Hello there. Welcome to the episode. Today.

We're going to talk about sexual function and the brain, and I am

here with Dr Ken Sharlin. He is a board certified neurologist,

functional medicine doctor and an author of the healthy brain

toolbox is based in Ozark, Missouri. He is the foremost

expert in Parkinson and Alzheimer's and anything related

to the brain. But on top of that, he's a great person and a

great doctor. Welcome. Dr Sharlin, well, thank

you. Dr Truong, it's great to be on the show.

Yeah. So today

we're going to talk everything for Ed, erectile

function and also the brain and the connection between the two.

Now before we started, you had mentioned about the connection

between Parkinson and Ed, and I found that fascinating as well,

too, because a lot of us don't think about how the penis

connected to the brain and vice versa, and which come first, Ed,

come first, and then Parkinson, or Parkinson first and then? Ed,

so can you give us some more information about the

connection?

Oh, yeah, that's a great intro. Thank you. Well,

first of all, I think if we were to do a little bit of wordplay,

and I said Anne, what do you think of when you think of

Parkinson's disease? Probably think of somebody who's sort of

shuffling along and rather shaky, and they have a tremor.

And that is true that often is sort of a presentation of

someone with more advanced disease, but we do call them

Parkinson's, a movement disorder. The interesting thing

about Parkinson's disease, however, much like say,

Alzheimer's, is a long what we might call pre clinical period,

meaning before the person develops the tremor, before the

person develops that shuffling gait, these motor symptoms, they

may experience a whole variety of symptoms that we don't

intuitively associate with Parkinson's, but in fact, it is

very much part of Parkinson's disease, and they are going To

get Parkinson's based on these things, and in fact, erectile

dysfunction may Herald, may precede the onset of these motor

symptoms they can and, of course, continues. But in terms

of which comes first, the chicken or the egg? In fact,

erectile dysfunction may herald the onset of the more familiar

symptoms of Parkinson's.

How is that? What the connection? Well, again, I

think

it's important to realize that when we become

aware of a spectrum of symptoms, in fact, we could probably apply

this to most any disease. We might want to discuss diabetes,

for example, well before the person has an elevated

hemoglobin, a 1c or fails a glucose tolerance test, we know

that they are becoming increasingly insulin resistant.

And one of my big gripes when it comes to diabetes, because it's

really a gateway disease to other disorders like

Parkinson's, like Alzheimer's, that we use terms like pre

diabetes, and in the conventional medical clinic, the

doctor says, well, you're pre diabetic. And it's almost like

saying it's okay, but I just want you to know you're pre

diabetic. You're not diabetic yet, so you don't really have to

change anything, but you're moving in that direction. But

you and I know there's a very serious problem, even in that

stage. I often say there really should be a pre pre diabetes,

because before that blood sugar is going the insulin levels are

going up, then the blood sugar is going up, and then it's so

high that, by the way, the house has burned down, and it's too

late to call the fire department, right? So we need to

be thinking of diseases that affect the brain, Parkinson's,

Alzheimer's, ALS, multiple sclerosis, Huntington's disease,

as really starting at the cellular and sub cellular level,

meaning what's happening inside the cell, and realize that these

changes evolve over a long period of time. And what's the

wonderful part about this is we are in the age of precision

medicine, meaning that we have the ability to identify these

changes at a very early, even potentially pre clinical stage

and put together interventions that may altogether prevent the

person from ever developing Parkinson Alzheimer's, MS, but

to speak very specifically about Parkinson's, some of these non

motor symptoms that Herald Dionne set up Parkinson's loss

of. Of the sense of smell, what is called REM sleep behavioral

disorder, which is kind of like acting out your dreams, in your

sleep, could be talking, could be very active, jumping up,

punching, taking a dive off the end of the bed. I've had bed

partners have to separate and live stay in different rooms,

because the REM sleep behavioral disorders. So bad changes in

personality, changes in gut function, particularly a long

history of constipation, often heralds the onset of Parkinson's

and then the erectile dysfunction that we're talking

about. So I don't want your listeners or viewers to believe

that if they have erectile dysfunction, they're destined to

get Parkinson's, but if they're having REM sleep behavioral

disorder, constipation, mood changes, losses and so smell,

they may well be. And regardless, I'm sure your

message has been, if you have erectile dysfunction, it did not

fall out of the sky and just happen. Yeah, still a reason for

this, and we still have to address the factors that

contribute to erectile dysfunction, which, by the way,

I'm sure as we get into our conversation, are very similar

to the factors that contribute to why a person gets

Parkinson's. Yeah,

I would love to touch upon that. So what you're

saying is that if you have ed, and then you have these other

symptoms, like loss of sense of smell, and then during sleep,

and you find yourself being hyperactive when you're

sleeping, and you mentioned a couple of other things to other

symptoms, so I remember the REM of constipation, one

smell constipation and such weird combination

words. But anyway, the REM sleep behavioral disorder and changes

in mood or personality. Changes

in mood, personality and Anne ed at the

same time, you probably need to see a neurologist. But is there

any tests that you can do, serum, wise, in the blood that

will kind of get you some hint that you may have Parkinson's

there absolutely is. Now, the caveat with the

three tests that are currently available is that what they're

really identifying is shared pathology. And what I mean by

that is that Parkinson's disease is really part of a group of

disorders. Before we started our recording, we were touching on a

family and a related family of disorders that falls under the

same umbrella as Parkinson's, called multiple system atrophy

or MSA. We would also include things like Lewy body dementia,

primary autonomic failure. All of these disorders have certain

commonalities. They share an abnormality in that a protein

called Alpha synuclein tends to accumulate in the brain tissue

as the disease evolves and becomes clinically apparent. Now

this alpha synuclein, if we turn back the time and go back to the

original descriptions of Parkinson's disease and the

early light microscope studies of the brain. It was known that

there was an accumulation of something. I don't even know if

it was really known what initially what it was, but you

could see it under the microscope. And they called them

Lewy bodies. That's where, like Lewy Body Dementia comes from.

What are the Lewy bodies composed of? Well, they're

composed primarily of this protein called Alpha synuclein.

And can you spell

that alpha? What? A, l, j, so alpha synuclein

is S, Y, N, U, C, l, e, i, n, alpha synuclein, and

not only does it accumulate in the brain, but it may, in fact,

that in a significant proportion of people, if not all, people

with Parkinson's actually start in the digestive tract and then

work its way to the brain by way of the vagus nerve. It's also

found in the skin. So I'm going to do a little commercial

promotion here. But there's a company called CND, Charlie

Nancy, David life sciences, that's among the directors or

head of the company is a neurologist named Dr Todd

Levine. And I know Dr Levine, and he and a couple other people

started this company because they were aware that this alpha

synuclein could be easily identified in something as

simple as a skin punch biopsy, and so now if I need to confirm

a diagnosis, I will invite the patient to my clinic. This is

covered by insurance. And what we're talking about is numbing

up an area of skin in three different areas. One is by the

ankle, one is by your knee, and then one is sort of in that bony

protuberance at the back of the neck, sort of toward the base of

the neck, that's called the c7 process. And we numb up. That

area. It's about the size of a nickel, a little lidocaine with

epinephrine, and then the skin punch biopsy instrument looks

like a pen where the ballpoint comes out. That's hollow, just

like the pen, except it is a cylindrical blade, instead of

just being the hole where the pen tip comes out. So we press

that blade on the skin, we twist a little bit, pull it out.

There's a core of skin about the size of the tip of this pen. And

then we put it in, you know, like a formalin tube, and send

it off to CND Life Sciences. They look at it under the

microscope. If folks want to go to that website, it's a very

good company, very good test. I don't get any money from them or

anything to promote them, but I really believe in the test is

very well published, very well validated, but you can actually

see pictures of what the Alpha synuclein looks like under the

microscope. But that tells us, in more contemporary terms, that

the patient suffers from something called a

synucleinopathy. So we are moving away from calling, say,

Parkinson's, Parkinson's disease, and identifying these

diseases, not historically, which is where Parkinson's comes

from, because it's named after James Parkinson, but by what it

actually is, which is a synucleinopathy. These proposals

are in the works at the very high level of where thought

leadership, the international movement, disorder, society and

so forth, lays down. This is how it's going to be moving forward.

These are the new definitions. These are the new standards. So

you can measure Alpha synuclein in the skin, you can measure

Alpha synuclein in the spinal fluid with something called a

seed assay. The only advantage of that, other than the

inconvenience to have a spinal fluid test, but it can be

quantified. Unlike the skin, the skin, we just say it's there.

It's not there more or less, but it because it can be quantified.

If you have a drug that will reduce the amount of alpha

synuclein in the brain to treat Parkinson's, you want to know if

the drug is working, and you can measure that clinically and or

you can measure that by way of a laboratory test, meaning the

Seed assay. So that has we want to disease modifying therapy. We

want to know if the numbers are going down over time. So are

you supposed to have zero and then just

elevation, or there's like, a baseline level of the Alpha

nucleus as well?

Try to, yeah, these fantastic. The answer is that in

many of these diseases, whether Alzheimer's, Parkinson's, ALS,

many of these diseases have a characteristic protein that

seems to be closely linked to the disease. We refer to amyloid

protein in Alzheimer's, one called TDP 43 in ALS, one called

the Huntington protein in Huntington's disease and then

alpha synuclein and Parkinson's. We sometimes call this a protein

apathy, O, P, A, T, H, y, but in fact, what we discover is that

these proteins are really normal proteins in the brain or in the

body. They serve normal functions, but under certain

circumstances that we define as disease, instead of serving

their normal function, they accumulate, and they appear to

be associated with the degenerative process. So normal

and not normal is it depends. They should not accumulate, they

should not lead to neuro degeneration. So you probably

always have a certain amount of alpha synuclein, but it should

be soluble. It should be dissolvable. In other words, it

should not linger. It should not lead to neurodegeneration. Got

Yeah, so thank you. I didn't even know about that.

So there is a skin biopsy, and you said a blood test or

there will be, NIH has a lot of money. The Michael

J Fox Foundation also to grant various companies research

dollars so they can develop blood based biomarkers for

Parkinson's. And this is most definitely in the works, another

company we work with very closely here is called octave

Bioscience. It's O, C, T, A, V, E. They have a blood based

biomarker test for Alzheimer's, and they were awarded $10

million from the Michael J Fox Foundation to do the same for

Parkinson's. But there are other companies out there doing

similar work. Now,

how prevalent is Parkinson How common is it? And

what are your chances of getting that?

Well, the prevalence of Parkinson's

meaning, how common is it, is about a million individuals in

this country, in the United States, so it's really a

fraction of the numbers of people, say, affected by all.

Alzheimer's, which is around 7 million or so, about a million

with MS, for example, with ALS, much smaller numbers, probably

around 20,000 or so affected today by ALS. But what's

interesting is that the rate of rise the number of new cases of

Parkinson's is really exceeding the rate of rise of new cases,

for example, of Alzheimer's, which I recently read, is

actually going down in terms of new cases. We're still in

trouble with that, because the numbers are so big, and we're

going to have a hidden epidemic on our hands. You have 50

million potential Americans over the next couple of decades

affected by Alzheimer's, the healthcare dollar cost of that

is massive, so we're not in the same place with Parkinson's,

fortunately, but we still have a big problem with a million

people and a large rate of rise, for the most part, thought due

to environmental factors. So we had our environment, and we're

paying the price just for very, very brief clarity. And there is

another test we all need to get into it, but it's called a dot

scan, or dopamine transporter scan, just so the folks

listening know that there are basically three commercialized

tests that we can use to confirm the diagnosis. I'm

glad to know that there is some testing for

Parkinson. My father had Parkinson, and it was in 2005 he

had the severe one, the tremor or you couldn't walk, had to

take a very high dose of medication. So that's very close

to my heart. So the connection there is that Ed can precede

Parkinson if you have these other symptoms as well. How

about Ed to Alzheimer? Because Ed is the blood flow. Is the

blood flow disease decreased blood flow. And blood flow is

related to inflammation, endothelial inflammation, and

you had alluded to earlier, that a lot of the risk factors for

Parkinson's and possibly even Alzheimer's is probably related

to heart disease, which is related to endothelial

inflammation, which is related to Ed so it's Cox highlight all

make that. Oh, so is that the basis is that endothelial

inflammation,

so you're asking a couple different questions, and

I apologize I don't know the exact prevalence of erectile

dysfunction in Alzheimer's. I'm sure it's quite common. And to

your point, when we think about disease from a root cause

perspective, then we're really talking about some common

factors, whether we're really focusing on erectile

dysfunction, which, and I'm not an ED expert, per se. I know a

fair amount about it, but I'm sure you would agree that it's

probably an extremely rare thing to have isolated Ed, meaning

there's no other cause, there's no other factors. You just have

Ed and that's it. Because metabolic syndrome, it's usually

cardiovascular disease. Of course, there can be psychogenic

factors that are very important as well, and we can talk about

those. But to your point, you and I have probably used the

term diabesity, and in our everyday professional career or

in talking on the podcast and so forth. We do have this epidemic

between being overweight and obese. I think it covers 50% or

so of all Americans. We have a epidemic of diabetes. Kids are

being treated for things that pediatricians never train for,

high blood pressure, cholesterol, type two Es,

insulin resistance. And really, if you want to, while certainly

we could talk about environmental factors and all

kinds of things, if you want to boil it down to what is really

the lowest hanging fruit? What is the biggest issue out there

that contributes to Alzheimer's, Parkinson's, als Ed? It's got to

be metabolic syndrome, in my opinion, it's got to be this is

a major, devastating, devastating epidemic that we're

in. And I think while I certainly like you know, I'm

excited about all the possibilities that the various

semaglutides and tertipatides and this and that offer, and the

future with these compounds that appear to do so much more than

just treat diabetes lower insulin levels. It's sort of

ironic that we spend decades feeding ourselves as Americans

junk food, and then we turn around and develop expensive

drugs so we can feed junk food. I mean, it's a crazy notion. How

about we just eat real food and forget about the drugs, right?

Yeah, exactly. So define what metabolic syndrome

is for our listener.

Well, formally, I want them to at least think

about three or four different things. Usually it's insulin

resistance, which, by the way, isn't always in the purest

definition. Diabetes, because I always define I tell people,

Look, your pancreas secretes insulin in response to a meal.

It acts as a key to a lock, and that lock is the glucose

transporter. So when your body secretes insulin, it drives the

glucose inside the cell, and that's helpful when it comes to

say, making energy. But just like we were talking about

alphas nuclei and amyloid protein, which can be normal in

certain circumstances, you can have too much of a good thing,

and so too much glucose inside the cell leads to the formation

of advanced glycation end products, which leads then to

oxidative stress, chronic inflammation, and ultimately

cell destruction, so insulin resistance, meaning that as a

person's discretions, or what all the factors that lead to

diabetes go up and up and up, the cell is trying to protect

itself from too much glucose inside the cell becomes

resistant to the effects of glucose. Initially, it just

means that your pancreas is pouring out more and more

insulin in order to manage your blood sugar levels, until it

reaches a point where the insulin resistance is so great

that your glucose level goes up. So there's sort of pre pre

diabetes, meaning before you ever see you could have a

glucose level on a blood test of 95 and so easily. You know,

maybe it's a little higher than optimal, but it's still pretty

normal. And you wouldn't think of 95 as diabetes, but there's a

big difference between a glucose of 95 and an insulin level of

five, and a glucose of 95 and an insulin level of 40 so insulin

resistance, high blood pressure, another one dyslipidemia. I know

everybody probably listening to this show. They don't like

statin drugs. It's common in holistic circles, but the

reality is, you can ignore the statin drugs, and that's fine.

And I'm not a big fan either, but we have to meet people where

they are as well. And if you're that inflamed and that much

oxidative stress and that much dyslipidemia, the risk of taking

a statin drug in the short run is probably much lower than the

risk of walking around with all of that inflamed, oxidized

cholesterol. You can make those lifestyle changes and follow a

functional and regenerative medicine approach and correct

that, but that takes time, so you have to gage. You always

have to meet that person where they are, and they're a 65 year

old person with two stents in their heart and insulin

resistance and dyslipidemia. They probably need to be on a

statin drug if they're 40 years old and so far so good, but

they're running high cholesterol, maybe they need to

work on those lifestyle changes first, because we're they're not

likely to have an event anytime soon, and we have much more time

to deal with

that, right? So metabolic syndrome is high blood

pressure, insulin resistance. So what that means for our

listeners is that when you eat, let's say pasta, your pancreas

release insulin, and then that insulin will drive the blood

sugar into your cell and then the blood sugar in your blood

will be lower. But what happened is that the insulin gets

released. Not a lot of things happen. They still have the high

blood sugar and the insulin just hang there. It's kind of like a

little insulin. That's why it's called insulin resistance. So

metabolic syndrome, high cholesterol, high blood pressure

and insulin resistance, and that is like a triad that create,

like an oxidative state, which is kind of like, I call it, like

inflammation of the blood vessels, right?

I usually like to add the waist to hip ratio in

there, the big belly that so many of us have, unfortunately,

and I remind people that it's called visceral adipose tissue,

and that is pure inflammation. It's a major risk factor for

just about anything you can name, including ed. So if we

we're going to work on Ed, and I'm sure you do this, you know,

we have to address metabolic syndrome

Absolutely. And that's actually sometimes even

harder than even treating Ed. We have many advances to treat Ed

now with your own themselves, such as platelet rich plasma and

high intensity shock wave therapy and Botox and now

electromagnetic energy to at least form those modalities. But

the hardest part is reversing the metabolic syndrome, changing

what you eat and then your exercise routine to lower your

blood pressure as well as lower your cholesterol and then lower

your insulin, because that's not something that you're born with.

You acquire that from your lifestyle. But I find that

that's even more challenging, because, like you said, we are,

you know, 67% of Americans are obese. We are now sitting in

front of the computer more than ever, and it's just less

opportunity to be active like we used to be. And food is so

accessible, it's so easy to eat something out of a box and a bag

rather than cooking it your. Yourself. I myself today was

eating some popcorn out of the bag because it was just more

available. So with you being the neurologist, the specialist in

the brain and a functional medicine doctor, on top of that,

with your holistic, comprehensive approach, and I

don't know how our listener feel, one of my scariest thing

is to have Alzheimer's and lose my cognitive ability as I get

older. And of course, this is a show on erectile dysfunction.

But aren't office at risk for dementia, Alzheimer's in some

way when we get older? And what can we do to decrease our risk

well,

that's to some extent true. Age is the biggest

risk factor for Alzheimer's. Yet we know of the blue zones where

people commonly live beyond 100 and they're very healthy and

vibrant and sharp minded. Of course, there is a gene that

anyone can be tested for. It's present about a third of the

population called ApoE four. And again, it's widely available.

It's usually in my world. It's covered by insurance. And while

it doesn't guarantee that the person will develop Alzheimer's,

and there are differences in ethnicity among different ethnic

groups, for example, meaning how they're impacted by the presence

of this gene. That being said, if you happen to be, say,

European, Caucasian descent, one copy of this gene triples your

risk of developing Alzheimer's, two copies 12 to 15 times the

risk. And yet, what is this gene doing? This gene is actually

making people much more responsive to things that drive

chronic inflammation. It's kind of like having a sports car

versus just a generic everyday your vehicle that you drive to

work is if you've ever driven a fancy car, like a Porsche or

whatever, man, you have to be so gentle on that accelerator,

because a little touch and it really goes, and not, I don't

drive horse free, yeah, but the point is that it's great if you

live in a very inflammatory environment, meaning you're

really at risk for infectious diseases, that you're protected.

But when we live as long as we do, and we are more vulnerable

to the effects of things that affect us, kind of in smaller

doses, but chronically over time, like air pollution, GMO

foods and junk food and all the things that drive metabolic

syndrome, heavy metals, what have you, chemicals, chronic

infections, all of those things that contribute to why we get

sick. Then these apo e4, genes, instead of protecting you, in

the very short run, become that driver of chronic inflammation.

So it doesn't mean that everybody's going to get

Alzheimer's if they carry the gene, but on the other hand, if

you carry the gene, you really have to dial in that, you know,

anti inflammatory diet and lifestyle. Wow. Now, how is that

gene tested by the blood we used to do a cheek swab, but now we

typically do blood. So it can be done either way.

Okay, so you can kind of test your risk factors.

So listeners, listen to that is the a full e4, is that

right? I don't know if you know Dale Bredesen is but

I know him quite well, and he's done a lot of very nice work.

People know the Bredesen protocol, but he has this

expression where he talks about the 36 holes in the roof

contributing to Alzheimer's disease, and that's because too

often we say, what causes Alzheimer's, you're like, well,

it's not really one thing. It's a lot of different things. What

causes Ed? Well, it's really not one thing. It's many different

things, and if we're really going to be root cause oriented,

we have to try to identify those factors and help people to

change whatever it is that's made them vulnerable,

foundationally, at least. So

let's say a guy has Ed and he work on his lifestyle

factor to lower his blood pressure, eat better, lowers

cholesterol, and then so it control his diabetes, loses a

little bit of weight, loses some of that belly fat, and increase

his testosterone, either through supplementation, injection or to

pallet. Does that lower his risk of Parkinson's and eventually,

like dementia or Alzheimer's as well.

Absolutely, absolutely it does. And it's

very clear that if you catch people in the earliest stages of

disease and you treat them that way, that you can potentially

reverse their disease. There are several papers out there. Dale

Bredesen group has published a few. I was one of the authors

with Dale in 2018 on reversal of cognitive decline. 100 patients

was the largest, and may still be the largest, published case

series of reversal of cognitive decline. And about a third of

those individuals came from Ozark, Missouri, from clinic.

But Dean Ornish is very well known. Kind of one of the

pioneers of holistic medicine, way back in the probably 90s,

when he first did His work, maybe 80s, I don't know, just

did, just published a paper in the last several months showing

that when he put people through a very simple, really diet and

lifestyle program, that he was actually reversing their

Alzheimer's disease. He wasn't just improving their cognitive

function, they were using biomarker based testing to show

that amyloid and another protein called tau, T, A, U, tau levels

were going down, and we've shown that in our clinic as well. And

by the way, circling this background to erectile

dysfunction, sildenafil, the phosphodiesterase inhibitors,

have been known to have a very powerful impact on the brain,

not just, of course, erection functioning. It's known that men

in a large sort of a retrospective historic study,

meaning they just go into large databases and look at men who

had been taking sildenafil or Viagra for erectile dysfunction,

and look at the prevalence of Alzheimer's disease among men

taking this drug. And is dramatically less, dramatically

less. And this has been seen in other studies, and we are

currently, I have a research site. We do quite a bit of

clinical research. We're working with a company called Ari bio,

A, R, i, b, i, o. They have a investigational product that

doesn't have a name, like a Viagra. It's called a r1, 1001

but it is a phosphodiesterase inhibitor, and in the phase two

trial with this product, it reversed Alzheimer's disease,

improving cognitive function up to 40% in people taking the

drug. So I actually use sildenafil off label in my

office as well. I combine it with oxytocin and a Troche,

which is for the Lister, is kind of a dissolving tablet, and we

are tracking their cognitive we're not only tracking their

cognitive function, we're tracking their amyloid and tau

levels over time. And I have cases of Alzheimer's reversal

with these patients as well.

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Let's just kind of dive into this, because you're saying if

somebody diagnosed with Alzheimer I assume, like low

dose, like so difficult, 20 milligrams, or what? How many

milligram

I'm actually using in this trophy? It's a 60

milligram trochee. I use half of the trophy twice a day. So take

30 twice a day. So

very well tolerated, right? But it's

combined with oxytocin, yes. How many milligram of oxytocin? 60

milligrams. They're both 60 milligrams.

So it's 3030, even though you take it half and they

take 30 of the oxytocin, 30. So dinner fill, and you're seeing

actually a reversal and improvement of Alzheimer's

symptoms. And

there's data that is effective for potentially,

this is investigational, but there is data supporting this

for Parkinson's as well. Because in the end, what is this doing?

Well, I always say, you know, maybe doing things at the

cellular level from this channel or that, whatever voltage gated,

whatever this receptor, can't talk in that kind of detail. But

if we think about blood flow, which is what erections are all

about. If you're increasing your blood flow to your brain, you're

bringing more oxygen, you're bringing more nutrients, but on

the outflow side, you're also enhancing the elimination of

toxins, including the toxic amyloid protein from the brain.

So you're affecting both the inflow and the outflow of the

brain in very positive ways. And to me, it's not surprising at

all that people's cognitive function is improving and their

amyloid levels are going down. Okay,

so at that dose, it's probably not so effective.

If you have Ed most me. With Ed require about 100 milligram of

sudena Phil or even up to 120 so have any of these Alzheimer

patient been noticing sexual function when they're taking

Viagra on with oxytocin on a daily basis? Well,

let's look at it a couple ways, and I have to admit

that, and you and I were kind of talking about this before we

started recording that too often. Doctors aren't asking

their patients about these things, and because I have a

multimodal approach, and many of my patients are also getting

testosterone, which can have a very profound effect on

neurodegeneration, of course, as well as erectile dysfunction. I

can't really exactly tease that out, but we of course, know

that, for example, Cialis, which is another phosphodiesterase

inhibitor. There's a daily dosing of Cialis, and you don't

take the same dose on a daily basis that you would take if you

use these drugs on an as needed basis. My patients are taking 60

milligrams a day of sildenafil, which may be on the lower side

for acute erectile needs, if you will. But I'm not so sure that

if you're taking every single day kind of like taking the low

dose daily Cialis. So I should be asking my patients, have you

noticed a real improvement in erectile function? But I'm

guilty as charged. I haven't asked them that yet.

Maybe you should. Maybe that's one of the reason

why they're so compliant, taking it every day, because there's

probably seeing maybe secondary effects. As you know, Sir,

didn't feel when it first came out. It was actually for

pulmonary hypertension. It wasn't made for Ed until they

start finding out the secondary effect, why the men were liking

it. So I wonder if these Alzheimer patients are observing

something. Maybe they're observing more Morning Wood,

maybe not enough for intercourse, but maybe some

morning wood or some activity there that they normally would

not have. It'd be interesting to find out, though, but I heard

about the study, but I haven't heard about mixing it with

oxytocin, which really does make sense. Now, we talked earlier

and you mentioned about the correlation between low

testosterone and Parkinson Could you tell us a little bit more

about that? Yeah, so

we kind of talked about those symptoms that often

herald the onset of Parkinson's and low T, of course, can be,

can present itself as a symptom. We wouldn't typically call it

low T at that point, it would be the person coming to you and

saying, I'm not getting erections. My libido is in the

trash can. I'm feeling irritable, I feel weak, I feel

over the hill. I just have no energy. And then that's turns

out to be a, you know, the low T is a major contributing factor

to that. But we do know, and again, well represented in the

peer reviewed literature, that heralding the onset of

Parkinson's in men, which, by the way, about 80% of men with

Parkinson's are affected by erectile dysfunction. But

heralding the onset of Parkinson's is often an abrupt

drop in testosterone levels. So in a multimodal approach, we do

need to be checking testosterone levels in men and women, by the

way, affected by Parkinson's, and treating men and women, in

my opinion, with testosterone, which the women may also get

estradiol and progesterone and things like that. But I am a

huge believer in hormone optimization, hormone

replacement therapy, right? How

does hormone for men and women? When we say

hormone, we're talking about testosterone for men, and then

testosterone, progesterone, estrogen for women. How does

hormone optimization help with the brain. So the

important thing for folks to realize, and I always

start, and this is a conversation I have with

patients every day in my clinic. I say, you know, I'm a

neurologist and I'm prescribing hormones. That's kind of

unusual, at least in your average neurology clinic, but

the reality is that every neurologist should be doing

this. And I would say you just go to a Google search box and

cross reference, say, testosterone and brain health,

or write, what does testosterone do for the brain? And you'll be

shocked and amazed. The thing about it is that these hormones,

by definition, a hormone, is a biologically active compound

secreted by a gland, released and into your bloodstream that

circulates around the body and has a distant effect on tissues,

meaning, it's not like a neurotransmitter, that those

neurons are microns apart and those neurotransmitters are very

localized in their effect. But if you give someone an

injection, even insulin, with which is a hormone, it will have

a profound effect in tissues throughout the body. So these

hormones are critical for brain health. They are anti

inflammatory. They have antioxidant properties. They act

as growth. Hormones are involved in memory formation, memory

consolidation. They are really, really critical. So shouldn't

be. Surprising that as women age and they go through menopause or

some surgeon takes out their ovaries, that twice as many

women are at risk for Alzheimer's disease as men. The

prevalence of Alzheimer's is twice as great when it comes by

gender for women compared to men. We need these hormones. Men

benefit from estradiol. I don't give them estradiol, but

testosterone, when we optimize testosterone levels, 800 900

1000 1100 they're converting that some of that testosterone

tester dial in their brain. So it's really, really important

for the brain, but it's really important for the whole body,

right? Anne, I mean, the heart health, the bone health. How

many women are told they have osteoporosis, right? If only

they were on hormones, they wouldn't have had osteoporosis

in the first place. So it's really eye opening. And this is

primary care for the brain.

I love that primary care for the brain hormones, and

I'm a big proponent of hormone myself because of really, it's

functional effect, and it's almost anti aging effect. And

I've been on hormone essentially day one of menopause, as well as

my husband. Both of us are on hormones as well. And I'm like

you, I believe that unless it's contra indicating certain cases,

you should be on hormone, because it's the same thing that

your body makes that when you get older, around, maybe past

age of 50, your body's just not making this much. You just need

to fill it up the tank a little bit more so you can have better

quality of life. I know you can relate to this. How often you

see especially female who are diagnosed with depression,

anxiety, insomnia and even dementia, when is really most

likely related to hormone very

common. And of course, in Parkinson's and in

Alzheimer's, there are early onset, or young we call it in

Parkinson's, young onset Parkinson's. So I have patients,

you know, in their 40s, with Parkinson's. And then there's

more factors that contribute to why they have low testosterone,

but they do often have low testosterone. I've had single

male patients, professional individuals in their 40s with

erectile dysfunction going, oh man, here I am. I'm still vital.

I'm interested in partnerships. I'm interested in sexual

relationships. I have Parkinson's and I can't get an

erection. It's a terrible situation. So many people, even

if they're not coming in with Ed, because I'm sure, you know,

low testosterone does not always immediately present with

erectile dysfunction. There are people with low T who still get

erections, but they're depressed, they're anxious, all

kind of and their doctors are putting them on, you know,

everything from valium to Prozac, when all they need was

testosterone. Absolutely,

I can't tell you how often this is more the

majority where we would start men and women testosterone, and

for women with estrogen and progesterone, that when they're

on hormone we get them off of their sleeping Med, off of their

anxiety Med, their depression Med, and then, because they

become more motivated, they're more energy, they're more

active. So therefore, they don't need their cholesterol meds

because their cholesterol is improved, because they're more

active. And then they are able to even get off of their

diabetic medication because they feel more energized. They did

eat better. There was a patient I saw last week got out of his

depression anxiety medicine that was he was taking for 15 years,

and I just gave him testosterone a month ago, and he said he

feels so much better. He stopped it. He said he felt much better

without his medication. And he was also taking a sleeping Med,

Ambien for a long time. And it was interesting that before we

started the hormone replacement therapy, he told me, Oh, I don't

know if I can get off of that. I've been on it for so long. And

I said, Well, you know, some of my patients able to get off of

it, but you think about next thing I know, he decided to wean

himself off of it when he was on hormone replacement therapy. But

having said that, thank you for sharing your wisdom. And I have

learned quite a bit of stuff, especially blood testing for

Alzheimer's, as well as Parkinson and I hope our

listener enjoyed that. I think you have to probably listen to

this again and kind of slow down when Dr charlin talked,

especially with all the tests that he mentioned, we'll make

sure, maybe we'll have some transcript available as well

too, so that way you can kind of follow along the blood test.

Because oftentimes knowledge is also powerful, because you may

bring this up to doctor and maybe get this tested. And is

this the blood test that you mentioned? Is that something

that normal neurologist would order that would you would

expect to go see a neurologist that would order the test?

Yeah, I mentioned the blood tests that you could

do for the apolipoprotein epsilon, or ApoE four gene. That

is not a test per se for Alzheimer's, is a test for a

gene which increases the risk of Alzheimer's. But. But there is

now a well validated blood test specifically for Alzheimer's.

Actually, I was an author in the paper was published just a few

weeks ago. The company is called C 2n diagnostics, and the test

is called the precipitate, A, D, 2p, R, E, C, I, V, i, t, y, A,

D, for like Alzheimer's disease to the number two, because there

was a precipity one, or they just called it precipitate ad.

But at any rate, this is a specific, highly accurate,

highly predictive, correlated, meaning that historically, the

gold standard to get a very expensive, very complicated test

called an amyloid PET scan or check the spinal fluid. And now

this test had been shown to be equally accurate, just a simple,

relatively much less expensive blood test.

The blood test got it okay. It is a blood test.

Okay. Wow, is that covered by insurance or not yet? Oh, no, it

is okay. I

would just discourage folks who have

absolutely no symptoms from getting a blood test, especially

they're fairly young. Not that I'm certainly a root cause

medicine doctor and believed in catching things early and

preventative brain health and all that. But you know,

sometimes you have to understand that first of all, what you're

testing for are changes in the brain. And we would define

Alzheimer's by both changes in the brain and the clinical

expression of the disease, meaning difficulty with short

term memory, people who cannot carry out what are called

instrumental activities of daily living. And we know that there

are people who can have Alzheimer's changes in their

brain who will never actually develop the full blown disease.

And if you happen to be let's say you're 55 years old, no

symptoms at all, and you decide to test yourself for those

changes, you have to be very prepared, mentally, emotionally,

psychologically, for what that really means, and also willing

to do something about it. Because if you're just getting

information, I would be very concerned at the impact on your

life, your relationships, your family, but we certainly don't

want to dismiss the importance of prevention. Regardless, you

don't necessarily need the blood test to take the steps to

prevent Alzheimer's or Parkinson's. You get your

testosterone, you address that metabolic syndrome, right that

we talked all about, do all the other things that are important,

sleep and exercise and so forth, and you could have a major

impact on your risk.

Wow, that's a good way to end that really eat,

healthy exercise, sleep, don't smoke, and that will kind of

carry you through as well. So if you do want to be tested and you

do have Parkinson or you feel that you have a loved one that

has Alzheimer's as well, seek out Dr Ken charlin, and where

can our listener find out more about you, and if they need to

connect with you,

we have a wonderful website. It is functional

medicine, dot doctor. Functional Medicine, dot doctor. And we do

have an opportunity, if you go to the website to sign up for a

complimentary 15 minute consultation. We'd love to learn

more about you, make sure that it's good fit, that we can help

you. And we'd love to have you in Ozark or get to know you via

telemedicine, which we also do now,

tell us about your book. Where can they get a copy

of your book? It is

on Barnes and Noble, but I think most people

buy it on amazon.com, or right off the website as well. It's

called the Healthy Brain toolbox. Also have a companion

book, which is called nourishment, the brain tune up

Food Guide. Because brain tune up is our brain health program.

We help people with Parkinson's and Alzheimer's and ALS and MS

and so forth really changed that trajectory, awesome.

So make sure that you at least check out his book,

and that's how we actually met. I think I even have a copy of

your book. Having said that, I'm grateful Dr Truong for being

here and sharing your wisdom and teaching us, and I hope that our

listener will get a lot from this as well, too. If anything,

just know that if you take care of your body, your body's your

temple, you may even avoid all these Parkinson's and dementia

and Alzheimer's as well. Sometimes as simple as eating

healthy, like following the Mediterranean diet, which is

anti inflammatory diet, exercise, stop smoking and enjoy

Mother Nature, sleep well, and that will probably go along

absolutely as well too, and it will even help with your ED so

having said that, we will see you in the next episode. Thank

you. Okay, modern man, you are not alone, and you don't have to

suffer anymore. Ed, can feel isolating, frustrating and even

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not feeling like yourself. It's exhausting. But here's the

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at getwood now.com. I'll see you there. You