Transcript

Confronting Dr. Amen On His Viral Brain Scans

From Doctor Mike · Episode page · Watch on YouTube

· 1 h 59 min · 18,067 words · 326 timestamped sections

This is the full, timestamped transcript of "Confronting Dr. Amen On His Viral Brain Scans", an episode of Doctor Mike published December 14, 2025 (1 h 59 min, about 18,067 words). It mentions 11 people, works and ideas, including SPECT, Dr. Daniel Aean, Change Your Brain, Change Your Pain, Brain MD, Aean Clinics.

What is discussed, and when

  1. – 10:00: Dr. Daniel Aean, Aean Clinics, Brain MD, Change Your Brain, Change Your Pain
  2. – 20:00: Change Your Brain, Change Your Pain
  3. – 30:00: Change Your Brain, Change Your Pain
  4. – 40:00: Brain MD
  5. – 50:00: Daniel Plan, Rick Warren, Brain MD
  6. – 1:00:00: Paul Mitchell
  7. – 1:30:00: Lancet
  8. – 1:40:00: Dr. Daniel Aean, Julius Randall, Lancet
  9. – 1:50:00: The End of Mental Illness

Notable quotes from "Confronting Dr. Amen On His Viral Brain Scans"

  • A, spec, scan, takes, 3D, images, of, the brain, looking at blood flow and activity. Dr. Aean says the images can be a powerful tool to diagnose underlying problems.
    about Dr. Daniel Aean · at
  • Better treatment plans for his patients which often includes supplements he sells through his other company, Brain MD. As you'll hear him say, he's reviewed hundreds of…
    about Brain MD · at
  • Yeah., You're, looking, at, it, more holistically, right?, I, did, a, program, with, Pastor, Rick Warren called the Daniel Plan. actually came out of a prayer. I went to my…
    about Rick Warren · at
  • Right., I, I, heard, once, John, Paul, Deoria speak. He founded Paul Mitchell, the famous shampoo company. He said, You never want to be in the order business.
    about Paul Mitchell · at
  • You if we present randomized control data to the AAN, APA, we publish it in the Lancet together, let's say, we can change the practice in the United States. Isn't that…
    about Lancet · at
  • Serious about it. It's one of the beautiful parts about imaging. on my podcast, we had Julius Randall recently, three-time NBA Allstar he's depressed, smoking way too much pot, about to get divorced, and he saw a.
    about Julius Randall · at
  • We've, published, a, lot., I, mean, it's, very important for people to understand in my book the end of mental illness there are84 references because if I'm going to like make…
    about The End of Mental Illness · at

Who and what is mentioned in this episode?

People

Books & papers

Companies & orgs

  • Brain MD — Company · 3 mentions · first at
  • Aean Clinics — Company · 2 mentions · first at
    Author and has just published a new book called Change Your Brain, Change Your Pain. He is also the founder of Aean Clinics, a nationwide network of offices that rely heavily…
  • Paul Mitchell — Company · 1 mention · first at

Concepts & topics

  • SPECT — Concept · 5 mentions
  • Daniel Plan — Concept · 2 mentions · first at
    Holistically, right?, I, did, a, program, with, Pastor, Rick Warren called the Daniel Plan. actually came out of a prayer. I went to my church. I just finished writing Change Your Brain, Change Your Body.

Full transcript with timestamps

Don't you want to try and disprove your method in order to prove how strong it is?

So,, at, this, point, in, my, career,, no. A, spec, scan, takes, 3D, images, of, the brain, looking at blood flow and activity. Dr. Aean says the images can be a powerful tool to diagnose underlying problems.

I, have, more, experience, in, this, than anybody probably in the history of the world. Do you not feel that it's an issue that there is no randomized control data?

You, know,, I, went, and, got, a, brain, scan, by this guy called Daniel Amen. How do you know what is actually going on in that person's brain without looking? By asking them questions. By doing

complete, crap,, Mike,, it's, complete, crap. Today's guest is Dr. Daniel Aean, a physician with double board certifications in psychiatry and child and adolescent psychiatry. He's a multiple New York Times best-selling author and has just published a new book called Change Your Brain, Change Your Pain. He is also the founder of Aean Clinics, a nationwide network of offices that rely heavily on spec scans, a unique functional imaging approach that Dr. Aean claims is capable of identifying psychiatric diagnoses within the brain, which allows him to create better treatment plans for his patients which often includes supplements he sells through his other company, Brain MD. As you'll hear him say, he's reviewed hundreds of thousands of these scans, which he's used to improve the lives of countless patients over his decades long career. Given that major health organizations have come out against using Spect in this way, I

needed to ask what research he was using to guide his protocols because if you're going to go against the APA, the AAN you have to have some pretty compelling data, right? Let's talk historically how you got into this space because um I don't see a lot of folks at least on the internet talking about neurology psychiatry and the how these two fields come together. Is this a a unique field? I'm not certainly exposed to it as a primary care doctor. So I'm curious how you found your interest in that. Um, so when I was 18, um, Vietnam was going on and I became an infantry medic and that's where my love of medicine was born. Um, but about a year into it, I realized I didn't like being shot at. So I got retrained as an X-ray technician.

And that was pivotal for me because our professors used to say, "How do you know unless you look?"

And, then, 1979,, I'm, a, secondy, year medical student. um someone I love tries to kill herself and I took her to see a wonderful psychiatrist and I came to realize if he helped her which he did it wouldn't just help her that it would help me it would help her children it would help her grandchildren is they would be shaped by someone who was happier and more stable so 46 years ago I fell in love with psychiatry loved it every day since the only medical specialty that never looks at the organ it treats. Think about that.

Is, that, true? That, is, absolutely, true, that, they, still make diagnoses based on symptom clusters. The DSM that has no neuroscience in it. They make diagnoses based on symptom clusters with no biological data. Exactly like they did with Abraham Lincoln in 1841. So think about that.

Yeah., Why, is, that?, uh, because, it's, the paradigm that feeds the pharmaceutical industry. It doesn't feed outcomes cuz our outcomes are not better than they were in the 1950s, the year I was born.

How, are, you, where, is, the, like, in, terms of more people being sick or people not being helped?

More, people, being, sick, and, if, you, are sick, your ability to get better, right? Emipramine was released in the 1950s. We don't have anti-depressants that are more effective now. We have ones with fewer side effects but not more efficacy. Thorazine was released in the 1950s. Rolin was released in the 1950s. Um why? And so I asked the question and and when I when I was growing up, my dad had two favorite phrases. was his first one. Like everything was And no, no. And so when I'm like, well, why aren't we looking?

They go, well, it's the future. And I'm like, no, we should do it now. There's technology now. And in 1991, I went to a lecture on the imaging study we do at Aean Clinics. I have 11 clinics around the country. It's called brain spec imaging. ect is a nuclear medicine study that looks at blood flow and activity. It looks at how your brain works. And

how's, that, different, from, functional MRI? So, functional, MRI, is, harder., You, have, to catch that difference in brain activity. Spec actually gives you a look at how the brain works over time. So it looks at about a twominut snapshot of brain activity, but it happens to be very consistent over your lifetime unless you do things to change your brain. And so now we have almost 300,000 scans we've done on people from 155 countries. And literally it changed everything in my life from the time I go to bed because what I realized most psychiatric illnesses are not mental health issues they're brain health issues. Get your brain healthy

and, your, mind, will, follow., And, so, when you how, is, that, what's, the, difference between mental versus

so, if, you, think, of, it, as, mental, health? So number one, no one wants to be called mental, right? Because it shames you. It's stigmatizing. And it's sort of about you. When it's brain health, well everybody wants it. And if it's mental health okay diagnosis symptom clusters,

let's, do, this, medicine, or, that, medicine. Right? As a family doctor, you treat more psychiatric patients than most psychiatrists. Uh it's like almost half of the patients that come see you are stressed. They're not sleeping. They're anxious or depressed

especially, my, pain, patients. And, the, tools, you, have, in, a, limited office visit is medicine. And yeah, it's like okay, symptom clusters medicine or therapy, and then I'll see you back. Where if it's brain health you have to lose weight because I published three studies on 33,000 people that show as your weight goes up, the size and function of your brain goes down, which should scare the fat off anyone. You have to get your diabetes under control. you need to go to bed. Alcohol is not a health food and marijuana is not innocuous. So what you you begin every patient, this is not true if it's sort of a mental health issue. If it's a brain health issue, you have to ask yourself whatever you're doing today, is it good or bad for your brain? So it's a completely different paradigm and a completely different discussion. Mhm. I'm trying to think of how I go about seeing a patient that perhaps has a a psychiatric concern

or maybe even doesn't and doesn't realize that they have a psychiatric situation going on. Um, obviously doing the symptom clusters, the checklists the PHQ9s, all of these GAD 7s that they fill out and then you're right, it's either therapy or medication, a combination of medication, and then see you later. Especially with our broken health care system, it's near impossible for anyone with not the greatest insurance or paying cash to even get therapy, let alone quality therapy. So I see that happening. But the idea of weight loss and getting their diabetes under control to me as a family medicine doctor, especially as a DO who thinks very holistically, that is almost always included in my mental health uh portfolio. Is it just because I'm automatically thinking about mental health as brain health?

No,, it's, because, you're, rare., that, very few family doctors go you're depressed could be from the inflammation you're carrying creating from the extra weight and the ultrarocessed food.

It's, you're, depressed, that, means, you need an SSRI and you know the serotonin hypothesis for depression is it's not well supported. Oh

for, sure., and and, we've, gone, back, and, forth, on, is, it receptor modulation, is it?

See,, I, I, don't, think, depression, should be an illness. I think depression is like chest pain. Nobody gets a diagnosis of chest pain. Why?

That's, in, my, ICD10, diagnosis. Well,, yes,, but, but, no,, nobody, gets, no thoughtful cardiologist goes, "That's your problem. You have chest pain." It's a symptom. Mhm.

Um,, depression, is, a, symptom, that, has many different causes and there are certain brain patterns that respond to SSRIs, uh, especially if you have increased activity in an area of the brain called the subgenial singular gyrus. So yes SSRIs work for that, but what if you have low activity in that part of the brain? SSRIs can make you violent oral. And there are blackbox warnings on SSRIs. blackbox warnings on every psychiatric drug because depression can happen from a head injury. Um, like you had a whiplash injury, so you never even really thought you had a head injury.

Um, it could come from toxic exposure like lead or heavy metal or mold. It could come because your brain works too hard from Lyme disease or not hard enough. And so the the standard your PHQ9 is elevated. So here's an anti-depressant plus therapy or one or the other. And I'm like, well, why are you depressed? And that's not the question people really ask.

Uh, I'm, curious, about, the, chicken, or, the egg scenario with the weight and poor diet. I have patients that I believe that there's a component of their weight, their diet, their choices in life are impacting their feelings leading to the symptom of depression because technically I don't diagnose someone with depression. I diagnose them with major depressive disorder or dimeia some kind of uh more DSM appropriate diagnosis. So, how do I know? Is this a symptom or a sign of them having major depressive disorder leading to unhealthy eating or is it the other way around that the unhealthy eating is causing those symptoms?

Well,, I, would, think, we, should, look, at their brain before we go about changing it and then I think a really good detailed history will give you a good idea. Now, if you can't get a scan, um look at their ACE score. And I don't know if you do that routinely, uh, but I published a study last year on 7,500 patients, uh, looking at adverse childhood experiences. So on a scale of 0 to 10, how many bad things happened to you as a child? And so if you have increased trauma, you have increased activity in your limbic or emotional brain. you know, when we talk about the pain book in the suffering pathway of the brain. So, you're more likely to eat uh simple carbohydrate foods because that raises serotonin. You can get an insulin response. Then it raises tryptophan in the brain and serotonin and you feel happy. Now, you don't feel happy really.

You feel happy. You feel happy for the next, right? I want I want my patients to feel good now and later versus now

without, the, negative, effects, of overeating without, the, negative, effects.

Um, so, uh, in, these, scenarios, uh, when let's say they have elevated ACE scores and as a result they're having worse lifestyle changes how does the imaging getting the imaging improve that level of treatment? Because let's say I have a patient who has a high a score who's consuming a lot of foods. We would be discussing the consumption of those foods as part of their metabolic workup knowing that there's an added benefit to their mental health state, but it would be primarily focused from a metabolic standpoint. So what does the imaging add to it?

Um so many different things. The first thing it adds is compliance because people see their brain, they begin to have a relationship with their brain and they want it to be better. Okay?

So,, it's, the, reason it's, showing, them, a, bad, EKG, when, they're having chest pain

and, or, high, liver, function, tests, and they're drinking fatty liver right?, in, 66%, of, the, time, if, you, show them an abnormal lab test, they want to do something to make it better. But now so when I did my first scan was 1991, I scanned my mom the week before and her brain was beautiful and mine wasn't. And I developed a concept I call brain envy. Freud was wrong. Penis envy is not the cause of anybody's problem. the brain envy, right? That's the organ where size really does matter. You want a healthier brain and I just wanted my brain to be better. So that leads to a cascades of decisions.

If you go, is this good for my brain or bad for it? That's the first thing that I felt with imaging compliance and it decreases stigma

and, it, gives, you, as, a, physician, targets to go after is the brain overactive so I need to calm it down and from a medicine standpoint SSRI or anti-convulsant medications calm it down but if it's low in activity to start and you calm it down you've just disinhibited that person which can be

well, there's, some, activating anti-depressants well butrin is a common option

but, but, how, would, you, know, where, to start well, based, on, symptoms, and, what, they're

based, on, symptoms, but, what, other specialty in medicine acts without imaging

I, don't, know, if, that's, a, valuable question though because not every specialty is going to have equivalent need for imaging. For example, for me to make a diagnosis of a UTI, I don't need any imaging or any lab test.

You, don't., It's, a, clinical, diagnosis. So, if someone has symptoms, dysura super pubic pain on a physical exam perhaps CVA tenderness, I can make that diagnosis. I technically don't need the tests. There are in moments where it's valuable to get a test if you're concerned about a kidney stone, if you're worried about uh someone who has a high risk UTI like someone in pregnancy, so you need to get a urine culture to confirm sensitivity. So there are there's a lot of these specifics, but I I'm interested in your reasoning, the compliance, the stigma.

Uh I think those are really and, the, road, map and, the, road, map, of, treating, to, to, some outcome. So now I'm curious about the compliance portion of that. Uh, not every patient's going to have access to imaging simply because of the nature of our health care system. It sucks. A lot of people can't afford even basic medications. The other day I prescribed Clinomyosin for a patient and their insurance denied it because I sent capsules, not tablets. Just some ridiculous notion, which is typical for our system. So when I think about our our system and who uh I treat especially in a community health center, I think about those people who can't get imaging and then the worry that it instills in them as if I'm treating them badly because they will view our podcast or they'll hear a news story about the need for imaging and that we're functioning basically as we're blind and then those people feel like they can't get care

from me or their psychiatrist. Do you worry about that outcome? So from the beginning of the time I've done imaging and that's why I write that's why online you can take our brain health assessment know what based on our work what type of brain you have you have a balanced brain spontaneous brain that's my ADD group a persistent brain my OCD group sensitive or cautious brain so these symptoms tend to go with these patterns. So, I think people can benefit from my work for free, right? They go to the library and get change your brain, change your pain or change your brain, change your life or any of the 40 books I've written or they can listen to our podcast. And so there's so many people everywhere I go people go, "Your work changed my life."

And they never got a scan. Um but I would argue but I would argue psychiatry, is, broken, and, we, need, to, be viewed as a real medical specialty with imaging because if you don't look you don't know. So for example

one, of the, big, lessons, is, mild, traumatic brain injury is a major cause of psychiatric problems and nobody knows it because psychiatrists don't look at the brain or family doctors don't look at the brain and this person who's having problems with domestic violence or this person who's been incarcerated three times or this person that is homeless and no one's thinking did that car accident damage their brain.

So, are, psychiatrists, who, are, not, using brain imaging by functioning without looking, are they doing a disservice to their patients?

I, think, they're, flying, blind, and, they're missing so much that could be gotten from imaging. Is your brain hurt? Is it toxic? Is it overactive? Is it underactive? like I'm a psychiatrist. Why do I care about Lyme disease? Because it's a major cause of psychiatric problems. Um yeah, I think as a profession we can do so much better.

And, you, mentioned and, that's, why, in, medical, school psychiatry is sort of looked down on. It's like really that's

Well,, is, it, looked, down, upon, because it's the lowest reimburseed field out of all of the specialies?

No,, I, don't, think, so., I, think, it's family, medicine,, pediatrics,, and psychiatry are the lowest ranked fields and they're the lowest three I was interested in when I was a medical student. Uh because it wasn't about the money. It was about where I could do the most good where

Well,, we, definitely, need, the, most, help in those specialities because I think a good primary care system is the backbone., I, don't know, if, you, agree, a good healthare system. Yeah, you should have a wonderful family medicine doctor but you know, most people use the emergency room

or, urgent, care., There's, no, continuity and it's that the relationship and I trained in the early 80s before managed care took over medicine. And I'm so grateful that I did because in the early '9s, psychiatrists became the prescriber and they just ruined the profession. Like for me, I was taught to do family therapy and group therapy and individual therapy and medicine was just sort of a part of what I did. And I I wouldn't be happy if I was the prescriber. Mhm. Uh probably in the same way that I can relate to that in being a family medicine doctor, there are a subset of family doctors who have trained to be referologists who, oh, you have high blood pressure here's a cardiology referral. Oh, you have UTI, here's urology referral. You don't need to do that. I constantly have to remind my residents that 90% of all medical ailments can be handled by a primary care doctor. And there are

subsets that are complex that require specialist intervention. uh procedures. We don't do colonoscopies as a simple one surgeries. So there's a lot we can handle and I think there needs to be improvement across all all these fields especially in the area of education. So much how you're talking about the prescriber, I'm talking about the referer in in that.

No,, I, love, that., It's, the, first, time, I heard that term and it's like no, that's not why we went to medical school. Correct. We had to take all of those rotations.

Exactly., And, we, forget, them, because, it's easy to just refer. It also shifts the legal concern. Oh, well, I sent you to the cardiologist. They made the decision. It takes the decision-making pressure off me. So, I don't like that in terms of practicing medicine that way. So, I agree with you in that regard. Um, you mentioned some of these um brain classifications that you do to see if someone has a uh ADHD type brain. You know, we have all of these validated PHQ9s, GAD7s, Vanderbilt, MCATs. These are questionnaers we give to patients.

Sometimes we give them to parents to teachers. Do you not like those uh ways that we

give, them, to, our, patients?, But depression is clearly not one thing. Anxiety disorders are clearly not one thing. Now you get a high GAD 7. Um so what do you do with that? Do you give them a benzo that's addictive that increases their risk of dementia?

I, mean, that's, out, of, standard. You, don't, but that's, out, of, standard, care., 27% of all doctor visits someone's getting a benzo. This is

poor, medical, care., But, that's, not, what the agencies recommend. Right? If we were to go on to the APA or any of these organizations, they wouldn't say that that's standard.

I, mean,, hopefully, you, teach, them diaphragmatic breathing, you give them things like theine, maybe from a medicine standpoint, proprenal. Um but that's not

I, mean, now, we're, even, introducing, uh allergy medication for people who have anxiety. So

yeah, the, antihistamines, would, also increase the risk of dementia. Yeah, for sure. Overuse a lot of But I mean, every medication has some sort of trade-off

right?, But, teaching, someone, not, to believe every stupid thing they think. And teaching them diaphragmatic breathing, no side effects, no increased risk of dementia, probably decrease the risk.

It, sounds, like, you're, a, fan, of, therapy, of cognitive behavioral therapy, are you?

Uh,, absolutely. Okay., Um,, and, I, think, family, doctors, if they just learn some of the basic principles, right? Oh, let's I talk about killing the ants, the automatic negative thoughts that steal your happiness. Whenever you feel sad, mad nervous, or out of control, write down what you're thinking and just ask yourself whether or not it's true. Um and in the book, part of the doom loop is an invasion of ants, these automatic negative thoughts. And there's nowhere in school where we teach kids not to believe every stupid thing they think. I was 28 years old in my psychiatric residency when one of our professors said, "You have to teach your patients not to believe every stupid thing they think." And I'm like, but I believe every stupid thing I think.

Revolutionary, idea. It's, like,, but, that's, such, an, important concept. You, know,, if, patients, came, in, knowing how to manage their minds, they're going to have a lot less back pain. They're going to have a lot less neck pain because negative thinking goes to more tension, which then leads to more pain.

Yeah,, we, talk, about, that, a, lot, on, the channel. Are you familiar with Dr. Sarno's work? love Dr. Sers. I talk about him in the new book because what he basically says is chronic pain is repressed rage, but he doesn't do a great job of helping people get rid of the rage. And so in the book, Polyiana actually meets Hannibal Lectar because you have to have a mechanism to get in touch and express the rage in an appropriate way while you're directing your mind to what's right rather than what's wrong. Yeah, I think he was ahead of his time to some degree.

And people will point out flaws of he had this theory of increased muscle spasms due to decreased uh blood flow to a specific area. And when that was somewhat disproven or questionable, he threw out all his theories. And I feel like as someone who's practiced medicine for over a decade, I've seen his theories play out, not just from uh I see this happening with my patient, but direct intervention in handling anxiety stress, childhood traumas, just discussion of those issues leading to elbow pain going away. So, I believe that there's definitely a variable there. Sometimes it's hard to get patients on board, though. Uh I've had patients get very offended at me when I say, "Hey, um what's going on in your life uh emotionally? what's what how what was your upbringing like? And they'll say, "Why the hell are you asking me this?" And I explain. They say, "Well, you're one of these doctors that just wants to blame it on

me." And I say "No, no, no. Quite the opposite. I'm explaining that you have an internal regulator that basically dials up volume when you're stressed, as it's supposed to, as part of its survival mechanism, and then downregulates it when they're having a good time." Because you just told me that your pain is only there when you're working, but not when you're having fun with your friends. But it's still sometimes hard to get buy in. What's your strategy on getting that buy in?

People, say,, "Oh,, well,, you, think, it's all in my head." Well, absolutely. But it's in your brain, which is in your head. That if you've had pain for more than a couple of weeks, that now has a signature in your brain. And if we don't get your brain healthy, the pain's going to stick around. And one of the reasons I wrote change your brain, change your pain. I'm 71. Is I just got tired of being in pain all the time. It was my back, it was my knee, it was my neck, it was my hip. And I'm like, what is going on? So read Sarno's work. Started looking at the scans of our patients in chronic pain and I'm like, oh, pain gets stuck in your brain. And the the one study that just completely blew my mind was 80% of people my age have abnormal backs who have no pain.

Oh, yeah,, that's who, have, the, classic, example, pain. Why, try, and, talk, patients, out, of, MRIs for their spines just because

and, what, what, I, have, found, that, when people go get them after I teach them this, their abnormal neck doesn't freak them out. So they automatically go get surgery. They go, "Oh, 70% of people my age have abnormal necks who have no pain." So it means your body can figure out how to heal around the arthritis in your neck or the crushed disc in your neck. Um, and that's so freeing uh to me. And it's like if I calm my brain down, my pain's going to be less. And now I'm in no pain at all, which I dearly love. Uh because it doesn't freak me out if it if I wake up and my neck is sore.

Sure., What, do, you, say, to, patients? Because I've had this uh end up even with the patient filing a complaint against me. I have a whole video on the channel about it where I was trying to discourage the patient from getting an MRI uh for low back pain that I believed not to be from a spinal cause based on my physical exam, the history of present illness, and I felt like there was an emotional component. I introduced it. I asked how they feel about that. They said, "I still want the MRI." I said "I'm happy to order the MRI, but I'm just explaining that if we find something on this MRI, we're likely to end up chasing it when it's not the cause." And she didn't like that answer.

So I'm curious how you go about avoiding unnecessary imaging in those cases. Well,, you, know,, I'm, a, huge, fan, of informed consent.

It's, that, this, is,, you, know,, do, we, agree on what the problem is? So back pain. Okay, you have back pain. Here are the things we can do and here are the pros and cons of those things. What do you want to do? You decide. And if I've done a good job of connecting with them, generally they'll choose what my recommendation is, but not always. And as long as it's not irrational, I feel like I work for my patients. I don't work for the insurance companies. I work for my patients. And generally that works out for me. Um, and and I think works out for my patient because if they do something that, you know, I don't think I would have done it. Um and it doesn't work, they trust me because they feel like I'm their partner.

So,, you're, saying, perhaps, I, didn't, form a good doctor patient alliance with this patient.

So,, alliance, is, so, important., I, mean,, I I don't know because I wasn't there and you probably were as kind and empathetic and listening as you could have been. Um, you know, one of the things I learn is, and I guess I'm free associating you have to ask patients 10 times whether or not they've ever had a brain injury. Shocking to me. So, I start imaging. I'm like, "Oh, have you ever had a brain injury?" You can see the damage to the left front and to their anterior temporal poles. It's sign of traumatic brain injury. They go, "No."

I'm like "Well, are you sure? Have you ever fallen out of a tree, fell off a fence, dove into a shallow pool, had a concussion playing sports, been in a car accident? No. No. No. No. No. Oh, it's always no. No. No. Oh. I fell out of a second story window when I was seven. Do you think that counts? where I fell out of a moving vehicle going 30 miles an hour. Do you think that counts? And um I just think it's one of the major causes of psychiatric problems.

So, when, you, have, a, patient, that, you, come across with a history of falling out of a window when they're seven, how do you alter your approach to treating that patient?

Well,, we, go, repair, the, brain, injury, right? If you don't do that, then they're going to be living with chronic whatever depression, irritability

not, surgically, not, put, them, in, a, hyperbaric, chamber. So, I did the big NFL study when the NFL was sort of lying. They had a problem with traumatic brain injury in football right? Everybody knows CTE.

Um, and they had the wrong thoughts on CTE which we could talk about. Um but in 1999, Brent Boyd was offensive guard for the Minnesota Vikings, came to see me. Clearly had traumatic brain injury on scans. And by then, I'd already been scanning people for eight years. Um he filed a workers's comp claim. The NFL said he was faking and called me a quack and just completely dismissed it. Mhm.

Well,, in, 2007,, Anthony, Davis,, the, Hall of Fame running back from USC, uh came to see me. His brain at 54 looked like he was 94, but 5 months later, he's dramatically better. And, uh, we partnered with the NFL Players Association in Los Angeles, published the first largest study on 100 active and retired NFL players, high levels of damage, but 80% of our players got better. We put them on a really good multiple vitamin, high dose, high quality fish oil and a supplement that brain supplement that works in six different ways. 80% of our players got better. Their imaging was better. And for those that didn't, we put them in a hyperaric chamber and that improved our outcomes even more. So I'm really excited. So the idea is okay boxing football soccer rugby, horseback riding, they're brain damaging sports,

but, you, can, get, better, if, you, put, the brain in a healing environment. So we specifically target repairing those parts of the brain. and I own a supplement company, so I I'm a huge fan. Um, but I'm also a huge fan of hyperbaric oxygen therapy. Published a study on soldiers who had blast injuries, showed significant improvement after the first session and then much more after the 40th session.

You, mentioned, you're, the, owner, of, the supplement company. How do you protect yourself from the conflict of interest that can happen in scenarios like that? you know, I write about the research. Uh, I love what we do. I'm so proud of what we do. So, for example um, we make happy saffron 28 randomized controlled trials, 30 milligrams of saffron equally effective to anti-depressants. So, I think my job is just one tell people I own a supplement company. So

clear, disclosure, people, know, it, and, then, write, about, the science behind the ingredients we have. And so I always say no brand violations that we only want high quality things that have efficacy

and, I, love, that., So, it's, it's, not, a secret, right? Brain MD by Dr. Daniel Layman. And people go, "Oh, but he makes money." Well, I'm like, "No margin, no mission." It's like, "That's not illegal, right? All doctors get paid for what they do." Um, but I love it. And after we made happy saffron with saffron, zinc, and curcumins, there's a brand new metaanalysis on 192 studies on 17,000 patients. Saffron effective as an anti-depressant. But when you add zinc and curcumin, now this is true. If you add it to saffron or lexapro, if you add zinc and curcumins they actually work much better. So I was very happy that I figured that out before.

Um, for the the conflict of interest portion, people always uh I get this sent to me, you're a pharmaceill uh you prescribe medications, therefore whatever you're recommending is not good. And we hear even Secretary Kennedy of HHS now say think similar things. Basically, people badmouth pharma because they're forprofit. Do you think that's unfair?

Absolutely., Um, I, mean, there, are, other reasons to badmouth pharma. Um, but we absolutely need pharmaceuticals and for the right brain, they're incredibly effective. And if the companies didn't make money, they wouldn't be in business.

And, I'm, a, huge, fan, of, medicine, and prescribe them when I think it's appropriate. And I'm a huge fan of supplements. And why why did I get interested in supplements? When I started imaging, I realized some of the medications I was prescribing were not good for the brain. And you remember in medical school, they go first do no harm and use the least toxic, most effective treatment. And so if omega-3 fatty acids headto-head against Prozac were more effective in a study from New Zealand um, well, why wouldn't I start with that? uh or

well, it, depends, how, severe, the, person's symptoms are. Someone is having ideation. You don't want to start with omega-3s.

Well,, nothing, works, by, itself,, right?, If you look at the studies, there's not much that works by itself for the most severely depressed people. Um, and I would argue it's because often it's not only the depression, but it's the head injury that's complicating it or it's the infection. Um

yeah, you, mentioned that's, why, I, got, interested, in, it. Yeah., You, mentioned, there, are, some reasons to be critical of pharma. What are those? Well, I think that they market them nonstop and so they almost creating the market for it. Um

how, is, that, different, than, your supplement line? That's, a, good, question., Um, supplement companies like mine don't have nearly the money that pharma has. And so

well,, the, Global, Wellness, Institute estimates that the wellness industry is a $2 trillion a year industry in the United States and big pharma is 700 billion.

That, would, shock, shock, me,, right?, Cuz, I own a supplement company. Knowing our budget as opposed to Eli Liy's budget it's like we're not even talking the same thing. or even the very large supplement companies. So, I just don't know the

Yeah., Well,, let's, take, the, numbers, out of it because that needs to be fact checked. But let's say um uh for those who want to advertise a supplement, like if I want to start my own supplement company, we have 14 million subscribers very healthy YouTube channel, very active audience. If I wanted to start a supplement company, it wouldn't take much. I have to get someone to give me the ingredients to create the label send it out. But pharma has to go through trials. The FDA has to approve it. They have to spend a lot of money.

Don't you think it's easier to create a supplement than it is to create a pharmaceutical?

Yeah., No,, I, think, absolutely, you're correct. And there are a lot of bad actors in the supplement world. So

finding, somebody, you, trust, is, important. What's a bad actor in the supplement space?

Well,, somebody, who, doesn't, test, the ingredients. Someone who you don't feel confident what it says on the label is actually in the bottle.

So,, how, does, a, average, person, to, decide that? I, think, they, have, to, find, brands, they trust. Consumer Reports, uh, does analysis, does independent testing. There are other companies that do that.

Yeah., Like, Consumer, Labs,, Consumer Reports have done a lot of these trials and they go to the localarmacies. They take things that are top selling and they find 70% of them don't have accurate ingredient lists. Shouldn't that worry people about the supplement industry?

It, should., And, I, think, they, should, be cautious careful. And, again,, I'm, trying, to, figure, out, what practical advice to give them there. So how can they be cautious careful? They can't test what's in there. Which is why I think the

go, to, a, place, like, consumer, labs, and, go which are companies that are reliable consistent. Uh I think that's my best advice. But before I had my supplement company, I would do that and recommend certain brands for my patients. Mhm. And if let's say so the FDA currently doesn't look at supplements, right? But they look at the pharma industry to make sure everything is standardized, validated efficacy rates are tested. Even if pharma markets a medication for a use that it wasn't initially approved for they get in trouble, right? They get huge.

If, the, FDC,, the, Federal, Trade Commission, if you're marketing a supplement, uh inappropriately they'll send you a letter, they'll fine you, they'll put you out of business.

Yeah., You, have, to, be, somewhat, careful because I looked into this into starting a supplement line. I if you don't say that something clearly cures something and you just say balanced brain or uh healthy energy levels and you don't clearly say that it does that you can get by making all sorts of claims and historically people have destroyed their livers with some of these supplements the hydroxy cut scandal of years ago. So there's all these sort it's like kind of the wild west out there when it comes to the supplement.

Yeah., I, read, one, study,, your, chances, of dying from a supplement are like 60,000 times less than dying from a medicine. Um, now it doesn't mean that you shouldn't be thoughtful and careful um on what you put in your body. You absolutely should be. Um but when we look at pharma and the level of death from pharmaceuticals it's not even in the same league with supplements.

So, death, is, the, way, you, judge, the, safety of these medications. Well,, it', be, one, way., Well,, sure., But the idea that 70% of them don't have the thing in them, that's pretty problematic, too. Imagine the pharmaceutical industry turned out that when we tested their their medications they didn't have what was in there. their insulin was only present 70% of the time. That would be a big deal.

You, know,, I, can, only, speak, for, Brain, MD and I'm very proud Yeah., of, what, we, do.

Do, you, think, the, FDA, should, be, out, there randomly sampling and testing to make sure that these supplement companies have what's written on the label?

I, I, think, it's, a, it's, a, good, idea, to police whatever people put in their bodies.

Mhm., Yeah., I, I'm, always, for, that, just cuz right now it's again such a wild west. Even Consumer Reports published recently a study of heavy metals inside protein powders and how people can be inadvertently trying to be healthy but perhaps getting especially if they're taking mega doses, you know, some of these bodybuilders scoop scoop scoop scoop. Uh and before you know it, you can get a serious problem developing there. And some of the brands are very legitimate, very popular brands that you see selling quite well. So, I'm always trying to figure out what's a safe recommendation that I can give universally to my patients. I'm curious uh we never kind of settled on our uh question about the compliance issue that you mentioned that getting these imaging tests is valuable for compliance and I was talking about how it could potentially scare people away from seeking health care from a mental health

care specifically from a provider who doesn't do imaging. Do you have any fear that you might be discouraging patients from getting good quality medical care or mental health care just because they're not doing imaging?

Well,, I, guess, you, know, the, question, I have is do you really get good quality brain health, mental health care if you have no idea what's going on?

Well,, that's, a, good, question., Maybe, you can answer that. That, you're, treating.

I, I, don't, think, so., I, mean,, I, I, I, wanted to write a book once called Flying Blind and the Rain of the American Mind. Wow.

And, um, and, I'm, sort, of, sad, I, didn't write it. I actually had a book deal for that book. Um and I'm like, it's just too negative. But what is happening in American society today where 57% of teenage girls report being persistently sad or that it has increased significantly in the young since the year 2000 that with all this sadness the use of anti-depressant medication has skyrocketed. 2021 there were 337 million prescriptions written for anti-dopressants and we're not teaching people how to love and care for their brains or manage their minds. And I think if we imaged that people would care about their brain a lot more. They care. They would just eat better, think better. um and do a better job of taking care of themselves.

So, I I'm I think we're in I call it a whole four crisis. Um we haven't talked about this. Don't hate me. God, it's so frustrating. I'm working with the White House on a national brain health revolution initiative uh specifically with the White House faith office because they believe that brain and mental health are sacred human rights and uh I have people that um just love me and support my work there. And as I explain it, it's we're in this whole four crisis. We're in a physical health crisis. I think you and I would agree with that. With 75% alltime high of people overweight or obese, 50% diabetic or pre-diabetic 90% of our healthc care dollars are spent on chronic preventable illnesses.

We have these epidemics of anxiety depression autism ADHD addiction before the pandemic and then everything got worse. um loneliness 58% so biological psychological, social, spiritual where 58% of young people report a lack of meaning and purpose. But I believe the answer to these epidemics is not to see them as separate disorders, but as different expressions of the same unhealthy lifestyle that have exactly the same cure, which is getting your brain, mind, relationships, and spirit healthy all at the same time.

Yeah., You're, looking, at, it, more holistically, right?, I, did, a, program, with, Pastor, Rick Warren called the Daniel Plan. Um actually came out of a prayer. I went to my church. I just finished writing Change Your Brain, Change Your Body. It's 2010. Went to my church on a Sunday morning. I was so happy. And walk by hundreds of donuts for sale for charity. And it just pissed me off. I'm just like, I'm going to church to get my soul fed. These people are trying to kill me. And I prayed God would use me to change the culture of food at church. And two weeks later, Rick Warren, who is our generation's best-selling author, he wrote The Purpose-Driven Life, sold 50 million copies. He called me up. He said, "I'm fat. My church is fat. Will you help me?" We created this program called the Daniel Plan that ended up being done in thousands of churches around the world.

And, uh, like,, how, do, you, get, people healthy? you get them healthy where they live whe in their community in their churches in their businesses in their schools and uh that's part of this sort of national brain health revolution.

Yeah., These, uh, mental, health, this, mental health crisis that we're facing we have as you said teenage girls experiencing high level of sadness. Uh the amount of SSRI and anti-depressant uh prescriptions are going up and up. uh you think this is partially due or maybe majority due to the fact that psychiatrists are ringing their brains.

I, think, that, as, a, specialty we have gone to be the prescriber rather than the healer. That anti-depressants don't cure anything. They suppress symptoms. I think um they obviously it's not psychiatry's fault. I'm

I've, never, heard, a, psychiatrist, say, that anti-depressants cure depression.

You, don't, hear, that. Yeah. That, it, cures, anything., Right. Right., I, I, heard, once, John, Paul, Deoria speak. He uh founded Paul Mitchell, the famous shampoo company. He said, "You never want to be in the order business.

You, always, want, to, be, in, the, reorder business.", And, you, know,, once, you, start these medications, people don't stop them. Well, the goal is not to use them indefinitely. I think the correct indication is to create a bridge to get people over their life.

How, many, of, your, patients, once, you, start them stop them? Almost, all. I have a rule that if we're starting an anti-depressant, we're creating a date that both me and the patient are comfortable with where we're doing re-evaluations whether or not they feel that they're in a safe place to come off given their circumstances. Because being in a community health center, I'm working with people who are disadvantaged, who are taking care of multiple children on their own, family members in prison, and as a result, sometimes they need the anti-depressant. They don't have the capacity to get scans to get a hyperbaric chamber. It just it's not feasible. There's the perfect model and then there's the realistic model by which a lot of family medicine doctors have to practice by and we're talking about two different things. Um yes, I think in this situation, but most people who start stay on them. Most

people who start don't have Dr. Mike that go, we're going to start this and then we're going to re-evaluate it and work on getting you off of it. That's not been my experience.

I, agree, with, you., Uh, I, think, there's, a lot of reasons to that from what I've seen in the medical community. A big part of it is the consumerization of it. You know, we blame pharma for marketing these medications when I have seen patients say that I'm not getting rid of this. This helps me and I need this and I can't function without it. and if you're not prescribing it to me, you're evil. And perhaps they are right in some instances. So I don't want to discredit what they're experiencing. But in some instances where I feel that we should be having that discussion, some patients aren't open to that. Well, and ultimately I I think my job is informed consent like I we talked about before.

But head-to-head against anti-dopressants, exercise is equally effective. Head-to-head

again,, there's, a, lot, of, caveats, that need to head headto head but, learning, how, not, to, believe, every stupid thing you think is equally effective.

Sure. And, omega-3, fatty, acids, and, saffron., And so I'm thinking let me at least

go, the, because, a, lot, of, patients, who come to see me, they don't want to take medicine. They're like anything. Which is why I think our worlds are so different. You're having this pre-selected, highly motivated treatment preferred specific group come to you versus I essentially function in the wild and you're working in a zoo for lack of a better example with domesticated

animal., I, was, an, army, psychiatrist, for seven years and but, I, mean, in, your, clinic

uh and, here, those, patients, aren't, super excited about a specific approach.

Yeah., No,, the, people, come, see, me, are excited about it. huge. Do you see that? That's a huge advantage.

But, then, a, lot, of, them, grandma's, paying, for, them, to, come, see, us and they're not super excited and we have to get them excited and the imaging really helps that.

Well,, let's, talk, about, the, imaging because Kim Kardashian recently got some imaging done and you found some results on her. Tell me about that.

Um,, she, had, sleepy, frontal, loes, and what, does, that, mean? So,, SPECT, is, a, study, of, relative, blood flow. looks at activity. Actually 49% of the tracer is taken up in the mitochondria in the brain and uh she had less activity in the front third of her brain. Um which means it's going to go with things like forethought and judgment and impulse control and focus and uh she wanted to be better. She's in law school and getting ready to take her boards and um or the bar, getting ready to take the bar and wanted to function better. And I had previously seen Kendall who had postcoid anxiety and Khloe who had a traumatic brain injury.

She was in a bad car accident. Um and they got benefit from my work. So I saw Kim and it just blew up because the little clip they played was her and I talking showing her brain with lower activity in the front part which is not good for her

and, once, you, find, that, there's, this, low activity what is your recommendation in those scenarios

is, fix, it, is, improve, it, and, so, you, can do it with medicine you can do it with supplements you could put them in a hyperaric chamber and see that does it. Uh there's um neuro feedback that you can do. There are also some stimulating um like uh treatments, you know, things like TMS. Um so my job is to give her the options. Uh I think we went with stimulating supplements and see how that works. And the cool thing is you can look at it again and go, "Well, is that working?"

Um,, if, you, were, to, interview, uh, Kim, and hear all these struggles that she's having taking the bar, issues with impulse control, were would you have been able to come to that same diagnosis without the imaging?

Well,, I, would, have, been, able, to, guess, at it, but I wouldn't be able to know.

Well,, there's, a, difference, between guessing and asking validated questionnaires. So I had this discussion actually with the head of the National Institute of Drug Abuse and she goes "But the brain has language and it's like no, you can't see low blood flow from just talking to somebody that

Well,, I, could, see, low, blood, insane, on patient position, in, in, my, mind., It's, like,, well, how would you really know if you didn't look?" And it's like, "Oh, well, I can tell because you had these symptoms." It's like, "No, you can't." It's like that's a leap in logic that just isn't correct. Cuz that's like that's like that's what most psychiatrists believe now. Oh, you have six of these nine symptoms. You're depressed. That means your limbic brain is too active. I'm going to give you something to calm it down.

Well, SSRIs wouldn't have blackbox warnings if they if it worked like that all the time. And it's just not my experience even a little bit is I can get a hundred people that are depressed and we're going to find seven or eight different patterns. In fact, I wrote a book um on ADD uh healing ADD, see and heal the seven types. I'm like, it's not one thing. Why is riddling controversial when it can take the right kids from C's, D's, and Fs, A's, and B's but make other kids s, right? I mean why is Riddle and controversial? Because it works dramatically well for some kids and it disrupts other kids or adults.

You said that based on uh your questionnaire, you would still have questions that needed to be answered that you could get answered by this imaging protocol. Uh does your treatment then change

79%, of, the, time?, I, published, a, study, on this where we took 107 cases, gave them to boardcertified psychiatrists, took out the imaging, and we got here's the history, here's the mental status exam here are the answers to the qu questionnaires. What's a diagnosis and what would you do? And then we added imaging and we go in what percentage would it change eight times out of 10

from, their, protocol, it, changed, their guidance? Changed, their, guidance. Why, is, the, imaging, so, controversial? Like even when you came in you said that people hate you now. Is it because of the imaging?

Well,, some, people, love, me, but, um you, have, a, lot, of, people, who, love, you., I have a lot of people with me and but if I'm right and I think I am um that means 40,000 psychiatrists and actually hundreds of thousands family medicine doctors nurse practitioners um OBGYn doctors internists right everybody and their mother prescribes psychiatric drugs 85% of psychiatric drugs were prescribed by non- psychiatric physicians are flying blind. And when you say that they don't say thank you to that. It's like we need a new paradigm. And we need a paradigm based on imaging. Um because what imaging will do is completely reshape how we diagnose and treat people?

Why, don't, like, uh, if, we're, flying, blind, why don't we include this imaging? Why doesn't every family medicine doctor why does the American Psychiatric Association, American Academy of Neurology, why are they against this imaging?

Well,, not, everybody's, against, imaging. That's really the um Society for Nuclear.

Did, you, ever, read, um, Thomas, Cun's, book, The Structure of Scientific Revolution?

It's, such, a, good, book., It, was, written, in 1962 because when I first started imaging, there was all day seminars at the American Psychiatric Association on brain spec imaging in child and adolescent psychiatry. Um, all day seminars and I went I loved it. 1993 I taught in it and then they go, "Oh, you shouldn't use this." We're like, "Well why?" Um, remember I told you my dad "Bullshit no." I'm like "Bullshit no. Why? I'm a better doctor because I use this and it doesn't fit the paradigm.

It, does, not, fit, the, DSM, paradigm, is, we make simp we make diagnoses based on symptom clusters with no biological data. This is the paradigm

but, if, it, works, why, wouldn't, they, want it? Okay, so, Cune, talks, about, six, stages, of scientific revolution normal science. So, you're just going along doing what everybody else does. Stage two, somebody notices there is a problem. I prescribe Prozac. Some people get better. Some people want to kill themselves. Okay, we have a problem. Um three, the status quo sees there as a problem, but they make small incremental changes to protect itself and the money. And so, how many versions of the DSM are there? Well, there's six uh of it. Even though it's DSM5, there was three and three are um but it's the same as DSM3.

It's really not different at all. Um stage four, somebody comes up with a new paradigm, detailed histories, imaging natural ways to heal the brain in an integrative or functional medicine approach. We haven't talked about that yet. Stage five is the most consistent of all the stages, the rejection. It's like "No, you're crazy. This is how we do it. The brain has language. You don't need imaging."

You, know,, in, science,, we're, trying, to always come up with the validated solution to our problems. And when I read people who are smarter than me who understand this field, like the Society of Nuclear Medicine, I I I don't fully understand what they're talking about. if I can't argue the nuances with them. I can't argue the nuances with you. But their statement as an organization that is set out to seek the best for their patients perhaps imperfectly at times say that this imaging is not validated enough to be used. Um and it's not that they're against imaging. They're just saying that the imaging is not validated or can be used repetitively across a diverse group of patients. So, it's not that they're anti- looking at the braid they're anti- this specific method because they feel that it doesn't have any effect.

I, know, the, Canadian, Association, of Nuclear Medicine wrote procedure guidelines on spec as if I wrote them. That spec is indicated for head trauma for seizures, for dementia, for stroke for addiction, for toxic exposure, for neuroscychiatric indications. So it really depends who you read, right?

Well,, I'm, reading, the, largest, agencies that represent neurologists psychiatrists, these are it's like that me saying something fully against the American Academy of Family Physicians without evidence to say why I'm disagreeing with them.

Well,, I, have, 90, studies, that, I, have published and I have the world's largest database and I actually don't know what the point of us arguing about it is. I have more experience in this than anybody probably in the history of the world. And if you don't look, you don't know. And some people go, "Oh, no. We should just continue to do what we're doing," which is a disaster in our society. And I'm like, "No, I don't believe that. We need to do better. And if you don't look, you don't know." I I logically what you're saying makes sense. And I think evolutionwise scientifically, all these organizations will agree with you that we need to move in that space.

But do we have the randomized control data to be able to back these things up? Well, give me an example and I'll tell you what the research is. Is it

Well,, has, let, me, ask, you, a, specific question. Is there randomized control data on spec scans and their efficacy in a specific mental health condition?

Yes., Which, one? Well,, which, one, do, you, want, to, talk about? Anyone? I mean, if you go on PubMed,

well,, can, you, name, one, right, now? Gov, today. You're, the, leading, expert., So,, I'm, a family medicine doctor.

Distinguishing., One, of, the, most important things to do is distinguishing post-traumatic stress disorder from traumatic brain injury.

And, because, they, often, present, with similar symptoms, but the treatments are actually opposed to each other. PTSD generally you want to calm the brain down. Traumatic brain injury you have to repair and stimulate it. I published two studies on 21,000 people showing we can separate these groups with high levels of accuracy. In 2016, Discover magazine listed our research is one of the top 100 stories in science. Um, we could also talk about Alzheimer's disease. There are

That's, not, a, randomized, controlled study. I'm, sorry. That's, not, a, randomized, controlled study.

We're, talking, imaging. Yeah. This, is, not, a, pharmaceutical intervention where we're going to do a

Well,, the, goal, of, doing, the, imaging, is to create more customizable treatments as you said and if you have customizable treatments, your outcomes should be better. That's the randomized controlled study

and, our, outcomes, are, better., We published a study. That's, not, the, question, I'm, asking. Randomized control data is really important, wouldn't you say? To develop a causal relationship.

I'm, sorry., Say, this, again. Randomized, control, trials, are, very important to creation causal interventions to say that this isn't just a correlation. This is a causitive pathway. You need the randomized control data to remove outliers, to create a generalized group, to have them double blinded, to not know which one's getting intervention, which one's not, because it's great that you're helping people. And I am so for that you're helping people, and I want more of that. Now I'm trying to think as a family medicine doctor, how can we generalize what you're doing so that I can do it, too?

But in order for me to do it, I need to know it works from a randomized controlled study. Why don't we have that? So, design it for me because you're going to randomize.

Um,, you, got, imaging,, you, didn't,, so automatically it's not blinded. Well,, you, can, get, sham, imaging.

Okay. you've been doing this since 1991. Uh so I'm trying to look at you as the expert like do you not feel that it's an issue that there is no randomized control data? Like you're asking me to design the trial right now.

We, have, data, that, goes you get better and you don't. So who what's the difference in depression of people who got better and those who didn't? Where are you sourcing those patients from?

Well,, from, our, clinics. So,, all, your, patients, are, getting, the spec. You're, not, separating, into, groups, of here. We're treating patients who didn't get spec.

Well,, no,, not, everybody, gets, scanned, at our clinics. But, for, the, research,, you're, pointing out like you have this study that shows 84% of your patients improved, but we're not comparing them against a group of people who didn't get spec. No, but nobody is that I know of has outcomes like that.

But, do, you, think, that's, enough, for, me, to start doing spec in my clinic?

I, think, if, you, started, doing, spec, in your clinic, it would revolutionize your practice.

And, you're, saying, that, as, someone, who's passionate about it or that there's proof of that?

No,, I'm, saying, it, as, someone, who, has taught people around the world to do imaging. and and they become passionate about it.

Yeah., So,, we, talked, about, the, patient selection of it all earlier. How if you have patients who are highly motivated it can bias your outcomes. Like we do journal club in my family medicine residency and part of it is is there a bias from the patients? Is there a selection bias of who you're selecting? And when you have your clinic who people who love you, is there a chance that you could be introducing bias by only looking at the people who love you support you, and want your treatment? Well, I mean, we do have a more motivated group for sure.

We have a group um Yeah, I think it's a more motivated group for sure. And, what, outcome, do, you, think, that, has on the outcomes that you study? So, we actually did this study this week on compliance because we do a formal outcome study on everybody we see. I mean, I don't know if you know many clinics that do that but um the people who are very compliant get better way faster and much bigger numbers. So, we ask everybody about their compliance and compliance is just huge. I think you would agree with me.

Yeah,, for, sure., And, it's, great, that you're doing the reassessment because I feel like that's missed a lot of the time.

Well,, very, few, clinics, actually focus on outcomes. And for us, it's research, but it's also quality control.

Sure., Um,, and, if, you're not compliant at all, your outcomes are not very good.

That's, for, sure., But, also, mental, health patients or patients who have issues with their mental health, they tend to have lower compliance, not because they're bad people or saying something negative about them. They're going through something.

No,, it's, because, their, brains, aren't healthy. So I mean yes they're going through something but in large

human, experience, of, their, brains, are, not healthy. I mean we might agree maybe not that if you're depressed something's going on in the organ of how you feel which is your brain.

Sure., And, like, you're, such, a, proponent of CBT. We say depression can be a chemical imbalance. Well, CBT actually alters the chemicals in your brains right?

Yes., That, psychological, treatments, like EMDR or CBT impact DBT,, whatever, alphabet, soup, we, want, to put, they all help with changing the chemical composition

right?, But, you're, still, advocating,, at least what I'm hearing is you're still advocating for not looking before you go about changing. I because I don't want this to feel like a gotcha because what I'm trying to do is

it, doesn't, feel, like, a, gotcha., It, feels like a good conversation. I, really, want, to, learn, from, what, you're doing because I want to be a better doctor genuinely. Like my goal, why I still practice medicine is because I want to deliver the best care for my patients. And if what you're doing is great, we need to get that message out there to the world as fast as possible because otherwise people are suffering. So in order to make the generalization that everyone should get a spec scan before

that's, not, what, I, said, but, oh if, I, you, to, be, a, better, doctor, just start thinking of mental health as brain health

is, this, person actively working for their brains health you can do that in your practice and there's going to be a day

when, spec, or, fMRI, or, quantitative, EEG, or PET is going to be covered by insurance and you're going to be able to use it. But what you can do today is you can go if we improve the health of your brain your anxiety is going to be less. And it starts with one question I teach all of my patients. Whatever you're going to do today, is it good for your brain or bad for it? Is it good for your brain or bad for it? and that will begin to spark a revolution in their life. Now, if you have somebody that's not getting better you should advocate for them to be imaged because to continue to fly blind it's not anybody's interest.

So for my patients who have such bad major depressive disorder that they can't groom themselves, they have trouble taking a shower. The solution is asking them if what they're doing is good or bad for their brain. You think that's enough motivation to help this individual?

No,, it's, all, of, it. See,, now, I, I, feel, like, you're, twisting my to create conflict. Please tell me uh

how, do, I, if, somebody cuz, you're, saying, the, one, question if, somebody, is, that, bad, you, should, be advocating to look at their brain because you don't know if they're living in a moldfilled home that is damaging their brain.

Mhm. Right., We, check, everyone's, brains. Everybody, should, be, asking, themselves that question. Is what I'm doing today good for my brain or bad for it? But do you spend any time as a family doctor asking about mold question?

No. Is, this, good, for, your, brain, or, bad, for it? Going through their habits or just teaching them to love.

I'll, be, honest,, I, don't, I, don't, and, I'll tell you why I don't. Um a we don't have enough time with our patients. So that's a little bit of a copout. But at the same time

Yeah., Cuz, that's, a, really, easy, question. That's that's like in the seven minute visit you can take 30 seconds to ask them that question. surprised you don't have it in your head yet because we were never taught that mental health I do ask that question without asking the question was my second point

I, ask, questions, that, don't, directly, ask about the brain but ultimately point to me behaviors that they have that put their brain at risk so I ask about smoking I ask about alcohol I ask about diet I asked about intimate intimate partner violence. I ask a PHQ2 screening question. So while I may not be saying the question as specifically as you are I am figuring out the mental health state of the brain. So but not the brain health state of the brain. See that that that is the distinction that if we get anything

what, is, that, distinction?, Because, I'm having trouble understanding that it's, not, mental, health,, it's, brain health. What can

the, distinction, is, one, is, loose, mental health that's very loose you an PHQ9 GAD 7 stuff or is your brain healthy and if you want to keep your brain healthier rescue it you have to prevent or treat the 11 major risk factors so I told you so the big three ways I want to transform psychiatry imaging if you don't look You really don't know natural ways to heal the brain in an integrative or functional medicine model. And that's why our model not only works to decrease depression, it helps to prevent Alzheimer's disease. And I think you prevent Alzheimer's disease by prevent or treating these 11 risk factors. And the acronym I talk about is bright minds. uh like B is for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer's disease. S is sleep and then

all, sorts, of, things, in, between. So, you, said, that, when, a, patient, is, that severely depressed, they should get a spec scan. Is that true for all patients

that, are, that, severely, depressed that, they, have, trouble, showering, getting up out of bed?

Absolutely., Because, how, do, you, know, why they're that way? Well, uh, the issue that, uh, I believe

No,, no,, answer, the, question., How, do, you know what is actually going on in that person's brain without looking?

By, asking, them, questions,, by, doing, it's, complete, crap,, Mike., It's, complete crap that you know what's going on in that person's brain. You're guessing. Now, maybe it's an educated guess, but don't tell me you know, cuz you completely don't. Well, here's my defense of why I feel like it's better than just a slightly educated guess. Because when you look at randomized control trials for people who get either therapy or anti-depressants or sometimes both, we see the improvements. So while it it looks on paper like a guess, we see the outcomes hold up validated across

I've, been, doing, this, for, 45, years. You're guessing and, maybe, you, can, point, to, some, studies that say, "Oh

are, you, saying, there's, no, studies, that show therapy CBT has you're, completely, mixing, lots, of different concepts?"

This, part,, this, patient, you, don't, know because you didn't look. Now, are there studies on big populations and most of the severely depressed like you're talking about? There's not one single thing that works for them. They need a combination of things.

I, didn't, say, that, they, wouldn't., I, just said that there could be a combination

but, you, don't, know, what's, causing, it. And, I, think, imaging, holds, such, a, key here, which is why I'm trying to figure out how to get it to the masses on a level that is scalable. Um, so I'm trying to figure out how we get there. How do we get specked across the APA the AAN, how do we get everyone?

I, think, the, Canadian, model,, I, mean,, it's covered by insurance in Canada. I think that is a really great model that there's a lot of research that when you really understand it and put it together that imaging plus clinical evaluation

we, have, better, outcomes, and, that's, why they wrote the paper I didn't write it I'm not an author on it um

but, we, don't, have, that, I, just, asked no, we, just, we, do, have, imaging, and, head trauma imaging and depression for imaging you're

in, order, to, universally, recommend, a treatment you need randomized it's, an, assessment

I, know, the, assessment, leading, to, the treatment which changes ultimately the treatment because it's customizable in order to verify this we need to be able to test it with a randomized double-blinded controlled study and in 30 plus years of doing this you're okay with not one study being

So, I've published a lot like I publish on NFL players and I published on here's the pattern for it. Here's the pattern that after treatment. Um I haven't done a study where okay everybody gets scanned but we only use the scans and half the people

and, see, I, think, that's, the, study, your well, let, me, ask, it, to, you, in, a, different way that takes us out of the equation if a pharmaceutical company came out and said we have this medication it works we never tested it against any other placebo no randomized control data but everyone who takes it loves it would you buy into that pharmaceutical or would you say I need to see the data?

You, always, have, to, see, the, data. Where, is, the, data, with, spec, scans?

15,000 abstracts on spec on pubmed.gov today. But, again,, we're, talking, about, the, need for the randomized control data to be able to take bias out of the equation. You said you have a more mo motivated patient population. These are all issues that can make actually spec not helpful for people and perhaps a spending of money that is not valuable given how constricted our healthcare spending is already or needs to be.

So, you're, arguing, we, should, just continue to fly blind. No,, I, argue, but, see, the, do, you, you, think I am advocating for flying blind? Can I tell you what I'm advocating for and then you tell me if you agree with my notion? I think we should test spec to see if we can improve and no longer fly blind. And if it's not spec, perhaps it's something else. You don't think that's reasonable of me to say that?

No,, I, I, think, more, studies, uh one, study I, think, that, would, only, help.

Yeah,, I, I, agree, too., And, I'm, curious, why do you think they haven't been done?

I, don't, know., The, first, study, that, was presented in 1992 at the American Psychiatric Association is they took a 100 bipolar teenagers. 50 of them were scanned on the day of admission. 50 of them were never scanned. They looked at the average length of stay for the kids who were never scanned. It was 44 days. Now, this wasn't you could actually keep people in psychiatric hospitals. For the kids who were scanned, it was 15 days. Was an average cost savings of $15,000 per hospital stay. Is that the kind of study you're thinking about?

No,, but, it's, getting, there., That's, a great preliminary piece of research that I think we can build upon because I think we would agree that there's a hierarchy of evidence for recommendation for deciding between causation and correlation. You agree with that?

Yeah., So, to, me,, unless, we, have, that randomization where we take two groups ideally match them as best as we can randomize them so they don't know what they're getting, blind them, test the outcomes based on the treatments being more customizable in the spec category and then if we see this drastic improvement, everyone changes their mind. A APA is recommending it. We're all getting it done.

Yeah., See,, I, don't, I'm That would be great if that happened. You, don't, want, to, make, a, push, for, that on this podcast?

I'm, not, sure, this, podcast, is, going, to get us to where we need to go. Why, not?

That, would, surprise, me. But, this, is, so, valuable., I, I, feel, like spec can help so many people based on the way you're presenting it.

I, think, it, can, too., But, you, know,, so, if you if we present randomized control data to the AAN, APA, we publish it in the Lancet together, let's say, we can change the practice in the United States. Isn't that something you would want? Absolutely. So what's stopping us from doing it?

I I'm all for it. Okay., Well,, at least, you're, for, it., That that's really exciting because when we think about uh people who are critics of spec, I want to prove them wrong, right? Because I want to help people and I'm on your side and I want to figure out how to get this done correctly. But if we're trying to do scientific research, it shouldn't be done in a way where Secretary Kennedy said, "We're going to prove that this causes this." Scientific research starts with asking a hypothetical, asking a question creating a hypothesis disproving yourself, proving the null hypothesis, not just agreeing with yourself or seeking to agree with yourself. Do you agree with that?

I, know., I, was, thinking um you, want, to, set, out, to, disprove, yourself if you're doing research because ultimately if you can't disprove yourself that makes your information stronger and look there are some instances where correlation can be strong enough where you actually don't need a randomized control trial because with

how, do, you, do, a, randomized, control, trial on you have Alzheimer's or you don't I mean they have autopsy the confirmed data

that, Alzheimer's, disease, which, has, been described in the literature for 35 years

um so you need better data than that to say spec can help in the diagnosis of Alzheimer's disease

I, need, spec, to, differentiate, itself, from the standard of care as exists today for it to be found valuable and widespread recommendation.

Okay., And, I, would, argue, for because, SP, spect, is, expensive,, spec, has radiation, it can fuel misdiagnosis. So I also don't want to overdo it with spec. So I'm trying to find the reasonable middle ground.

Okay. Is that I don't correct me if please disagree with me. I Yeah you're, arguing, for, the, status, quo until someone can show you a randomized controlled trial for a specific diagnosis. Um although I gave you the one with bipolar disorder. Um yeah. I'm just thinking flying blind's not the answer.

I, agree., I, don't, think, we, disagree. And, I, didn't, I, didn't, you, didn't, bring this up and probably you don't know. The American Psychiatric Association last year named me a thought leader and

but, I'm, not, I'm, not, attacking, you, here. This isn't I'm not anti your work. I'm trying to figure out how to get your work to more people. I'm literally I'm we're on the same team helping patients.

Yeah., And, hopefully, bringing, psychiatry into the 21st century rather than making diagnosis just based on symptom.

I, agree. And, I, think, uh I'm, just, trying, to, do, it, without, doing it prematurely because with any medical intervention there could be drawbacks.

I, don't, think, we, did, it, prematurely., I think. But, you, don't, have, one, randomized control trial.

Well,, we're, not, we're, not, thinking, about it in exactly the same way. 1992

if, I, get, a, scan, on, the, day, of, admission, it cuts hospital days 67%. That's pretty exciting. And what I saw as a clinician is it changed what I did eight times out of 10. Not only did it increase compliance and decrease stigma, it made me more effective because I had a roadbound. Um, I think that's great. But again, how do we get that out there? Because I'll give you an example. So uh, for my patients who are over the age of 40, I can do the ASCVD risk score which is their 10-year risk score of having a stroke or heart attack. Now I plug in some numbers into this calculator and I get a percentage. This percent based off this percentage I can decide course of action for this patient. And the reason why I'm comfortable using the score calculator is because it's validated across diverse patient population randomized controlled studies done on it seeing what the actual outcomes are from doing this uh

risk score calculator as well as the interventions that follow. There are some people who make their own risk score calculators in the cardiovascular world and they choose their own numbers to plug into their calculator. Here's why I don't agree with it. Because it's not validated across a diverse group of patients. Do you see why I don't like their calculator as opposed to the 10-year ASBD calculator. But some of them will come and show that their calculator helps 84% of their patients. now using their anecdote of helping their patients. Should I then just throw away my other calculator and say patients I'm going to use this new calculator now because this person said this about their clinic or should there be a level of skepticism like your father said and said BS no let's test it or should we just accept it?

Well,, I, think, you, should, test, it, which is why we do outcomes on all of our patients. Um, now is that is that going to randomize

is, that, gonna, go, with, your, patients? No,, but, your, patients, will, be, better, if you added imaging.

But, are, we, going, to, talk, about, the, book at all or Well,, I, mean,, this, is, a, premise, of, your book. No.

Imaging, is, not, the, premise, of, my, book. It's, not, in, your, book. It's, in, the, book,, but, it's, not, spec, in the book.

We're, not, going, to, talk, about, the, book. What, do, you, mean?, We, talked, about, pain. We talked about the cycle of pain, how your brain has this blueprint that it starts cycling between that we're on board with. We talked about Dr. Sarno's work. Do do you feel like I'm being unfair? If you think so, please tell me.

Yes. How, so?, Because, you're, like, going, on, the same thing over and over again. It Yeah. No, it doesn't feel fun or fair. But I love talking about our work and uh it it's interesting to me often I've been criticized and very few people go so you've seen more scans than anyone in the history of the world. What have you learned? And as opposed to, well you didn't do this and you didn't do that and you should have done this and don't you think it'd be better if you did that as opposed to So, what did you learn from nearly 300,000 scans?

Are, you, saying, I, said, that? No., That, it, just, doesn't, feel, like, it, right? I mean, I can only tell you my experience. just feels like.

But, don't, you, think, I, should, be, a skeptic on behalf of my patients? I, think, you, should, be, curious.

I'm, so, in, behalf, of, your, patients. That if you could help them have a better brain, they would have a better life. and that things like Alzheimer's disease. So, I wrote a book in 2005 called Preventing Alzheimer's Disease and got no end of grief. It's like that's giving people false hope. And last year, the Lancet came out with an article that said 50% of Alzheimer's is preventable.

And what, were, the, tips, that, you, gave, in, that book? So,, it, was, bright, minds., If, you, want, to keep your brain healthy or rescue it you have to prevent or treat these 11 risk factors that if you're pre-diabetic, that's an emergency because diabetes if you have diabetes, you have all 11 risk factors, just that one. Mhm.

So,, um, it it's going back to really creating this revolution in brain health, getting people to love and care for their brain. And if I was a family medicine doctor, I would be thinking as mental health is brain health. like the need for treating patients who have pre-diabetes. Uh I frequently struggle actually in finding motivation uh from my patients when they do flag on their labs having a hemoglobin A1C in that level of saying hey this is when it's reversible because once technically maybe there's some outliers once you become a diabetic you're a diabetic for life at least in terms of your risk factors weight loss extreme weight loss can seemingly control it because we've seen those who have beriatric surgery not need medications anymore even though they were diagnosed with type two diabetes. Um but in the majority of cases the time when it's reversible is the pre-diabetic stage. So I struggle in

helping my patients get motivation there. So which of these 11 recommendations in the Alzheimer's book do you think that we're lacking in the primary care space so we can encourage doctors to do I think it's that so much of these bad things that happened to your parents that we can prevent if we work together to be very serious about it. It's one of the beautiful parts about imaging. Um on my podcast, uh, we had Julius Randall recently, um, three-time NBA Allstar um, he's depressed, smoking way too much pot, about to get divorced, and he saw a scan and he's like, "Oh, no. I don't like that." Immediately stopped smoking pot.

Um, and a year later his life's completely different because the images created an idea in his head

that if he didn't do the right thing, it was going to get worse and he would be worse. And if he did the right thing, it could be better. One of the reasons I fell in love with imaging um it's creating the hope and hope is tomorrow can be better and I have a role in it. It's creating that sense of agency in your patients and if they don't ever get a scan you could show them the images. If we don't do the right thing, your brain is headed this way. But if you do the right things, it can be better. Which is why my first big book, Change Your Brain, Change Your Life, I think worked because it was a book of strategies and hope. Yeah. Because using that motivational tool as a behavior modification tool could be quite valuable. Like I I actually am not against finding unique ways of trying to motivate my patients because ultimately if I had to say my biggest struggle outside of our health care system is

finding motivation in my patients who are perhaps depressed or maybe don't even have a formal diagnosis but have issues with life that are ongoing that aren't easily resolvable, custody battles divorces etc. So my only concern with using the imaging as the compliance benefit is that if you were just using it in that way, I see the benefit. But then when you're criticizing the rest of the psychiatric community, it's almost impacting our ability to practice medicine because we're not doing the imaging. Do you see what I'm saying with that?

Yeah., But, I, can't, not, say, what, I, believe the truth is because then the field will never change.

And, if, the, field, never, change is, beneficial. I'm, sorry. Why, can't, you, just, say, this, is beneficial? This is how I motivate my patients. But when you say we're flying blind, you're creating this distinction for patients that are saying we don't see Dr. Aean and we see Dr. Mike. We're going to get subpar blind care. Why would we ever do that? Why would anyone want to go see a doctor that's flying blind?

It's, a, good, question, but, do, you, see, how, it, sets, up, the dichotomy for patients where they have to make this terrible decision and they're already not in a good mental health space? So I'm curious, can we use it as a compliance booster but not necessarily shame the rest of psychiatry and instead

so, so, how, do, we, move, forward, if, we, don't say that what we're doing is, flawed. We need to well first of all you could say what we're doing is flawed but I think it's not fair to say you have the solution until we have the randomized control data. Yeah,

you, could, say, you're, working, towards because I have outcomes on thousands of patients. I mean, I published the outcomes on the first 500. Um

and, this, is, what, I, believe, that, if, you don't look, you don't really know. And it's not based on 40 cases we've seen. It's based

You, keep, saying, these, criticisms, and defending them that I'm not saying. I'm not saying that you have a limited number of cases. I'm not saying anything negative about you. I'm just saying that the randomized control data that I need for universal recommendation is missing. And I feel like that's important. I mean, the critics of spec say uh depending if you have a cup of coffee certain parts of the brain imaging will change. It's the same.

They're, very, consistent, over, time. There's a study from UCLA Ishmael Mana um that over three weeks there's less than 3% variability plus in our clinic we do two we do one at rest one when you concentrate and so we have 100,000 rest concentration scans and your pattern is going to be your pattern unless you get drunk. It does change during the time of your cycle. Uh which is very interesting. If you never believed in PMS, uh scans during different times of the cycle will convince you it can be a real thing. Um yeah, no, they're very consistent over time.

Well,, given, the, fact, that, certain, things interfere with them, couldn't that make it weaker? Like for example, when I prescribe a patient to get a HIV screening test, right? I know the sensitivity and specificity is to a level that I'm comfortable giving this test to someone who has no symptoms. But in these scenarios what is the sensitivity of a spec scan on the same person weeks apart across a diverse group of people? And does it hold up? We don't know that yet.

Well,, Mina, said, it, was, less, than, 3%. well in that study, but I'm saying the randomized control data is missing to be able to diversify it. Again, I'm not talking about the initial research being I think the research that you're doing is so important because you need foundational research. The first doctor that said wash your hands in between the morg and delivering patients was viewed as someone who's making stuff up and sees something on

died, in, poverty in, the, in, say, an, asylum, or, something. So uh ignvice but we need to be able to test whether or not these things are valuable. And I'm I don't understand why you're not leading the charge for that as the number one proponent.

I've, published, more, research, than, almost anybody on but, there's, a, difference, between publishing outcome data

outcomes,, how, it, changes, clinical practice. I published on ADD multiple times of a new study coming out on bipolar disorder. We've published on traumatic brain injury. Um I've published review review papers. There's a lot of published research on it. We haven't done your study

but, you, keep, saying, it's, my, study or, the, one, from, the, hierarchy, of keep, talking, about, over, and, over, again in the last hour or so. Um

well,, if, you're, trying, to, find, out, we've, published, a, lot., I, mean, it's, very important for people to understand in my book the end of mental illness there are84 references because if I'm going to like make this big idea paradigm shift stop calling it mental illness start calling these things what they really are their brain health issues that I have to be able to back that up and talk about a lot of the research on spect for a wide variety of conditions. But even though I can tell you the pattern for OCD, I can tell you the pattern for autism, it doesn't say what your brain who has OCD looks like.

And if you don't because if all the patterns were 80% sensitive and specific and we have ADHD data that's way higher than that but not everybody has that pattern. That's why you look not because spec can say oh you have this or that diagnosis. You and I can say you have this or that diagnosis. What you and I can do can never be able to do is to go this is your brain pattern and that's how I need to target the treatment to you not your cluster of symptoms.

We, can, change, the, threshold, in, imaging to make it appear different. So meaning

what, does, what, does, that, mean? Basically, I, can, make, your, scan, look terrible by changing the threshold. That's what I'm saying. But why would I do that? I mean I make how we render

we, make, a, threshold, for, what, is pre-diabetes we take a diverse set of people that is generalizable to the individual and because we have this randomized control data validated data we can then say above 5.6 six, you're entering pre-diabetes. Above 6.5, you're getting diabetes. But with these thresholds, do we have validated thresholds to say this is where you should set your imaging parameters?

We, do. Yeah. And, with, with, normal,, we, have, normal., So average is 72%. So spec is a study of relative blood flow. What that means is we take the coldest spot in the brain, make that zero, the hottest spot in the brain make that 100, and we scale everything between these two poles. And the average most parts of the brain outside the cerebellum is 72. And so two standard deviations, standard deviation is six. Two standard deviations 84. So above 84% we think that's increased activity in the brain. Below 60% we actually use 55 for safety.

It's two standard deviations or more below. Those are the thresholds. That's how we set it. Again very consistent with the data from UCLA.

I, have, an, idea, for, that, randomized controlled study that you mentioned that I could design. What about taking people uh randomizing them into two groups scanning actually both groups with spec but for one group not using the spec data to see to to guide treatment.

Yeah,, that's, what, we, talked, about earlier. So, you're, not, treat, you're, not, treating off of that, but you're still randomized. The doctors still don't know I mean the patients still don't know which group they're in. and then going treatment-wise and then seeing their outcomes from a clinical perspective seeing how they're doing through patient surveys and then also looking back at their spec, redoing their spec and seeing if there's a change. Isn't that a great study that could truly perhaps prove that spec can be generalizable to the general public?

Yes., No,, I, think, that's, a, a, great, idea. and um and then we'd probably need three or four independent avail sites to do that as well.

I, think, it's, an, important, question, to ask. If we do that randomized controlled study that we've just talked about and it turns out that it's not useful, would you give it up?

Absolutely, not. Why? Because how am I going to know if your symptoms are a result of your brain working too hard or not hard enough, if it's toxic or traumatic? So you're just asking me to give up

you, know,, 35, years, of, experience, showing how imaging changes what I do or guides what I do based on a study of 50 people. I the study will be

Why'd, you, underpower, my, study, so quickly? Well,, well,, there's, 300, people,, right? I'm not giving up imaging because you don't know. I mean there um there's this thing called face validity that it makes I mean there just so many advantages to imaging that um you know probably if there were 50 studies done like that 40 of them would come out positive and maybe 10 wouldn't. Why? Well, you've been around research long enough to go whatever the person thinks is going to happen, they'll set it up to make it happen. Uh that maybe you have way more confidence in imaging in research than I do, but one statistician told me um that 16 out of 17 statistics lie depending on what people think. You you saw it, Dr. McCary just come out recently with the hormone um study and he goes when you actually read the study they made that huge recommendation that kept uh HRT from women for what 20 years that it was

actually based on flawed data. So, I'm, I'm, not, giving, up, the, idea, that imaging is useful. Um can we use it better? Absolutely. And we're using AI tools in studying um all of our patients data because they allow us to study anonymized data. Um so in my mind, no, I wouldn't give it up. Um but there's ways to use it better I'm certain.

Mhm., You, said, like, 16, out, of, 17, research articles are flawed. Does that apply to your research?

No., 16, out, of, 17, statistics, lie. Oh. So, is, that, true, about, your, research, as well?

No. Why? Because, we, want, it, to, be, reproducible, but, the, rest, of, the, scientific, community doesn't.

I'm, just, asking, why, your, assumption, is that this randomized controlled study would be flawed, but yours aren't. You said I didn't have any randomized control trials.

I, didn't, say, your, randomized, control trial. I said your trials. I, I, I, just, don't, know, why, there's, such, a negative push to the scientific field. Like we're we're now discounting data because you're saying data is always flawed. But you use data.

So, you, don't, believe, that? Really? I, mean, after, all, the, time, you've, been, a doctor.

Well,, what's, the, questionific Dr. McCary who's the commissioner of the FDA women's, health, initi

that when he actually went and looked at the data it, actually, said, the, opposite

of, what, the, press, release, came, out, and said which then hurt millions of women. the medications that were used in that trial were appropriate for what that trial was trying to achieve and what we were trying to extrapolate for it was not what the study was trying to achieve. In addition, the way that the study patient selected, which carries a tremendous impact on the study, they tried to pick people without menopausal symptoms, hot flashes, all of these things because they were worried that if people saw their hot flashes improve, they would know and it would no longer be a blinded study. So, there are criticisms of the research, and there's always criticisms of the research

always., But, my, concern, is, that, when you're ready to write off the research that disagrees with you you're part of the problem that you just said that if you you're just seeking to agree with yourself that how the scientific community says that they you just said they do that they try and get research that agrees with them. Don't you want to try and disprove your method in order to prove how strong it is? So, at this point in my career, No.

Why, is, that? That, if, I, looked, at, your, scan Mhm., I, feel, really, confident that it tells me how healthy your brain is, if it's overactive, if it's underactive compared to not just our normal group, but our hundreds of thousands of scans. And for you to just sit here and go, but don't you want to prove yourself wrong? It's like, no

that's, a, scientific, method., When, you fail to prove yourself wrong, that strengthens

early, on, but, we're, pretty, early, on helpful. Um, yeah., No,, I, find, it, incredibly, helpful. Um,

what, if, you, just, like, what's I'm, I'm, just, I'm, just, asking, myself what's the point

right?, It, just, seems, like, we're, arguing to argue as opposed to, learn, anything, new.

If, you, scan, my, brain, and, it, shows, low brain activity, uh perhaps holes, uh sleepy, uh frontal lobe, but I'm crushing it. I love life. I'm happy. I'm excelling at sports. Podcast is going well. What does that mean? Well, it means you have low frontal lobe activity and you're compensating for it and you're not suffering. And so Alzheimer's disease actually starts in the brain 20 years before you have any symptoms. Frontal temporal lobe dementia starts in the brain way before you have symptoms. So what it means in my mind based on my experience is your brain's vulnerable and it's probably not good for you. So you may be crushing it, but are you going to be crushing it 20 years from now? or would it be better for you to get it as healthy as it could be so you could continue to crush it and you end up not being a burden to your children?

That's, a, really, good, question, and, I think the way we figure that out is by doing the research to figure out if that intervention will get me there.

So, I, think, we, should, look, at, your, brain. I have a clinic here in New York and the radiation is about the same as a head CT ordered millions of times every year in the United States.

There, was, a, recent, report, that, uh, CTS are raising our risk of cancer by uh double digits. So got to be careful about that. But go ahead. Sorry.

Ordered, millions, of, times, every, year, in the United States. Um I think it would be interesting. and then you could decide if it was valuable for you.

Yeah., My, hesitation, is, uh, so, why, I, tell patients who uh residents rather that want to reflexively check uh thyroid levels in my patients that are not having symptoms like part of their screening. Basically, a healthy person comes in and my resident automatically checks off checking thyroid. And I said 'Well, why? They said, 'Well, I want to check and make sure it's optimized. So my question to them is, let's say a patient comes in and their T4 is marginally low. Are you going to treat that patient who's comfortable and then give them thyroid hormone leading them to have palpitations and discomfort? So like every time I'm ordering a test, I'm trying to think what if, how is this going to change my practice of care? And if you're saying that if I have these findings on the spec scan and I'm feeling great now, there's a chance I won't feel great later, I would want to know how sure of that you are based on

randomized validated data. I think that's pretty reasonable to ask. No, I think it's also reasonable to ask is what's your experience? Is it as healthy as it could be? And and I actually disagree with you. I think people should know their important numbers every year. Like you should know your BMI. You should know what your thyroid is doing. You should know your testosterone

levels., Uh but, there's, such, natural, fluctuations, of these numbers that are outside of your control that will lead you to premature perhaps unnecessary treatment so many times. So many times. So, if you're hanging with a testosterone level of 250, which is not uncommon today.

Okay. You, think what, time, of, day, did, you, test?, probably morning because, a, lot, of, these, clinics, that, do it don't do it in the morning in order to prescribe testosterone for their patients

which, is, bad, because, you, know, too, high your libido goes up and your empathy goes down and you get divorced.

Well, I, think, about, also, the, medical problems that come along with that. It's like, so I'm just, you know, I often say, how do you know unless you look?

Well,, thank, you, so, much, for, your, time. Thank you for your work. Everyone can check out the book. Uh, pre-orders until December 9th.

December, 9th, and, then, that's, when, it, publishes. Congratulations on another I know this is going to be a New York Times bestseller. So, wishing you the best of luck for that. Thank you, doctor. Click here to see a list of 10 surprising causes of headaches your pillow could be. As always, stay happy and healthy.

Questions about this episode

What is discussed in "Confronting Dr. Amen On His Viral Brain Scans"?

In order: 0:00 Dr. Daniel Aean, Aean Clinics, Brain MD, Change Your Brain, Change Your Pain; 10:00 Change Your Brain, Change Your Pain; 20:00 Change Your Brain, Change Your Pain; 30:00 Brain MD; 40:00 Daniel Plan, Rick Warren, Brain MD; 50:00 Paul Mitchell; 1:20:00 Lancet; 1:30:00 Dr. Daniel Aean, Julius Randall, Lancet; 1:40:00 The End of Mental Illness.

What is mentioned in this Doctor Mike episode?

11 people, works and ideas are mentioned, including SPECT, Dr. Daniel Aean, Change Your Brain, Change Your Pain, Brain MD, Aean Clinics, Rick Warren. Each one on this page links to its own page with every episode that mentions it.

How long is "Confronting Dr. Amen On His Viral Brain Scans"?

The episode runs 1 h 59 min; the transcript is about 18,067 words in 326 timestamped sections.

More from Doctor Mike

About this transcript: the episode's spoken words as captioned on YouTube, split into timestamped sections. Reclip.Me locates every person, work and idea in the text, keeps the time it is first named, and quotes the words around it verbatim. Last updated January 24, 2026.