The Dr. Hyman Show Don't Wait for Alzheimer's — A Neurologist's 30-Year Plan to Protect Your Brain
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Aug 19, 2026 
David Perlmutter, board-certified neurologist and bestselling author focused on brain health and the microbiome, offers a 30-year plan to protect cognition. He explains immunometabolism and microglial shifts, which lifestyle factors matter most, and which biomarkers to track. Practical topics include exercise, diet for blood sugar control, gut microbiome, toxins, and early prevention strategies.
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Microglia Metabolism Controls Brain Health
- Brain immune cells called microglia toggle between supportive M2 and destructive M1 states that determine brain health.
- Loss of microglial mitochondrial function drives the shift to M1, causing synapse destruction and neuroinflammation.
TSPO Scans Reveal Brain Immune Activation
- TSPO brain scans can image activated microglia in living humans across many conditions.
- Positive TSPO appears in Alzheimer's, Parkinson's, major depression, PTSD and long COVID, linking diverse disorders to microglial activation.
Get These Three Metabolic Numbers Now
- Know your metabolic numbers: fasting blood sugar, fasting insulin, and A1C to protect your brain.
- Dr. Perlmutter recommends simple, obtainable blood tests and tracking insulin as core preventative metrics.
