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Testosterone for women: what the evidence actually shows vs. what social media is selling you.
Testosterone has become the hormone every midlife woman is told she is missing: the third hormone lost at menopause, the fix for brain fog, low energy, stubborn weight, and thinning muscle.
The science tells a different and more reassuring story.
In this episode, Dr. Ayesha Sherzai sits down with Professor Susan Davis, MBBS, FRACP, PhD, the clinician-researcher and academic endocrinologist who gathered much of the data and helped write the global guidelines, to separate what the research supports from what is simply being sold.
Your Brain On... Testosterone [Season 7, Episode 7]
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In this episode:
Professor Susan Davis is a consulting endocrinologist at Monash University in Melbourne, where she directs a leading women's health research program. She has studied testosterone in women since the 1990s and is the lead author of the Global Consensus Position Statement on the Use of Testosterone Therapy for Women, endorsed by the International Menopause Society, The Endocrine Society, and menopause and obstetric societies around the world.
References:
Does testosterone crash at menopause? Wang Y, Islam RM, Bond M, Davis SR. Testosterone and pre-androgens by age and menopausal stage at midlife: findings from a cross-sectional study. EBioMedicine. 2025;121:105972. PMID: 41106025. Davis SR, Bell RJ, Robinson PJ, et al. Testosterone and estrone increase from the age of 70 years: findings from the Sex Hormones in Older Women Study. J Clin Endocrinol Metab. 2019;104(12):6291–6300. PMID: 31408149. Islam RM, Bell RJ, Handelsman DJ, Robinson PJ, Wolfe R, Davis SR. Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over. Clin Endocrinol (Oxf). 2021;94(3):443–448. PMID: 33351205.
Does testosterone improve memory or protect against dementia? Sultana F, Davis SR, Wolfe RS, McNeil JJ, Islam RM. Associations between blood sex hormones, cognitive decline and incident dementia in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2025;28(4):446–455. PMID: 40085743. Sultana F, Islam RM, Davis SR. Associations between declining testosterone concentrations and cognitive performance in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2026;29(1):46–52.
What does testosterone therapy actually do? Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754–766. PMID: 31353194.
What do the global guidelines say? Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666. PMID: 31498871.
Can a blood test diagnose low testosterone? Wang Y, Islam RM, Hodge A, Handelsman DJ, Karim MN, Bond M, Davis SR. Associations between testosterone and pre-androgens and sexual function: findings from the Australian Women's Midlife Years Study. Fertility and Sterility. 2026.
Get our FREE NEURO Plan Brain Health Playbook: https://thebraindocs.com/playbook
Hosted by Drs. Ayesha & Dean Sherzai.
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The neurologist who built the test that was used on the President of the United States explains what memory tests actually tell you, and why even a perfect score isn't the whole picture.
We sit down with Dr. Ziad Nasreddine, the neurologist who created the Montreal Cognitive Assessment (MoCA), to look at how memory is actually measured, why a score can be shaped by your education and how comfortable you are with tests, and what separates a quick screen from a full neuropsychological evaluation.
The conversation opens with a patient who passed a short memory screen but whose family knew something was wrong, and what a deeper test revealed. From there it moves to how the MoCA works, how it became famous after a presidential exam (and the memorization problem that followed), why your education and nerves can shift a score, and why the real progress against dementia is happening in detection and prevention, not treatment.
A memory test is not a verdict. Its value is early, honest information, and what you can do once you have it.
In this episode:
Dr. Ziad Nasreddine is a neurologist and the creator of the Montreal Cognitive Assessment (MoCA), which he first developed in 1996 and spent nine years validating. It has since been translated into more than 50 languages and is used in over 100 countries, making it one of the most widely used cognitive tests in medicine. He completed his cognitive neurology fellowship at UCLA under Dr. Jeffrey Cummings. His more recent work includes XpressO, a free at-home pre-screener, and MoCA Solo, an AI-administered version of the test.
Resources:
Hosted by Drs. Ayesha & Dean Sherzai
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We're more connected than ever, yet, we've never been lonelier.
We sit down with neuroscientist Dr. Ben Rein, author of Why Brains Need Friends, to look at what isolation does to the brain and body, why we badly underestimate our own social skills, and how to build real connection back into ordinary life.
The conversation opens 45,000 years ago, with a healed bone that points to one of the earliest signs of human caregiving. From there it moves to the present: why "rejection hurts because it used to kill," how chronic loneliness raises cortisol and inflammation, and why regular social connection lowers the risk of dementia, heart disease, diabetes, anxiety, and depression.
In this episode:
Dr. Ben Rein is a neuroscientist, science communicator, and author of Why Brains Need Friends: The Neuroscience of Social Connection (Penguin Random House). He is chief science officer of the Mind Science Foundation, an adjunct lecturer at Stanford University, and a clinical assistant professor at SUNY Buffalo. His research focuses on the neuroscience of social interaction, and he teaches neuroscience to more than 1 million followers online.
Resources:
Hosted by Drs. Ayesha & Dean Sherzai
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Researchers found people who ate these 9 foods consistently had brains that aged 7.5 years slower.
Not a supplement stack, not a protocol, not a hack. A pattern of real food that keeps showing up across decades and across the world.
It's called the MIND diet, and it's what we're breaking down in this episode.
We explore the scoring system behind the MIND diet with a registered dietician who came to brain health through her own mother's Alzheimer's diagnosis, and who has spent 20 years helping real women in real kitchens make these changes stick.
In this episode, you'll learn:
Barbie Boules is a registered dietician with more than 20 years of experience in women's health and brain health nutrition. Her mother was diagnosed with Alzheimer's in 2022, and her work bridges clinical evidence with practical, accessible meal planning for women in midlife.
Follow Barbie: https://www.instagram.com/the_cognition_dietitian
Hosted by Drs. Ayesha & Dean Sherzai
Subscribe to The Synapse (free weekly newsletter): thebraindocs.com/newsletter
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It's 3 AM and your brain won't shut off. About 1 in 10 adults meets the clinical definition of chronic insomnia, and most never get treated. Instead, they scroll through an endless aisle of magnesium gummies, melatonin, and $300 trackers that don't address the real problem.
We brought in a neurologist and a psychologist who never spoke to each other and landed on almost the exact same conclusions.
In this episode, you'll learn:
Dr. Sujay Kansagra is a pediatric neurologist and sleep medicine specialist at Duke University, director of Duke's Pediatric Neurology Sleep Medicine Program, and author of "My Child Won't Sleep." Follow Dr. Kansagra: @thatsleepdoc
Dr. Shelby Harris is a clinical psychologist and behavioral sleep medicine specialist. She treats insomnia in women during perimenopause and menopause and is the author of "The Women's Guide to Overcoming Insomnia." Website: drshelbyharris.com Follow Dr. Harris: @SleepDocShelby
Hosted by Drs. Ayesha & Dean Sherzai Subscribe to The Synapse (free weekly newsletter): thebraindocs.com/newsletter Follow @TheBrainDocs on Instagram
Headlines warned us about microplastics in our brains. A chemist says the study may have been measuring brain fat instead.
In 2025, a study claiming microplastics accumulate in human brain tissue dominated our feeds. We covered it. Then Dr. Michelle Wong, a chemical scientist and science communicator, flagged a problem with the methodology.
So we went to the primary literature, read the critique, and brought in one of the first scientists to publicly challenge the findings: Dr. Oliver Jones, Professor of Analytical Chemistry at RMIT University in Melbourne.
In this episode, we unpack what went wrong with the measurement method, what it means for the broader microplastics conversation, and why being willing to say "I was wrong" is so vital for good science.
In this episode:
Dr. Oliver Jones is Professor of Analytical Chemistry and Associate Dean of Biosciences and Food Technology at RMIT University in Melbourne. A Fellow of the Royal Society of Chemistry (FRSC) and the Royal Australian Chemical Institute (FRACI), he holds degrees from Imperial College London and Cambridge. He is one of only 118 scientists worldwide named to the IUPAC Periodic Table of Outstanding Younger Chemists. His research focuses on developing methods to measure environmental contaminants, including microplastics, and he was among the first scientists to publicly challenge the methodology of the viral "microplastics in the brain" study.
Follow Dr. Jones: @dr_oli_jones RMIT faculty page: rmit.edu.au/oliver-jones
Dr. Michelle Wong (Lab Muffin Beauty Science) first flagged the methodological concerns to us.
Hosted by Drs. Ayesha & Dean Sherzai Subscribe to The Synapse (free weekly newsletter): https://thebraindocs.com/newsletter Follow @TheBrainDocs on Instagram
Menopause hormone therapy and your brain: what the evidence says vs. what the algorithm is selling you.
Two-thirds of Alzheimer's patients are women. That statistic has fueled a social media narrative that hormone therapy can prevent dementia, but the current evidence doesn't support that claim. In this episode, Drs. Ayesha and Dean Sherzai sit down with OBGYN Dr. Jen Gunter and neuroscientist Dr. Sarah McKay to separate the science from the soundbites.
Your Brain On... Menopause Hormone Therapy [Season 7, Episode 1]
Get our FREE NEURO Plan Brain Health Playbook: https://thebraindocs.com/playbook
In this episode:
00:00 Intro
01:09 Why the menopause hormone therapy conversation matters
07:10 Dr. Jen Gunter: the dangerous dichotomy around MHT
10:20 The Women's Health Initiative, revisited
16:25 Who is menopause hormone therapy actually for?
18:20 The placebo response nobody talks about
22:33 When does perimenopause actually start?
26:00 Does MHT actually prevent dementia?
29:11 "Bioidentical" is not a medical term
36:27 The problem with unregulated hormone testing
41:08 How to advocate for yourself at the doctor
44:36 New drugs that could change menopause research
47:17 The pTau217 study and what it means for women on MHT
52:20 Dr. Sarah McKay: what happens in your brain during menopause
59:34 The oversimplified estrogen-Alzheimer's story
1:04:13 When social media primes your symptoms
1:11:18 What the aging brain actually gains
1:21:35 Grandmothers rule the world!
1:25:43 What MHT is actually good for
1:26:28 7 things to do for your brain
Dr. Jen Gunter is an OBGYN, pain medicine physician, New York Times columnist, and bestselling author of The Menopause Manifesto, The Vagina Bible, and Blood. She writes The Vajenda on Substack and is one of the most prominent voices challenging misinformation in women's health.
Dr. Sarah McKay is a neuroscientist, science communicator, and author of The Women's Brain Book. She is the founder of The Neuroscience Academy and Think Brain training programs.
References: North American Menopause Society 2022 Hormone Therapy Guidelines: menopause.org Australasian Menopause Society: menopause.org.au The Vajenda (Substack): jenssubstack.com
Get our FREE NEURO Plan Brain Health Playbook: https://thebraindocs.com/playbook
Hosted by Drs. Ayesha & Dean Sherzai. Subscribe to The Synapse (free weekly newsletter): thebraindocs.com/newsletter Follow @TheBrainDocs on Instagram
Most people think dementia starts with memory loss. But for millions, it actually begins decades earlier: in the blood vessels.
Long before someone forgets a name or misses an appointment, the brain is being quietly damaged by high blood pressure, cholesterol imbalance, poor sleep, inflammation, and chronic stress, day after day, year after year.
This kind of damage doesn't look dramatic. There's no big stroke, no clear warning sign. It happens slowly and silently, which is why it's so often missed until it's too late.
But here's the good news: vascular dementia is one of the most preventable and manageable forms of cognitive decline. When caught early, lifestyle changes and medical interventions can help slow the onset and manage the effects.
In this episode, we explore:
Our guest for this episode is DR. COLUMBUS BATISTE, a board-certified interventional cardiologist, an incredible science communicator, and author of 'Selfish: A Cardiologist's Guide to Healing a Broken Heart'. Dr. Batiste brings deep expertise on how cardiovascular health shapes brain health, and why protecting the endothelium (the inner lining of blood vessels) is foundational to longevity. His work emphasizes that all roads to longevity are paved by the heart, and what's good for the heart is good for the brain!
'Your Brain On…' is hosted by neurologists, scientists, and public health advocates Drs. Ayesha and Dean Sherzai.
SUPPORTED BY: NEURO World, a science-based brain health community designed to help you protect your brain long before problems begin. Learn more at https://neuro.world/
'Your Brain On… Vascular Dementia' • SEASON 6 • EPISODE 8
———
LINKS
Dr. Columbus Batiste: https://drbatiste.com/
Instagram: @HeartHealthyDoc
Facebook: https://www.facebook.com/drbatiste
——— FOLLOW US
Join NEURO World: https://neuro.world/
Instagram: https://www.instagram.com/thebraindocs
YouTube: https://www.youtube.com/thebraindocs
———
REFERENCES
Core Definitions & Diagnostic Framework
• Diagnostic and Statistical Manual of Mental Disorders (5th ed.) - American Psychiatric Publishing
• Vascular contributions to cognitive impairment and dementia - https://doi.org/10.1161/STR.0b013e3182299496
• Classifying neurocognitive disorders: The DSM-5 approach - https://doi.org/10.1038/nrneurol.2014.181
Epidemiology & Public Health Burden
• Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer's disease - https://doi.org/10.1007/s00401-016-1571-z
• Vascular dementia - https://doi.org/10.1016/S0140-6736(15)00463-8
• Risk reduction of cognitive decline and dementia: WHO guidelines - WHO Press
Small Vessel Disease & Subcortical Vascular Dementia
• Small vessel disease: Mechanisms and clinical implications - https://doi.org/10.1016/S1474-4422(19)30079-1
• Cerebral small vessel disease: From pathogenesis and clinical characteristics to therapeutic challenges - https://doi.org/10.1016/S1474-4422(10)70104-6
• The clinical importance of white matter hyperintensities on brain magnetic resonance imaging - https://doi.org/10.1136/bmj.c3666
Mixed Dementia & Alzheimer–Vascular Overlap
• Mixed brain pathologies account for most dementia cases in community-dwelling older persons - https://doi.org/10.1212/01.wnl.0000271090.28148.24
• Early role of vascular dysregulation on late-onset Alzheimer's disease - https://doi.org/10.1016/j.neurobiolaging.2016.04.009
• The pathobiology of vascular dementia - https://doi.org/10.1016/j.neuron.2013.10.008
Cerebral Amyloid Angiopathy (CAA)
• Cerebral amyloid angiopathy and Alzheimer disease—one peptide, two pathways - https://doi.org/10.1038/s41582-019-0281-2
• Emerging concepts in sporadic cerebral amyloid angiopathy - https://doi.org/10.1093/brain/awx047
Genetics, Inflammation, and Repair
• Apolipoprotein E controls cerebrovascular integrity via cyclophilin A - https://doi.org/10.1038/nature11087
• TREM2—A key player in microglial biology and Alzheimer disease - https://doi.org/10.1038/s41582-018-0072-1
Prevention & Vascular Risk Factors
• Dementia prevention, intervention, and care: 2020 report of the Lancet Commission - https://doi.org/10.1016/S0140-6736(20)30367-6
• Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease - https://doi.org/10.1038/s41582-018-0070-3
Further Reading
• The role of vascular risk factors in Alzheimer's disease - https://doi.org/10.1038/s41582-021-00530-4
Cold plunges are everywhere, and the way people talk about them, you'd think they're a miracle cure for your brain, body, and soul.
But in an age of algorithm-fueled evangelism, when a ritual becomes this ubiquitous and loud, we have to ask: how much of the buzz is backed by science… and how much is just marketing?
In this episode, we explore the neuroscience of cold exposure: what's real, what's overstated, and why this "discomfort" has become a billion-dollar industry.
We discuss:
Joining us for this conversation is investigative journalist and bestselling author Scott Carney (What Doesn't Kill Us, The Wedge), who has spent years inside the cold exposure world, first as a skeptic, then as a believer, and eventually as a critic of the culture that formed around it. His work reveals what happens when discomfort becomes identity, and when unfounded "social media science" outruns real science.
Your Brain On... is hosted by neurologists, scientists, and public health advocates Drs. Ayesha and Dean Sherzai.
SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: neuroworldretreat.com
Your Brain On... Cold Plunges • SEASON 6 • EPISODE 7
REFERENCES
Cold Water Immersion, Muscle Adaptation, and Recovery
Roberts, L. A., Raastad, T., Markworth, J. F., Figueiredo, V. C., Egner, I. M., Shield, A., Cameron-Smith, D., Coombes, J. S., & Peake, J. M. (2015). Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. Journal of Physiology, 593(18), 4285–4301. https://doi.org/10.1113/JP270570
Bleakley, C. M., McDonough, S. M., & MacAuley, D. C. (2004). The use of ice in the treatment of acute soft-tissue injury: A systematic review of randomized controlled trials. American Journal of Sports Medicine, 32(1), 251–261. https://doi.org/10.1177/0363546503260757
Leeder, J., Gissane, C., van Someren, K., Gregson, W., & Howatson, G. (2012). Cold water immersion and recovery from strenuous exercise: A meta-analysis. British Journal of Sports Medicine, 46(4), 233–240. https://doi.org/10.1136/bjsports-2011-090061
White, G. E., & Wells, G. D. (2013). Cold-water immersion and other forms of cryotherapy: Physiological changes potentially affecting recovery from high-intensity exercise. Sports Medicine, 43(8), 695–706. https://doi.org/10.1007/s40279-013-0055-8
Kellmann, M., Bertollo, M., Bosquet, L., Brink, M., Coutts, A. J., Duffield, R., Erlacher, D., Halson, S. L., Hecksteden, A., Heidari, J., Kölling, S., Meyer, T., Mujika, I., Robazza, C., Skorski, S., Venter, R., & Beckmann, J. (2018). Recovery and performance in sport: Consensus statement. International Journal of Sports Physiology and Performance, 13(2), 240–245. https://doi.org/10.1123/ijspp.2017-0759
Inflammation, Pain, and Perceived Recovery
Hohenauer, E., Taeymans, J., Baeyens, J. P., Clarys, P., & Clijsen, R. (2015). The effect of post-exercise cryotherapy on recovery characteristics: A systematic review and meta-analysis. PLoS ONE, 10(9), e0139028. https://doi.org/10.1371/journal.pone.0139028
Costello, J. T., Culligan, K., Selfe, J., & Donnelly, A. E. (2012). Muscle, skin and core temperature after –110°C cold air and 8°C water treatment. PLoS ONE, 7(11), e48190. https://doi.org/10.1371/journal.pone.0048190
Brown Adipose Tissue (BAT) – Human Imaging & Metabolism
van Marken Lichtenbelt, W. D., Vanhommerig, J. W., Smulders, N. M., Drossaerts, J. M., Kemerink, G. J., Bouvy, N. D., Schrauwen, P., & Teule, G. J. (2009). Cold-activated brown adipose tissue in healthy men. New England Journal of Medicine, 360(15), 1500–1508. https://doi.org/10.1056/NEJMoa0808718
Virtanen, K. A., Lidell, M. E., Orava, J., Heglind, M., Westergren, R., Niemi, T., Taittonen, M., Laine, J., Savisto, N. J., Enerbäck, S., & Nuutila, P. (2009). Functional brown adipose tissue in healthy adults. New England Journal of Medicine, 360(15), 1518–1525. https://doi.org/10.1056/NEJMoa0808949
Betz, M. J., & Enerbäck, S. (2015). Human brown adipose tissue: What we have learned so far. Diabetes, 64(7), 2352–2360. https://doi.org/10.2337/db15-0146
Autonomic Nervous System, HRV, and Cold Exposure
Mourot, L., Bouhaddi, M., Regnard, J., Tordi, N., & Rouillon, J. D. (2008). Cardiac autonomic control during short-term exposure to cold water in humans. European Journal of Applied Physiology, 104(3), 541–547. https://doi.org/10.1007/s00421-008-0810-3
Janský, L., Pospíšilová, D., Honzová, S., Uličný, B., Šrámek, P., Zeman, V., & Kamínková, J. (1996). Immune system of cold-exposed and cold-adapted humans. European Journal of Applied Physiology, 72(5–6), 445–450. https://doi.org/10.1007/BF00242276
Cardiovascular Stress and Cold Shock
Tipton, M. J., Collier, N., Massey, H., Corbett, J., & Harper, M. (2017). Cold water immersion: Kill or cure? Experimental Physiology, 102(11), 1335–1355. https://doi.org/10.1113/EP086283
Tipton, M. J., & Bradford, C. (2014). Cold water immersion and cold shock response. Extreme Physiology & Medicine, 3(1), 1–10. https://doi.org/10.1186/2046-7648-3-7
Whole-Body Cryotherapy (Distinct From Cold Plunges)
Costello, J. T., Baker, P. R., Minett, G. M., Bieuzen, F., Stewart, I. B., & Bleakley, C. (2015). Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database of Systematic Reviews, 2015(9), CD010789. https://doi.org/10.1002/14651858.CD010789.pub2
LINKS
Scott Carney's website: https://www.scottcarney.com/
FOLLOW US
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Around the start of 2026, a study sparked viral headlines claiming that cheese could reduce dementia risk.
But... nutrition science almost never works like this. One study can't "prove" a food is protective or harmful, and viral health claims often miss the most important details of research: how the data was gathered, what was actually measured, what variables were controlled for, and what it means in real life.
In this episode, we unpack what the 'viral cheese study' (PMID: 41406402) actually found, what it DOESN'T mean, and why critical thinking around nutrition headlines matters more than ever.
We discuss:
• Why viral food headlines are so persuasive (and so often misleading)
• What the cheese study REALLY reported
• The difference between correlation and causation in nutrition research
• Why long-term dietary recall data can be unreliable
• How bias (including our personal food preferences) shapes interpretation of research
• What "show me the data" really means in a world of clickbait science
• How to interpret food and brain health studies without falling into extremes
We also speak to Emily Sonestedt, research group leader and associate professor at Lund University, and one of the authors of the viral study.
"Your Brain On..." is hosted by neurologists, scientists, and public health advocates Drs. Ayesha and Dean Sherzai.
SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: https://www.neuroworldretreat.com/
'Your Brain On... Cheese' • SEASON 6 • EPISODE 6
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LINKS
The study, 'High- and Low-Fat Dairy Consumption and Long-Term Risk of Dementia: Evidence From a 25-Year Prospective Cohort Study': https://pubmed.ncbi.nlm.nih.gov/41406402/
———
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More info and episodes: TheBrainDocs.com/Podcast
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