This DOCTOR Knows What Causes Alzheimer’s and How You Can PREVENT It | Jay Lombard on Health Theory

But I think what people most forget is that the the the closest proximity of infectious diseases to the blood brain barrier is in periodontal diseases and that's been strongly associated with with Alzheimer's disease. [music] Everybody, welcome to another episode of Health Theory. I am joined today by Dr. Jay Lombard. Jay, thank you so much for joining me today. It's a pleasure to be here. Thank you. Dude, I'm really excited to go into this. You are bringing together a lot of different things in your field. I'm used to dealing with holistic people when it comes to nutrition, when it comes to metabolic health, but you're sort of the first person I've come across that's bringing similar areas together when we look at neurological conditions. And so as a I guess a flag post here for everybody in the audience, we're going to go on a pretty epic journey I think today regarding what impacts the brain negatively, some of the neurological disorders that are cropping up like mad and what we can do to fix them. And let's get really specific about what your core hypothesis is and it'll be interesting to see because there's actually for how impressive I find you, there is precious little um interview material out there on you. And so I could watch your thinking evolving in real time as I you know, watch these interviews. And so the sort of last guide post that I had in terms of what you were talking about publicly was that hey, I think that we what we may have is um a pathogenic problem in the gut that is making its way to the brain through leaky brain and that may be causing I mean you you very specifically said I have a hypothesis that ALS is caused by C. diff. And that was as as of last guide post was the thing that you said that people were really pushing back on. [snorts] And I'm curious, is that still where you're at or Uh well, it's evolved since then. So, I'm glad to have this interview right now because I I think C. diff uh one of the issues with uh correlating infectious disease with neurological diseases uh is is there's two questions, basically. The first question is uh are they comorbid conditions? Not necessarily being causal. Meaning that you can see patients that have infectious disease like C. diff. Uh it doesn't necessarily mean that that those infectious diseases are causing neurological problems. So, one of one of the gaps in our understanding is how specifically do infectious diseases actually lead uh to neurological injury? That's sort of, you know, one big step that has had evolve in my thinking uh to establish, you know, uh I will I won't say the word causality, but but pathogenic mechanisms that overlap uh between infectious diseases and neurological problems. And the second thing that I I kind of have to backpedal on, I thought that it was C. diff was the primary smoking gun. Uh that's why I'm glad that I'm on this uh call with you today because I don't think it's a single infection. Um I think it's a multitude of chronic infectious diseases uh whether it's a combination of bacterial, uh fungal, as well as viral diseases, Lyme disease. Uh I'm a I'm an astute listener to my patients. So, when my patients tell me that there's a connection between uh when they developed uh a hepatic infection or Lyme disease and thereafter developed, you know, MS symptoms, uh I started paying attention and not being dismissive uh of what patients told me they thought the connection was between infectious disease and a neurological problem. Yeah, so if your former hypothesis and and you were very clear that this was a hypothesis, and every time I've ever heard you speak, you're very metered, um which I love, but I also like that you're not afraid to have a hypothesis that you're pursuing. So, is now your thinking that basically that we're getting these neurological symptoms, we think that we need to focus entirely on the brain, but really the effects in the brain are merely a uh a symptom of a pathogen that has intruded somewhere else, whether it be from a tick bite and it's Lyme disease, or whether it be from your diet and um you're you've caused disruption in your microbiome, and now C. diff overpopulates. Is is that the idea that all of this is pathogen-related, or is there potentially something else? Yeah, so first of all, I'm glad that that uh that this is a hypothesis. This is a theory, right? And it's it's it should not I I do not want to be credited for this theory. I mean, there's plenty of publications from in nature, from all sorts of esteemed journals that have actually asked this question, you know, is Alzheimer's an infectious disease? Uh and other neurodegenerative diseases Parkinson's. So, I I don't want to take credit for this theory. Uh that's number one. Number two is I think that the way my thinking has evolved regarding this hypothesis is to try to explore how specifically uh does any infection uh produce neurological problems? So, my in regards to how my thinking is involved, uh I think that these conditions are ultimately vascular-based. Uh meaning that uh inflammatory conditions, infectious diseases, uh bad lifestyle, insulin resistance, hypertension, uh all converge on the endothelium, on on blood vessels, basically, in the walls of blood vessels. Uh and that is sort of the underlying mechanism of neurological injury uh that connects all these epigenetic factors to neurological diseases like ALS, Parkinson's, and Alzheimer's disease. So, you know, in the old days back, uh, you know, in the 1990s when I finished my neurology residency, we would see on on MRI studies when they first came out because it was, you know, that in those days MRI was just being introduced, uh, we would see all sorts of of changes, ischemic changes, changes like like what we call mini strokes, uh, or vascular changes, uh, in various areas of the nervous system. So, for instance, in Parkinson's disease patients, we would see, you know, evidence of what's called small vessel ischemic disease. Uh, you know, the ischemic mean? Ischemic means lack of blood flow, interruption of blood flow. Um, and we still see these changes. If we do, uh, MRIs on Alzheimer's patients or in patients with ALS, uh, we see what what are called these unidentified bright objects, these UBOs, uh, that the radiologist, uh, kind of comment on and they they say differential diagnosis could be vasculitis, it could be Lyme disease, uh, it could be just age-related white matter changes. But what what all those things actually mean in principle is that whatever the provoking factor is, whether it's inflammatory mechanisms, uh, infectious mechanisms, uh, or some combination of of various, uh, interruptions, traumatic brain injury is another example that can produce these vascular changes. Uh, the the smoking gun, if you will, uh, is really based upon disruption, uh, in these very very small blood vessels that are responsible to perfuse the brain because without perfusion of the brain, you could take any supplement you want, uh, but if you don't have adequate perfusion, uh, you're not going to have a healthy brain. Meaning you no longer have the functioning vasculature to get said supplement to the regions of the brain that actually need it. Exactly. So, all neurodegenerative diseases, whether it's ALS, Parkinson's, Alzheimer's, are characterized by the production of of proteins that are misfolded. Uh so, think of these proteins as basketballs uh that need to be inflated a certain uh volume so you can dribble correctly, right? Once once that that basketball becomes deflated uh as a protein, we call these misfolded proteins. So, there really there really are two challenges uh in our approaches to ALS and other conditions. One is to uh figure out how to block the production of these proteins cuz these proteins will continuously be misfolded uh based upon genetic abnormalities that a person uh has acquired as a result of these conditions. And the second challenge is once those misfolded proteins are actually um uh created, how do you degrade them? Because at they these proteins are pathological, and they build up like atherosclerosis. In fact, we now there's there's plenty evidence right now uh that these conditions uh you know, ALS, Parkinson's, uh and Alzheimer's disease uh have these plaques uh in the vascular system. There's a condition called amyloid angiopathy, which which speaks to that. So, in other words, I the way I the way I've been thinking about uh neurology right now is the way that I think cardiologists began thinking about heart disease uh back in the '70s, meaning that that, you know, unless you're at the stage where you need sur- surgery, right? To remove whatever plaques are building up, the best bet is identifying who has these conditions, number one, uh and number two, uh putting a a preventive program uh with the same risk factor management as we do for cardiovascular disease because like you said, you know, the the pathology manifests based upon where a person's most vulnerable. People with genetic risk for Alzheimer's, that's where this pathology is going to show up. But the pathology itself is very similar. I mean, you know, misfolded proteins are basically what clots are, right? Clots are basically protein aggregates that are misfolded and therefore can't be removed by the body's immune system. So, uh what I what I mean to say is that I think that, you know, our our goals here are to to manage these as chronic diseases. I I tell people, my goal as a clinician is to help you live with ALS, not die from the condition. That's that's what I, you know, try to encourage people to think about. Very interesting. So, do you think that all of these chronic diseases, whether it's cancer, whether it's heart disease, Alzheimer's, ALS, do you think that they all have um What I was going to ask is do you think they have the same set is probably the right word of underlying conditions, or do you think it's just that the body only has so many uh make-or-break mechanics and things impact those make-or-break mechanics in different ways? That's that's a fantastic question, by the way. Fantastic question. So, I think that we need to understand sort of uh a little bit more in depth about how the body normally handles these proteins because there are uh cellular mechanisms uh within our cells that are endogenous mechanisms that help us break down these proteins. Uh it's an area of the cell called the lysosome, uh which is a very acidic environment that takes a degraded protein uh and literally breaks it down so that it's no longer pathological. Basically, you know, the body has to find a housekeeping effect to essentially dissolve these pathological proteins. So, a lot of leading investigators in all sorts of fields, cardiology, basic science of cardiology, basic science in oncology, basic science in neurology have identified lysosomal failure. Uh meaning an inadequacy of the ability of lysosomes to degrade these pathological proteins regardless of what disease a person particularly has. Meaning that there's an overlapping mechanism of reduced ability for our bodies to break down these pathological proteins. Do you think that is due to the amount or due to the type of misfolding that maybe the lysosome doesn't understand? Because when I think about things like that in our body, I I am truly dazzled that there is a part of our body that goes I know I recognize you. You're a good protein. I'm going to leave you alone. Ooh, you look weird. You're damaged in some way and now I'm going to dissolve you cuz they have to be selective. Right. So, is the system just being overwhelmed or is there a way to misfold that is due to a modern lifestyle that the lysosome is just not familiar with? Uh it's a combination of various things. So, the the proteins responsible to identify misfolded proteins are called heat shock proteins. These are proteins that are elevated by hyperthermia. So, that's sort of the original principle of why hyperthermia may be an efficacious biophysical approach to conditions like this by elevating these heat shock proteins. Because those are the the chaperones that say, "Hey, you're a misfolded protein. It's time for you to leave the cytoplasm. Come with me to lysosome. Don't worry. We're not going to get rid of you. We're just going to recycle you." So, they these heat shock proteins take uh misfolded protein, they send it to the lysosome, the lysosome then digests the protein, breaks it down, then it sends it to the what's called the endoplasmic reticulum, which is another cellular structure that helps to kind of recycle all those pathways. So, this sort of uh combination of a sort of a three-hit hypothesis is one that there's not enough heat shock proteins uh because aging itself uh and you know, one of the things that that I think I spoke about on with Dr. Hyman is one of the things that is a very classic history I hear from patients is that they're unable to mount a fever. Mhm. Uh very often, you know, oh yeah, I've had C. diff or I've had, you know, Lyme, I've had sinusitis, but I never get a fever. That means that the the body's endogenous mechanisms to increase heat shock protein 70 are defective. Uh then you have a second hit, which is that the lysosome So, think of a lysosome like as a as a pool, right? And you have to put just the amount of chlorine in the pool or salt if you're not into chlorine, right? Uh but if you put too much salt in the pool, uh your eyes are going to burn. Meaning that if it's too acidic, uh that's also unhealthy for the cell. But if you don't put any salt into the pool, you're going to have overgrowth of mold, overgrowth of of these various uh infectious diseases. In fact, one of the most interesting things I just recently found in my research is that bacterial infections actually inhibit lysosomes. They actually inhibit lysosomes. Part part of their survival mechanism uh is based upon inhibiting the enzymes that are normally required to digest them. Cuz don't forget You can take me to the swimming pool, but the pool's not going to kill me. That's exactly right. Yep. Wow. Sure. Take me to the pool, but you know what, guys? I'm going to hang out here. And that's And that's what sort of creates the this the chronicity of infectious diseases is that the lysosome is unable to digest them properly cuz the immune system saying, "Hey, okay, we found, you know, something that doesn't belong to human DNA. This is, you know, a bacterial antigen or a fungal antigen, uh you know, a protein that doesn't look like us." Okay, great. The heat shock protein has to uh bind to that particular pathological protein, right? If the heat shock protein uh is not elevated enough because a person can't mount a fever, then the the infection will remain because it's not able to be carried to the lysosome. But let's say you it does take it to the lysosome, the lysosome says, "Hey, guys, I'm out of acid. I have no more enzymes uh to degrade this this protein. So, you know, you're you're looking at at at many pathological steps uh in the pathology these conditions that are that are disrupted uh and and why, you know, my research is so focused on trying to figure out ways of actually improving the immune system by enhancing lysosomal function. Wow. Okay, so I've heard of heat shock proteins a bazillion times. I have never heard anybody explain what they do, only that this may be the reason that saunas are connected. I'm not even sure if people are making the bold claim that there there's a causation, but that they're connected to lowered risk of um heart disease. Yes. Do you think that's why? I I think it's definitely why. And and the other the other thing I want to bring up cuz, you know, everyone is sort of, you know, uh kind of puts this gut-brain problem uh into things like SIBO uh or dysbiosis or, you know, um you know, hyperpermeability of the gut, but I think what people most forget is that the the the closest proximity of infectious diseases to the blood-brain barrier is in periodontal diseases. And that's been strongly associated with with Alzheimer's disease. It's It's It's, you know, the the the oral cavity is directly proximal to the sinuses of the brain. So, that anywhere where you're going to see a leaky mucosal barrier, it's in people that have periodontal disease, because that's the the first area of of staging of the battle between these various infectious diseases and the immune system. So, what happens is that the immune system is activated, right, to try to break down these pathogens. And by the way, I used to think, cuz I'm not a dentist, I used to think that, you know, periodontal disease is all bacterial. But in fact, periodontal disease has association with candida, fungal infections. It's It's not just bacteria that that causes periodontal disease. But the point is that that they're so close to the blood-brain barrier that they have an easier ability to migrate into the brain and produce inflammatory reaction in the brain than leaky gut does. So, I think that, you know, one of the take-home messages I would have for your listeners is that, yes, I think that leaky gut is is a very important aspect of, you know, a functional medicine approach to any condition, but I think the first and foremost point of assessment would be assessing periodontal disease in those patients. Wow. Okay, we're starting to understand some of the mechanisms that are causing the issue here. How does one improve their oral health? Like, is this just what you eat? Is this better brushing and flossing? Like, what do we actually need to do? So, uh it's it's a uh both a simple question and a and a complicated question to answer because obviously, you know, um I'm not a periodontist, so I don't want to speak out of turn about, you know, how to manage periodontal disease. But, um you know, I I think the the first point is yes, uh you know, oral hygiene is critically important. Uh there's lots of various types of mouthwashes and like tea tree oil, for instance, which has, you know, very good antimicrobial effects. Um so, I I think that uh you know, a strategy that both includes, you know, very good oral hygiene, but also some type of of natural antibacterial um mouthwashes uh really makes sense to me as well. Okay, so now going beyond the mouth, what are we doing on a lifestyle basis to live as optimally healthy, high cognition, avoid things like Alzheimer's? Like, what do we need to be doing? I think people should watch your show more often. That's my my first recommendation. Um Good advice. You know, so um I I think that you know, first of all, people should, you know, identify uh whether they have these risk factors, right? So, if people have a family history of of cardiovascular disease or, you know, heart disease or or lung disease, uh uh inflammatory diseases or neurological diseases, uh they're the ones that really need to pay attention uh to preventive strategies going forward. I mean, we all do, obviously, but we know that the those people have a high genetic risk because their family members have had similar diseases. So, you know, Ben Franklin said an ounce of prevention is worth a pound of cure, right? So, I I think the same recommendations that we have for cardiovascular disease are are equally warranted for prevention of neurological conditions. There There are There are two uh phenomena that regulate epigenetics. Okay? So, regardless of what gene you have, cuz everyone everyone has bad genes for for something, right? I mean, you know, there's an old workup, you know, what's a healthy person? Someone who hasn't had a a full diagnostic workup yet, right? Because we all have, you know, genes that are going to lead to something down the road. Uh but epigenetic expression uh is modified by two processes. One is called methylation, uh which is why, you know, high doses of methylfolic acid have proven to be very effective in a variety of clinical conditions like depression, uh uh but also the second process is called acetylation. So, methylation uh and acetylation uh are able to kind of repress uh pathological genes from expression. But, people have done a lot of uh work on the methylation processes, but there's much less understanding of how nutraceuticals uh and certain pharmaceutical agents promote what's called uh uh inhibiting the deacetylation, the breakdown of of acetyl groups that are responsible to prevent the pathological expression of a bad protein. Think of a mummy, right? Uh the mummy's got all this stuff wrapped around him, right? Uh the the methylation and and acetylation help to keep that mummy under wraps. And what's under the wrapping is our DNA, correct? The expression of the DNA, correct. Yep. What do you mean the expression? So, in in the what my layman's understanding of DNA goes like this, it's this tightly wound thing, and depending on how much it's wound, any given gene is wound up will determine its level of expression. So, when a gene gets turned on by something in our environment that loosens the winding, and now that gene can be read, and therefore it expresses. Now, I get that that's probably super clumsy, but if that's sort of the rough idea, is that not then inside the wrapping is our DNA? Correct. So, what's what wraps the DNA is something called chromatin, uh which is just a way it it keeps it it basically regulates the expression of genes, right? So, and by the way, just as as a shout-out to what you just said, so there's many non-pharmaceutical uh nutraceutical um compounds that prevent uh the deacetylation, the the breakdown of the mummy wraps to help uh prevent the expression of pathological genes. Uh some of this work was done by uh Andy Zimmer, who's a pediatric neurologist. I think he was at Hopkins at one point that demonstrated that um certain isothiocyanates from broccoli and from uh other uh healthy foods um actually uh have um neuroprotective effects by actually preventing the expression of pathological genes in autism. All right, this is uh man, this stuff is so complex, but the fascinating thing is the more I interview amazing minds like yours, I I'm actually starting to piece this stuff together. It's pretty crazy. Uh okay, so All right, so you were explaining epigenetics and how those were the two elements of epigenetics, and we were ultimately trying to get to like what those lifestyle things are that we can do that are going to make sure that we don't end up expressing um some you mentioned autism now, and I do want to get into that, but first I want to sort of finish this lifestyle aspect. Um I I've heard you talk about ketogenic, so I know you have familiarity with at least the byproduct of certain diets. I'm curious to know like where you come down on veganism versus carnivore and things like that. Like do you have a take on what lifestyle gives us the sort of optimal results? Yes. Regardless of whether you live it or not. That I'm not worried about that at all. [laughter] Full disclosure, right? Uh no, so I I practice fasting on a regular basis. Um The The only reason why I do it though is not not because of the health issues. It's because I'm so busy that I have no time to eat from like 6:00 in the morning till like 8:00 at night. So I think fasting is one of the most healthy things people can do as long as they don't have, you know, diabetes or or, you know, a risk of developing hypoglycemia. Ooh, let's see if the layperson can really get himself in trouble here. So if somebody came to me and said, "I have diabetes." I would say, "The first thing you need to do is fast." And you're saying that that is a dangerous answer. It could be because if they need to have proper amounts of glucose in their bodies, they can actually have, you know, a fair fairly serious consequence of having too low blood sugar. But just in in a, you know, a broader spectrum, what fasting does is it actually increases heat shock proteins. Um so it's Why are they called heat shock? Ah, very good question. Excellent question, by the way. So what happens when a person is under stress or when a plant is under stress, right? The plants also make heat shock proteins. It's really the wrong word, heat shock proteins. They're basically environmental shock proteins, meaning that that extreme temperatures of either kind, hot or cold, will activate those proteins. But anyway, so fasting I think is a great idea. Um I am very much uh a uh a believer in protein-based uh veget- vegetarian protein-based diets as opposed to Sorry, real fast before we move off of um fasting, the one thing I wanted to note, when you say fast, you you talking 16 hours, 24 hours, 48 hours? Like what duration do you then consider to fast and not just being a space between meals? Um I usually start fasting uh like around 6:00 uh at night. And then I will eat something very light uh for breakfast, and then I won't eat anything again for until dinner time. And the reason that it's healthy is that it produces less stress, uh particularly on the liver, which is, you know, primarily responsible uh to metabolize the proteins that we ingest. You know, one of the problems with the high-protein diets, not that I'm against high-protein diets, but that it produces a lot of stress on the liver to actually uh you know, to break down those proteins properly. And if the liver is impaired in some way, uh when a person has a high-protein intake, that may increase something called ammonia, uh which is a byproduct of protein metabolism. So, you know, one of the the ideas here is that, you know, by resting the hepatic function uh through uh less consumption of of you know, foods on a regular basis, uh reduces something in the body called uh ER stress, endoplasmic reticulum stress, which is at the level of the liver. So, you know, by the way, a lot of a lot of patients that I see have evidence of fatty liver in association with uh neurological diseases, uh which is why I'm very encouraged with something I mentioned uh with Mark Hyman on last podcast I did about Tudca. Tudca is a a secondary bile acid that promotes hepatic metabolism that has been shown to have potentially beneficial neuroprotective effects on a variety of of conditions like ALS. Very interesting. Okay, so we're we know we're doing fasting. You were about to say then what we want to eat. What do we want to eat? Right. So I I I generally recommend the following: a third, a third, a third. A third of protein. So think about like three fists of food on your plate. One fistful should be, and again this is my opinion only, vegetable-based proteins. Um two are, you know, high-quality fats from, you know, nuts, avocados, uh olive oil, those those types of foods. And then the third from complex carbs like, you know, fruits and vegetables that are very colorful that contain a a wide variety of what are called polyphenols, uh which are the things that like broccoli, cauliflower are able to uh repress pathological genes through the process we discussed, um as well as folic acid. Okay, so what would be um what would be a complex carb? That that that is the one at least for me that I have found just essentially avoiding. So would like where do you fall on sweet potatoes, which would be my favorite, but I find that I put on fat when I eat them. Right. What are your thoughts on that or do you have a better complex carb that you recommend? No, I think sweet potatoes is an excellent. Look, I strongly believe that if nature produces these types of foods, right? Grapes, artichokes, uh sweet potatoes, onions, cauliflower, uh you know, that these that have, you know, complex carbs as part of their uh, makeup that they're not they're not unhealthy. It's just it's you know, what's unhealthy are are simple sugars, not complex carbohydrates uh, that produce insulin resistance going forward. So, I I I strongly am a proponent uh, of those types of dietary factors being incorporated into a diet. So, basically the punchline there is if you're eating whole food, you're probably fine. But, where you're going to get yourself into trouble is when it's been processed and the sugar's been refined out and then added back into something. Is that accurate? Correct. And the same thing is true with with meats and fish as well because you have to look at not just the the the uh, the the the the quality of the food, but the processing process that goes from you know, from farm to table. That has to be looked at as well. Mhm. Yeah, one thing that I never thought would matter is what your food ate. Yep. Absolutely. And the same thing is true for fish, by the way, as well. I think we we pay, you know, not enough attention to to fish as a as a source of of course of omega-3 fatty acids, which are essential. Uh, but many fish uh, people that consume a lot of fish uh, may have high mercury uh, as a result of consuming fish. Um, so, it's you know, like everything else uh, in life, uh, these kinds of issues are very very complex uh, and there's a lot of variables that go into those decisions uh, for each person that decides to follow whatever diet that they want to follow. So, I'm I'm not, you know, to be honest with you, I'm I'm a traditional physician. Uh, I you know, usually refer people to a dietitian for questions about what I think is is optimal dietary approaches to to these conditions. Um, so, uh, Uh, but I I have sort of a broad understanding uh, what I think are the proper dietary consumptions that a person should have in general. Jim, I'm sad that you don't do more interviews. I will say that you are not a traditional clinician. Uh, and I think what you're saying now is and I I completely understand and because I'm so much more ignorant than you, I am so comfortable making guesses and drawing conclusions. Um, but while I get that you're not a dietitian and all that and you're, you know, hedging your bets about those aren't my areas of expertise, what makes you so amazing, dude, is the way that you're pulling these different threads together and saying there might be something here. You need to look at that. There might be something here. And so, for instance, if I were diagnosed with ALS tomorrow, you would be my first phone call. If for no other reason than you're looking at things that not a lot of other people are looking at. And so, tying this now sort of finally back into lifestyle, um, how do you think about these sort of hopeless neurological cases that for, like, autism, in fact, let's let's go with that one. That for so long people just threw their hands up and, you know, once it happens, it happens and there's nothing you can do and it's purely genetics. Um, how do you think about a problem like that? Uh, let's talk about ALS. I've moved into a dimension uh, in my mind and in my practice that where where people who will not give up hope uh, and and believe that that whatever condition that they have, whether it's Parkinson's or or ALS or, you know, I see some of the most difficult cases in the world, to be honest with you. And what I find most humbling uh, to me as a physician, uh, is their sense of of not accepting nihilism, uh, and their their sense of purpose, uh, cuz many times I've heard I've heard my patients say to me that I feel that Parkinson's is a gift. And I'm like, "Really?" I mean, I I would ne- I would be so angry at at at God if I got, you know, Parkinson's or ALS. I I don't know how I would come to accept that uh, as a condition. But, uh, they've done studies and we've actually looked at people who had uh, long-term survival from ALS who were given a prognosis of like 3 to 5 years who are still living. Uh, and I've spoken to some of those those particular folks myself. Uh, and I want to give a big shout-out, by the way, to, uh, a nonprofit called Everything ALS uh, that has really helped uh, the community of ALS patients, uh, realize that that we're not going to go down without a fight on their behalf. So, Everything ALS is just, you know, an extraordinary organization uh, that is working towards uh, the ability to to not accept the therapeutic nihilism, uh, that comes with the diagnosis of ALS. Um, and what the the common thread of of long-term survivors has been a sense of purpose and faith uh, in the ineffable. Whatever You can You can call it God, you can call it a higher calling, you can call it It doesn't have a name, basically, but it's a sense of of a spiritual connection to oneself and and and the rest of the world that helps them endure, uh, as a mind-body method of helping patients, uh, deal with these conditions. Um, and it's something that, you know, I'm glad you reminded me about because that's sort of, you know, where I come from as a clinician. Uh is is based upon trying to uh you know, for my in my own life to come to accept that that whatever problems that we have are are to learn from those problems, to to grow as individuals, and to and to deal with them uh without running away from the problem itself. Yeah, that that to me is sort of the nexus of um why I'm so fascinated by you is really bringing these disparate worlds together. So, right before I do an interview, I always journal essentially on, "Okay, what is it about this person that's interesting or unique or fresh?" And that was the thing I kept coming back to you with you is there's nobody else that's like pulling these threads together. Like, up until this moment of the interview, no one would have any idea that you have this sort of breathtaking expansive view of um God and our brain and sort of the connection therein. Because you're still utterly motivated by evidence and science, but yet I could have in this interview flipped it, and this could have been totally about faith and meaning and purpose, and you would have been just as eloquent. Um and I don't know, there's something in that for me in the open-mindedness that has allowed you to escape the nihilism, um which I find useful and I think is really important. But then we get into uh connection and love and hope, and where do you come down on that, and do you think about that as a clinician? Every second of my life. Every second of my life. Um you know, love love is is is is biology, basically, right? Uh when when we love, we increase our endorphins, which helps us to uh bear whatever pain that we're experiencing with whatever condition. My experience with people who have conditions like ALS, who have very strong social support through their families and and their and their friends, have much much better prognoses than the same patient, same age, same condition without those social support systems. And you know, just a quick aside, Victor Frankl, who wrote a book, he was a he was a psychiatrist who wrote a book about logotherapy was it was what he developed. He found evidence-based that people were able to endure the worst conditions in the Holocaust if they had a sense of purpose. He said, "Look, I'm going to survive this no matter what because I know at the end of the day I'm going to be reunited with my my my kids or my my my my my parents." And people who had lost hope completely died. So the idea that that we can infuse medicine with a sense of of purpose is I think of extraordinary value, you know, for everybody to to appreciate. Yeah. Yeah, it's uh I don't understand it. I don't know why it's true, but it is experientially self-evidently true. Right. And you know, reading Man's Search for Meaning by Victor Frankl was an utterly transformational book for me. And I just thought, "Wow!" Like to think about how there is something, some connection between the brain and the body where when the brain no longer has a sense of purpose in all of this, you actually shut off biologically. Yes. I wrote about that in the book, by the way. I mean, there's actually explanations about how that happens and why that happens, as well. Give it to us. So, there are growth factors in the brain. Uh they're proteins uh that are called neurotrophic factors, like BDNF is one example. Uh which, by the way, is what exercise promotes and why exercise has an antidepressant effect is because it increases BDNF levels. Uh but, there's a direct uh association between experience uh and cellular pathways uh that results in a uh inability to produce adequate amounts of these neurotrophic survival factors. There clearly is a a biological explanation for how uh existential states of hopelessness uh lead to, you know, premature death. And how existential states of living a life of purpose uh are able to overcome uh those on a biological basis, meaning that it's it's not like uh a game of smoke and mirrors. It's There are explanations about how that actually occurs biologically. Yeah. Jay, you are so intriguing to me. I am so grateful that you took the time to meet with me today. Uh you you are hard to find on the internet, but where can people connect with you? Uh well, I have a a a website that's pretty, you know, not a great website, but it is what it is. It's www.drjaylombard.com. Uh www.drjaylombard.com. I highly recommend that people uh follow you, that they go to your website, read your books. Um I have thoroughly enjoyed my time researching you and spending time with you today. Uh really, really amazing, man. Um thank you again for taking the time. Likewise, I've I've enjoyed speaking to you as well. Thank you. Guys, trust me, while he doesn't put out a lot of social content, this is somebody the content that's out there is breathtaking, really intriguing, and I highly encourage you to check out his books as well. Watch this interview on a loop, and then hopefully we will get him back again someday. And speaking of things that you should do on a loop, if you haven't already, be sure to subscribe. And until next time, my friends, be legendary. Take care. Thank you guys so much for watching and being a part of this community. If you haven't already, be sure to subscribe. 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