The Empowering Neurologist Podcast

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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.
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00:00 Intro
04:49 Andrew Koutnik’s Story Obesity Type 1 Diabetes and Metabolism
09:44 Ketogenic Diets and Type 1 Diabetes
20:15 Sponsor Break - Optoceutics
21:28 Why This Goes Far Beyond Type 1 Diabetes
26:59 Why Low Carb Diabetes Care Was Abandoned
31:49 Ketosis vs Diabetic Ketoacidosis
35:10 Sponsor Break - Fresh Pressed Olive Oil
37:04 How to Measure Ketone Levels
39:13 Are Breath Ketone Tests Reliable
40:15 What Beta Hydroxybutyrate Actually Does
42:39 Exogenous Ketones and High Altitude Performance
45:49 Sponsor Break - 3X4 Genetics
48:33 MCT Oil and Ketone Production
52:52 The Carb Loading Myth in Sports Performance
1:00:06 Metabolic Flexibility and Keto Adaptation
1:03:17 Rethinking Hypoglycemia in Keto Adapted Athletes
1:07:19 How Carbohydrates Shut Down Fat Burning
1:09:58 Body Fat vs Glycogen as Fuel
1:14:34 What This Means for Endurance Athletes
1:16:17 Fat Metabolism as a Survival Mechanism
1:18:09 The New USDA Dietary Guidelines
1:20:46 Ultra Processed Food and Alzheimer’s Risk
1:22:40 Final Thoughts on Metabolic Flexibility
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Dr. Andrew Koutnik is a research scientist focused on how nutrition, metabolism, and lifestyle can optimize human health, performance, and resilience. Living with type 1 diabetes for over 17 years, his work bridges personal experience with cutting-edge science across chronic disease and extreme environments.

He earned his PhD in Medical Sciences from the University of South Florida and has led research funded by organizations including NASA, the Department of Defense, and the NIH, contributing to over 100 scientific publications and presentations. His work spans exercise physiology, cardiometabolic health, and therapeutic nutrition.

At Florida State University, Dr. Koutnik studies dietary strategies for diabetes, obesity, and performance under metabolic stress, collaborating with leading institutions worldwide. His mission is to advance evidence-based approaches that empower individuals to improve metabolic health and performance.

___________________________
Instagram: https://www.instagram.com/davidperlmutter/

Website: https://www.drperlmutter.com/

Subscribe to our channel:
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🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱

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.

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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
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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:
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🧠 Stay ahead with the latest in science, nutrition, and wellness by subscribing to Dr. Perlmutter’s newsletter at: www.drperlmutter.com. ✉️🌱

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.

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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
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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

🧠 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.

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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
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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

🧠 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.

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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
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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/
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