 Well, hello, and welcome to Resiliency Radio, your go-to podcast for the most cutting-edge insights in functional and integrative medicine. I'm Dr. Jill, and in each episode, we delve into the heart of healing and personal transformation. Today, we're talking to the Jean Queen, Sarah Morgan, not only the Jean Queen, but a dear friend of mine, about unlocking the choline connection, a key to Alzheimer's in women, decoding its impact, genetic factors, and vital strategies for you out there for optimal brain health. Sarah Morgan, the Jean Queen, is a clinical nutritionist, seasoned product innovator, founder, author, inventor, and thought leader in the field of health and wellness, and personally a dear friend who I can always count on for ideas and vision and to bounce things off of. She's one of my favorite people to talk to about innovative ideas. She has created patented technologies and dietary supplements, medical foods, and bioidentical hormones known for her innovative ideas that connect science to everyday life. She delivers impactful science-based solutions for common health problems. Welcome, Sarah. Thanks so much for having me. It's just so great to be here. It is. It's like to coffee with a friend and everybody can listen in. And the funny thing is, this is like what we would be doing in a coffee shop anyway, right? Like this is true to life. So I want to dive into choline, and women's health in particular, so many women out there need to know this information. And many of them may be experiencing brain fog, cognitive issues related to hormones, or even, as we were talking about earlier, this lack of motivation that can sometimes come all related to our hormones. But before we dive in there, I always like to know your backstory. How did you get into innovation, nutrition, all the things that you've done? Tell us a little bit about the journey there. Yeah. Well, I was planning on originally going to medical school, come from a family of cardiologists, worked in a neuropedes and trauma floor with a hospital associated with the Mayo Clinic. And I really realized I had a passion for nutrition and this idea that our food could really be a foundational aspect of health. Now this was before this was actually cool or trendy. So I was this lone ranger and I made a really brave decision to say no to the path to medical school and find a program that really taught nutrition and biochemistry because it really is biochemistry at its core. And it's the way that we can utilize it to optimize human health. So I just jumped in and I haven't looked back ever since. It's been so fun to really utilize nutrition as this incredible tool to optimize human health in so many different ways. And on that journey, I got interested in genetics, too, to apply that as a proper puzzle piece of the overall story. I love that because, of course, you're known as the Jean Queen. And that brings so much, I think, impactful information to us in functional medicine. First of all, what you just described is really, as a doctor, even trained in medical school, we just go back to the biochemistry, the physiology, the stuff that you're talking about as well. Because that's really where we find the tools to solve these complex chronic issues, isn't it? Yeah, absolutely. Yeah, super excited. So today our topic is choline. But before we go there specifically, I mentioned women. Women's health. I'm now menopausal. So I'm right in this bucket as well as many of our listeners. Probably our primary constituent is the woman who is anywhere from 35 to 65 and either approaching menopause or full blown into menopause. Why is this important topic so relevant to women, especially and to our brains? You want to kind of lay the groundwork for us. Yeah, absolutely. So if you're listening and you're in this demographic, please listen to this whole podcast episode because I believe it is potentially, has the ability to save your brain for decades to come. So when we think about women, Jill, we have an increased risk for developing Alzheimer's and other forms of cognitive decline. We have twice the risk that men have. And currently one in three seniors die with Alzheimer's or another form of dementia and it kills more than breast cancer and prostate cancer combined. So when we think about that, it's like, well, why is this happening? Right. And I think the world is trying to solve this because it's a massive problem. So the first thing is, you know, people talk about age, right? Women now are living longer than men. So, oh, as you get older, your risk goes up. Okay. Well, maybe that's part of it. I think another thing that we've looked into is immune system function. Women have stronger immune systems than men. Yes, we can like brag about that a little bit. But it's also probably why we have more autoimmunity as females. So there is a theory out there that I'm sure you have lots of thoughts on about, you know, Alzheimer's could be the brain fighting an infection. So I think those might be, you know, things that we want to look at and say potentially yes to. But I do think there's more happening below the surface with genetics and hormones as it relates to cognition and a risk of Alzheimer's. And this was a really interesting 2020 study that I came across that suggested childbirth may play a role in the risk of dementia for females. The more children you have, the higher risk of different types of dementia, especially females in Europe and Latin America. So for me, one thing I think is, OK, well, when you go through pregnancy as a female and when you're nursing your baby, there's massive demand for choline in that stage of your life. And then if we look at some of these variants in our genetics that we're going to talk about today, women from European descent or Latin American descent have higher rates of these mutations in these genes that I think are really relevant to brain health. So there's a lot we can do. And there's a lot of things for us to know and be empowered by when it comes to our brain health. Well, what a great foundation. And what's interesting, a couple of things that you said, first of all, yes, autoimmune diseases four times or more and more common in women than men. And certainly hormones play some role in that. And like you said, we have this wonderful robust immune system, but it actually goes through a lot of things because like during pregnancy, it has to calm down so that we can accept a fetus into our body. This foreign being in our abdomen, in our uterus during that time. And then but then afterwards, and we often see this increase in autoimmunity, men are key when people start their periods, which is hormone related after pregnancy, menopausal. So there's these times that we know those links between immune system. And we can dive into that. The other thing that was surprising as you just shared those statistics was we know breast cancer is actually decreased risk with the more pregnancies that you have. So if you are nolaparous, which means no pregnancies, like someone like myself who's never been pregnant, you actually have a higher risk of breast cancer. But it sounds like it's the opposite with dementia and Alzheimer's. Yeah, really interesting, right? No matter what you do, there's like risks. I know. And it's funny because I have for years when I talk about like a hormone replacement in some of these topics as a woman who's had breast cancer 20 years ago, I often have to think about, OK, what's the benefits to brain? What's the benefits to breast? And not that we have to choose, but there's been certain situations where I'll always say, well, if I had to choose between risk of breast cancer and risk of Alzheimer's, I would choose my brain every time, which is. Thank you, right? I know, like this thing, I can deal without these, but this thing I can't do without. So I think that's relevant. So one gene that a lot of people have heard about because it's been on the news and I think it's some documentaries, certain famous people have talked about this APOE, right? Yes. Tell us a little about this gene, because if you haven't checked out, first of all, if you have someone in your family with Alzheimer's, you can tell us like the reasons why we need to maybe check our status. But what is this gene? Why does it matter to our brain health in particular? Yeah, so APOE. I always think Gray's Anatomy, I think, made it famous by like nicknaming at the Alzheimer gene. So it really is a gene that has to do with lipid and cholesterol metabolism that also impacts our brain function and can increase our genetic risk of developing Alzheimer's. So about 25% of people carry one copy of the APOE4 variant, which is the risk factor copy, and about 2 to 3% of the population carries two copies. So whenever we think about carrying more than one copy, there tends to be more risk involved. But again, it's important to remember just because you have an APOE4 variant doesn't mean you're going to get Alzheimer's. And if you don't have an APOE4 variant, it doesn't mean you won't develop Alzheimer's. So there's a lot of reasons for the development of this, and we're going to talk about several of them. But one we know is this APOE, and it's interesting because individuals with APOE4, they're astrocytes, which are these cool star-shaped cells in our central nervous system. They're kind of like the powerhouses of our central nervous system. They get kind of junked up in APOE4 individuals versus APOE3. They look a little bit more normal. And a fascinating thing is that when individuals who have APOE4 are given choline, these astrocytes are able to actually process lipids better, and they don't have the accumulation that they would without choline. So again, just another connection, I think, of even some of these variants that we see how important choline can be in terms of our brain health. And there's a lot of things you can do if you have APOE4 status, right? It shouldn't be this thing that keeps you up at night that you're fearful about. I don't believe that at all. You need to sleep well. You need to move well. You need to focus on your diet, your toxic load, getting your hormones optimized, micronutrients. And you can really set yourself up for great health for decades to come. Yeah, I couldn't agree more, Sarah. And one of the things that I always think about, I do check this in my patients because I want to know, typically, like even Dale Bredesen uses the ketogenic diet very frequently, which is a very high fat, sometimes up to 80% fat in the diet to really switch the metabolic processing of sugars into ketones. However, those with APOE44, I always feel like they're that unique class that we have to be careful with the lipids in the diet. Do you want to talk just a little bit about, like, why they might want to be on a lower fat diet than average just because of the status? Yeah, that's a great point. And I actually see this. This is why I love genetics is people are always like, what kind of diet should you eat, Sarah? Do you like carnivore, paleo, vegan, you know, all these different things? I'm like, well, it depends on your genes. So the reason APOE4, you want to be careful with fats, and I would say especially saturated fats from animal. So that would be things like red meat or even dairy saturated fats is that you're going to have a harder time with lipid processing, right? So I see a lot of these people, if they go on a keto diet or a high fat diet, their cholesterol goes up. They'll even have issues with their insulin, metabolic health. And then, you know, we don't really have great imaging for the brain to see what's happening, but I think it's very reflective when we see that happening metabolically to also probably what's happening in the brain. So I'm a big proponent of these people going much more of a Mediterranean style diet, and they tend to do really well without any check-in on their blood markers. Hey, everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience Through Functional Medicine, Science and Faith, is now available for order wherever you purchase books. 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Guys, I couldn't agree more because a lot of people I really do think in general, we eat too many carbs, processed carbs, most U.S. standard American diet is more metabolically prone to induced diabetes, but this unique portion of people actually do better on almost more of a vegan or plant-based diet, even if they're doing some meats, less meat than the other types of people would do. So very, very interesting. And choline, I did not know that this actually affects choline processing that you can actually use choline as a nutrient to help these patients. That's cool. I love it. Amazing, but it all fits together. Well, let's dive into nutrients because that is your, obviously genetics, but also nutrition is your background. Let's talk a little about what are some of the key nutrients and some of the key concepts around brain health and preventing Alzheimer's, especially in women when it comes to nutrition. Yeah, so I became really fascinated with choline as a nutrient about eight years ago, and I started to dig into the scientific literature and choline is really, think about it like a B vitamin. And as I started digging in, I was like, okay, I'm not the only one because the American Medical Association, the American Academy of Pediatrics and the FDA were all talking about choline. And the things that they were saying was one, oh, it's actually an essential nutrient. We hadn't thought about it that way. And the American Academy of Pediatrics was like, it's really critical for brain boosting, brain function, which in children, when their brains are developing, that's really important, as well as in pregnancy, women need to get enough of it. And we've now connected it to choline should be viewed as equivalent to folate. And it's important for prevention of neural tube defects or any kind of birth defect, because it also is a methyl donor. It functions in all these different methylation pathways that are very active in pregnancy. So I'm looking into all this, my jaw is kind of dropping and I'm like, okay, what does choline do in the body? What are all the things that it's really important for? And there's three things that you should remember about choline that it does in the body. Number one is it helps with our cell membranes. So it's really the building block of all of our cell membranes. We have trillions of them. So if we're even slightly deficient in choline, we can, I believe develop leaky cells, just like we have leaky gut. And we even have this topic now about leaky mitochondria, leaky brain. There's all these things that become leaky if we don't have the right nutrients and choline is critical for that. Second thing is liver health. So we have an epidemic in our world today of non-alcoholic fatty liver disease. And I actually just heard something on the radio this morning that it's impacting kids as young as two years old Joe that their livers are 60% fat. And we believe part of this is fructose gets turned to fat, right? So these kids are on formula-fed diets that have fructose corn syrup solids in their formula. They're eating processed foods and they're not getting enough choline. So what's the connection there, right? A choline deficient diet increases your risk for non-alcoholic fatty liver disease, meaning it's not from alcohol that your liver is fatty because choline helps move fat through the liver our liver is filtering and metabolizing fats. It's really important, right? It's a critical aspect of what our liver does every single day. But if we don't have enough choline, it kind of gets all clogged up with fat, which is not a good thing. It also helps with bio flow. So we make bile in our liver and it goes to our gallbladder and it's released into the first part of our small intestines. It helps digest all of our fats. It's also really important in detoxification of environmental toxins. And if we don't have enough choline, we don't get good bio flow. And I think it's this mis-piece of a lot of GI issues is choline liver gallbladder problems. And if you look at women who go through pregnancy, they have their babies. What happens a lot of times are their gallbladders. They have gallbladder attacks because they don't have enough choline and they're using so much of it in pregnancy with those massive demands. And then the third thing to remember about choline that's really important is brain health. And the reason it's important for brain health is choline is used to make this critical neurotransmitter for memory, learning, even mood regulation called acetylcholine. So we talk a lot about serotonin, dopamine, even adrenaline. And I feel like acetylcholines is forgotten neurotransmitter. My favorite. That is so critical. My favorite too. I'm like, we need to talk about it more because I do think it's this breakthrough. And so I saw this pattern, Jill. I'm a pattern thinker. And I was like, here's a woman's journey to Alzheimer's. Yeah. Okay. So you make choline in your liver. Some of us make more of it than others depending on the status of a gene called PEMT. It stands for phosphatidylethanolamine, methyltransferase, it's a mouthful. You don't need to remember, but you should know this gene status. I highly recommend, especially if you're a female. And if you have mutations, which you said you might have mutations in this gene. I absolutely. It's just a matter of one or two copies. I'm not sure about 100%. That's why when you mentioned this topic, I was like, yes, because it's relevant to both you and I. Yes. So I'm homozygous. I have two copies. So I need a lot of choline from my diet because my liver doesn't make as much of it. Now, the other thing about this is today, Jill, 90% of women are choline deficient that are walking around. So it's like, we talk about vitamin D. We talk about all these, you know, magnesium. Nobody's talking about the fact that we are sucked bone, dried up choline of our need for choline, especially as women. So we go, you know, into our 20s and 30s, we have a pregnancy, we nurse that baby. Maybe we have another baby or another baby after that. And we have these huge demands for choline. We don't get enough in our diet. We don't get enough in our supplements. And all of a sudden we experience mommy brain, right? It's like, I can't think. I have such severe brain fog that I walk into the kitchen and I'm like, what was I gonna grab? I can't remember my husband's name. I can't remember my name some days. And we laugh it off. But I think it's actually a sign of acetylcholine levels being low in the brain. And we're not recognizing it. And then as females, after all that fun, and we're stressed and we're sleep deprived and we're raising our kids and, you know, working in our careers, then we go into perimenopause. Welcome, right to your course. And, you know, even in your early 40s, your estrogen levels can decline. Now what's the massive connection here is this gene that makes choline for you, one of the inducers of PEMT, so you can make more choline in your body is estrogen. So when you have estrogen in higher levels as a menstruating female, you're naturally gonna have more choline that's being made by your body. And you should because you go through these childbearing season where you need more choline. And then you go into perimenopause and your levels of estrogen start to drop and so does choline, but we forget about that. And we start to have lower estrogen, we start to have lower choline production. And, you know, we now know that women from 40 to 50 experience the biggest loss of brain volume of their entire life because they start to lose these hormones. And I also believe because we start to lose choline and what acetylcholine does in our body. And we see this even in our hippocampus, right? This, we have memory decline, our sleep worsens, we lose our sense of self. That's our hippocampus that gives us our sense of self. So choline and estrogen, there's this massive connection. And I believe in perimenopause and menopause we really need both of them. Otherwise as women we walk ourselves into Alzheimer's over decades of choline deprivation. And I think it's so fixable, Jill, so fixable. And I'm guessing you want to start at 30 or 30, I mean, or even before then, like really, so there's so many thoughts as you're talking. First of all, I know you and I have talked about this, but prenatal vitamins, not all of them being choline, right? And that does tragedy. So if you're pre-conception, you're in your 20s or 30s or wanting to have babies or you just got pregnant and had to be, you know, anywhere in there, talk just briefly about that. And then we'll go on to the, because I think that's a tragedy when a woman's prenatal does not contain choline, right? Yes. And it's getting better. But I formulated a prenatal years ago and I learned all this and I was like, okay, we are gonna put as much choline. I think you were the first one who's mentioned and I'm like, right? And I can make so much sense. So yeah, I'm sorry to interrupt. Yeah, so it's really important now there's some prenatals that have choline, but they don't have enough of it. So, you know, and this is where dose is really important, right? Here are some milligrams. Like what are we talking about? Because I know in the toxic patient and the menopause patients what I'm using, but what are you recommending for these different areas of life? Yeah, so I would say 450, 450 milligrams total intake is absolute bare minimum for choline. 550 is if you're pregnant or even thinking about getting pregnant, you should start with this idea of conscious conception and prepping ahead of time because this also impacts gene expression before you're pregnant, which means you're gonna have a healthier baby. So I would say 550 and I actually would argue up to potentially 800, 900 milligrams. The third trimester women need, even if they have normal PEMT status, they need around 800, 900 milligrams because of the rapid, rapid cellular growth that baby is growing so much. And there's massive demand. So I think choline is it needs to come from supplement and from diet and in women during this time. And you need to look for a prenatal that has a good hard hitting dose of choline. Otherwise it's not gonna move the needle. So thanks for your work on that. Thanks for being part of developing this because I remember again, our conversations realizing how powerful and looking at some of the prenatals that some of our companies use and not all of them have choline, which is shocking. Let's move to the menopause, perimenopausal woman, the ones we talked about earlier. Should a woman lifelong be supplementing? What are food sources? What are doses kind of give us an outline of that woman who's 35, 45, 55, 65, what should they be doing? Yeah, I really believe in food first always in terms of what we should do. But I also think this is a great example of if you know your PEMT status like me, I can't get enough choline from my diet alone. There's just no way for me to do it because I have such high needs. So I'm always gonna supplement. Once I learn this about myself. So I really believe anybody who has variants in PEMT that's a female, you should be supplementing. You should be supplementing if you're gonna be pregnant, if you're after you've had your babies, if you're perimenopausal, if you're in and through menopause, I think it's one of the most critical nutrients you should supplement. Now, food sources, the best one is eggs. And I think both of us now can't eat eggs. Right. So it's such a bummer because egg yolks specifically are where we get all of our choline. But there are other places like organ meats, fish, chicken, mushrooms, some of the cruciferous vegetables like cauliflower, broccoli, brussel sprouts, it's at lower doses, but you still get some choline from that. So I think it should be a both and, if you can tolerate eggs, huge fan. There's about 125 to 150 milligrams of choline per egg yolk. So if you're pregnant, nursing, if you're in menopause, eat the omelets, right? Like have the eggs as part of your diet. It's a great way to go. And make sure that you're getting choline in a supplement form as well. I love that. And again, as I really realized my own status, of course, I've been supplementing. Now we use for a whole different reason, which you alluded to. Obviously I deal with mold toxicity. It's one of my fortes. And a lot of people who have mold toxicity have really unhealthy membranes. So they need an oil change, which I think PCs core, right? For mitochondria, for brain, for membranes. And for that production of bile, I love that you mentioned that because, and people have heard me talk before when you know this, our bile acid is where we dump the toxins. So as we, you know, push the bile, number one, we sterilize the small bile. So we prevent overgrowth of bacteria and we get things moving. And then we also are dumping toxins and excess cholesterol. So if we aren't really producing good amount of bile, we're more likely to be toxic. So I've used both oral and IVPC protocols in my really toxic patients. Now I'd love to know your thought on this because I've felt like in my clinical experience, there's a timing issue. If someone's really, really sick, really toxic, really has a significant leaky gut, PC and phospholibids in general, create liposomes, right? Translocation. And so my thought has always been, if someone has a very dysbatic overgrowth of bacteria in the gut or some problems with massive toxicity, sometimes there's a timing of PC that it feels like you don't want to pour in a ton of this thing that actually creates more translocation across that permeable membrane until you kind of clean up the garbage. What do you think of that? I think it's totally right. So we're talking about something called the enterohepatic circulation. Eventually I want to write a book on this called Poop Out Your Problems because- I love it. How we do it, right? Our blood is filtered through our liver, right? Our liver collects the garbage and then the main dump truck is our bile. And then it goes into the gallbladder out in the GI tract and it's like goodbye. I hope you leave, but the problem is we actually recycle. Right. 95% of it, right? So we have to, I think the first step is we have to interrupt that recycling by binding in the gut and helping ensure that that is happening. And then we can kind of push that more of the garbage getting mobilized later. Otherwise, I actually did this to myself. When I learned this, I of course went really hard and I took a ton of choline. And I took it at night because I didn't connect like acetylcholine kind of feeling more awake and- Oh, are you wide awake? I laid in bed and I was like, why do you wake? But the craziest thing happened to me. I was grabbing my left arm because my ulnar nerve was firing every couple of seconds for about three hours. And I was like, what the heck is going on? So I talked to, I think it was on one of our hikes, all of us ladies, we have a little brain trust here in Colorado. And Dr. Charlize Pratt was like, did you injure that arm? And I was like, yeah, I did in a hockey injury. And she goes, it was probably doing repair to your nerve. Well, I was awake and it did repair to my nerve and all these wild things that I think can happen. And I did take a mega dose. So I think it's all about dose and timing, absolutely based off of someone's history, their genetics, even some of their current symptoms. But I've seen choline supplementation done right. Change someone's, like I have mommy brain, brain fog too. I feel like I've come back. I feel like myself again within weeks if we do it right. That makes so much sense. And what I really loved is you talked about this connection. We started with the ApoE, which is a lot to do with dysfunctional, lipid metabolism and transfer. And I know from talking about the gut for decades now that we have this LPS lipopolysaccharide, toting of bacteria in the gut that is carried across the gut lumen into the bloodstream, which is part of the cause of fatty liver because that's our filter, right? And that carrying across gets, it's carried more quickly by the saturated fats. So to me, this kind of comes full circle because it's that higher risk of that translocation and why for those types of people, especially that saturated fat is only gonna lead to more liver damage, brain damage, all these kinds of things in that subset of population. And the fact that choline is one of the regulators of fat transport makes a ton of sense because in my mind it's almost like that's the brake pedal if we're going to supplement, you wanna make sure you have this not massive permeability, not massive toxicity. And one of the things you mentioned as well is there's this thing mobilization of toxins and then excretion, right? I always think of it that way because it's easy for me to help patients understand if we mobilize too quickly and we can excrete, we get really, really sick, right? I did that to myself too. When I took all that choline, one thing happened that I was like, oh my gosh, I look like a 12, 13 year old teenager with all this acne and massive breakout because I pushed too much. I was mobilizing all these toxins and I didn't know that I was supposed to bind it up. So it's a journey, it's a learning experience. And I think that push and pull too is something you have to figure out sometimes in experimentation of what works. It's interesting what you mentioned too because choline is very connected to insulin sensitivity, even things like diabetes, metabolic health and heart health too. And I think it connects to the liver, to lipid metabolism, all the things that you're talking about, even with a gut, right? Makes so much sense. And especially we know every sling done some talks on nitric oxide and the importance because after the age of 40 and women and men, we declined by 50% production and after the age of 60, it's 15% production. Nitric oxide, I know, right? So nitric oxide opens up vessels, allows us to have good blood flow, prevent heart attack, stroke. And so it was one of those things where when you look at the graphs, men's heart attack risk is actually above women's all the way until menopause. And then guess what? If you look at a chart, all those women dramatically right around 45 to 55, which is when they hit menopause. And I've always thought about it as being number one related to decreased nitric oxide production. But as you're talking about estrogen and PEMT and choline, I think it's just as equally that declining estrogen, which can cause hyperlipidemia in women all of a sudden because they're not transporting. And again, if they have this underlying thing like you and I have the PEM. And again, just in case you're listening and you're wanting to write this down PEMT, that's the gene, you could have almost any of the gene tests now, we'll test that. And Sarah, is there more than a lot of these times there's tests where there's like four variants of PEMT? Do you know, is there quite a few different variants? Is there a few main ones? Yeah, I think there's two, it's a great question. I think there's two main RSIDs that are the most clinically relevant in terms of your endogenous production in the liver of how well your body is gonna make choline. And I don't have them on the tip of my tongue and in my brain, but we could look up and share it in the show. We can't include it, exactly. We'll include that in the show next time we're gonna look it up. We'll make sure and link those there because you and I can both do a little research and make sure we have the right ones. You mentioned some lifestyle factors, but that's where this can be a little overwhelming. Let's go back to what can the average woman who is either wanting to get pregnant, pregnant, post-pregnancy or perimenopause or after what can women do to actually enhance choline? Yeah, so I would say again, just look for choline-rich sources of food to just start adding to your diet, right? And everything matters in terms of even like a little step of, okay, I haven't actually been eating eggs that often or I'm gonna add more cruciferous vegetables to my diet. Those are things that are gonna be helpful. I would also say make sure that you're really reading your supplement labels. Anything that I formulate now, I'm very passionate about putting choline in there because I think it's just this missing piece that moves the needle so much for individuals. So make sure to look for that in your supplement. And then in terms of this connection to brain health, I think that the other things that are really good to do are looking at making sure you're getting adequate sleep. That is such an important thing for your brain health, your ability to repair. What's really interesting is choline is actually used by the brain stem at night to get into proper REM sleep. So if you're choline deprived or again, peri and menopause, I think there's hormonal factors, but one that we miss is choline is directly used by the brain to get into that sleep cycle. So it's like I'm working on my sleep, but I can't sleep, right? I think sometimes hormones are helpful and then choline can actually help you get into better sleep. Exercise movement is really good for your brain. It moves everything around, that lymphatic flow, an anti-inflammatory diet. So another thing is sugars and toxic fats are just destroyers of brain health and even your liver, all these things that we've been talking about today. I also love to say challenge yourself to learn something new. I think it's so good for our brains. And part of that too is like as adults, we forget to play. And I think play is so important for our brains in all these different stages of our life that we go through as women. And then I would say another one for brain health is I'm not anti-alcohol, but we don't wanna overdo it. I think as females, we are more sensitive. We have less of a tolerance. And so just being conscious of when and how much alcohol you're consuming are some of the lifestyle factors that can impact choline, your hormone health and your brain health kind of as this really important triad for your overall health and well-being for all the decades of life that you walk through. Wow, this is such great practical information. And I'm sure that a lot of people like you and I have mutations, maybe they do or don't know it. Just because we can mention, do you have any particular gene reports or things that you like that you particularly if someone wants to do a report themselves, what kind of companies or labs? Do you? Yeah, my favorite that I use is nutrition genome and it's just nutritiongenome.com. Alex Swanson is the founder of that company and he is a brilliant mind in the world of genetics, nutrigenomics. It is such a great research backed report and it really is focused on lifestyle and food first which is what I love about it. I'm glad you mentioned that because I would agree, I totally love that. In fact, our brain trusts of women we all like that test, don't we? We talk about it. Yes, we do. And you've been on the board and advising as well just because you're so knowledgeable in that area. I always like to ask guests, any one last takeaway in life or in brain health or in really any topic at all, any last bit of advice that you'd like to leave our listeners with? I would say that when it comes to genetics because I'm the gene queen, it is one of the most empowering things that you can know about yourself. And remember that it's your uniqueness that makes you you and understanding those different strengths and weaknesses you have even in your biochemistry. Every single time I go through one of these reports it's like a magic unlock for someone to really not only understand themselves but take a step towards more optimized health. And it's not something to be afraid of, it's something to be excited about if it's applied properly. So health can be really fun and really hopeful when you do the right things and you look at the information in the right way. I love that. And that's another thing about the report we're talking about. They give, here's the bonuses, right? It's not just like doom and gloom. It's like, yeah, there's these things you might want to work on but they actually do, I think above and beyond and like, here's your strength, which is so cool. It's good to remember we all have our strengths, right? We all have our unique superpowers. Yes, Sarah, you are a wealth of knowledge and I'm so grateful for your friendship and your wisdom and all of your innovation ideas. Thanks again for taking the time today. Oh, thanks for having me on, it was so fun.