A veteran walks into the clinic with a persistent migraine. Four minutes of vagal nerve stimulation later, the migraine is gone. This is not a one-off result. It is what Dr. Michael Hoffman has been observing for over seven years in the VA hospital system, using non-invasive devices he considers severely underutilized.

Dr. Hoffman is a stroke and cognitive-behavioral neurologist who trained at Columbia University, spent 14 years in the VA system, and has evaluated an estimated 10,000 stroke patients across his career. He now practices at the University of Central Florida, where he integrates ketogenic nutrition, advanced imaging, vagal nerve stimulation, and hyperbaric oxygen into his neurological care.

In this episode, Dr. Hoffman walks through what he calls the "five brain fitness rules," the specific, measurable lifestyle prescriptions he gives every patient, and explains why standard cognitive screening tools like the MoCA and Mini Mental miss the most dramatic behavioral syndromes caused by brain injury.

He also discusses why PET scans and diffusion tensor imaging should be used far more often, and why post-TBI hormonal evaluation is critical but routinely overlooked.

Questions Answered in This Episode:

• What are the five brain fitness rules every neurological patient should follow?
• Why do standard cognitive tests fail to detect some of the most severe brain injury syndromes?
• How is vagal nerve stimulation treating migraines, and why is it so underutilized outside the VA?
• What clinical changes would most improve neurological care today?
• Does the evidence support hyperbaric oxygen therapy for traumatic brain injury?
• Could fungal infections contribute to some long-standing Alzheimer's diagnoses?
• What is the surprising decade when your brain's cognitive function peaks?

Dr. Hoffman makes a case that the gap between what we know about the brain and what we do in clinical practice has never been wider, and that closing it starts with giving clinicians the time and tools to actually examine their patients.

Learn more about Dr. Hoffman on his website here.

Special thanks to the sponsors of this episode:

✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here
✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here
✅ ZocDoc - Find and instantly book a top-rated doctor here
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

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Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

You could have elevated levels of contaminants like uranium or arsenic in your drinking water—and not know it. Many of these compounds are colorless, odorless, and undetectable without testing.

Johnny Pujol is a water chemist and the founder of Tap Score, a drinking water testing platform supported by a network of roughly 270 specialized laboratories. His path from electrochemistry research to consumer water testing was driven by a simple realization: the chemistry inside what looks like a clear glass of water is far more complex than most people realize.

In this episode, Dr. Dominic D’Agostino and Johnny break down what’s actually in drinking water, how regulatory standards are set, and where they may lag behind emerging research. They also discuss how chronic exposure to certain contaminants may intersect with metabolic health and long-term disease risk.

Johnny also shares insights from Tap Score’s forthcoming research comparing contaminant profiles in unfiltered tap water, bottled water, and filtered tap water.

Questions Answered in This Episode:

• Why does the EPA action level for lead differ from the ideal target of zero?
• Can certain filtration systems introduce unintended issues, like microbial growth, if not properly maintained?
• How can environmental factors like rainfall impact private well water quality?
• What's the difference between a "first draw" sample and a "representative" sample, and why does it matter?
• Is the health risk from showering in contaminated water meaningful compared to drinking it?
• Why do some water tests cost $600 to $800 while others cost a fraction of that?

Understanding your drinking water starts with recognizing the difference between what’s legally permitted and what may be considered optimal from a health perspective. This conversation explores that gap, and what individuals can do to better assess their own water quality.

Learn more here: https://mytapscore.com/

Special thanks to the sponsors of this episode:

✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here.
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Register for a live Q&A with Dr. Tommy Wood on Wednesday, March 25th.

Decreased glucose uptake in the brain is often considered a hallmark of Alzheimer's disease. But Dr. Tommy Wood asks whether part of that metabolic signature may reflect how little cognitive demand we place on the brain.

He sits down with Dr. Dominic D'Agostino for a nuanced conversation on metabolic health and cognitive function.. Dr. Wood is a neuroscientist, neonatal brain injury researcher, and author of The Stimulated Mind.

This episode follows the metabolic thread through every stage of brain health. Pre-diabetes and type 2 diabetes as predictors of cognitive decline. Neurovascular coupling as the reason heart disease risk factors double as brain disease risk factors. Lactate crossing the blood-brain barrier to drive BDNF production where it actually matters. Creatine as a brain energy distributor that most people still only associate with muscle. Dr. Wood lays out his Three S Model — Stimulus, Supply, Support — and makes the case that cognitive demand drives glucose uptake into the brain the same way muscular contraction drives it into skeletal muscle.

Questions Answered in This Episode:

• Does the brain respond to energy demand the same way skeletal muscle does?
• What role does creatine play in brain energy distribution, and what do the clinical trials show?
• Can heavy resistance training produce the same brain-relevant lactate response as HIIT?
• How should exercise be dosed after a concussion or traumatic brain injury?
• Is cognitive decline in your 50s, 60s, and 70s actually inevitable, or is that a statistical artifact?
• Why are pre-diabetes and metabolic syndrome among the strongest predictors of dementia?

The mechanistic throughline here is demand-driven metabolism. Dr. Wood makes the case that the same principles governing glucose uptake in skeletal muscle apply to the brain — and the conversation gets into what that means for how we interpret FDG-PET data, design lifestyle interventions, and think about neurodegeneration itself.

Find more at DrTommyWood.com

Special thanks to the sponsors of this episode:

✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here

✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here

✅ Toups and Co – Get 15% off your first order with code METABOLIC here

✅ ZocDoc - Find and instantly book a top-rated doctor here

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.