THINKWELL
AGEWELL
The Systems Approach to Brain Health and Healthy Aging
AGEWELL
The Systems Approach to Brain Health and Healthy Aging
In this episode, I sit down with Dr. Robert Silverman to explore what it really means to age well. We discuss the connection between muscle mass, gut health, inflammation, mitochondria, and brain function — and why longevity is about far more than simply living longer. Dr. Silverman shares practical strategies for improving healthspan naturally, including nutrition, exercise, supplements, vagus nerve support, and reducing chronic inflammation to protect cognitive health and vitality as we age.
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Dr. Heather Sandison, ND (00:00.971)
Welcome back to the Think Well, Age Well podcast. I am your host, Dr. Heather Sandison. Today’s guest is someone who truly bridges the gap between performance, longevity, and real world clinical results. Dr. Robert Silverman is a chiropractic physician, certified clinical nutritionist, and internationally recognized leader in functional and integrative health. He’s the founder and CEO of Westchester Integrative Health Center. He’s known for combining advanced nutritional science with hands-on clinical care.
to help patients not just feel better, but perform at higher levels across every single stage of life. He’s the best-selling author of Immune Reboot and Inside Out Health. He was named Sports Chiropractor of the Year by the American Chiropractic Association and has led FDA-level research on laser therapy, contributing to the advancement of non-invasive treatments for healing and recovery. With a global audience of nearly a million followers,
and a top ranked podcast, Proven Health Alternatives, Dr. Silverman has become a trusted voice in longevity, resilience, and what it actually takes to add life to your years, not just years to your life. Dr. Silverman, it’s really a privilege to have you welcome. I’m really looking forward to digging into this conversation.
Dr Rob Silverman (01:17.358)
Thanks for having me, Dr. Sanderson. I’m stoked to be here. And by the way, as I’ve told you off camera, you do a great job. Keep up with your work. You’re changing lives.
Dr. Heather Sandison, ND (01:27.895)
Thank you, right back at you. So let’s get into this. Let’s talk about adding years to your life. In the dementia space, this comes up a lot, right? What is a well-lived, meaningful life, especially in that last quarter? How can we create a mindset where we’re thinking about longevity and living longer as really something that we look forward to not dread? So how do you define longevity?
Dr Rob Silverman (01:54.51)
know, longevity for me is simply defined lifespan versus healthspan. Lifespan, how long we live. Healthspan, how long we live without chronic disease. 76.4 % of Americans have chronic disease. It’s way too high. You and I are seeing too many people with chronic disease and we’re seeing too many people with chronic disease at too early of an age. It’s a strain on our healthcare system. 86 % of our Medicare dollars are spent on chronic disease. 98 % of our Medicaid
dollars are spent on chronic disease. Enough said. So for me, lifespan, healthspan, but really vitality. I think it’s the white cloud above the head, kind of like the beautiful picture at the crescent that we think about. And vitality means like, you know, I’m scheduled Friday to have a hike with my wife and I want to be able to have a hike with my wife. I’m going to get up the next morning and grab a connecting flight and go lecture somewhere. Get back from Mother’s Day. So to be able to be vital and do these things, that’s what it’s all
It’s not about a 400 pound or 500 pound deadlift or 75 push-ups instead of 55 push-ups. And there’s a new theme, the idea of peak SPAD, which is a period in your life during which we sustain at least 90 % of our peak function performance in any given health domain or system domain. The problem is the decline in our systems and our body are asynchronous. Our muscle, endocrine, our cardiovascular, they’re all at different parts and they’re all at different stages and they decline.
I mean a male has peak muscularity at 21 years old. know the 21 year old Rob looks different than a 60 year old Rob. So how do I extend that peak span? How do I extend it without taking TRT? How do I expand it and keep myself vital? Because you know muscle mass is the currency of longevity.
Dr. Heather Sandison, ND (03:44.801)
Yeah, so how do you?
Dr Rob Silverman (03:48.141)
That’s a great question as far as muscle mass. You know, interesting. So I’m a big believer in…
weight resistance. And when I say weight resistance, that doesn’t mean you have to buy your old Marcy Barbell set. It doesn’t mean you have to use a kettlebell. It doesn’t mean you can use all that I’ve mentioned, a dumbbell. You can simply do body weight because that’s resistance. So you and I, both men and women, need to do weight resistance. And I think that’s a critical ad we need to exercise because it is, as Gabriella Lyon said, the longevity organ. Because muscle mass is much more than just movement.
It’s much more than just posture. It’s an endocrine organ. It’s an immune organ. It’s a neuro organ.
And muscle mass is a critical add to everybody’s own health span, lifespan, and vitality. And you can add in good quality protein. You know, it’s fascinating. I just had this conversation with somebody and everybody says no carbs. Well, there’s only three macronutrients that we really talk about. I mean, I think a good quality carb is fine, but I think the miracle macronutrient for now is protein.
And so for me, for both men and women, and some people may feel that it’s a little controversial, what I’m about to say, I think a gram per day per body weight is ample as long as it’s split up and it’s not really fast acting protein. So for me, again, protein is a great choice. Animal protein is superior to pea protein. OK, before the vegans jump on me, if you’re taking a pea protein, great. Add leucine. Three grams of leucine will make the signaling as strong as an animal protein.
Dr Rob Silverman (05:25.016)
Therefore, they’re equalized in muscle hypertrophy, muscle mass, and muscle recovery.
Dr. Heather Sandison, ND (05:32.597)
We are big fans of creatine and the brain space, but also important for muscle. What’s your take on creatine?
Dr Rob Silverman (05:38.307)
You know, I was in the first class that had to write a thesis to graduate chiropractic school. My thesis was on creatine and muscle hypertrophy. So of course, creatine now is much more than muscle hypertrophy. Creatine is muscle hypertrophy, muscle recovery, muscle performance. But to speak to what you said about being in the brain space, when you get up to 10 grams a day,
You’re now in the space of helping brain cognitivity. Incidentally, women need to have more creatine than men because women have less muscle mass. So a couple of caveats on creatine. Creatine’s great with other nutrients. Creatine’s great in water. Do not drink creatine with coffee and do not drink creatine with a hot aqueous solution. So you could have an iced coffee and do not drink it with caffeine. They all disassemble the creatine molecules. It’s gotta be cool water.
So I love things in my coffee. have MCT oil, I have a little organic stevia. I may have some mushrooms, but not creatine. That’s gotta be taken separately. Remember, the first five milligrams of creatine go to your muscles, which are extraordinarily greedy. The next five go to your brain. Speaking of… Gram. Gram, I said milligrams. You caught me. I appreciate that.
Dr. Heather Sandison, ND (06:51.767)
grams or grams? We usually talk about creatine in gram doses.
Dr. Heather Sandison, ND (06:59.213)
No, that’s helpful. And we use upwards of even 20 grams in people with dementia daily. There was a small study on Alzheimer’s that showed an improvement in cognition with 20 grams a day and even as much as five grams a day, helping with brain. But I believe you that most of it is going to muscle at first and you really have to get up over that five gram dose to get meaningful cognitive benefit.
Dr Rob Silverman (07:23.756)
Right, the first five is typically muscle, next five is brain, and I agree with you. So I treat a lot of Parkinson’s patients, and I like to get them up at about 20 grams per day, both men and women. I think it’s a great ad, and without question, we’re talking about it now. It is the hot nutrient to discuss, or one of the hot nutrients to discuss.
Dr. Heather Sandison, ND (07:44.01)
And already some great takeaways for our listeners here, but you also often reference the hallmarks of aging. Can you walk us through each of those? I think some people have heard that term, the hallmarks of aging, but what are they? Like from a practical perspective and are there ones that we want to prioritize influencing sooner rather than later?
Dr Rob Silverman (08:03.682)
Well, we mentioned one of them, loss of muscle mass or sarcopenia, or really, dinopenia, the loss of muscle strength. So muscle mass, again, is that idea of a longevity organ. I believe the zeitgeist in modern health is clear. Muscle has become medicine, and it’s become a longevity medicine. So muscle mass would be one of the first ones we would discuss. The immune system, that’s why I wrote the book Immune Reboot, so it’s a red button, boom, press the red button and reboot your immune system.
We want to be able to have immune health, immune balance, immune support, immune rejuvenation, ultimately having an immune system that is resilient. I think that’s a term and a concept that we most adhere to now.
think one of the bigger hallmarks of aging is inflammation or chronic inflammation. I’ll tell you what, I noticed one thing about COVID. Half the world’s crazy, other half the world’s crazier. And I never knew what a cytokine storm was, I apologize, before COVID. And it came to the realization that people were pre-inflamed. Americans are pre-inflamed and they suffer from chronic inflammation. So anywhere from chiropractic, acupuncture to medical, if you don’t quell and squelch,
some of the inflammation and control it, patients never gonna get better. And isn’t Alzheimer’s a problem and an inability to control inflammation in the brain? Isn’t a lot of these neurodegenerative diseases a problem of controlling inflammation in general? Another hallmark of aging would be microbiome. Everybody knows I love to talk about the gut. The gut is the epicenter of your health.
80 % of your immune cells, as we all know, are in your gut. It’s where your macro and micronutrients are absorbed. That said, what have you done for your guts lately? Do you have the guts to be healthy? So if 80 % of my immune cells are in my gut, I need to do something for them every day because I want to put something in my health savings account, if you will, and that’s not the little card that I use when I go to the doctor. It’s my personal health savings account. Some other hallmarks of aging is mitochondrial dysfunction.
Dr Rob Silverman (10:11.13)
Oof.
I probably just hit a chord with you because you treat a lot of people with dementia and Alzheimer’s and it’s a function of mitochondrial dysfunction. The number one mitochondrial body part is your brain without question and I do a lot of work and I look to a lot of ideas on helping mitochondrial function. Some interesting things like fascial injuries are also a hallmark of aging. People don’t talk about that enough. What is fascia? Fascia is the saran wrap of the body. It’s your body’s own wetsuit.
If I took a chicken breast and looked at the chicken breast and peeled the skin away, I could see the muscle, I could see the skin and the white foam in between the two, that’s fascia. It holds the body together and fascia is an intracellular communicator. So what have we done to help our fascia and our fascia planes and our fascia injuries daily? Vagus nerve tone.
Now, when I graduated Chiro School 27 years ago, the vagus nerve of all I knew was cranial nerve number 10, and it was parasympathetic. And man, I got shortchanged. I want a refund. Because it’s so much more than that. It is captive to the parasympathetic nervous system. It goes from the brain stem to the gut. It is the neuro-communicator between the gut and the brain. It allows the gut and the brain to communicate. Therefore, the brain and the gut can be the super highway to health. So what have we done for vagus nerve tone?
And maybe the biggest hallmark of aging for me would be dysbiosis, that unleveling of good and bad bacteria. I gave you a lot. I apologize for loading you up. I’m trying to keep it concise. I’m sorry.
Dr. Heather Sandison, ND (11:49.146)
I took notes. This is great. Where do you see most clinicians? No, it’s perfect. And I think it gives us kind of a structure. Excuse me. Where do you see most clinicians missing the mark when it comes to these hallmarks of aging?
Dr Rob Silverman (12:08.814)
Well, I mean, I don’t see enough doctors talking about longevity. I think one of the bigger problems is they don’t use anything in reference to what I would like to refer to as a biomarker. So you’re a medical doctor. Medical doctors are great in using biomarkers.
Dr. Heather Sandison, ND (12:25.163)
I’m actually a naturopathic doctor, but thank you. But we use biomarkers all day long. But which ones would you use to look at someone’s longevity trajectory?
Dr Rob Silverman (12:29.804)
You guys use biomarkers.
Dr Rob Silverman (12:37.186)
Well, this is for anybody listening. This is not necessary for doctors writing this down to do for patients. Everybody should know that TNF-alpha, they’re interleukin-1-beta, they’re interleukin-6, and they’re interleukin-8.
Dr. Heather Sandison, ND (12:48.149)
And so some immune markers.
Dr Rob Silverman (12:50.284)
immune markers, inflammatory markers, and I’ll even twist it to musculoskeletal markers. Interleukin-1-beta also implies intervertebral disc injury. Interleukin-6 is a dynamic marker, you’re correct, and an immune marker. However, when interleukin-6 is produced by myokines and muscle contractions, it’s real positive. Interleukin-8 is obviously inflammatory. Interleukin-6 and 8 will appear to have a rise when you have chronic inflammation with chronic muscular issues.
In addition, C-reactive protein, and that’s pretty much a standard, that is tissue inflammatory marker. It’s high levels of inflammation, which are really registered in C-reactive protein, but the winner, the HS C-reactive protein, the high sensitivity C-reactive protein is critical because it’s a low inflammatory marker, but really specializes in arterial damage and is without question a heart attack marker.
Hemoglobin A1C would never be another biomarker. You know, it tells you pre-diabetes and diabetes. But I’m gonna speak and share something with you that I know you already know. 5.7 to 6.4 means you’re a pre-diabetic. 5.4, you go to most docs, double thumbs up.
Data indicates 5.4. You may be losing brain mass right now. So we want that hemoglobin A1c to be lower than that 5.2, 5.0. And that gets a little challenging for somebody who eats a little carbohydrates at 60, 65 years old, et cetera, especially who’s exposed to what we call the standard American diet. Everybody should know as a biomarker for longevity, they’re vitamin D levels. Vitamin D performs a swath of health promoting properties, immune, musculoskeletal,
Did you know that there’s a receptor site in every cell of your body for vitamin D3 and omega-3 fatty acids? So when people say, supplements do you recommend? Those are the two that I immediately do. My levels of vitamin D, I believe that will lead you down a health promoting path or about 60 to 80.
Dr. Heather Sandison, ND (14:52.255)
I’m in full agreement.
Dr Rob Silverman (14:54.072)
full agreement 80 to 100 is okay. I haven’t had anybody come in with over 150 or something like that so I haven’t had anybody suffer from vitamin Diosis or something like that. Good luck.
Dr. Heather Sandison, ND (15:05.357)
We’ve had some people with calcium toxicity because of parathyroid adenomas. And that is a case where I recommend people do not take vitamin D until they have that resolved because parathyroid adenomas and calcium toxicity can lead to kidney stones and cognitive changes and all kinds of things. I’ve seen it maybe 12 times in the 15 years of my practice. So it’s not common. It’s pretty rare, but I’ve seen it enough that we don’t want to miss it.
Dr Rob Silverman (15:09.537)
Okay.
Dr Rob Silverman (15:27.576)
Wow.
Dr. Heather Sandison, ND (15:31.949)
But yeah, for the most part, people with vitamin D levels up over 60 is ideal. I couldn’t agree more.
Dr Rob Silverman (15:32.397)
Go ahead.
Dr Rob Silverman (15:38.351)
60 to 80 and of course always test and don’t guess. Here’s one for you, something called APOE status. I think maybe you’ve talked about that a little bit. Yeah.
Dr. Heather Sandison, ND (15:41.525)
Yeah, exactly.
we’ve heard of that one, once or twice.
Dr Rob Silverman (15:49.525)
Once or twice, ApoE2, if the 1 % of the population, if you’re in that 1%, God bless you, you’ll probably never see Alzheimer’s. ApoE3, which I happen to be a 3-3, so I’m like in health neutral if my lifestyle’s good. I should be able to avoid Alzheimer’s, especially if I adhere to a recode lifestyle. And if I don’t, and I’m eating a standard American diet and exposed to toxins, et cetera, that ApoE3 can back up the car and take me towards Alzheimer’s, where it gets a little tricky.
is an Apo4. Now I always see Peter T. talking to Chris Hemsworth, Thor, and him telling him you have a double four, you have eight to ten times the incidence, however there’s light at the end of the tunnel because your lifestyle is really strong. So 25 % of Americans have at least one ApoE4. So they have a predilection, a genetic disposition towards Alzheimer’s. Why wouldn’t you test?
Dr. Heather Sandison, ND (16:45.741)
Yeah, you know, I used to have patients maybe 10 years ago say, well, if I test, I’m not going to be able to sleep. There’s nothing I can do. And I think I appreciated that at that point, right? If you’re awake, anxious about having Alzheimer’s later in life, that might be putting you at higher risk. But now I think that argument has really been flipped on its head because there’s so much, there’s an overwhelming amount that we know to do to protect brain health. And if you’re APOE 4, 4 positive, as you mentioned, if you’re part of
the 2 % of the population who has that, you can be making better health decisions about alcohol exposure, prioritizing sleep, about mold exposure, so many modifiable risk factors, you can start implementing changes in your lifestyle in your teens and 20s. Okay, I wanna keep going through these biomarkers, and I also wanna understand the patterns that you consistently see in people who are aging well versus those who aren’t.
So we’ve talked through a few of them, but what else pops up?
Dr Rob Silverman (17:50.147)
You know, just to piggyback on what you said with the APOE4, not to go back, that the average person I see, if I make a recommendation for omega-3 fatty acids, it’s two grams. If they have an APOE4, because their blood-brain barrier doesn’t function as well, I have to double down and give them four grams. And APOE4 is not just a predilection for Alzheimer’s, it’s for neurodegenerative disease, Parkinson’s, ALS, and the like. So, yeah, so without question.
Dr. Heather Sandison, ND (17:54.347)
No.
Dr. Heather Sandison, ND (18:14.741)
and cardiovascular disease.
Dr Rob Silverman (18:18.987)
Everybody should test it.
Some of the other things, believe it or not, is in the gut, which probably doesn’t surprise you after what I said, and that would be I’d be looking for something called LPS, which is an endotoxin. It holds gram-negative bacteria in the inside of the intestinal wall. In that, LPS stands for little pieces of stuff for me, or if you speak Spanish, el diablo, because if you have LPS floating around, you’re having a bad day. Incidentally, and I know you’re gonna get excited when I say this, it’s the exposure of LPS in the gut.
but the lung and the gum.
that without question increases the incidence of Alzheimer’s disease. So a big takeaway, so we don’t run out of time, is that neurodegenerative diseases have an origin in the gut, they’re neuroautoimmune, and they are bi-directional, and they are full system network insufficiencies. The body’s all interconnected. So without question, it’s not the one thing, it’s the whole thing. And my high school educated mom said one thing, I think the human body
is like a car. If there’s something out in the car and you don’t fix it, will cascade to other things. So everybody, please, if you have something wrong, don’t wait. Please be proactive. Don’t be reactive.
Dr. Heather Sandison, ND (19:33.441)
Right.
Dr. Heather Sandison, ND (19:37.046)
You emphasize gut health, I think even to your point right now, health starts in the gut, and there are people who suffer for decades with chronic constipation or diarrhea or food allergies. There’s something telling us that their gut isn’t quite right. Their gut is inflamed or reactive. Tell us why does the gut sit at the center of performance, immunity, aging, and how and why should people get help and support optimizing their gut function?
Dr Rob Silverman (20:05.826)
That’s such a great question. That’s probably five parts of any webinar, any podcast. mean, there’s such depth there. But when you really look at it, the gut is, as I said before, the 8 % of your health. There’s a gut to everywhere axis. So let’s talk about a few of those axes. Number one, there’s a gut to liver axis. Liver dysfunction affects the gut. Gut affects the liver dysfunction. 75 % of the toxins from the liver to the gut go via the bloodstream. 25 %
by the portal vein. By the way, the nerve that innervates the portal vein, no surprise, that great wanderer, that vagus nerve. There’s a gut to blood sugar axis, insulin resistance. There’s a gut to obesity axis. There’s a gut to thyroid axis. What a shock. The most sensitive gland in the body, thyroid, gets adversely affected, increased incidence of Hashimoto’s disease.
The expression of LPS in the blood increases the incidence of cardiovascular disease by three times. Now wouldn’t you think that testing for LPS should be a baseline biomarker? And of course there’s the gut to brain axis. Whatever you do to your gut, you do to your brain. Whatever you do to your brain, you do to your gut. And let me give you a little insight behind a lot of musculoskeletal aisles, and I take a lot of flack from my chiropractic brethren on this. There’s a gut to disc axis, and there’s a gut to joint axis.
The expression of cytokines because your gut is leaky or increased intestinal permeability leads you down a path of increased arthritis and joint pain. Something called…
Dr. Heather Sandison, ND (21:41.581)
Well, I hope they’ve had patients who have cut out gluten and realized that their joint pain goes away.
Dr Rob Silverman (21:46.393)
Gluten and dairy, I’m big on both of them and without question, gluten and joint pain, you know. Wow, I mean, it’s just so funny. I’m sure you get the same comments as I do, even though we practice in different parts of the country. They’ll say to me, gluten, what’s left to eat?
Dr. Heather Sandison, ND (22:04.181)
and that speaks to the problem. It’s in everything, so it is hard to avoid, and it means that people are getting doses when they don’t even realize it. And it directly increases inflammation, not just in the gut, but systemically.
Dr Rob Silverman (22:18.614)
And I’m sure you’re aware that gluten, when affected by the immune system, it gets cross-reactivity with the cerebellum.
Dr. Heather Sandison, ND (22:27.061)
in the thyroid. mean, it’s the there’s a long list. Yeah, it is. It’s one of those things I hope no one meets you or I in the interwebs across the interwebs or in our practices, who doesn’t take the opportunity to cut gluten out of their diet because it can be life changing.
Dr Rob Silverman (22:42.67)
Thanks.
I mean if I had a list of three things to do, know, as far as diet, number one would be ultra processed food. 57% of the calories we consume come from ultra processed food. That’s horrific number in 57% of the calories in adults, 67% in teenagers. Give me a break. Number two would be gluten. You can make the case that gluten is used in ultra processed food. And number three would be dairy. We’re the only species that drinks another species milk. I mean, we don’t need it. It’s a high allergy food.
and if you were to take those three away, it would be a better day. So, which really begs the question, how do I get people to remember them? Well, we’ve got to be a little pithy in the current market. So here’s some pithy acronyms, GPS. No gluten, no ultra-processed food, and dust on it, anything. If you’re gonna eat a fruit, kumbaya. DNA, no dairy, no nicotine, and we could talk about the nicotine patches if you like.
No artificial sweetness. And IRS.
inflammation reduction strategies. No processed seed oils, inherent in the word process. There are people who argue with me, guys, it’s processed. No deep fried foods and avoid food sensitivities because I believe that food sensitivities are one of the biggest reasons for chronic hidden inflammation. Food is a potentiator for health information. Bad food is a potentiator for inflammation. So we need to choose wisely.
Dr. Heather Sandison, ND (24:13.759)
Yeah, you know, I’m curious. Some people find that they’re more and more sensitive to more and more foods, right? And I get, the way I think about it clinically is like, okay, they’re oriented towards more and more hyper reactivity versus being more and more resilient. And so I want people to avoid their food allergies, their food sensitivities, and yet I also want them to be resilient and not have to avoid foods. I…
Sometimes I think that there’s something else disrupting the system, something else disrupting the gut that’s making you so reactive. How do you help patients navigate that?
Dr Rob Silverman (24:49.966)
You know, that is a great question. So the first way I help people navigate them is I do listen to them. Because I believe that the practitioner of today needs to listen, build trust, so they implement the things. Because if you go to a doctor and you hear no gluten and no dairy, and if they don’t like us or think that we’re listening, they’re not going to implement.
Number two, everything does revolve around the gut. So without question, we need to have a gut promoting diet that is individualized and personalized. And you know what? It’s an interesting thing and I think we should discuss it and share it. I’m not trying to dodge the question. What really excited me about the concept of functional medicine, functional health, functional nutrition was it took the symptoms, which are really basing on my protocols on sick care.
and then looking at the systems, which got it a little bit more exciting, 12 to 14 systems in the body, then it got to what we call root cause resolution. Well, to speak to the problem that you mentioned, it’s not root cause resolution, it’s root causes resolution, which can really lead to a myriad of issues. And if the doctor’s not testing and listening and eclectic like you, the patient’s lost.
Dr. Heather Sandison, ND (26:07.373)
Yeah, you I was making a note as you were sharing, it’s like this high level concept is super compelling, right? Root cause, instead of a pill for every ill, what we’re talking about is really getting at those root causal level pieces. And regardless of the diagnosis, people take different pathways there, right? And so neurodegenerative disease is rapidly rising.
Dr Rob Silverman (26:19.15)
Right.
Dr. Heather Sandison, ND (26:31.937)
I’m curious from your perspective, taking this high level concept, there’s multiple factors, there’s multiple root level causes that are gonna be individual, different between individuals. What feels genuinely new or promising right now from your perspective in prevention and management of neurodegenerative diseases associated with aging?
Dr Rob Silverman (26:54.318)
You know what, it’s interesting. Like you said, there’s drugs and drugs have their place. They do and we’re not here to bastardize drugs or anything like that, but they only can do so much. So what’s really come to the forefront is lifestyle. And lifestyle is the top of the funnel and it’s got all these branches. But I’m gonna pick on Parkinson’s because I know you cover Alzheimer’s all the time.
Dr. Heather Sandison, ND (27:00.085)
Of course, yes.
Dr Rob Silverman (27:18.252)
and I definitely don’t want to go into your genre. So let’s talk about Parkinson’s disease. What’s big with Parkinson’s outside L-Dopa, Carbidopa? Well, number one is they have something called rock steady boxing, non-contact of course. They found out that the movement and the coordination of moving the upper and the lower body really helps people with Parkinson’s who have a receptor site and a producer problem of dopamine. And in addition to that, they also have cognitive crossword puzzles and cognitive work.
Great, but let’s look at a nutritional protocol, vitamin D. Vitamin D actually improves balance and mobility. Coenzyme Q10, mitochondrial function and improves motor symptoms. Omega-3 fatty acids support cognitive functions. Pro-resolving mediators, which you use in Alzheimer’s, allow for the resolution of inflammation. It’s the only thing that gives a lipid class switch that presses the button from the initiation to the resolution of inflammation.
especially B2, they’re necessary for dopamine synthesis. They can lower homocysteine levels and a big problem with Parkinson’s is they have a D elevated B2. Glutathione and NAC, liposomal glutathione, the master antioxidant, great for the cells in the body, but NAC passes the blood brain barrier. So, depending on what you desire, obviously NAC makes a little more sense with Parkinson’s. Magnesium, because as you mentioned, lot of people
and degenerative diseases have constipation. Pre and probiotics, a great choice. I mean, I don’t take one without the other. And if you wanted to try and get some dopa on your own, you could try something called velvet bean. I will be honest, I don’t know one Parkinson’s patient that has been able to dose the velvet bean and take it with the theanine to pass the blood-brain barrier, but I’m always hopeful. Couple quick other ones would be NAD +, so I would use precursors for NAD.
passes the blood-brain barrier better, NR is better for the cells, again choose. Curcumin, very neuroprotective, reduces inflammation, and again your favorite creatine. There’s a boatload of studies that talk about creatine in exercise having great outcomes with Parkinson’s and maybe the secret sauce, maybe the device of the now would be non-thermal low-level laser. Non-thermal, not red light therapy. With all due respect to everybody.
Dr. Heather Sandison, ND (29:40.993)
Yeah.
Dr Rob Silverman (29:46.049)
I hear what you say about red light therapy, but red light therapy is like a light emitting diode. It heats up structures. I don’t want to give myself a fever. One of the big things about the brain is you want to keep it at a constant temperature.
Dr. Heather Sandison, ND (30:06.997)
And so I’m curious about patients who only improve when the brain and vagal pathways are addressed. You’ve talked a lot about that. What does that tell us about how we’ve been approaching chronic illness, including neurodegenerative illnesses? And particularly Parkinson’s, like you were just talking about.
Dr Rob Silverman (30:26.54)
Yeah, mean the vagus nerve is interesting in that one of the bigger problems with the vagus nerve, when the vagus nerve tone is down, it gives the ability of a protein called alpha synuclein to jump on that elevator up because 80 to 90 percent of the signals and fibers on the vagus nerve go from the gut to the brain.
and it’s able to get to the brain and get inside the brain and uncouple the mitochondria. So vagus nerve tone, proper tone, is critical for overall health. When vagus nerve tone is down, also have it in this, you have issues with constipation.
Fascinatingly enough, vagus nerve is a rest and digest. It’s your one and die nerve. So for me, the vagus nerve is a critical ad. I do a lot of vagus nerve stimulation via non-thermal low-level laser, and I check all my patients for something called heart rate variability. The more heart rate variability, if you will, as opposed to flatline, the healthier we are. The vagus nerve does communicate with the brain. So you’ve got that communication
you’re probably going to decrease the incidents. And it’s been a backbone of what I do in my office. It’s exciting stuff.
Dr. Heather Sandison, ND (31:43.671)
Parkinson’s and toxic exposure. There’s been, there was a recent study that got a lot of press around proximity to golf courses and how close people live to golf courses has an impact on their risk for Parkinson’s. How do you address that?
Dr Rob Silverman (31:58.287)
It’s a great question. think the exact number was an increase of 126 % if you live within a mile of a golf course. I live in Westchester County, New York, which has more golf courses per square foot than any other place. I’m wondering, and maybe I’m gonna ask you and a couple of your colleagues there if they wanna start a oral organic golf course. So maybe we can avoid that, but what it is to tell a golfer and say, you know, you’re exposing yourself.
And one of the, I would probably have to say one of the biggest causes of Parkinson’s is not obviously genetics, which is only 10 to 15%. One of the biggest problems is what you just mentioned, chemicals. But is it just chemicals in the air? Is it just chemicals in the soil? Is it the nanoparticles that we drink in bottled water? I mean, where does it stop?
We are exposed and it’s unfortunate with all these great leaps in medical, we haven’t had any great leaps in medical when it comes to neurodegenerative disease.
Dr. Heather Sandison, ND (33:00.385)
Yeah, well you’ve done a lot of research on the low level laser therapy that you’ve been speaking to. Can you break this down for us just so a lay person could understand what is going on with low level laser therapy?
Dr Rob Silverman (33:13.506)
low-level laser therapy is based on photonic energy. So it kind of is like photosynthesis of the body. As we all know, the sun produces light, which gets absorbed in the tree, and the tree produces a chemical reaction. So we want a photochemical reaction versus a photothermal reaction. So the proper type of non-thermal low-level laser allows for photosynthesis of the body.
Laser energy fuels the mitochondria. It can dampen inflammation, improve mitochondrial function, and optimize our genetic expression to enhance our overall quality of life. So what’s interesting about it is different wavelengths from the visible light. Andrew Huberman talked a little bit about this. He kind of got to the doorway. He’d walk in the door. I’m hoping somebody else does. I’m there for everybody.
Different wavelengths have different properties. So for instance, everybody talks about red light. It’s a 635 nanometer wavelength emitted by a laser diode. There’s a 532 laser wavelength that has a green light or visual green to it. There’s a 405 nanometer violet light. All of these wavelengths have different health properties. But when I put it on that brain, it has a tremendous nerve
cytotoxicity decrease. It decreases glutamate. It increases angiogenesis. It increases the release of brain-derived neurotrophic factors, which lead to brain neurogenesis and neuroplasticity. It also leads to a decrease in brain edema and lymphatic drainage. So all the things that go wrong in the brain, laser could conceivably reverse if utilized correctly.
laser work in the mitochondria. It’s all about mitochondria. It’s all about mitochondria. Dysfunction to function. But just remember, mitochondria aren’t just powerhouses. They’re also communicators. Emerging research shows mitochondria can function extracellularly, acting as a signaling hub that influence inflammation, immune response, and tissue repair. If that is truly true, mitochondria health isn’t just cellular, it’s systemic.
Dr. Heather Sandison, ND (35:26.999)
Right, yeah, and crucially important to our health as we age. I’m curious about GLP-1 medications. They are everywhere right now. And how do you think about them and how they might support these pathways or are there alternatives to them? Because certainly we see in conventional medicine, the standard American diet, you’ve spoken about
It leads to obesity, leads to inflammation, it leads to dysfunction, increases risk of all, it reduces health span, right? And end lifespan. And so, you know, when we think about the complexity of what you and I offer, right? The foundational diet, lifestyle, exercise interventions, is there a place for GLP-1s or an alternative to them?
Dr Rob Silverman (36:12.547)
Well.
I would have to say there is a place because I remember when they became really popular a couple of years ago, I sat with my medical friends, all three of them, Columbia, Stanford, and Harvard, and I sat there and man, I thought I had them. And these guys don’t prescribe them, they’re anesthesiologists, neurosurgeons, orthopedists, they’re not talking GLP-1. And they asked me, we, or do I see people that are 400 pounds on 15 different medications? And typically in a functional medicine world that I’m in,
not see that. So they believe that for that
extension of patients, it would work. But for people looking 50 pounds or less, the data’s not there to back up taking it because you have two tremendous side effects. Number one is gastrointestinal side effects, awful nausea, awful diarrhea, things of that nature. And the other one is the loss of muscle mass. So we all know it’s been documented 40 % of the weight loss comes from muscle mass. But some of the things that we don’t hear enough about is not only muscle mass, your heart’s a muscle.
So you’re losing heart muscle mass. You’re losing particle size.
Dr Rob Silverman (37:21.258)
muscle mass in your heart. You know, I know how to improve muscularity and I had improved muscularity in patients. I haven’t figured out the idea of improving heart muscle mass. So that said, let’s look at the numbers. The numbers for Ozempic and Wigolvi are not all that robust. And by the way, those numbers that they gave, which were 19 pounds for Ozempic and 27 pounds for Wigolvi in a year with people who had BMIs or 37 who are relatively corpulent, isn’t all that impressive.
of.
Now unfortunately, eight out of 10 people in the studies dropped out, seven out of 10 from gastrointestinal issues, and one out of 10 because they microdosed, which doesn’t really seem to work. Is it better to try it naturally? Yeah. So what things would I do to activate GLP-1 naturally? The number one supplement in the world, it’s called exercise. But beyond that, you want to talk real supplements? Berberine, ginseng, green tea, pomegranate
quality probiotics, fiber omega-3s, eat good quality protein, magnesium, glutamate, caffeine, fermentable fiber to get short chain fatty acids and make butyrate, allulose, which I’m sure you’re familiar with, allulose is 70% as sweet as sugar. It’s one little molecule, got a lot of fiber. And believe it or not, bitter melon. Bitter melon stimulates GLP-1s, whereas sugar turns them down, dentally.
GLP-1 receptor site on the lytic cells in your gut. There’s a GLP-1 receptor site on your vagus nerve. There’s a GLP-1 receptor site in your dorsal medial hypothalamus. A properly functioned GLP-1 pathway should be exemplar of the gut to brain axis.
Dr. Heather Sandison, ND (39:11.061)
And then, so supplements, we started to kind of down this path. You just listed a few. You also talked about omegas and vitamin D. Which nutrients or supplements consistently move the needle for longevity and why? And how much should someone consider taking?
Dr Rob Silverman (39:28.162)
You know, it’s funny because I’m the guy that people come into and they have shopping bags of supplements. And I’m like, I’m here to save you money and kind of streamline what you do. But that’s a great question.
For me, again, it’s a pre- and a probiotic. And the probiotics that come to mind for longevity would be Acromansia because it’s great for immune health. It’s also great for blood sugar regulation. And Bacillus subtilis, which is an endospore, which helps you ward off that alpha-synuclein that we talked about. Both are very viable for those people that have an LPS release, you know, like in Alzheimer’s. And the prebiotic of choice, it’s always food, but the supplement prebiotic of choice is XOS.
but it’s xylo-ogliosaccharides, which is a great prebiotic which feeds probiotics at a very low level. Another one which we talked about in good detail was creatine, without question like you said, vitamin D and omega-3s. Proisovere medias like I mentioned before. Something that we could probably add to the recode, I’m sure you probably have it now, is mushroom complexes like lion’s mane.
Dr. Heather Sandison, ND (40:36.737)
Yeah, love it.
Dr Rob Silverman (40:37.07)
collagen and plant-based protein, any liposomal vitamin, and maybe something that miracle mineral, 800 enzymatic reactions or up to about 800 enzymatic reactions, magnesium glycinate or bisglycinate if you will. And maybe, you know, my little secret weapon, the data’s starting to grow on it, BPC157 as a peptide because it’s great in the regulation of blood pressure, accelerates bone healing, helps with periodontal disease.
good for gut disease. I prefer it in an oral to an IV form. I found the oral to be very effective. You know, I’m not trying to throw shade, if you will, on the people in the IVs. At least I just…
Dr. Heather Sandison, ND (41:18.839)
Well, intermuscular usually for maybe the BPC.
Dr Rob Silverman (41:23.99)
Absolutely.
Dr. Heather Sandison, ND (41:25.067)
Yeah. And do you use any lorazetide?
Dr Rob Silverman (41:28.866)
I don’t.
Dr. Heather Sandison, ND (41:29.855)
I’m a huge fan of lorazetide for gut. I’ve seen just amazing results with that peptide orally for colitis, for celiac, for gluten sensitivities. It’s been helpful. I don’t know if you can get your hands on some of that. I highly recommend it. Looking ahead, what do you hope becomes the standard of care that people aren’t getting today?
Dr Rob Silverman (41:56.077)
Well, first, diagnostics are becoming far more precise. But the problem with it…
Dr. Heather Sandison, ND (42:02.271)
and accessible.
Dr Rob Silverman (42:03.604)
and accessible. Patients can get them, so doctors need to be up on it and understand what they’re revealing. Second, therapeutics are becoming more targeted and less invasive. And thirdly, the patient is becoming an active participant. It’s called something called CHAT GPT. You know, the doctor of the future is the patient of now, so we have to deal with it like it, not like it, whatever. It’s here to stay. It’s not going anywhere.
Dr. Heather Sandison, ND (42:29.517)
I love when patients come in and they’ve put all their labs into chat or into clod and we get to have a really nuanced conversation. And yeah, it’s like I’m talking to a colleague. It’s very stimulating and exciting and I love it personally.
Dr Rob Silverman (42:45.184)
I personally love it too. I think it gets them there and I think it does a lot of the groundwork for us, but, and it allows us to, like you say, nuance it and really individualize and personalize it so we can get to the end of one. mean, chat’s not there with the end of one, but it’s great for research, gives us the information and allows us to rocket ship the patient to a higher level.
Dr. Heather Sandison, ND (42:49.761)
Yeah.
Dr. Heather Sandison, ND (43:06.797)
couldn’t agree more. What brings you joy at this stage of life?
Dr Rob Silverman (43:11.406)
You know what? I had a great day today because someone stuck their hand out and said, thanks for making me feel better and thanks for giving the time and I’m happy that the protocol worked. I mean, I got the best job in the whole wide world. Because it’s not a job, it’s a credo. It’s a mission. You my dad told me, find something that you like to do so you never feel like you go to work and he’s 95 and he gets up every day and he goes somewhere.
Dr. Heather Sandison, ND (43:29.357)
Amazing.
Dr. Heather Sandison, ND (43:38.133)
I love it. When you look at patients or maybe your dad, what does aging well look like in real life?
Dr Rob Silverman (43:46.319)
You know, what I’ve seen aging well is it’s really an attitude. you know, from a philosophical and a physiological perspective, it’s like avoiding some of the chronic diseases or managing them once you get them in an appropriate manner. You know, don’t let the cascade happen.
But for me, the people that are older, I can tell when someone’s old and they give me a smile when they come in, they’re really stoked about what they’re doing as opposed to when they come in and they’re probably having a bad day, but they look down and they’re not that engaging.
Dr. Heather Sandison, ND (44:22.153)
Yeah, yeah. Well, I hope that this powerful and energizing conversation has inspired our listeners to make some decisions that are a little different, maybe add a supplement or get a test or think about low level laser therapy so that they can age a little better and really enjoy that phase of life a bit more. I really appreciate your work and how you bridge the science with what’s doable in real life.
Dr. Silverman, you have helped us connect the dots between gut health, brain health, metabolism, performance in a way that makes longevity not just feel possible, but really actionable. There’s something to do here. There’s a takeaway. And I think one of the biggest takeaways is that aging, well, isn’t about chasing one magic bullet. It’s about understanding how the systems are all connected, right? There’s a gut access to everything. I love that.
And then making the consistent and intentional choices that support the body’s ability to heal and adapt and then thrive. For everyone who is listening, if this conversation has resonated with you, I highly recommend checking out Dr. Silverman’s work, his books, Immune Reboot and Inside Out Health and his podcast, Proven Health Alternatives. He is a wealth of education and he shares that across platforms. Dr. Silverman, where do you like people to find you?
Dr Rob Silverman (45:42.447)
Just find me at drrobertsilverman.com. Any one of my social media channels are great. Reach out, say hi. Any questions you have, I’ll be happy to answer. And just remember, fix the gut, build muscle, protect your mitochondria. Those three systems drive almost everything in long-term health, which is truly longevity.
Dr. Heather Sandison, ND (46:03.649)
Thank you so much for the work that you’re doing, for pushing the field forward, for getting the word out, and for taking the time to be here with us today. To everyone listening, your longevity isn’t something you wait for. It is something that you build. If you found this helpful, please share it with others you love. Until next time, be well.
