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


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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.

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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.

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Join the conversation

    • 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?

  1. 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.

  2. For Brain Health! Check out Dr. Eric R. Braverman “The Edge Effect” his web site is http://www.pathmed.com.

    Balancing hormones with bioidentical hormones is also an important key to brain health.

  3. 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?

  4. 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.

  5. http://www.plosone.org/article/info:doi/10.1371/journal.pone.0011597

    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.

      • I take 100mg of lamictal a day and also take curcumin twice a day and i’m all good!!!!

    • 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?

  6. 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!!

  7. 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

  8. 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.

  9. 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.

  10. @ 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!

  11. 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!

  12. 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’…

  13. 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.

  14. 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.

  15. 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.

  16. 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 worse.off, 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.

  17. 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)