robert Rountree:

This is really sophisticated stuff.

Dr. Mary Kay Ross:

It is.

Dr. Robert Rountree:

You're anticipating that you will train doctors in this precision medicine, and then a client would come and see that specialist?

Dr. Mary Kay Ross:

Yes. So what we want to do is make this available. And obviously, ultimately the physicians are actually the doctors. So they'll be in charge of what they decide to do. But recommendations will be available to them utilizing this program. And we're starting actually a beta study in this brain program next week. So we have six physician groups that are going to be working with us initially. And we were really want to get the data and look at it, make sure that everything is exactly as we want it. Obviously, it's the first iteration of the program. So it's going to continue to get better, but that's kicking off next week. I mean, we've been working really hard on this.

Dr. Robert Rountree:

So this is behind the scenes at Thorne, you should say.

Dr. Mary Kay Ross:

That's right.

Dr. Robert Rountree:

This is what's going on. Now just to switch gears a little bit, you've been in the brain health world for a while now. Are there some general principles that you've gleaned from doing this work that you think are applicable to everybody? So this sort of segues into what can we do to keep our brains healthy? I know it's a huge umbrella, but are there some pearls that you've come up with that you think really should be emphasized?

Dr. Mary Kay Ross:

Absolutely. So it's things that we all probably know a little bit about, and we know we should be doing more of that or this. But honestly, your lifestyle is everything. So even if you have the genes, right, you want to be that person that works on things like making sure you exercise. Exercise is so important for brain perfusion. You can do a lot to reverse damage with exercise. There's been studies that show that with aerobic exercise, that hippocampal volume can change. The hippocampus is your memory center. And we know that high intensity interval training increases BDNF, brain derived neurotropic factor for the brain. It's like the growth moment for the brain. And as we get older, that declines. So exercise, it has so many benefits. I can't even begin to go into all of them. But it's certainly something to keep up with.

Dr. Robert Rountree:

And all kinds of exercise are good? So you have to do HIIT, do you have to run up mountains?

Dr. Mary Kay Ross:

No, you want to stay active. You want to move. You want to meet people where they're at. If you can challenge yourself a little bit, it is beneficial to push yourself a little harder and to make goals, to work a little harder at things. But certainly just stay active, stay moving is so essential.

Dr. Mary Kay Ross:

Sleep is another thing I want to mention. So make sure you don't have sleep apnea first of all. Because that right there is going to affect your cerebral blood flow, right? The blood flow to your brain, because you're not getting enough oxygen. And then you really want to work on sleep. You want to make sure you're getting between seven, eight hours of sleep. You want to measure if you're interested your deep sleep and your REM, because this is where the brain cleans house, and where we get rid of your debris that that can cloud up the system if you will.

Dr. Robert Rountree:

You recommend things like an Oura Ring for sleep tracking to see how much deep sleep you're getting?

Dr. Mary Kay Ross:

I wear an Oura Ring.

Dr. Robert Rountree:

Yeah, me too.

Dr. Mary Kay Ross:

So I love it. And I'm sure there's times that may not be as accurate. We don't all have great night's sleep. But it's really important to get, because that's really when the lymphatic system is going to clean everything out, and autophagy occurs. And then you want to have enough REM sleep. I think it's important to look at your heart rate variability, which it does give you a little glimpse at. And if you have problems, I don't want people to go to over-the-counter medications for sleep. I want them to work on a sleep hygiene program. Work on mindfulness. Toning down the evening earlier, and making things calmer, and working on less screen time, and really working at it. Because you can come up with a great sleep program, and it will do wonders for your health.

Dr. Mary Kay Ross:

Mindfulness is another thing I think is really important. It's really a way of life. It's also an approach to calming things down and not if you're that worrywart or that person that can't turn your brain off, mindfulness is very important. And it doesn't have to be done in one way, is my opinion. It is meditation, but some people shy away from that, and don't really like the word, and they don't understand it. The reality is it's just calming things down. It's relaxing. I use devices for that with a lot of my patients. I use the Muse headband or a HeartMath Inner Balance. Just depending on who the person is. Sometimes, you get the people that need this the most, and they're a CEO of a big company. And they want to see the results by golly. "I've been laying here for 20 minutes. Did I do anything?" It helps. Then you bring out the Muse headbands and see how many birds they can get. And then they like that, because it's a game and they keep score.

Dr. Robert Rountree:

And they're much less likely to go to a monastery for a month if they're a CEO of a corporation.

Dr. Mary Kay Ross:

Oh yeah. They're not going to do that.

Dr. Robert Rountree:

No.

Dr. Mary Kay Ross:

They're not going to do that at all. So these are all things you work on, and then diet is so essential. So I tell my patients, the brain could be like a hybrid car. So we're used to living on sugar, but we can also switch and become a different fuel and use ketones.

Dr. Robert Rountree:

Yep. Yep.

Dr. Mary Kay Ross:

And ketones are derived from fat. So this requires a higher fat diet. I really try to be very careful that we are not eating too much saturated fat and not a lot of meat. This is not the old Atkins diet where we have the cheeseburger, with the bacon, and the pork chop, and who knows what else. But this is looking very much like a lot of vegetables. But it can be done in a way that it's still delicious and in a very healthy way.

Dr. Mary Kay Ross:

Omega-3 fats. I use a lot of olive oil. I don't use a lot of coconut oil because I feel like it's too much saturated fat honestly. And people can have up to 70% of their calories from fat. So we use a lot of nuts and seeds. And that really makes a difference in the brain, especially if you're that person who's been eating a lot of carbohydrates

Dr. Robert Rountree:

Someday we need to talk about where you get good, extra Virgin, organic olive oil. Because now that olive oil has gotten so popular, it's gotten to be very difficult to know exactly what you're getting.

Dr. Mary Kay Ross:

That's a great thing. We had an olive oil expert come and speak to my patients. And I myself learned so much. Because you really don't know what is it that makes it so good. So the very simple thing that everybody can do if they don't want to go to an olive oil store specifically is you can buy California Olive Oil. And it comes from Greece. It comes from Argentina. But she really let us know that that is a quality olive oil.

Dr. Robert Rountree:

So that's the brand, California Olive Oil?

Dr. Mary Kay Ross:

It is, and it's in all the stores. So that is something I like because I travel a lot, and I usually do my own cooking. And it's easy to get. The other thing to know is that olive oils have a polyphenol count. So nowadays, the farmers are all pretty savvy. And you can actually go to an olive oil store or contact one online and find out what they have in stock that is the highest polyphenol count. And it changes. And you can just order a case of it and use it. And then you'll have to investigate the next time you purchase, which one has the higher polyphenol count. But that is what my patients do. Either that, or they'll buy the California Olive Oil if you're just in any store in the USA and you don't know what to do. That's a guaranteed good olive oil.

Dr. Robert Rountree:

Well, I think we're needing to take a break. So we're going to pause for a minute. And then we come back, we're going to respond to some questions from our community.

Dr. Robert Rountree:

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Dr. Robert Rountree:

And we're back. So now it's time to answer questions that have come in from our listener. The first question this week comes from someone who asks, "How can I test my brain health?" I assume that what they're asking is what can I do using my local lab or local facility, without getting into anything elaborate? So what would you say to that, Dr. Ross?

Dr. Mary Kay Ross:

Well first of all, for testing your brain out, so the way that we test very simply that every primary care physician, everybody should be able to do. We have several tests that are done in office. Five minute tests, the Mini-Mental State Exam. The MoCA, which is the Montreal Cognitive Assessment. And these are simple things. If you're worried about yourself, you should have this done. Have yourself evaluated and don't be afraid to.

Dr. Mary Kay Ross:

I do want to say Bob, one of the things that I think happens that really makes me feel horrible for patients and for just the population is that this is such a scary thing to think of losing your cognition, losing your brain. It's like the essence of who you are. People, they put it off. They ignore it, they hide it. They can fabulate. They're trying to think of their words when they're talking, and they can't think of the right words. But they'll come up with something else and they don't tell anyone.

Dr. Mary Kay Ross:

So the message is there is something that can be done. You need to get on it as soon as you think about it. Then you need to work on it. You need to go and unravel this problem. So those are the tests that you typically do.

Dr. Robert Rountree:

Is there an online version people can do? I think there's one that you've mentioned to me in the past, like a brain gym kind of thing that gives you an initial assessment. Or is that something, you want the assessment first?

Dr. Mary Kay Ross:

You can do that. Or you can do things like there's a way that we actually exercise our brain. And this is something that's available to everybody. There are major athletes that use this, people with dementia use this. Everybody can benefit from this. And BrainHQ is the company that we use. And it's Posit Science is the mother company. BrainHQ is the product. And you sign up for it online. And I will tell you that there's the free version and then there's the paid version like everything. And obviously, the paid version is better.

Dr. Mary Kay Ross:

It gives you these games to play is what they're supposed to be like. They're all focused on different parts of the brain. They look at executive function, they look at your memory. They focus on name and word finding, matching things. There's all kinds of things. There's even a game that helps you with your driving skills. And you can actually get a reduction in your insurance if you're of age for Medicare or older because you do this. So it really makes a big difference, and it increases neuroplasticity.

Dr. Mary Kay Ross:

So the founder of the company is Dr. Michael Merzenich, who is a great neuroscientist. And a lot of people would say he's the father of neuroplasticity. I don't know. But I would assume that when you went to school, when I went to school, I thought the brain was hardwired. I didn't think that we could change anything. It's like what you have is what you get. You lose it, it's gone. And now we know we can really make changes that will help you tremendously. That's something I would recommend. It does get much harder. Every time you get better, it gets harder. But that's a good thing. It's challenging you.

Dr. Robert Rountree:

So I have a question. Actually there's several questions that kind of all fit together. A listener wants to know what is the blood brain barrier? Why does the blood need to be separated from the brain? And if the blood is separated from the brain, how does the brain get oxygen?

Dr. Mary Kay Ross:

The blood brain barrier, first of all, the blood barrier keeps molecules and keeps bacteria out. It keeps viruses out. And you still are getting oxygen. You're still getting red blood cells. You're still oxygenating the cells of the brain. It really is all about trying to keep the brain separate.

Dr. Mary Kay Ross:

I will tell you. It's not as strong as I thought it was when I went to med school. I thought, "The blood brain barrier, nothing's getting in there." And that's not the case. And honestly, that's a big part of the dementia process is developing a leaky blood brain barrier.

Dr. Robert Rountree:

So just like leaky gut, you get a leaky blood brain barrier?

Dr. Mary Kay Ross:

That's right. And there are a lot of people that believe, and I definitely know that there's a big effect, right? With unhealthy gut, unhealthy brain. A lot of people tell you that the brain is actually a GI problem. A lot of people believe that. So yes. Leaky gut, leaky brain. The blood brain bigger can leak, and then it lets things in and that should never get in. And that's the problem with drugs as well.

Dr. Robert Rountree:

And do we know what can make the blood brain barrier leaky, and how to do something about that? For example, if you've got a leaky gut, then taking things like glutamine and probiotics can help.

Dr. Mary Kay Ross:

That's exactly right. So first of all, I do want to say this. I think it's really important to understand with the brain that you have to have a healthy gut, okay? Because these things are all interconnected. So if your immune system gets all flared up, that can carry over into the blood brain barrier and affect it as well. And I think that that's a really important thing.

Dr. Mary Kay Ross:

Glucose regulation can affect your blood brain barrier. So if you're that person with diabetes and you have a very high sugar diet, all of these things can affect it. Hypertension can affect it. And then we can certainly heal that and calm that down. We believe we can. And we have a whole host of supplements that we use to help heal the brain.

Dr. Robert Rountree:

Is there one that's your particular favorite or two or three that are your favorite supplements for blood brain barrier?

Dr. Mary Kay Ross:

Okay. So if you have a leaky blood brain barrier, I think one of the things to also understand is that the cells in the brain are similar to the gut in that they have gap junctions that are holding them together. So we want to use things like curcumin is one of them. It's really important for brain. Curcumin's going to help increase brain-derived neurotrophic factor, which is the growth hormone for the brain. We also want to use a whole set of herbs. And the herbs are going to be more nootropics that are going to help with cognitive enhancement.

Dr. Robert Rountree:

Are those the same, by the way? Somebody did ask that. Is a nootropic-

Dr. Mary Kay Ross:

They are the same. A nootropic is a drug that helps with memory, helps with cognition, and it is a cognitive enhancer. Absolutely. And there's a lot of those that are on the market today, right? And they do work to some degree or another for the most part. And some of them are better than others. And these are all the things that we're actually, I think it's really cool. We're taking all of the literature and really doing the deep dive to really put where the rubber meets the road, if you will. We're sure that we understand the mechanism, and what is working, and what isn't working. And if the literature doesn't support it, it's kind of taking the backseat if you will to this program. Whereas when I worked with Dale Bredesen, I felt like in many ways, we were throwing the kitchen sink at everybody, and hoping that something worked.

Dr. Robert Rountree:

Patching the 37 holes in the ceiling.

Dr. Mary Kay Ross:

That's right. And now we're trying to really understand how those work and what is so important and what isn't. Vitamin D is very important. The B vitamins are very important for the brain as well. Vitamin B6. So what we do is we're really looking at all of these markers. And we're trying to optimize them, I guess is the best way to put it. So it's not necessarily looking at what the lab says or the normal values. But we're trying to optimize them for the people.

Dr. Mary Kay Ross:

It was really interesting. In 2008, I had a small boutique practice. And one of the things that I did, I looked at the apoE4 genotype, which for the listeners is really important for cardiovascular disease. But it's also one of the markers that gives you an increased risk for Alzheimer's disease. And we now know that it's because of the way that the cholesterol is handled in the brain that has something to do with that.

Dr. Mary Kay Ross:

But back then, even then, I would tell people that this is related to Alzheimer's disease. And a lot of people would be very fearful and say, "Why would I ever want to know this? What can you possibly do?"

Dr. Robert Rountree:

Yeah, I don't want to test that.

Dr. Mary Kay Ross:

And the thing that I felt, which I'm really glad that I did that then, because now we know it's true. If you understand your risk, you can do something about it. It may not always work for everybody, and there's certainly cases where it doesn't. But for the most part, if you understand your risk and you're proactive, you take the supplements, you work on your diet, you exercise, you work on sleep, you do the right things, you can dodge that bullet.

Dr. Robert Rountree:

Now somebody actually asked, are there any memory supplements that actually work? And I'm sure that they're responding to what you see in the press all the time is that nootropics or cognitive enhancers are all just one big ripoff, and there's, "No evidence to support the use of any of them." Which I don't think is true, but I would love to hear what you have to say about that.

Dr. Mary Kay Ross:

Well, I don't think it's true either. And honestly in doing this program, I'll start people very slowly. And one of the things I'll start is the supplements. And they can see a difference immediately. Not everybody. But in a select few, that can make the difference. So certainly, I think that they definitely work. Some are better than others. I don't think that they're going to be the complete answer, but they definitely help no doubt.

Dr. Robert Rountree:

Can you say a little bit about taking exogenous ketones as a way to support the brain? I know that Dr. David Dodick at Mayo Clinic, who's one of the world's experts on traumatic brain injury, he seems to be a big fan of using that. In fact, I think he helped design, there's a Thorne particle called Synaquell [crosstalk 00:37:25] there. Yeah. I wonder if you could comment on that, and that'll probably be the last question we have time for today. So can you tell us about that?

Dr. Mary Kay Ross:

Absolutely. So first of all, exogenous ketones, ketone esters is exactly what he has in Synaquell, I believe. And it actually will help boost you into ketosis. So to go into ketosis, some people really have a hard time with it. You need to become metabolically flexible if you will. Your body is used to eating carbohydrates, eating higher, simple sugars. To make that conversion, it can be difficult. But if you take an exogenous keto tone and you try to work on your diet, it actually will help propel you into ketosis easier. I take exogenous ketones, and I can tell a huge difference in my numbers and how I feel. And I think I can tell a little difference in my brain function as well. I mean, I just feel sharper. More energy. It actually feels really good when you're in ketosis.

Dr. Robert Rountree:

So you don't have to do a ketogenic diet for those exogenous ketones? I think the one in Synaquell is a beta-hydroxybutyrate. Am I right about that?

Dr. Mary Kay Ross:

It is. It is. So Synaquell is a great product too, by the way. That's something that we're using as our when I put these bundles together for this program, that's one of the base products. And then we sort of build upon it. Because it makes it easier for people to include the ketones and acetylcysteine, which I think is really important, NAC, in there as well.

Dr. Mary Kay Ross:

One of the other things I want to mention or Nathan Price, or absolutely shoot me is phosphatidylcholine. Phosphatidylcholine. And Bob, I think you and I had a discussion about this. But this is a supplement that we feel makes a big difference, and it helps with the cholesterol homeostasis in the brain.

Dr. Robert Rountree:

And for people who think that's a bit of a weird chemical, it's actually just one of the main components of lecithin, which you can find in soy lecithin. In fact, you can find it in sunflower lecithin. So when you see a supplement that is called a phytosome like curcumin phytosome, phosphatidylcholine is one of the main components of that phytosome.

Dr. Mary Kay Ross:

Yeah. So this was one of the first things that we learned through the Embody model.

Dr. Robert Rountree:

Guess the PC was good.

Dr. Mary Kay Ross:

Yes.

Dr. Robert Rountree:

Wow. Well, this has been a pretty enlightening discussion. And I think there's so much more here, that we will do a part two with you if you'd like to come back and basically kind of continue along these same threads at a later date.

Dr. Mary Kay Ross:

Sure. I would love to. Thank you.

Dr. Robert Rountree:

So thank you so much for coming on the podcast. In the meantime, if people want to know more about what you're doing or what's evolving with the Thorne brain health, is there any way that they can keep tabs on you?

Dr. Mary Kay Ross:

Well actually, we're talking about starting some sort of a blog that will kind of keep people abreast of what's going on. And that's all in the very early works right now, but it's something that we are talking about.

Dr. Robert Rountree:

Okay. So stay tuned.

Dr. Mary Kay Ross:

Stay tuned.

Dr. Robert Rountree:

All right. Well thank you for being on the show. Thank you everyone for listening. If you like what you heard today, tell a friend to tune in. Until next time.

Dr. Robert Rountree:

Thanks for listening to the Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice. If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @thornehealth. You can also learn more about the topics we discussed by visiting thorne.com and checking out the latest news, videos, and stories on Thorne's Take 5 Daily blog. Once again, thanks for tuning in, and don't forget to join us next time for another episode of the Thorne Podcast.