Episode 130: Josh Turknett talks about holistic approaches that help people end chronic migraines
STEM-Talk
Cognitive Decline
Cognitive function typically declines around the third or fourth decade of a person's life. A previous guest on stem talk, doctor dale bredson, has proposed to multi metal model that includes things like toxic exposures and stressers as drivers of cognitive decline. And in his model, the capacity of the brain slowly decreases over time as the injury accumulates until supply of cognitive function no longer meets the demand. So how do you think they could be reconciled? Yes, a great question. I don't see these two things as mutually exclusive, but complimentary.
Our guest today is Dr. Josh Turknett, the author of “The Migraine Miracle” and “Keto for Migraine,” two books that have helped thousands of people use a holistic approach to end their chronic migraines. Josh is often referred to as “public enemy number one to migraines” everywhere.
He is a neurologist, musician, author, and entrepreneur. He has more than two decades of experience in the field of cognitive and behavioral neuroscience. Josh practices medicine in Atlanta at the Turknett Center for Neurology and Cognitive Enhancement.
In today’s episode, we talk to Josh about his own history with migraines and how migraine is a common and complex neurological disorder that includes a genetic component.
Josh earned a bachelor’s degree in cognitive neuroscience from Wesleyan University, an M.D. from Emory University, and completed his residency training at the University of Florida.
In addition to his medical practice, Josh also is the founder of Brainjo, a company that creates educational resources that utilize a system of instruction based on the science of learning and neuroplasticity. He’s a musician who plays in the band The Georgia Jays and teaches people to play the clawhammer banjo, fingerstyle banjo, fiddle and ukulele. As if he didn’t have enough to do, Josh also is the president of Physicians for Ancestral Health and the chief medical officer for humanOS, which was recently acquired by Restore Hyper Wellness. Josh also is the host of the Intelligence Unshackled podcast, which explores the many ways that human potential is constrained and how people can go about optimizing it.
Show notes:
[00:03:22] Dawn opens the interview asking Josh about his mother’s struggles with migraines.
[00:04:59] Dawn asks Josh how old he was when he first started having migraines.
[00:06:15] Ken asks Josh how he first became interested in science.
[00:08:24] Dawn asks Josh how he ended up in the Connecticut at Wesleyan University for his undergraduate degree.
[00:09:35] Ken asks if Josh knew he wanted to major in neuroscience when he first arrived at Wesleyan or if that was a later decision.
[00:10:49] Dawn asks if it is true that Josh’s girlfriend at the time played a role in his decision to move back to Atlanta to go to medical school at Emory after his undergrad.
[00:11:55] Dawn asks what motivated Josh to attend the University of Florida for his residency after being a lifelong Gator-hater.
[00:14:39] Ken mentions that despite all the hype around neuroscience when the field was emerging, the last major breakthrough in neurology was in the ‘90s with the discovery of triptan drugs for migraines. Ken asks if we have made any major neurological advances since then, and if not, why?
[00:17:41] Ken asks Josh what he would suggest to today’s neurology residents and neuroscience graduate students who might want to avoid the recent failures of the modern approaches to treating neurological disease.
[00:19:57] Dawn explains that a migraine is a complex neurological disorder affecting 15 to 20 percent of the population, with many subtypes including a genetic component. Dawn asks Josh what is currently understood about the genetic component of migraines.
[00:21:28] Ken asks Josh at what point in his career did he decide to specialize in migraines.
[00:23:17] Dawn asks Josh to explain to people who have not suffered from migraines what it feels like to experience a cascade of symptoms such as numbness, tingling, visual disturbances, nausea, vomiting, dizziness, fatigue, and blinding headaches.
[00:25:15] Ken asks Josh what the difference is between cluster headaches and migraines.
[00:26:49] Dawn mentions that people can start to feel the onset of a migraine 48 hours before the pain sets in, a phase called the prodrome. Josh explains what the prodrome is and what its symptoms are.
[00:28:03] Dawn mentions the fact that the pain of a migraine is preceded by an aura, which is often a frightening but temporary neurological disturbance that sets off an alarm of an impending migraine headache. She asks Josh what is known about auras.
[00:30:11] Ken asks if the auras experienced by migraine sufferers is similar to the experiences some people have preceding an epileptic seizure.
[00:30:41] Ken asks if people bounce back immediately once the migraine is over, or if there is a recovery period involved.
[00:31:53] Dawn switches to the topic of how diet and lifestyle can help people manage their migraines by asking Josh about how his interest in ancestral health, and the ancestral way of eating.
[00:34:43] Ken asks Josh what discoveries led him to write his 2013 book, “The Migraine Miracle.”
[00:38:12] Dawn mentions that the ketogenic diet has become extremely popular over the past few years. Dawn goes on to say that while the ketogenic diet has been largely understood to help people with weight loss, epileptic seizures, metabolic disorders, and many other health issues. Dawn asks Josh to talk about how when his book “Keto for Migraine” came out, there weren’t many references to how a low-carb/high-fat diet could help people with their migraines.
[00:42:16] Dawn mentions that in “Keto for Migraine” Josh points out that the typical version of the ketogenic diet can make migraines worse. Given that, Dawn asks what the keys are for maximizing the benefits of keto for the migraine brain.
[00:43:12] Dawn asks Josh to address how ketosis impacts blood cholesterol testing.
[00:45:46] Ken asks what other things Josh has learned about ketosis and the migraine brain.
[00:48:42] Ken mentions fasting as a way to induce ketosis, and asks if Josh utilizes fasting, either for himself or as a recommendation for his patients.
[00:51:43] Although fasting has become a popular fad in recent years, the journalist Upton Sinclair wrote a best-selling book back in 1911 called “The Fasting Cure.” Dawn asks Josh about the interesting things he learned from reading Sinclair’s book.
[00:53:34] Ken asks if Josh has investigated the possibility of a connection between migraines and gut health, given the multitude of disorders now being associated with a breakdown in the gut.
[00:56:25] Dawn mentions that in addition to Josh’s medical practice, he is a musician, playing banjo for the Georgia Jays. He also is an entrepreneur, a business consultant, and is currently the president of the Physicians for Ancestral Health, a role previously held by Tommy Wood. Dawn asks how Josh can manage this wide variety of roles and interests.
[00:58:49] Dawn asks how long Josh has been playing banjo. Josh also talks about the band he plays with, the Georgia Jays.
[01:00:08] Dawn mentions Josh’s book “The Laws of Brainjo,” a compilation of articles about the fundamental principles of learning, described by Josh as a neuroscience-based system of instruction for learning as well as an owner’s manual for molding a musical mind at any age. Josh gives a brief overview of his Brainjo system.
[01:03:33] Ken mentions Josh’s recent IHMC lecture about how the significant reduction in cognitively demanding activities that occurs over a typical human lifespan may be a driving force in the development of cognitive decline and dementia, a phenomenon described as the Demand Driven Decline Theory. Ken asks Josh to touch on the Demand Driven Decline Theory and on some of the key points from his lecture.
[01:08:04] Dawn mentions that a previous STEM-Talk guest, Dr. Dale Bredesen has proposed a multi-modal model that includes toxic exposures, stressors, diet, genetics, and hormonal effects as drivers of cognitive decline that need to be individually assessed and addressed based on the patient. Dawn goes on to explain that in this model, the capacity of the brain slowly decreases over time as injury accumulates, until supply of cognitive function no longer meets demand. This model contrasts Josh’s Demand Driven Decline Theory and given that there is evidence to support both theories, Dawn asks Josh how they might be reconciled.
[01:11:15] Ken asks Josh to reiterate the importance of adults doing things they are not good at, and if Josh has any thoughts on how we can encourage and support people to continue to learn new skills.
[01:15:09] Dawn mentions that in 2018, Josh launched the Intelligence Unshackled podcast, which explores the potential of human intelligence. Dawn goes on to mention that on the show’s home page, Josh points out that the human brain has far more potential than most people realize and that releasing that potential requires people to understand and address the ways in which their brains are limited or shackled. Josh talks about what led him to enter the podcast world and gives an overview of his show.
[[01:18:01] Dawn mentions that Josh plays tennis in his spare time, asking if this is something he has always done, or an interest taken up later in life.
[01:19:24] Ken asks if it is true that another part of Josh’s daily routine is a walk with his wife.
[01:20:19] Ken closes the interview mentioning that a little birdie, perhaps a Georgia Jay, told him that Josh and his family have a special musical tradition at Christmas.
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