Brain Defenders: How Hormones and Metabolism Shape Your Brain's Future | Dr. David Perlmutter

Your brain has its own immune cells, and the way you live each day helps decide whether they protect you or turn on you. Two-thirds of Americans living with Alzheimer's are women. Living longer doesn't explain that gap, girlfriend. So what does? I'm so happy to welcome back my dear friend Dr. David Perlmutter, board-certified neurologist and author of the New York Times bestseller Brain Defenders. He explains microglia, the immune cells that make up about 10% of your brain. On a good day, they're like firefighters in the firehouse, quietly repairing the blood-brain barrier and helping your brain build new connections. Under pressure from high blood sugar or inflammation, they can flip into what he calls the evil twin. Dr. Perlmutter walks me through what happens in the brain when estradiol drops in perimenopause and menopause, and how estrogen and your mitochondria, the energy makers inside your cells, keep each other going. He makes the case for caring about metabolic health in your 30s and 40s, long before memory changes show up. He shares the labs he wants on your radar, including hemoglobin A1C, homocysteine, fasting insulin, vitamin D and the p-tau217 blood test, plus why normal isn't the same as optimal. You'll hear why carrying the APOE4 gene is a predisposition, not a destiny, and exactly where he stands on hormone therapy for women. My favorite part was how oxytocin, my Queen Mother hormone, and time with the people you love help keep your brain's immune cells in their supportive state. You get to be the architect of your brain's destiny. This conversation shows you where to start. This episode is for educational purposes only and is not medical advice. Guest views are their own. Talk with your healthcare provider before making changes to your health routine or medications. Key Timestamps 00:00 Welcome back Dr. David Perlmutter and Brain Defenders 05:25 How blood sugar and inflammation create the evil twin 10:25 Falling estradiol and the loss of brain connections 12:50 How mitochondria and estrogen support each other 14:50 Blood sugar and brain risk 15:55 Why brain health starts in your 30s and 40s 16:45 Common medications and brain health 18:30 The labs you can ask for 20:05 A1C and why normal isn't optimal 22:55 The p-tau217 blood test 23:40 APOE4 is a predisposition, not a destiny 31:35 Oxytocin, connection and your brain's immune cells 33:20 Where Dr. Perlmutter stands on hormone therapy 38:10 Cortisol, sleep and your daily rhythm 41:35 What FSH may be telling you after menopause Memorable Quotes 1. "It's really all about agency, about each of us being the architect of our brain's destiny." — Dr. David Perlmutter 2. "Hormone imbalances and mood disorders are metabolic until proven otherwise." — Dr. Anna Cabeca 3. "It's time that we re-message what's going on with this genetic predisposition, and not a predetermination." — Dr. David Perlmutter 4. "One of the biggest threats for brain decline is isolation." — Dr. David Perlmutter 5. "Some is good. Too much is bad. The devil is in the dose." — Dr. David Perlmutter Connect With Dr. David Perlmutter Instagram: @davidperlmutter LinkedIn: David Perlmutter, MD YouTube: @DavidPerlmutterMD X: @DavidPerlmutter Facebook: David Perlmutter, MD Podcast: The Empowering Neurologist Brain Defender Link: http://braindefenders.com/ Connect With Dr. Anna Website: Dranna.com Instagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca Facebook: https://www.facebook.com/thegirlfrienddoctor If you loved this conversation, share it with a girlfriend who's been worried about her memory, and leave us a review on Apple or Spotify. It helps more women find these conversations.