In this episode of The Curious Cardiologist Podcast, Dr. Sanjay Bhojraj sits down with Dr. Spencer Zimmerman, a chiropractor specializing in brain health, cognitive decline, and autonomic dysfunctions like Postural Orthostatic Tachycardia Syndrome (POTS). They dive into why so many patients with brain fog, dizziness, fatigue, and memory issues fall through the cracks of conventional medicine, and how looking beyond normal MRIs and “age-appropriate” changes can uncover the real root causes. Dr. Zimmerman explains why cognitive issues often begin in our 40s, how balance testing can reveal hidden neurological dysfunction, and why concussions and even minor head injuries can accelerate cognitive decline. He also unpacks the misunderstood world of POTS — its connection to the immune system, neurology, and even hormones — and shares practical lifestyle strategies to improve brain and autonomic health. This conversation is both sobering and hopeful, offering insight into how we can better evaluate, diagnose, and support patients struggling with invisible but debilitating conditions. Episode Chapters 00:44 – Introduction to Dr. Spencer Zimmerman 02:25 – The rise of brain fog, fatigue, and cognitive decline 03:50 – Why patients feel unheard in conventional medicine 05:43 – Normal MRI ≠ Normal Brain Function 08:22 – When to take memory lapses seriously 09:19 – The four cornerstones of a healthy brain 11:06 – Cognitive testing: MoCA, CNS Vital Signs & balance 13:59 – Balance as a window into brain health 16:47 – The devastating impact of falls in older adults 18:04 – "Age-appropriate" brain changes — myth or reality? 20:04 – Concussions: the hidden epidemic 24:46 – Introduction to POTS and dysautonomia 26:24 – What is POTS really? Symptoms and confusion around diagnosis 29:09 – Who gets POTS? Age, gender, and post-COVID trends 32:14 – The diagnostic odyssey: years without answers 34:25 – Emotional toll of misdiagnosis and chronic illness 36:27 – Diagnostic criteria vs. functional root causes 38:34 – The vestibular system’s surprising role in blood pressure regulation 43:15 – POTS as a neuro-immune disorder 46:36 – Parsing out neuro vs. immune vs. endocrine drivers 50:13 – Lifestyle foundations: sleep, diet, stress, movement 54:51 – Respecting the brain: small wins in rehab 56:53 – Dr. Zimmerman’s brain health intensives 1:00:09 – Rapid-fire: favorite place, food, and what keeps him curious Key Takeaways Cognitive decline begins decades before diagnosis — mild cognitive impairment is not “mild.” Normal scans don’t mean a normal brain — dysfunction often hides in connectivity and inflammation. Balance testing is a powerful predictor of cognitive and neurological health. Concussions and head trauma have long-term effects often missed by traditional medicine. POTS is not just “a heart issue” — it’s often a neuro-immune problem with hormonal influences. Foundational health practices matter: sleep, diet, stress, and gentle movement like recumbent biking. Individualized, nuanced care is essential for brain health and POTS management. Links Connect with Dr. Spencer Zimmerman: Instagram: @drspencerzimmerman Website: