Author: Robbie Poe

Dr. Rudolph Tanzi’s SHIELD method gives us a brilliant acronym for brain health. But here’s what most practitioners miss when they recommend it.

We’re treating symptoms of a much deeper crisis.

Before industrialization, humans routinely lived past 100 with sharp, wisdom-filled minds. We didn’t need acronyms to remember how to be human. We lived in tight social communities, moved our bodies for survival, ate foods that nourished our microbiome, and naturally recycled our NAD+ stores.

Then we collectively forgot.

The Energy Crisis Nobody Talks About

The real story behind brain decline starts in your mitochondria. NAD+ is how we produce energy through the Krebs cycle. It fuels ATP production and recycles glutathione.

But here’s the problem: we lose mitochondrial function with age, and NAD+ synthesis decreases as we get older.

Your Krebs cycle needs three fuel sources. Amino acids from proteins require B vitamins and alpha lipoic acid. Carbohydrates need those same B vitamins plus magnesium. Fats only need B2 and carnitine.

Fats are our most efficient fuel source. Yet the same American Heart Association that educates on mental health tells people to avoid fats and eat fat-free diets.

We’ve spent 100+ years letting medical elites control the narrative around nutrition.

How We Broke Our Ancient Pathways

Our modern microbiome barely resembles what our ancestors had. We don’t play in dirt or get exposed to diverse microbes like people did 100 years ago.

When we’re chronically stressed, we stop producing digestive enzymes. We can’t neutralize normal bacteria in our throats or break down proteins efficiently.

Those undigested proteins ferment in the gut, creating neurotoxic sugar alcohols. They feed fungi like candida and bad bacteria like clostridia.

These organisms produce neurotoxins that leak across your gut barrier. If you have a leaky gut, you have a leaky brain barrier.

The molecules they produce, like LPS, create massive inflammation in brain centers associated with consciousness and cognitive stability. Clostridia forms oxalate crystals that deposit into muscles, tendons, ligaments, blood vessels, and nerves.

Your body becomes stiff and arthritic. Blood vessels lose flexibility. The tiny capillaries that pump oxygen-rich blood to the deepest parts of your brain stop working properly.

The Generational Inheritance Problem

Here’s what makes this crisis profound: we inherit our mitochondrial production capacity directly from our mothers.

The baby boomer generation was convinced to eat fast food and ultra-processed convenience foods. They fed these same foods to their children. We’re now several generations into severely blunted NAD+ production capacity.

Mental health comes from the ability to fuel mitochondria in your frontal lobe. The central executive cortex houses your attention, emotional management, and stress management centers.

When multiple generations have poor mitochondria, we get what we have now: the biggest mental health crisis in human history.

We need acronyms to help people remember how to be human.

Why SHIELD Falls Short

Dr. Tanzi’s method addresses the right components. Sleep, handling stress, intellectual stimulation, exercise, lifestyle connections, and diet.

But telling someone to “handle stress through meditation” is like telling an overweight person to “lose weight through diet and exercise.” It falls massively short of providing actual tools people can use.

Most people we see are simply trying to get out of pain. Their lives are packed with activity and stress. They lack true community. Even with real-life guidance from a health professional, they won’t utilize simple tools we give them.

The challenge isn’t knowing what to do. It’s developing sustainable practices that restore ancient maintenance activities.

What Actually Works In Clinical Practice

At The Dearing Clinic, we see the difference between patients who successfully restore these pathways and those who struggle.

Success comes through repetition and feeling good from that repetition. It’s the only thing that motivates people to continue lifestyle shifts.

What works: morning and evening routines focused on movement and body awareness. Breathing exercises that evolve into meditative practices. Exercise routines that maintain freedom of movement without pain.

When patients develop healthy habits for these ancient maintenance activities, they begin to thrive. This motivates them to keep building, progressing, and learning about diet, herbs, and microbiome maintenance.

Those who struggle continue falling back on poor routines because of convenience or habit. They never achieve what should be our ancient birthright: freedom from suffering and feelings of clarity and balance.

The Restoration Protocol

We use advanced diagnostics like qEEG brain mapping and functional lab testing to understand each person’s unique patterns. But the foundation remains simple.

Start with morning movement. Even five minutes of breathing exercises. Build slowly.

Address the gut-brain axis through proper nutrition that supports NAD+ production. Focus on easily converted fats, properly prepared proteins, and complex carbohydrates with the right cofactors.

Create genuine social connections. Social isolation increases dementia risk by 60%.

Use regenerative therapies like NAD+ infusions, hyperbaric oxygen therapy, and targeted peptides to support mitochondrial restoration.

But remember: you can’t spend your way out of debt, and you can’t supplement your way out of poor lifestyle choices.

Breaking The Generational Cycle

The good news: we can maintain and duplicate healthy mitochondria at any age if we put these principles into practice.

We’re not just treating individual symptoms. We’re working to restore resilience that can be passed to the next generation.

The SHIELD method provides a framework. But implementation requires understanding the deeper mechanisms, addressing root causes, and developing sustainable practices that honor our biological design.

We didn’t evolve to live the way we’re living now. But we can remember how to feed our brains the way they were meant to be fed.

The question isn’t whether these ancient pathways can be restored. It’s whether we’re willing to do the work to restore them.

The numbers stopped me cold. A landmark study tracking over 4,000 adults revealed something extraordinary: people who could sit on the floor and rise without using their hands had a six-fold lower risk of death.

Six times lower.

Most people think this sitting-rising test measures muscle strength or joint flexibility. They’re missing the real story.

What this test actually reveals is the energy reserves of your consciousness itself.

The Consciousness Circuit Hidden in Plain Sight

The ability to rise from the floor engages what I call the “consciousness circuit.” This isn’t about your biceps or your knees.

It’s about a brain region called the parieto-insular vestibular cortex (PIVC). Think of it as mission control for your relationship with gravity.

Here’s what most people don’t know: the PIVC connects directly to your insula, the brain’s energy-hungry headquarters for conscious awareness. This circuit consumes more energy per gram than any other part of your cortex.

When chronic stress depletes this system, your brain switches into survival mode. It hyper-attunes to external threats while losing its internal compass.

The sitting-rising test exposes this energy crisis in real time.

The Falcon Rocket Landing in Your Brain

Watch someone rise from the floor and you’re witnessing something remarkable. Their brain performs thousands of micro-calculations per second.

The moment you intend to stand, an intentional preparation signal primes the circuit. Motor planning launches the go signal. Muscles activate and immediately assess gravity.

It’s like watching a falcon rocket landing on an ocean pad, constantly adjusting pitch and roll. Fast reflex signals run through your coordination system, fine-tuning front-to-back and side-to-side balance.

This isn’t just movement. It’s your brain calibrating to reality itself.

The vestibulo-spinal reflexes maintain balance during descent and ascent. The vestibulo-collic reflex keeps your head aligned to gravity. The vestibular cortex integrates body position, balance, and movement planning in real time.

All of this depends on the energy reserves of your consciousness circuit.

When the Circuit Breaks Down

I see the progression in my practice every day. When the consciousness circuit starts failing, the symptoms follow a predictable pattern.

Early signs include balance loss during simple tasks, chronic shoulder tension, jaw clenching, and persistent headaches. Dizziness becomes common. Brain fog settles in like a low-grade fever.

People describe feeling “out of it” or chronically dysregulated, swinging between anxiety and depression.

Later, chronic pain affects movement and posture. Memory slips and word-finding difficulties emerge. Autoimmune conditions and immune deficiencies often follow.

The sitting-rising test catches this decline before it becomes irreversible.

The Energy Economics of Survival

Your brain faces a brutal economic reality. Consciousness costs enormous energy to maintain.

The salience network, centered in your insula, must constantly decide what deserves your attention. When chronic stressors from diet, work, relationships, and finances drain this system, it can’t afford the luxury of perfect balance.

Your brain makes a survival calculation: better to sacrifice some coordination than run out of fuel entirely.

This is why the sitting-rising test predicts mortality so accurately. It’s measuring your brain’s energy reserves, not your gym performance.

What fires together, wires together. The more you challenge these movement demands with balance and body awareness, the stronger these circuits become.

Maintaining a straight spine and head position constantly calibrates you to gravity. This switches your attention inward to body awareness and generates calmer, neuroprotective brainwave patterns.

The Head-Neck Connection Nobody Talks About

Here’s something fascinating: head and neck motion connects directly to memory formation. These systems interweave through the same circuits that control balance and consciousness.

As we age, our heads and necks stiffen from arthritis, postural tension, and repetitive work conditions. Stress and anxiety create additional neck tension that most people never address.

When these circuits lose plasticity from lack of use, your brain can’t maintain gravity calibration. The rocket landing system starts failing.

This explains why neck stiffness often precedes memory problems and balance issues by years.

Beyond the Test Score

The original study found that each 1-point improvement in sitting-rising test scores correlated with a 21% reduction in mortality risk. Small improvements yield dramatic benefits.

But I don’t use this test to scare people. I use it to reveal possibilities.

When someone struggles to rise from the floor, I’m not seeing weakness. I’m seeing a nervous system that ran out of fuel and feedback.

The beautiful thing about neuroplasticity is that these circuits can be rebuilt. Through targeted functional neurology, we can restore the energy economics of consciousness.

This might involve craniosacral work to improve head-neck mobility. Vestibular rehabilitation to strengthen balance circuits. Neurofeedback to optimize brainwave patterns. Sometimes regenerative therapies to fuel cellular recovery.

The goal isn’t just passing a test. It’s restoring your brain’s relationship with gravity, consciousness, and life itself.

The Real Test of Longevity

Traditional medicine measures longevity through blood pressure, cholesterol, and VO2 max. These matter, but they miss the deeper story.

Your ability to rise from the floor without support reveals something more fundamental: whether your consciousness circuit has enough energy to keep you connected to your body and the physical world.

This connection determines not just how long you live, but how present you remain for the life you’re living.

The sitting-rising test isn’t measuring your past. It’s revealing your brain’s capacity for future resilience.

That’s why I tell my patients: you’re not broken. Your nervous system just needs better fuel and feedback.

The rocket can learn to land again.

Deep in your brain’s most vital circuits, energy production determines everything from focus to resilience. When these circuits falter due to inflammation, stress, or aging, the downstream effects ripple through every aspect of cognitive function.

As a functional neurologist, I’ve witnessed this cellular energy crisis play out in countless patients. The symptoms vary, but the underlying pattern remains consistent: compromised mitochondrial function in the brain’s most metabolically demanding regions.

This is where methylene blue enters the conversation. Not as a miracle cure, but as a fascinating compound with specific mechanisms that warrant both attention and caution.

Beyond the Blue Dye: A Mitochondrial Rescue Agent

Methylene blue isn’t just another supplement trending on social media. Its mechanism of action is uniquely suited for addressing compromised brain energy.

It bypasses damaged steps in the electron transport chain, shuttling electrons directly to cytochrome c. This maintains ATP production while reducing oxidative stress—essentially acting as a mitochondrial rescue agent in aging or inflamed brain tissue.

This mechanism has been well-documented in research showing how methylene blue can serve as an “alternative electron transport pathway” when normal cellular energetics are compromised PMC5826781.

When combined with NAD+ precursors like nicotinamide riboside and pterostilbene, methylene blue’s effect amplifies. While methylene blue keeps electron flow moving, NAD+ fuels redox balance and SIRT-driven repair pathways.

The Brain’s Most Vulnerable Circuits

One of the most critical and metabolically demanding circuits in the brain is the cortico-striatal-thalamic loop, particularly between the dorsal anterior cingulate cortex (dACC) and the neostriatum.

This loop underpins motivation, attention, motor control, and decision-making—functions that decline early with neuroinflammation, immune activation, and mitochondrial dysfunction.

What makes this circuit so vulnerable is its high demand for oxygen and ATP. These brain regions are energy-hungry and rich in glutamatergic and dopaminergic signaling, which become unstable when mitochondrial output falters.

This loop is among the first to break down under chronic stress, inflammation, aging, or viral damage. Methylene blue functions as a neuro-metabolic switchboard, bypassing damaged mitochondria to keep these energy-intensive circuits functioning Healthspan.

Safety First: Not All Blue Is Created Equal

Despite its potential benefits, methylene blue requires significant caution. The most serious concern involves its interaction with serotonergic medications.

Methylene blue is a potent monoamine oxidase inhibitor (MAOI). When combined with SSRIs or SNRIs, it can cause potentially fatal serotonin syndrome, even at lower doses than previously thought FDA.

Quality sourcing presents another critical concern. Industrial applications of methylene blue don’t require the same purity standards as medical uses, leading to potential heavy metal contamination in unverified sources.

In my practice, I consider methylene blue more akin to a prescription medication than a supplement. I only recommend pharmaceutical-grade methylene blue from compounding pharmacies that test each batch for purity.

The recent explosion of methylene blue products in the unregulated supplement market deeply concerns me. Many of these products may contain contaminants that pose serious health risks.

Beyond the Molecule: A Systems Approach

Methylene blue is never a standalone solution. In my clinical experience, it works best as part of a comprehensive approach to neuroinflammation and metabolic health.

For the deep structures of the cortex, we often combine methylene blue with ISF (infra-slow) neurofeedback to directly exercise these systems. We also implement functional neurological exercises targeting specific symptoms.

The gut-brain connection cannot be overlooked. Even when neuroinflammation begins in the brain via viral infection or injury, this triggers changes in gut function. Addressing gut health becomes essential when supporting brain metabolism.

We monitor progress through multiple biomarkers: microbiome analysis for gut health, organic acid testing (OAT) for metabolic efficiency, brain tissue antibody panels for neuroinflammation, and qEEG brain maps to track functional improvements.

Heart rate variability (HRV) provides perhaps our most important metric, reflecting the return of autonomic resilience—a key indicator of successful treatment.

Sustainable Alternatives: Medicine from the Earth

While methylene blue offers powerful support for patients in acute need, I prefer sustainable, natural approaches for long-term brain health.

Herbs can help preserve energy-producing circuits without the need for synthetic compounds. My favorite combination includes holy basil, spearmint, lemon balm, and eleuthero as a daily NAD-preservation strategy.

For evening support, I recommend hibiscus, lemon balm, spearmint, and gotu kola—a blend that calms the nervous system, supports circulation, and restores homeostasis after stress or detoxification.

These natural medicines offer more subtle benefits but provide sustainable support without dependency on manufactured compounds. They help maintain the metabolic balance necessary for optimal brain function.

The Healthspan Revolution

The growing interest in methylene blue reflects our cultural shift toward optimizing healthspan, not just lifespan. People are seeking solutions that maintain cognitive function and metabolic health throughout aging.

This represents progress from conventional approaches focused solely on disease management. However, we must balance innovation with evidence, especially when exploring compounds with powerful biological effects.

The current healthcare crisis—with 42% of Americans projected to develop Alzheimer’s or dementia between ages 55 and 95—demands we reconsider our approach to brain health.

This requires integrating ancient wisdom about resilience with modern understanding of cellular metabolism. Neither alone is sufficient.

A Balanced Perspective

Methylene blue illustrates both the promise and peril of our quest for cognitive optimization. Its mechanism offers genuine benefits for specific conditions, particularly those involving compromised brain energy production.

However, its growing popularity has outpaced careful clinical validation for general use. The risks of improper sourcing and medication interactions cannot be overlooked.

In my practice, I evaluate each patient individually, considering methylene blue only when appropriate based on comprehensive assessment and always as part of a broader treatment strategy.

The most sustainable approach combines targeted interventions like methylene blue for acute needs with natural, resilience-building practices for long-term brain health.

This balanced perspective—respecting both innovation and traditional wisdom—offers the best path forward as we navigate the complex landscape of brain health optimization.