How to Prevent Spending the Last 10 Years of Your Life in a Diaper and a Wheelchair | Chris Kresser

How to Prevent Spending the Last 10 Years of Your Life in a Diaper and a Wheelchair

by Chris Kresser

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Everything you have ever experienced, felt, or conducted in life is due to brain function. The ability to enjoy, perceive, sense and experience live is dictated by the firing rate and health of your brain. It is impossible for a person to become healthy mentally or physiologically without a healthy brain. – Datis Kharrazian, DC, MS

Maybe this goes without saying, but I think it’s worth pointing out: our ability to enjoy life is brain-based. The capacity to taste food, appreciate and create art and music, smell a flower, feel the sun or wind on our skin, experience orgasm, and contribute to life in a meaningful way is entirely mediated by the brain.

In fact, everything we’ve ever done, are doing now or will do depends on brain function.

With that in mind, consider this. Two things in life we can be absolutely sure of are:

  1. We are all going to die.
  2. Our brains are going to degenerate before we die.

While this might seem morbid to some, it’s the simple truth. And the more you’re able to accept this truth and act accordingly, the better chance you’ll have of aging gracefully.

Aging = neurodegeneration

We associate the symptoms of neurodegeneration with normal aging. We see advertisements for Depends diapers, nursing homes, medications for Alzheimers and Parkinson’s and laxatives all around us. Expressions like “having a senior moment” are part of the vernacular, and we’re often quick to explain loss of brain or physiological function as “just getting older”.

We assume that the aches, pains and frustrating and sometimes embarrassing decline in quality of life we experience as we age is “normal”, because we see others around us going through the same changes.

But as I’ve pointed out many times, what’s common isn’t necessarily normal.

Studies that have looked only at only the healthiest elderly people find minimal cognitive decline even into the ninth decade. These data suggest that significant cognitive decline is not an inevitable consequence of advanced age.

Yet more than 4 million Americans have dementia today, and that number is projected to grow to 14 million in the next 50 years. 1 in 100 Americans over the age of 60 have full-blown Parkinson’s disease, and a greater number has “Parkionsonian-like” symptoms (early Parkinson’s).

There is no cure for dementia, Alzheimer’s and Parkison’s, and they are devastating diseases. What’s more, conventional medicine is hopeless when it comes to diagnosing and treating these conditions. If you go to the doctor with early dementia signs, most will tell you to come back when your symptoms have progressed to the point that they are irreversible. By then it’s too late. You’ve lost too many neurons, and your brain is quite literally atrophied and shrunken. And there are no drugs that improve brain function.

So if you want to age well, minimize neurodegeneration and protect against common (but not normal) conditions associated with aging, you need to take matters into your own hands.

You had more brain cells the day you were born than you’ll ever have again

The first, and perhaps most important thing you need to know about the brain is that you have the most neurons (brain cells) you’ll ever have on the day you’re born. Brain tissue is post-mytotic, which means it does not regenerate. You start losing neurons from the first day of your life, and whatever neurons you lose are forever lost.

While that might sound depressing (and it is, really), it’s not the whole story. Because of a phenomenon called neurotropism, neurons have the ability to form new connections with other neurons to preserve function even in the face of declining quantity or quality of brain cells.

Let’s say neuron A is connected to neuron B which is connected to neuron C. If neuron B dies, or loses function, the connection between A & C will be interrupted. But neurotropism, also known as neuroplasticity, means that neuron A can form a new connection with neuron C without involving neuron B. This occurs through something called dendritic branching, where the threadlike extensions of a neuron reach out and form new connections with other neurons.

The short video below illustrates an example of this occurring with a single neuron over 36 hours.


But there’s a limit, of course, to how much function neuroplasticity can preserve. The more brain cells you lose, the fewer neurons there will be to form connections. So while plasticity can prevent some of the loss of function we experience from neurodegeneration, it’s not magic.

3 signs that you’re losing brain cells (neurodegenerating)

The following are the 3 earliest signs of neurodegeneration.

Fatigue promoted by brain activity

Let’s say you used to be able to study for 3 hours at a time without getting tired, but now you can only go for 30 minutes before your brain turns to mush. Or maybe you get really tired after driving, or doing your taxes or performing other tasks that heavily involve your brain. This is a sign your neurons are degenerating and have lost the ability to make ATP.


In depression, the frontal cortex (the part of the brain thought to be involved with higher level thinking, planning and goal formation) is not firing well and actually atrophies. This is one reason why taking antidepressants, which increase neurotransmitter levels in the synaptic cleft but do nothing to increase the health of the brain environment, are often limited in their effect.

Poor digestive function

90 percent of the brain’s output goes into something called the pontomedullary system. The brain is constantly receiving input from receptors, and it is constantly sending outputs as well. The main output conduit is the brain stem; specifically, the parasympathetic cranial nerve nuclei and especially the vagus nerve.

The vagus nerve enervates the digestive tract and controls everything from the secretion of stomach acid and pancreatic enzymes to intestinal motility and gall bladder contraction.

If 90 percent of the brain’s output goes into the vagus area, and your brain is not firing well, you’re going to have digestive problems. (I recently recorded a podcast on the gut-brain axis with much more detail on this topic. You can find it here.)

Other symptoms of gut-brain axis dysregulation include cold hands and feet, toenail fungus that won’t heal and brain fog.

Okay. Now, guess what 3 of the main problems seniors experience are? That’s right – fatigue, depression and digestive problems. That is not a coincidence. That’s neurodegeneration.

What causes neurodegeneration?

As I said at the beginning of the article, some amount of neurodegeneration is completely unavoidable. However, the following factors are likely to kill your brain cells at a much faster rate:

  • blood sugar problems (Alzheimer’s is now referred to as “diabetes of the brain” in some circles)
  • hypoxia (reduced oxygen deliverability, often caused by poor circulation or anemias)
  • systemic inflammation (autoimmunity, leaky gut, chronic infections, food toxins, etc.)
  • hormone imbalances
  • altered methylation (leading to elevated homocysteine and atrophy of the hippocampus)
  • traumatic brain injury

Anti-aging = fix your brain

The current anti-aging movement is about botox and plastic surgery, tanning machines and hormone creams. That’s a complete joke. There’s nothing about these activities that does anything at all to slow down neurodegeneration and improve plasticity, which is the ultimate goal of any true “anti-aging” program.

You do this by following these guidelines:

  • Avoid food toxins. These include industrial seed oils, excess sugar (especially fructose), cereal grains and processed soy
  • Ensure adequate micronutrient status. Especially those nutrients involved in oxygen deliverability (B12, iron & folate)
  • Improve fatty acid balance (n-6:n-3 ratio). 60% of the brain is phospholipid, and DHA has been shown to enhance plasticity and brain function while reducing inflammation and neurodegenerative conditions.
  • Fix the gut. There’s a saying in functional medicine, “Fire in the gut = fire in the brain”. Inflammation in the gut will cause activation of the microglial cells (immune cells) of the brain.
  • Stay mentally active. Neurons need constant stimulation or they will atrophy and die. This is why elderly people that stay active and mentally engaged in something age better than those that view retirement as an opportunity to watch golf on TV for 6 hours a day.
  • Increase blood flow to the brain. Exercise is one of the best ways to do this. Acupuncture and stress management are also important.
  • Get enough sleep. Not getting enough sleep can sabotage brain health in just about every conceivable way.

Finally, there are certain nutrients and botanicals that have been shown to protect against neurodeneration, prevent and even reverse neuroinflammation and preserve brain function. In fact, nutritional medicine really shines in this area.

If you look in the scientific literature, you’ll see that almost all of the treatments being studied are either micronutrients or botanicals. That’s because there are no drugs that actually improve the health of the brain environment like natural therapies can.

These include:

  • DHA (as mentioned above)
  • Huperzine A. Has been shown to increase acetyl-choline activity, activate eNOS and nNOS systems (increasing blood flow to the brain) and suppress iNOS (which causes tissue damage).
  • Vinpocetine. Also increases blood flow to peripheral tissues, including the brain.
  • Gingko Biloba. Increases blood flow to the brain and promotes healthy brain function via multiple mechanisms.
  • Polyphenols like apigenin, luteolin, baicalin, rutin, catechin and tumeric. Shown to reduce microglial activation and inflammation, which protect the neurons against degeneration.

Please don’t go out and buy a shopping bag full of these and start taking them all. The key is to identify the underlying mechanism and address that. Is it gut inflammation? Is it micronutrient deficiency? Is it blood sugar dysregulation? You’ll make far more progress correcting those problems than you will taking a bunch of supplements.

That said, the supplements and botanicals can provide additional support and therapeutic effect, especially when the problem is advanced or recalcitrant.

A healthy brain is the key to aging well

The next time someone says they’re having a senior moment, you’ll know what that really means: their brain is neurodegenerating. If you don’t want to be “that guy”, start following the guidelines above if you’re not already. You’ve only got one brain, you’re not making any more neurons, and your capacity to enjoy life and be productive is entirely dependent upon your brain health.


Join the conversation

  1. I was diagnosed with Parkinson’s disease in my mid to late 40’s. I had hand tremors for several years. Gradually became worse. I then noticed when I was tired the tremors were worse. I started falling for no apparent reason. I now have stiffness in my legs and need to walk with 2 canes or a walker. I am very slow getting around. I am now 52 years old. I am forgetful at times and have difficulty expressing myself. I have difficulty swallowing at times. I become tired easily, I also become quite dizzy when performing any athletic function (jogging). I was on Levodopa/Carbidopa, 100/25. nothing was really working to help my condition. Finally i started on parkinson’s natural herbal formula i ordered from MED LAB TEC, i read alot of great reviews from other patients who used the parkinson’s herbal treatment. My symptoms totally declined over a 4-5 weeks use of the Health herbal clinic Parkinsons disease natural herbal formula. , its effects on parkinson’s is amazing, all My symptoms gradually faded away, I have been active and hope to continue! or email at ere unbelievably reversed, herbs are truly gift from God. contact this herbal clinic via their email;medlabtec(AT)mail(DOT)com) I recommend this Parkinson’s herbal formula for all Parkinson’s Patients. and other similar sickness HPB,ALS Hepatitis Virus etc ;never stop trying .

    My husband was diagnosed of Parkinsons disease nearly 7 years ago, when he was 49. He had a stooped posture, tremors, right arm does not move and also a pulsating feeling in his body. He was placed on Senemet for 8 months and then Siferol was introduced and replaced the Senemet, during this time span he was also diagnosed with dementia. He started having hallucinations, lost touch with reality. Suspecting it was the medication I took him off the Siferol (with the doctor’s knowledge) and started him on PD natural herbal formula we ordered from NEWLIFE HERBAL CLINIC, his symptoms totally declined over a 3-4 weeks use of the Newlife Parkinsons disease natural herbal formula. He is now almost 57 and doing very well, the disease is totally reversed! (Visit their website www . newlifeherbalclinic . com)

  3. I was diagnosed with Parkinson’s disease 3 year ago at the age of 69. For several months I had noticed tremors in my right hand and the shaking of my right foot when sitting, as the disease progressed i totally lost balance. Neurologist had me walk down the hall and said I didn’t swing my right arm. I had never noticed! I was in denial for a while as there is no history in my family. I used amantadine, Carbidopa/levodopa and physical therapy to strenghten muscles all failed. In 2016 a friend suggested Newife Heral Clinic who have successful heral treatment for Parkinson’s disease, i contacted the heral clinic via their website and purchased the Parkinson’s disease herbal supplement, i used the herbs for 7 weeks and my symptoms were reveresed. Its been 6 months no sign of parkinson’s disease, contact this herbal clinic via their email (newlifeherbal @ gmail. com) or visit their website (www. newlifeherbalclinic. weebly. com)

  4. Make sure you get enough cholesterol. I also believe mycoplasmas contribute to Alzheimer’s because they consume cholesterol. They get it from the glial cells. High LDL levels indicate an infection. I bet if they checked Alzheimer’s patients cholesterol they will have high LDL levels.

  5. Smoke marijuana. It repairs the myelin sheath and I’ve heard that as a result, it can heal the brain and prevent further degeneration. I would recommend a healthy diet like Paleo. Get off of all grains, legumes and dairy.

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  7. Agree with you!
    I suffered a very severe Traumatic Brain Injury (1988). Like you outline, I focussed and was mentally active. Through this my abilities returned slowly -but noticeably! (it has been a long haul, but I now thing other fellow TBI survivors (esp under the age of 50) ought to be aware of this.
    I also benefited my abilities –> reintegration through boosting Blood flow. Especially, through Ginkgo biloba and Zinc!

  8. I wonder about the supplements to stop brain atrophy.
    What do you think of “Huperzine A”? Any other advice?

  9. Does Mr. Kresser really mean “enervates” or am I missing something? Just wondering.

    The vagus nerve enervates the digestive tract and controls everything from the secretion of stomach acid and pancreatic enzymes to intestinal motility and gall bladder contraction.

    [v. en-er-veyt; adj. ih-nur-vit]
    verb (used with object), en·er·vat·ed, en·er·vat·ing.
    to deprive of force or strength; destroy the vigor of; weaken. Synonyms: enfeeble, debilitate, sap, exhaust.
    1595–1605; < Latin ēnervātus weakened (past participle of ēnervāre )

    • It isn’t.

      (1) The extract fed during the study to rats was non-standardised, and may have been of dubious quality. There have been a couple of studies before claiming Ginkgo Biloba is harmful, where it later emerged the extract used in both studies (the same one, from egypt) was low-quality and had been adulterated in several ways.

      (2) Mortality increased in male rats but decreased in females, so the effects were not all bad, even at the ridiculosusly high doses used.

      (3) The doses where some bad effects were seen were incredibly high. The highest dose where the most problems occurred, would be fatal if it were aspirin. Are we to conclude that Ginkgo is dangerous because megadoses caused tumours, and Aspirin is safe because megadoses only caused death?

  10. It’s interesting to hear Bruce Fife talk about how the addition of several Tablespoons of coconut oil can show a marked improvement in Alzheimer’s patients after just one dose, and how this amazing fat can help prevent and heal neurological disorders and decline when combined with other dietary measures like reduced sugars, eating real, unprocessed foods, etc. I’d recommend his latest book, called Stop Alzheimer’s Now: How to Prevent & Reverse Dementia, Parkinson’s, ALS, Multiple Sclerosis & Other Neurodegenerative Disorders.

  11. I believe in the importance of avoiding food toxins. When you mention cereal grains and processed soy as toxins, do you also mean to avoid organic, non-GMO options?

  12. The topically applied medication is waterproof and easy to apply.
    Here are some helpful tips on conquering these pests. Gently work the comb through your dogs coat paying
    special attention to the belly and lower back as
    this is where fleas like to gather most.


    We found that acute sexual experience increased circulating corticosterone levels and the number of new neurons in the hippocampus. Chronic sexual experience no longer produced an increase in corticosterone levels but continued to promote adult neurogenesis and stimulate the growth of dendritic spines and dendritic architecture. Chronic sexual experience also reduced anxiety-like behavior. These findings suggest that a rewarding experience not only buffers against the deleterious actions of early elevated glucocorticoids but actually promotes neuronal growth and reduces anxiety.

    My conclusion: People need to stop putting limitations on the ability of the mind-body.

    Chris, just because you are an atheist doesn’t mean we all have to die at 80 years because you say so. Neuroscience is always evolving and with the new fMRI units today, evidence will eventually prove without a shadow of a doubt, that new neurons can be generated similar to the study I cited above.

    My credentials? I’m a neuroscientist PhD studying at University of British Columbia and we all believe in adult neurogenesis and we are working to effectively prove it’s existence.

    More and more evidence is emerging that new NEURONS and not just GLIAL CELLS can be generated into adulthood. The problem is simply this; is the generation going to produce a net amount of neurons? Because as we age, most of us stop learning new information and thus the death of existing neurons is usually faster than the creation of new ones.

    We see this with people who stop exercising, it doesn’t take very long for your muscles to waste away when you sit around on your ass all day, just like it doesn’t take long for your neurons to atrophy and die when you stare at a TV all day. The goal here is constant growth, constant growth.

    • Hi jason,
      I would be interested in finding out, I have been searching for a very long time, wether curcumin interacts with lamictal. I have epilepsy after brain surgery (absess) and would like to add this to my therapy. The brand I have is longevita, proven in clinical trials to reduce inflamation and penetrate brain blood barrier. Let me know your thoughts.

    • Thanks for your thoughts & links to other articles. I work with people with dementia, & dont want to end up in that spare chair either. I agree its So important to keep learning & moving. I read an article that said the memory can be regained with stimulation. Your thoughts?

  14. Thank you, Chris, for spending your time giving us free information on everything you’ve experienced in your practice. It is very generous of you not to charge people for newsletters that some health practitioners do. No one person is right 100% of the time, but implementing bits and pieces of the collective advice given here will undoubtedly make people healthier. Thank you for having a forum to allow people to voice their views too!!

  15. Great post, Chris. Thank you.

    Re Megaera: in the words of WWII US Army general Joe “Vinegar” Stillwell, “illegitimi non carborundum!”

    …and this may be re Megaera as well, one never really knows, but I would like you to respond, if possible, to the commenter that queried about EtOH and brain neurodegeneration. Seems like a given if one indulges regularly to excess, which many seem to do.

    Thanks again for all you do and all of your help. Your information sharing has changed
    my life. <3

  16. Dear Chris,
    Along the lines of aging and accepted maladies that come with getting older, I have some questions about kidney stones. A friend of mine in her mid-fifties was just diagnosed with kidney stones and told to completely change her diet to exclude all berries, nuts, green leafy vegetables, tea, chocolate, whole grains, and many types of other fruits and vegetables. Previous to the surprise diagnosis (she has no discomfort yet) she was eating a fairly paleo diet that included some diary and some grains, but the foundation of which was spinach, veggies, meats, nuts, berries, fruits-basically everything her doctor told her to cut out! In my amateur internet research, I’ve read that high consumption of caffeine and low consumption of water can lead to kidney stones. This does describe her pre-diagnosis diet-very little water and a ton of black tea. I’m wondering a couple of things. First, is there a paleo modification that would suit someone with kidney stones? And also, is it possible that simply eliminating caffeine and significantly increasing her water intake could do most of work for preventing more stones? She’s been diligent in removing all of the foods her doctor instructed her to for a couple of months now, and I can tell she’s suffering emotionally from the bland diet and lack of all her favorite foods she once thought were healthy for her. It’s so hard to watch her eliminate all these good things, at the advice of a doctor who won’t even refer her to a nutritionist. What do you think?

    • I think there is a problem with the recommendation your friend received. Cutting out veggies and berries to reduce oxalates seems to be problematic. If I understand it correctly, insufficiency of magnesium can contribute to forming of kidney stones. I would suggest that she increase her magnesium (and vitamin K) intake in addition to cutting out caffeine and adding water.
      I am not a physician, so please do research.

      • Thanks Anna. My new tactic is to convince my friend to get other doctors’ opinions. It’s been nearly 6 months and she remains frustrated but diligent to this prescribed diet-with no way of knowing whether it is preventing future stones.

        • Eh… the oxelate issue is pretty common actually and can be devastating. There are plenty of greens and fruit you can eat. Many of the people who have to lower oxalates are those whose gut microbione were damaged by antibiotics.

  17. My mother and I have been suffering from depression for YEARS.
    No SSRI was useful. Only a tricyclic (Anafranil 50-75mg/d) was found effective. If we stop for 20-30 days we relapse severely.
    I also use Lamictal (100mg/d) and for 8 years it was enough; Lamictal does not affect Serotonine or Dopamine.
    Never tried diet modification but blood tests show no gluten sensitivity.
    L-Tyrosine, 5-HTP, hypericum, Same, High dose fish oil never worked… for us.
    I Believe Clomipramine (= anafranil) or Lamictal are NOT placebos.

  18. @ Chris- Excellent article! I could not open the link to “The short video below illustrates an example of [dendritic branching] occurring with a single neuron over 36 hours.”


    @Galatea- Excellent video! thank you!

  19. Interesting. I have a Ph.D. in biomedical sciences and specialized in the immune response in the brain.
    I wanted to comment primarily on the antidepressant issue. Depression isn’t always a symptom of aging; it can affect the young as well. Some react differently than others to SSRI treatments; it partiallly depends on your biology. The typical time-to-effectiveness is based on a few things mostly tied in to how long it takes to build up a therapeutically effective dose. When you swallow a pill, that 10 mg of drug is going to be digested. Some will likely not make it through the digestive process intact. What does must also successfully enter the bloodstream, where it circulates through your entire body. Next, it must possess certain characteristics to get across the blood-brain barrier (in certain areas of the brain such as the cerebral cortex). Only then can it start to have an effect. How long it remains “biologically available” depends on the drug’s inherent stability and your body’s processing speed. Altogether, a single dose, or even a few, may not be enough to get enough drug into your brain to be effective. For some, it is; I am particularly sensitive to SSRIs and have noticeable effects within 20 minutes to 3 days (depending on the drug). Even there, it takes time to build a dose that is considered therapeutically optimal; I may have some immediate relief of symptoms, but do not achieve full effect for up to a week.

    That said, I do know of a few things that can help avert age-related decline in mental function. Good diet is way up there-we critically need some forms of lipids to maintain our nerve cell structure and function, and B vitamins, which play key roles in neurodevelopment and energy metabolism. Staying physically active also plays a strong role–and I can’t help but think that it is because physical activity necessitates mental activity and forces you to use your brain. In other words, get outside and play! Realistically, we understand very little about how our brains work–but we’re studying that as fast as we can. Unfortunately, I know of nothing that helps me keep track of my keys!

  20. I think it’s pretty shocking when anyone uses the anonymity of the internet to insult other users. It is especially deplorable when the insults are directed at helpful, scrupulous information-providers like Chris Kresser. Fortunately, intelligent readers usually recognise the use of such insults as characteristic of the uninformed.

    • megaera came across to me as informed,not to mention highly intelligent and educated;I didn’t find the comments insulting,rather quite interesting;the response from Chris ‘smug and arrogant’-well,that is an insult,along with the later ‘sociopath’…

  21. A very informative article. I definitely want to spend my old age as healthy as I can, thanks for the useful tips, I am bookmarking this site.

  22. Are you seriously this profoundly vexed over a straightforward criticism? . You and I and anyone reading this interchange are perfectly aware that I never made any such claim.. What I said was the symptoms you chose to list are quite consonant with hypothyroidism, which is absolutely true, as you are well aware; your own writings support that statement. I don’t know by what overreach you turn that into some vast and sweeping pronunciamento about thyroid disorders being the primary cause of aging. but if it comes to that, I trust you’re not seeking to assert the contrary, i.e., that the dietary components particularly offensive to you are the primary causes of neurodegeneration and the symptoms associated with aging — because to the best of my admittedly imperfect knowledge, people have been degenerating neurologically and aging comprehensively for quite a number of millennia unassisted by the diet of the last century’s West.

    • When you make insulting statements like “assuming you CAN think through that brain fog”, do you expect me to treat it as straightforward criticism? Then you claim that everything I listed in the article doesn’t work. On what basis? What is your clinical experience? Have you read the relevant literature on the subject? Apparently not, or else you couldn’t possibly make such a claim. You now admit to your “imperfect knowledge”, but I suggest you go back and read your original comment. If you can’t see why I reacted the way I did, you must be a sociopath.

      • This is my experience with moderating my subclinical autoimmune thyroiditis AKA Hashimoto’s Disease. I had a TSH that gradually rose to 10 with an anti-TPO in the 800’s (strongly positive). After lots of reading of blogs and Facebook pages, I introduced a few changes to my diet and a few supplements. I have gone nearly gluten-free and am cheating less and less e.g. a peice of a workmate’s delicious home-made cake but definitely no gluten-containing bread. I also have a couple of tablespoons a day of virgin coconut oil, 3 brazil nuts a day for the selenium and a daily dose of a magnesium tablet. After about a year, my TSH is down to 3 which puts it officially in the normal range and my anti-TPO is now 63 which is classified as weakly positive. If I’d done the usual medical route, I would have started on thyroxin medication when my TSH got up to 10 but I did my homework and hopefully it will continue to pay off. This ashwagandra looks interesting too. I’ll do a bit of research on how much I need to take.

  23. In fact, I’m fully aware of your blogging history and have read a substantial amount of your output on thyroid and a number of other topics (including the reader comments), and have done the same on Stephan’s blog and several others writing in this general area over the last six months. I do not comment “rashly”, “smugly” or “arrogantly”: you chose to ascribe a panoply of symptoms–jeeringly conflated with “ending your life in adult diapers” due to brain damage– exclusively to a still-unproven hypothesis when all of those symptoms are in fact far more readily ascribable to a well-recognized medical disorder occurring widely in the population. Why shouldn’t someone call you on it? Occam’s Razor still applies, you know, Someone reading your single blog entry without a full research background effort on your other work is quite likely to be left with a highly erroneous impression. Is that what you want?

    • Show me your evidence that neurodegeneration and the symptoms associated with aging are caused primarily by thyroid disorders. Please, I’d love to see it.

  24. I will probably be rejected from this site as well as Stephan’s for failure to recognize the full glory of The Received Truth, but — honestly, now — do you guys actually pay attention to what you’re writing? Every symptom you list, singly and as a group, is a classic indicator for thyroid malfunction. Brain fog? Major check. Digestive issues? check. Circulatory disorders? check. And on, and on … and not one of the eager commentors points this out. Hashimoto’s, and other manifestations of hypothyroidism are huge risks in the aging, especially for females, and I assure you, they can’t be cured or even ameliorated by diet changes, happy thoughts, mental exercises, clean living, the supplements of the day, avoiding the latest concept of “food toxins”, or “fixing the gut”, because until someone who is thyroid deficient gets more thyroid none of the other stuff is going to follow. Sorry, all the clean living in the world won’t work — not going to happen. Personal experience, and all that. Oh, and by the way, even after you get the thyroid issues dealt with, the other stuff listed above? It still doesn’t work. In fact, following some of those recommendations may actually it may make you, So get your thyroid checked, and then think (assuming you CAN think through that brain fog) long and carefully about what to do next.

    • Maybe you should take a moment before writing smug and arrogant comments on people’s blogs to take a look around. I’ve written a full series with about 8 articles on thyroid disease, and have acknowledged its importance over and over in my writings and my podcast.

  25. Great article! I have a friend that has been suffering from some depression for a while and even though I preach a paleo “ish” diet at my gym, I guess I didn’t even think of having my friend do the normal fixes to fix his depression.

    You rule Chis, I am trying to catch up on your pod casts right now and all the information in your head blows my mind!

    I didn’t realize you were from SF, until I seen that last paragraph >Don’t be “that guy”< haha does that quote come from Kstar? (SFCF)

  26. “With that in mind, consider this. Two things in life we can be absolutely sure of are:

    1. We are all going to die.
    2. Our brains are going to degenerate before we die.

    While this might seem morbid to some, it’s the simple truth. And the more you’re able to accept this truth and act accordingly, the better chance you’ll have of aging gracefully.”

    Well, not necessarily. There is no way to be sure what the future will look like, but there are plenty of people who think aging will be cured one day (Aubrey de Grey among others):

    And as for aging gracefully, that’s a meaningless euphemism. There’s no such thing as aging gracefully; you can’t put a positive spin on deterioration.

    – JLL

    • I couldn’t disagree more. It is possible to age gracefully, and our culture’s irrational obsession with life extension is simply fear of death and denial of the natural cycle all living organisms on this planet go through.

      • Well, I’m a bit late for the party, but I couldn’t agree more with you Chris! Luckily we can age gracefully and it certainly starts with a positive attitude combined with a constant awareness and care of oneself. It is a constant and daily struggle to go through the cycle of life without the stigma of ugly deterioration. And by the way, at what age does deterioration start to become ugly? And indeed, it is much this society’s obsession with quantity (life extension) rather than quality that is to blame.

  27. Interesting article, Chris, you may be interested in the research for ashwagandha. There’s a lot of it in relation to neurodegeneration, and quite a bit of evidence that, at least in rats, certain ashwagandha extracts show a tremendous power for neuroregeneration:

    A quick search in pubmed also points to evidence of the anticancer, antioxidative, antiinflamatory and pro-inmune properties of ashwagandha.

    There’s even evidence of it’s ability to support the thyroid!

    Not to say it is a panacea, but it is certainly promising.

  28. I’d like to see an articel about foods to include and foods to avoid to enhance brain function. Sugar we know to avoid. Others?

    • Hi Dave, IMHO, foods that contribute to chronic inflammation are best avoided. Here is a list of some common inflammatory foods you may want to cut down.

      On the other hand, there are also foods that could enhance brain functions. Many of these foods also turn out to be anti-inflammatory in nature. Here are some brain foods to check out.

      Hope these info are useful to you.

  29. Other symptoms of gut-brain axis dysregulation include cold hands and feet, toenail fungus that won’t heal and brain fog

    I’ve had toenail fungus for over 30 years, (since I was in my 20s), but no brain fog or cold extremities. I also get fungal infections–I assume that’s what it is– on my left knee and crotch rot. I’ve taken various medications, but it always came back, sometimes after a few years, sometimes a few months, sometimes a few weeks. I eat paleo (grassfed beef, safe starches, no vegetable oils or processed foods), drink lots of raw milk, kefir and yogurt. I’m normal weight, exercise, and in otherwise excellent health, and have been my entire life. I do all the right things to keep my gut and body healthy. I cut out most wheat in the last year, and the crotch rot is almost gone, although running seems to aggravate it and the knee fungus temporarily. I started rubbing virgin coconut oil on the knee and that seems to be helping.

    I stopped taking any meds for the toenail fungus at least 10 years ago because it didn’t ultimately help, I don’t like any chronic medications and the toenail fungus just looks bad but does not cause any discomfort. But your posts and Paul Jaminet’s seem to imply that longterm fungal infections are a sign of potential problems.

    Do you recommend medications or diet to clear up the toenail fungus or both? Is toenail fungus really a symptom of a larger, more serious issue?

    • toenail fungus: look at your shoes. Sometimes toe nail fungus results from an allergy to the dyes in leather shoes. Dead serious. It can go through socks. It destroys the skins pH level and allows the fungus to replicate.

  30. Great article, Chris.

    Another association with age related mental conditions include heavy metals like aluminum. Several epidemiological studies have shown a link between aluminum in drinking water and Alzheimer’s. I’m sure you already knew this, but to those who weren’t aware, take caution.

    “When you lose the mental game, you lose the physical game.”

  31. I too followed a low fat diet for 2 years because of my MS. I definitely improved but now realize that was probably due to the fact that I gave up sugar,gluten and dairy. I was terrified to bring fat into my diet sure that it would cause my MS to spike. When I brought the fat back in I lost a lingering fatigue in my legs that I just couldn’t get rid of on the low-fat diet. I have had no exacerbation of my MS and continue to feel better and while I give credit to my MS diet for introducing me to the notion of leaky-gut, I feel that the low fat part of most MS diets is holding back MSer’s from feeling their optimum.

  32. @ Brent

    Admittedly, most of what I understand about neurobiology beyond a few biology and A & P classes in my education is due to life with my husband, a “basic” research scientist in the apoptosis field; I’m not a scientist or trained in medicine, but I’m always picking his brain about things I find curious. He’s many times during our child’s infancy and early childhood mentioned in discussions that humans have more brain cells at birth than at any other point in post-natal life.

    The growth of the skull size during infancy and childhood shouldn’t be confused with neurogenesis. Any increases in brain size (which isn’t the same as skull size) are more likely due to increase in number and mass of glial cells, not an increase in neurons. My understanding is that post-natal neural development is thought to be due to forming new neural pathways (connections) and that actually involves the death of a lot of neurons. As my husband’s research is often cited in neuroscience papers, he is quite familiar with this subject matter. He tells me that a lot of the interest surrounding adult neurogenesis is based on rat olfactory-brain research (with a major player in this area working at an institute very near to his own), but in humans olfactory-brain function isn’t as an important function as it is in rats, so it remains to be seen if it is significant for humans.

    Chris, Dr. Larry McLeary, a pediatric neurosurgeon, lists nearly the same supplements/botanicals for brain health that you list. Are you familiar with him?

    • Any increases in brain size (which isn’t the same as skull size) are more likely due to increase in number and mass of glial cells, not an increase in neurons.

      Thanks for your comment, againstthegrain. That’s exactly what the paper I linked to earlier argued.

      Yes, I’ve heard of Dr. McLeary. I just want to be clear that I don’t recommend taking a bunch of these supplements without identifying and addressing the underlying mechanisms. I said that in the article but I’ll say it again here.

  33. One thing is sure, discussions about brain aging can bring out strong opinions. You would not believe the stink I raised by mentioning that Myelin sheaths are made out of fat – in a low fat household with MS… backing away with hands raised to my sides….

    Which, BTW, myeliation may account for some of the increasing brain weight in youth.

  34. You might want to add references to your post, lots of them… If you don’t, it’s just another load of unsubstantiated claims.
    I don’t want to sound too negative, I like the post, but good luck finding evidence for ginkgo and vinpocetine, for example.

    • I didn’t say they were useless. I said I think it’s best to try to address the underlying mechanisms. In this case, that would mean addressing the cause of the hormone imbalance instead of just using exogenous hormone creams, which bypass the body’s natural regulatory mechanisms and can cause problems in the long-term.

  35. Wasn’t there a study connecting dementia and forgetfulness with statins?

    Doesn’t physical and mental activity play a role as well? I’d include the social aspect of ones life also additive in its effects on quality of life at late stage. All stages actually.

    • I mentioned physical and mental activity in the post. Yes, statins can cause memory loss (including global transient amnesia – as was the case with Duane Graveline) and cognitive problems, probably because of their extreme cholesterol-lowering effect.

  36. Would the best exercise to maintain brain function be aerobic or anerobic. A rhetoric question from me as I routinely do both. I’d like to remember what I was up to on my 60th next year.

    • I’m not an absolute expert but do know a bit about exercise/nutrition…. I would say both aerobic and anerobic are good for the brain….. but aerobic primarily because it is most beneficial to your heart and thus maintaining healthy blood flow to the brain. But weigh training (anerobic) is good for maintaining bone strength and preventing osteoperosis and slows the ageing process. So I say do a bit of both and you’ll be best off!!

  37. Kirsch et al found that antidepressant drugs work no better than dummy pills – reported here: And most antidepressants make you fatter because of fluid retention, and damage health in many ways. The one I am most acquainted with is amitriptyline, which is still very widely prescribed. It is an extremely harmful drug. I have written about it here:

    • Margaret….. I think you have taken it out of context….. you always need to read the full peer reviewed article not just a news/media article written by some journalist who just pulls out the info he/she wants to……. Kirsch et al. were obviously referring to mild depression as the article quotes him as saying “reserve these drugs for very severely depressed patients.” If it was not for anti-depressants I would have killed myself years ago…. I have been on them for 19 years and tried to come off them several times – every time I do I just become completely suicidal. It’s true that they are probably overprescribed for mild cases but that doesn’t mean they are as useless as placebo drugs – I agree they are not not neccessary for everyone and care should definitely be taken in prescribing them, but for some, like me, they are a lifeline.

      • Mary

        I have indeed read the full peer-reviewed article and much more besides, and I do not agree with your interpretation of Kirsch’s views. Obviously your own experience is your experience and I would not question that, but the great majority of people prescribed anti-depressants, they are no better than dummy pills. And of course their harmful, and lasting, side-effects are very commonly experienced.

        • Mary

          Just a little more. You may be interested to read Kirsch’s outspoken views about anti-depressants here: where he writes, “Antidepressants are supposed to be the magic bullet for curing depression. But are they? I used to think so. As a clinical psychologist, I used to refer depressed clients to psychiatric colleagues to have them prescribed. But over the past decade, researchers have uncovered mounting evidence that they are not. It seems that we have been misled. Depression is not a brain disease, and chemicals don’t cure it.” He later refers to them as “dangerous but largely ineffective drugs.”

          They certainly caused me, and many other people who have written to me over the years, a great deal of permanent harm – and of course SSRIs, the most common type of antidepressants, increase the risk of suicide for children, adolescents and young adults.

          They are recklessly over-prescribed.

          • Sure, they have caused me many bad side effects too – but I have tried going off them and only got WORSE so I weighed the pros and cons and decided I was better on them than off. I take SSRIs (EFEXOR) and yes, I agree they are NOT A NICE DRUG to be dependent on. If I could find an alternative I would certainly go off them, but short of ECT (which I refuse to have as it has caused a few of my friends to lose their memory) I have tried EVERYTHING. I would certainly RATHER be drug free but it seems that I need them… when I go off them I am extrememly suicidal and non-functional.
            I was actually prescribed antidepressants at the age of 13…. sometimes I wonder if they did me more harm than good back then and maybe that’s why 25 years later I am still unwell.

  38. I would have to add to the guidelines suggested:

    Kegels- or similar pelvic floor exercises- for obvious reasons
    Hatha Yoga including inverted poses, which contribute to cerebral circulation and general vascular toning
    Avoid or Reduce interaction w/ all unnatural electromagnetic frequencies
    Many herbal formulations, including those prepared over a hundred years ago by Naturopaths Alfred Vogel and Dr. Christopher – are focused in strengthening Cerebral Circulation.
    I challenge ANYONE to go on a complete sugar fast, with the exception of a few whole unprocessed fruits daily- including ALL sugar in ALL products (salad dressing, soups, sauces, read labels)- and compare your mental clarity.

    • I gave up all sugar and it’s made an amazing difference! Once or twice when I’ve fallen off the wagon and eaten sweets, it’s taken a few days to wake up again.

      • I must agree. I have cut way back on the sugar. Then I made some delicious cheese cake, only 2/3 c sugar in the recipe. But made me feel lousy, headache, indigestion, yuck!

    • I agree with everything you said, except your advice regarding Kegels. Kegels are not effective at maintaining the integrity of the pelvic floor. Check out Katy Bowman’s awesome site at to understand why kegels are just not effective, and why squatting regularly, with good alignment will do far more for your pelvic floor than those over-hyped kegels ever dreamed of doing. (I am not affiliated with the blog in any way, nor do I benefit from it in any way other than pee no longer leaking when I laugh.)

    • Just to make it clear why, since they are mostly used to boost memory :

      – Piracetam prolongs the life of mice and rats under conditions of Hypoxia. Since hypoxia can occur in varous patological situations of the brain, the prolonged survival under such conditions can prevent severe brain damage.
      – Piracetam improves Blood Circulation to the Brain. This means more nutrients and more efficient functioning.
      – Piracetam regenerates the Central Nervous System. The good CNS influence the brain gut axis also.
      – Piracetam facilitates the Interhemispheric Flow of Information between the two hemispheres of the Brain. This means that more of the brain’s potential is used since people have hemisphere bias.
      – Piracetam increases the body’s tolerance to Stress. This can mean bunch of things, among others, reduced weight.
      – Piracetam is good for sleep. Good sleep is essential for multiple health issues and weight control.

    • You’re right. Unfortunately, much of the damage in Alzheimer’s and dementia is irreversible and permanent. However, if you take steps to improve plasticity and create a healthy brain environment, improvements are possible. I’ve seen this is two patients I’m working with currently that have dementia.

    • Chris — I’m with Matt in wondering about alcohol. I’m off all sugars, grains, processed foods, and alcohol, and subsequently my energy and mental clarity have much improved — but I don’t have a clear picture about alcohol. One of my docs swears a glass of wine a way is useful for brain health, and the other says it’s a known neurotoxin and must be avoided.

      Have you addressed this in any posts? Thanks!

  39. Hi Chris, I love and appreciate your work, but lately you’ve been making two claims that I do not believe are correct. If you have some good references to back them up, I’d love to check them out — perhaps I’m wrong.

    The claims that I take issue with are 1) new born baby brains have more neurons than adult brains. It’s been a decade since I took a course in developmental psychology, but I remember being taught that the opposite is so — newborns have very little neural development in the cerebral cortex, and brain cells of all types grow prolifically after birth.

    The second claim I question is 2) that new neurons are not created throughout life, only lost. From reading articles in the science press over the past few years, I got the impression that adult neurons have much greater plasticity and genesis than was previously thought. A quick read of the Wikipedia entry on neurogenesis confirms this (“New neurons are continually born throughout adulthood…”):

    Indeed, the physical size of a newborn’s head compared to that of an adult’s should be enough to make one pause and reflect about these claims.

    Thanks, and keep up the good work.


    • You may be right, Brent. I can give you several references that support the idea that the brain is post-mytotic, but as Bill suggested, there are other studies showing neurogenesis is possible. But to what extent? Clearly not enough to prevent the conditions caused by accelerated neurodegeneration.

      In any event, I don’t think it really changes the thrust of the post, which is A) neurodegenration is primarily responsible for many of the diseases we associate with “normal aging”, and B) protecting against neurodegeneration to the greatest possible extent is the key to aging well.

      • I don’t think neurogenesis happens with all brain tissue types, and you see more turnover in the hippocampus than pretty much anywhere else. Rule of thumb: If it has to do with memory and learning, you probably make new cells for it. But with other functions, don’t count on it.

      • 1) BRAIN HORMONES are effectively supported by supplementation with E-EPA. E-EPA is an ethylated form of EPA which is able to cross the blood brain barrier at a 95% uptake rate, and is used by the brain to produce seratonin, dopamine, etc. EPA is usually delivered with DHA. The body firstly absorbs DHA with EPA absorption a poor second. DHA is stored in the body, where as EPA is not stored by the body. EPA is rapidly used when the body is under stess, anxiety, etc, and requires regular replenishment.
        E-EPA works well for me – nothing else has worked for depression / anxiety.

        2) Several supplements which support BRAIN HEALTH for degenerative conditions are LIONS MANE MUSHROOM and MILK THISTLE.
        Lions Mane Mushroom is trditionally used for memory and concentration, and also for stomach and digestion. Research has confirmed these, and added immune system support, cancer treatment, growing myelin sheath, and stimulating NGF. Clinical trials confirm its successful use with degenerative neural conditions ranging from dementias, stroke, acquired brain injury, MS, Parkinsons disease, etc.
        The silymarin in Milk Thistle not only detoxes the liver, it also protects nerves, slows the brain aging process and Inhibits plaque formation, preventing Alzheimer`s Disease.

      • Hot off the press:

        Now Columbia researchers have found that under stressful conditions, neural stem cells in the adult hippocampus can produce not only neurons, but also new stem cells. The brain stockpiles the neural stem cells, which later may produce neurons when conditions become favorable. This response to environmental conditions represents a novel form of brain plasticity. The findings were published online in Neuron on June 9, 2011.

        Article at:

    • To be fair, while babies do start out high with lots of neurons and then rapidly prune them down, it’s not a ‘loss’ per se. That pruning of some areas is how babies learn; they’re born with an equal ability to learn spoken language or how to climb a tree (to make a gross oversimplification). Depending on what kind of enviroment they’re born into, their brains go on to specialize in certain basic life skills. If they retained that basic even keel they start with, they’d never learn how to understand human speech, or that television pictures aren’t real (just to give two examples our ancestors’ didn’t need, but we learn almost immediately).

      So while these brain cells start off high and decrease (not sure what current research says about neurogenesis, I think it’s true) all the pop-science claims about baby brain potential (e.g. you have to cram in as much academic work as you can before their brain closes off and they’re doomed!) have been debunked. Two good books that touch on this are Nutureshock and Hothouse Kids (Nutureshock is particularly enjoyable [and shocking]).

  40. I know that even after 40 years and some pretty strong evidence it is still controversial, but adult neurogenesis does happen and might work even better in a more normal insulin climate.

    • Yep. Here’s more info.

      Interestingly, most of it seems to be happening in the hippocampus.

      FYI, for anyone reading this who’s been on antidepressants: If your medication did not work immediately, but took a couple weeks to kick in and become effective, it is very likely you weren’t making enough new brain cells in your hippocampus. I’m suspicious that most cases of depression have nothing to do with serotonin levels; if they did, SSRIs would work immediately in everyone.

      • As I understood it, less serotonin over time will cause the cells, or neurons or whatever to lose serotonin receptors. Therefore, one with low serotonin who starts taking an antidepressant might right away have more serotonin, but it takes time for the S receptors to grow back in the presence of increased S levels, so there is no effect right away.

    • I have to agree with you fully- at an earlier time I did not connect this w/ insulin climate but this makes perfect sense, as indigenous people’s elderly have typically been sharp minded, revered, and strong- people who are not exposed to degenerated diets.

      RE: “Other symptoms of gut-brain axis dysregulation include cold hands and feet, toenail fungus that won’t heal and brain fog.Okay. Now, guess what 3 of the main problems seniors experience are? That’s right – fatigue, depression and digestive problems. That is not a coincidence. That’s neurodegeneration.” – I would say this is a allopathic-type view and over simplification of general lack of vitality of holistic, interrelated body-systems – one which ultimately remains limited.

      • “as indigenous people’s elderly have typically been sharp minded, revered, and strong- people who are not exposed to degenerated diets.”
        What age are elders in indigenous societies and how many people grew old enough to be elders? I think you’d be comparing 60 year olds with 90 year olds; if people were eating diets that slowly cause degeneration, we probably wouldn’t know about, especially if that same diet were somehow beneficial when they were younger. Of course, we’re both arguing hypotheticals here…

        • Get your hands on Nutrition and Physical Degeneration ASAP. In most traditional societies before any kind of outside contact, if you didn’t die of acute injury (lion attack!), you lived to 80 or 90 with few wrinkles, fairly strong body, & strong mind. You declined rapidly at the end and died peacefully in your sleep.

          • That’s what happened to my grandparents. My grandmother who was 88 at the time, woke around 6am. She started boiling water to make her usual morning coffee. She told my aunt that she was feeling tired and was going to lay down a bit. She never woke up. My grandfather passed away two years later. His health deteriorated rapidly after my grandmother died. He wound up becoming paralyzed but his mind remained sharp. I am from what used to be known as North Borneo.

          • This is exactly how my grandmother, great-grandfather, and virtually everyone on my father’s side of the family went. Lived in excellent health (and for my mom’s side, unfuckingbelievable health) until mid- to late-nineties, then ‘got sick’ (caught something? sudden cancer? they didn’t check old people too carefully back then) and died a couple weeks later. But that was after decades of good health.

            Seriously, my great-grandfather was still playing baseball, sliding into home and everything, into his seventies. His last team-mandated physical, at 73, his doctor said he would swear he was looking at a 35 year old man if he didn’t know any better. I wish I could have found out more about how he lived and ate, but my grandmother ‘left the farm’ so to speak, and except for a few downhome recipes I know nothing of how they lived.

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