Dr. David Perlmutter

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585 appearances 1 recordings 1 series first heard Jul 2026 last heard 15 Jul

Dr. David Perlmutter’s voice in public audio — every appearance, attributed to the second.

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Recordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.

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Be Well by Kelly Leveque · 393: Alzheimer's Starts Decades Before Symptoms…Here's Why | David Perlmutter · 15 Jul 2026 podcast

I've cursed the darkness.

We'll move on.

And that said, I think that getting back to our original idea here, that

microglial cells can digest away our synapses and loss of synapses is fundamentally what's going on in Alzheimer's brains, why would these microglial cells be more active in the woman's brain compared to the man's?

Well, that's actually been studied.

And what's been found is, interestingly, when estradiol levels plummet, there is an activity in the brain that turns on a system called the complement system.

It's a primitive immune-related system.

These complement proteins bind to the synapse.

When they bind to the synapse, it says to the microglial cells, destroy me.

Exactly right.

These are called, as Dr. Beth Stevens at Brigham and Women's Hospital in Boston said, these send eat me signals to the microglial cells.

The loss of estradiol allows complement to bind to synapse and then they are destroyed by the microglial cells.

So we want to keep our microglial cells in their supportive, loving M2 configuration by being as metabolically intact as we can be, by reducing our exposure to toxins in the environment.

We'll mention that in just a moment.

And at the same time,

I came out in favor in this book, so there's no confusion of the use of hormone replacement therapy in women in the perimenopausal period.

I think postmenopausal, we're not going to get the benefit.

So what should postmenopausal women do who are cognitively intact or already having issues?

They need to double down on the metabolic inroads.

make sure that their microbiomes are intact, that they're eating a diet that's rich in fiber, that they're not threatening their microbiome by taking proton pump-inhibiting, acid-blocking drugs or non-steroid anti-inflammatory drugs or using antibiotics whenever they have a sniffle.

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