Original subtitles

(gentle electronic music)

(heavy breathing)

(somber music)

David, can you blow my nose?

Thank you.

Life on Earth was created

in the primordial ocean with sunlight as an energy source.

Cyanobacteria were among the first living organisms,

and they created oxygen that soon helped form an atmosphere

and the basis for all other life on Earth.

Cyanobacteria gave life where there was none.

Are the same organisms today,

fed by human pollution and climate change,

claiming human lives as nature's revenge?

Do you have any advice?

My advice is make sure you drink clean water.

Don't drink green, smelly water.

Do not get exposed to cyanobacteria.

And we know, for example, in Australia,

that there are very large blooms

of blue-green algae that occur often,

and the size and frequency of those blooms

is increasing with increasing temperatures,

increasing global temperatures,

increasing rising sea levels, et cetera.

Because we have proven a link

between the environmental health,

the health of the environment and human health.

And people have to understand that,

that this is not a theory, this is fact.

This is like a slow toxin

and it's a silent killer in a sense,

because we don't know that it's

in the water that we're drinking,

we don't know it's in the food that we're eating,

but we now know that it can cause

these neurodegenerative conditions like Alzheimer's disease.

Yeah, it is, I lose an ALS patient

maybe once every two weeks.

I see two to three new or follow-up ALS patients every week.

I see the devastation it has on families, on patients.

You know, many of us have written grants on this topic,

and we can't get traction.

So the funding has come from the private sector,

not from the public sector.

I think the fact that there is an environmental cause

is somehow going to make this research

less likely to be pursued,

less likely to be accepted by society.

I think this has been the missing puzzle piece,

because there's a lot of very interesting work going on,

but a direct connection

between what we're doing and human disease,

Alzheimer's disease, the Guam disease, ALS, Parkinson's,

that puzzle piece has been missing.

As a biologist and investigative filmmaker,

Bo Landin has for decades brought

important environmental issues to the forefront worldwide.

Well, my hunt for the hidden killer

will start with a journey to Jackson, Wyoming.

I'm about to meet with Paul Cox, an ethnobotanist,

who is gonna take me on a global quest

to solve a puzzle that scientists have tried to solve

for a very, very long time, and that is to find a cure

for ALS, Alzheimer's and Parkinson's.

But my journey with Paul Cox actually started 27 years ago.

Right now I'm driving through a fairly barren

western landscape in the United States,

and this is Wyoming.

But when I first met Paul Cox

it was in a totally different environment.

That was in the rainforest of the South Pacific,

in Western Samoa.

(speaking in foreign language)

Oh look, it's flowering here.

Yeah. In fact, you know,

this is the first time I've seen the flowers.

(speaking in foreign language)

He says it's used for any inflammation activities here.

And we've taken this to the National Cancer Institute.

We're testing it against

39 different types of human cell cancer,

and then we're also looking at

its activity against the AIDS virus.

So our hope here, of course,

is that we can find something of use.

It's really important to make herbarium voucher specimens

of the plants we collect here.

That way if there's ever any question

about the botanical identity of these plants,

we can answer it. (gentle ambient music)

So if we find something of interest here,

we can come back and recollect it,

we can tell the people which plants they are,

and perhaps the people could even grow these things someday

if they turn out to be useful for medicine,

and then help their local economy.

Paul Cox is a different kind of scientist,

driven by a passion for people,

nature, and cultures worldwide.

As a scientist he works

on the frontiers of human understanding,

and as an ethnobotanist he has

a profound respect for traditional knowledge.

My thinking was that indigenous people

have thousands of years of experience

in treating illness, recognizing illness,

using the plants around them to make remedies.

So I decided I would focus in ethnomedicine.

I'd try use patterns of disease and wellness

among indigenous people to yield clues

that we could then test in a laboratory

to come up with new drugs.

I thought about going back to medical school

to become an oncologist.

I realized, well, maybe as a doctor

I could treat hundreds of patients,

but if I could discover a new drug

it would help millions of people,

and I thought it was worth the gamble.

And then the big quest for me was

to try find something to treat ALS,

amyotrophic lateral sclerosis, motor neurone disease,

known in the United States as Lou Gehrig's disease.

I mean, this is probably one of the worst diseases known.

People who get this essentially have a death sentence.

And there have been no drugs discovered since 1993,

not one, for this terrible, terrible illness,

so even though the shot of success is so small,

I think it's worth my life

to try find a new drug for these poor people.

(gentle music)

This story has its origin 15 years ago

on the island of Guam in the Pacific Ocean.

In some villages, after World War II

almost 25% of the local Chamorro people died

in an illness that looked like a combination

of ALS, Alzheimer's, and Parkinson's.

The doctors had no clue what caused

these severe neurological diseases.

The Chamorro people knew that flour

made from cycad seeds and used for tortillas was toxic,

so the seeds were carefully rinsed,

but toxic levels in the flour were low

and could not explain the illnesses.

Paul Cox knew Chamorro people also liked

to eat flying foxes, fruit-eating bats,

which themselves foraged on the cycad seeds.

The scientist found the concentration

of toxins in the flying fox flesh

to be 100 times higher than in cycad flour.

But how did the toxins get into the plants to start with?

That's the first piece of the puzzle Paul looked for.

So if you look around near the base of the soil,

you can find these very unusual coralloid roots.

There is something really fantastic

I'd like to show you here if I can.

So you're saying this is actually the root of.

That's a specialized type of root,

and it harbors something truly incredible inside.

There we go. Oh there, that's.

That's a good one.

You can see that green layer, those are cyanobacteria,

and they live in symbiosis with the tree.

While the tree gets nitrogen fix, so fertilizer,

it also get the toxins the cyanobacteria produce.

But why would it need a toxic substance?

Well, it protects the tree, so you go out in the jungle,

I mean, there's nothing that eats the leaves.

Well, that was sort of the inspiration

because I was thinking about this problem,

thinking about this village,

suddenly realized they're eating the flying foxes,

and then when I suddenly realized

that these cyanobacteria in the roots

I thought, bingo, maybe that's the source of the toxin.

It was April 2003, we discovered two things.

We discovered that cyanobacteria produced this toxin, BMAA.

We also found that BMAA was in the brain tissues

of the villagers who died of the disease,

but not in control patients.

And we discovered it was in the brain tissues

of Alzheimer's patients.

Wow!

I said, you know, we could be self-deluded here.

We really need outside eyes, people who've never heard this,

to give us some confidential feedback.

What are you proposing?

I said, we should go to Stockholm right now.

(laughs) And they said, why?

I said, well, what I'll do is I'll contact

the Royal Academy of Sciences in Stockholm,

ask them for a closed meeting

where we have neurologists, chemists,

and then we'll wait for the gunfire.

And they will point out to us all the things that were wrong

or any way that we've deluded ourselves here.

So we gave our results for about an hour,

and then we stopped, and said, okay,

we welcome your comments or criticisms,

and there was no reaction.

And of course I'm very fond of Swedes,

and they're extremely polite people, but they are academics.

And so I said, you know, we've budgeted two hours here

just to hear your criticisms.

And I think it was Sebastian Conradi,

a famous neurologist from the Karolinska Institute,

he spoke, he said, "You know,

"when we first heard of your ideas

"it was cocktail party jokes here in Stockholm.

"Now we'd like to join with you."

And so that was the beginning of the consortium.

Rachel Dunlop works with Ken Rogers

in Sydney, Australia.

In the world of science,

people that work in different disciplines

don't tend to talk to each other.

So we don't understand what plant biologists are doing,

we don't understand what marine biologists are doing.

I'm a cell biologist, we work in a little silo.

And Paul Cox breaks down those silos

by coming to people with different areas of expertise.

Paul Cox came to you because he has been,

he had this hunch that BMAA, the toxin he found in Guam,

could mess something up in our bodies.

So what did he tell you, and what did he ask you to do?

He knew that we had this special technique

and we had a series of skills

that we used in our lab routinely,

and he came and said,

"Well, I know you guys work in heart disease research,

"but would you mind just stopping all of that

"and maybe coming and doing motor neurone disease, ALS?"

And reading your paper now,

you did find an answer for him.

We did, which was unexpected and also very exciting.

We found that BMAA can actually be mistaken

for another amino acid that our body

naturally uses to make proteins.

So it's a little bit like a battle here between BMAA,

the toxic substances that comes into the body,

and the serine that is naturally occurring in there,

so it's a tug-of-war.

That's right, it is.

I think that's a good analogy, a tug-of-war,

because if there's more BMAA in the cell

it will win the war.

So this may be a trigger in susceptible people

for ALS, a motor neurone disease.

Rachel Dunlop and Ken Rogers

deliver a crucial piece to the toxic puzzle.

They can explain what's happening in the cells.

The BMAA toxin corrupts the body's

protein-building processes.

And they also discover

that the body's own amino acid, L-serine,

in higher doses can counter the effects of the toxin.

That's what we've seen,

I mean you can see these, the shape.

(tank rumbling)

The next piece of this toxic puzzle

comes from an unlikely place, Kuwait.

During the Desert Storm campaign,

soldiers faced and defeated the enemy on the battlefield,

unaware of a hidden killer blowing in the wind.

Bo called up his friend, Kirby Kearns in Qatar.

I need your help.

You know, after the desert war in Kuwait in early 1990s

a lot of American soldiers came down

with ALS, or Lou Gehrig's disease,

as it's called here in the United States,

and no one has been able to explain why.

But Paul Cox has an idea

and this is where we need your help.

So we need to get an air filter

from a truck that drives in Qatar.

Do you think you can find one?

Absolutely, I can do that.

I know just the place, actually.

I know just where I can go to get one.

The roads stretch across the desert landscape,

with many trucks delivering supplies

to the U.S. air base inland.

If anything is sailing in the wind,

truck engines will suck it in.

Hey. How you doing?

Hi, my name is Kirby.

Hi, my name is Ali.

Thank you for helping me, man.

Is this for me?

Ah yes.

Thank you, man. Take it.

Excellent, thank you very much.

I help, brother? Yes please, thank you.

Thank you.

A piece of the desert arrives in Jackson Hole.

(knocking)

Hi, Capri. Hey, how are ya?

Good, how are you? Good.

Thanks very much.

Paul Cox and his team

are about to make a surprising discovery.

Stuck in the filter they find cyanobacteria.

Is it really possible that there are cyanobacteria,

also known as blue-green algae,

in a desert?

(energetic Middle Eastern music)

Suddenly a whole new world opens up to Paul Cox.

In Qatar, Paul teams up with Renee Richer

and Aspasia Chatziefthimiou.

One more piece of the puzzle is about to drop into place.

This desert does hold an important and very dark secret.

Something out here triggered ALS

in those personnel attending

and I'm determined to figure out what it was.

Oh, look at that!

I mean, that's incredible, you look at it.

Oh, look at that, look at that, look, you're seeing.

Oh go, that thing's incredible.

Oh, look at that, do you see how fast that's green?

Renee, get in here, look at this.

Look how green it is right there, I mean, it's incredible.

(camera shutter clicking)

What I'm gonna do is to photograph this while it's dry.

Let's pour some water on

and see how long it takes to green up.

(water pouring)

It's usually on a really hot day,

we can see the green right away,

but I can already see the pigmentation here.

We think of the desert as dry, brown and dusty.

Actually this desert here

is one gigantic green cyanobacteria mat

given the right conditions, and I aim to prove that here.

When we find that the same

cyanobacteria produce neurotoxins,

we realize that cyanobacteria are in desert dust.

In the case of Operation Desert Storm,

the ground forces and mechanics that worked

on the helicopters were deployed for less than a year,

and yet they had a doubling of the rate of ALS

10 years after that deployment,

which we believe is linked to the inhalation of dust.

I arrive in Paris eager to meet a person

who has inspired me to go on

this hunt for the hidden killer.

(speaking in foreign language)

One thing is what you can see in a lab,

it's very different to meet with people

who can give a scientific search a human face.

This will be the first time that I meet Ellie O'Connell.

We have been communicating via emails for a long time now.

And she used to live in Santa Barbara,

and right now she has moved to Paris.

Her ALS is far gone,

and she writes these very inspiring emails to me,

and she's so full of life,

she's so full of fighting this disease

that has struck her and her family.

And she sent me this picture of herself

and her husband, David,

before the ALS went too far.

And they have now made Paris their home.

I'm so amazed that she can smile about her situation.

And she writes, "I have now decided

"that I am in a battle with God.

"I think I told him that either he shows up

"or I'm boycotting him.

"So that's where I'm at."

(solemn ambient music)

(doorbell ringing)

Good evening, hi.

Bo. Hi, Victor.

Hello, everybody. Hi!

Hi there, Ellie. How are you?

Good to see you. Finally we meet.

How are you? Nice to see you.

I feel like I already know you.

Huh?

I feel like I already know you.

Yeah, we do, don't we? We do.

Yeah.

Only 10, 15% of ALS cases

are genetic in nature and are hereditary.

Ellie belongs to the group

who has sporadic ALS, without known causes.

She was already far into her illness

before she realized she had a problem.

But what did you do?

I ignored it from November of 2010

until June of 2011.

I didn't do anything.

I just thought, I have a backache, or I'm very tired.

Like I couldn't cut my fingernails,

I couldn't do my eyebrows.

But I didn't do anything about it.

I went to an acupuncturist, and that was it.

And then finally it was David's birthday,

and I thought, okay, let me go see a doctor,

and like within five minutes she said,

"I think you need to see a neurologist."

And I'm like, what's that?

I had no idea what a neurologist was.

So I said, okay, so I go the next day,

and the neurologist looks at me,

and he looked at me really weird.

When they didn't tell you what was happening to you,

what did that make you feel?

I felt bad for them.

For them? Yes.

Can you explain that, how can it be painful for them?

Because they knew what my future was.

I didn't know, because I had no idea what ALS was.

Even when they told me I had to go home and Google it.

And I just sat there and I read,

will die, will die, will die.

And I'm like, this cannot be happening to me.

And then like paralyzed, vegetable,

breathing tube, feeding tube.

And I'm like, you're joking me.

An hour ago, you know, I was okay, I thought I had sciatica,

and now you're telling me like this is it?

So does it feel for you like you have ALS too?

Definitely, I mean definitely.

You have it more than I do.

Well, I have it differently, I mean,

you know, because You're more affected.

it affects you emotionally,

it affects you financially, it affects,

I mean, everything, you know, everything.

So I mean, changes everything.

I mean, there's no going back.

It's not like someone comes and rips your face off.

Like you lose everything slowly.

So nothing is a shock.

I mean, in the beginning, fairly quickly,

there were a slow process,

but fairly quickly you lost the ability to walk.

So it's not like a shock. No.

But it's horrible, but it's a slow horrible.

So nothing like, like I feel for people

who have like cancer, like they're physically sick.

I don't feel sick ever, you know.

Like I feel great, I just can't move my body.

My brain is perfect, and luckily I can still move my head.

And I can feel everything, but I don't feel sick.

I've never been sick since I've had ALS,

never even had a cold, this was it.

Funny you are saying that, I've never been sick since I.

Right.

Isn't it funny? Yeah.

It's so true, though, that was the first time I was sick.

What do you feel like when I'm joking about it?

I love it, I love all that.

All my friends know that, like,

we are gonna joke about this until like the day I die.

(gentle ambient music)

Back in Jackson,

Paul's work goes into high gear.

What we really do in this little cabin

in the middle of this rural part of Wyoming is produce hope.

Every morning we wake up, walk into this building,

in this cabin, thinking about ALS.

And the work that's come out of here

has been pretty amazing.

And ALS patients don't have time to sit around

and wait for decades, for years.

They are dying now, they need help now.

We used to put pictures of the

patients up in the laboratory.

And the people I work with here are totally amazing people.

(dramatic orchestral music)

The two Jameses, Powell and Metcalf,

and Sandra Banack, are part of his team.

Dr. Sandra Banack gave up full lifetime tenure

at California State University to come here.

I was taking James Metcalf,

we were out canoeing one afternoon.

I said, would you like me to drop you

back to your apartment?

He said no, take me to the lab.

I said, well, it's 10:00 p.m.

He said, well, there's time to do one more experiment.

And that's the, that's the mode of my colleagues here.

It's like, do one more, go further,

let's keep going further.

What we've done is build a virtual pharmaceutical firm.

I've gone around the world

to the smartest people I could find.

I've gone, I've said, you know, you're top of your field,

you have won prizes, you've published books,

published papers, please now stop,

and help us with this problem.

So far I haven't had a single person turn me down.

What I really wanna do in this building

is to bring together these 50 scientific minds,

these geniuses from around the world,

focus them on this problem,

and then have drugs walk outta here

that can help change the trajectory for ALS patients.

When I took my PhD at Harvard

I was criticized by my doctoral committee

for being emotionally tied to my work.

To me, the emotion for me, the compassion, the love,

is what's driven this research.

(ambient orchestral music)

My hunt for the hidden killer has brought me to Ohio.

I was not quite prepared for what I was about to see.

Grand Lake St. Marys is like an open wound,

infested and covered by slimy green cyanobacteria.

Wow!

This is kind of scary, in the middle of vacation season,

the beach, not a single person.

By scanning this sign here I can actually get

the latest information about the situation in the lake,

and it is scary reading about harmful algae blooms,

and we know of course they are also cyanobacteria,

and they tell me what to do and not to do in here.

Stay out of the water, don't let the kids play

with the debris and green stuff along the shoreline.

Do not let pets drink the water.

Don't cook with this water,

and see a doctor if you think you or your kid

has swallowed any of this lake water.

But this is also the drinking water for thousands of people.

(water whooshing)

To eat fish out of this lake is probably a really bad idea.

But this guy explains to me

he is only using the catch as bait fish

when fishing in other lakes.

I hope he sticks to that story.

Many thoughts flow through my head

as the green water meanders through the Ohio landscape.

They tell me the drinking water

in the city of Celina is still safe,

that the authorities are on top of the situation.

But do they really know

about the new toxin found, the BMAA?

We begin with hundreds of thousands of people

in Toledo, Ohio without water now for a second day.

They're having to live without the most basic necessities,

limited showers, no washing dishes.

You can see right there, lines of people forming,

waiting to get their hands on

a limited supply of bottled water.

The governor of Ohio

and the mayor of Toledo saying new tests

on the water show improvement,

but they're not ready to lift the ban.

Over decades, Lake Erie has been the poster child

of troubled waters in the United States.

Dave Spangler has spent a lifetime here

taking tourists fishing.

Today he brings me and scientist George Bullerjahn

out on the lake, fishing for facts.

We saw this coming.

I'm not skeptical with a respect to BMAA

as a neurotoxic compound, I'm completely on board with that.

But is this a location where people are going to die of ALS

as a consequence of living here

and being exposed to these blooms?

It's still an open question.

Nearby, a reconnaissance flight

from NASA's Glenn Research Station

takes off to monitor the lake from above.

The situation is alarming.

Cyanobacterial blooms now seem to be a regular occurrence.

The lake is like a green soup.

From NASA's airplane they can see the boat,

cutting through the cyanobacteria

as it heads out to Toledo's water intake.

And so, you know, you go through the denial,

the shock, and then being upset.

I'll grab a water sample

so you can see what the algae look like.

This is not the worst it could be,

but it's bad enough,

with colonies of cyanobacteria

giving the lake a greenish hue.

(whooshing)

And what's happened today is that the wind action

has dispersed the surface scum that these organisms form,

but you can see that they form colonies.

To the average person that comes out here,

they may not ever realize what they're looking at.

This whole situation continues to upset me.

(dramatic electronic music)

Monitoring from space,

the extent of the cyanobacterial bloom is obvious.

The blooms extend for weeks and months,

and in the middle of the green goo,

the city of Sandusky is taking its drinking water.

Daily monitoring is a must,

because this is the water they pump in from Lake Erie,

filled with cyanobacteria.

Before this can be consumed as drinking water

fit for humans, a lot of work must be done.

They keep a close eye on what's in the water,

before and after treatment,

to make sure they protect the citizens of Sandusky.

A lot of them.

These are alarm bells.

Actually, the best identification is visual.

If I can see it as it's coming into my plant,

I know exactly what's coming in.

Cyanotoxins and stuff shoot up,

that kinda gives us an idea that something's coming in,

and then once I visualize it and see it,

I know what's here in the plant.

Water's very safe, yeah.

Last year at this time we had a lot coming in,

we never got a detect in our drinking tap water.

They know how to stop

the cyanobacteria causing acute toxicity,

but can their system protect people

from the new piece of the puzzle, the BMAA,

which is a substance they do not look for

and do not have a capacity to test for?

(light piano music)

Up the coast in Ohio is Conneaut,

a small town known for its fishing and inviting beaches.

(waves crashing)

But what was once a young kids' paradise

has now turned into an adult man's hell.

I meet with Mike Helfenstein,

who has recently lost his wife to ALS.

Now, when we went to school

the environmental issues were never discussed.

When we were out fishing, I mean, that's all we did.

You thought of Lake Erie as being

a very clean place to have fun.

So there was never a thought, never a discussion, ever,

there was never a discussion about the quality of water.

Now that I look at water, whether it be the Lake Erie,

whether it'd be the creek running into Lake Erie,

I am suspect to all of those issues now.

Now I look into the water to see if it's colored different.

I start to process information different

than I did prior to my wife's death.

But you are pretty convinced

that you have seen so many ALS cases here.

So you think you have a cluster of those diseases here?

It's my opinion based on what I've seen

and that is there is a multitude of ALS cases

which should not be on the radar of this community.

We should have maybe one every five or six years,

and WEA documented seven or eight

just from one doctor in this town.

His wife Benthina was a very active woman,

running two restaurants at the time she got sick.

She soon found herself in a wheelchair

with rapidly declining health.

Before she died she had a chance

to welcome a grandkid and become a grandmother.

Since childhood she was lovingly called Squeak.

There's a lot of memories in here.

Absolutely, this is my wife.

So once you knew Squeak has ALS, your life changed?

Completely, instantly, it literally took

two years of tests to come up with the diagnosis.

And then one year?

It was over with.

So when you realized she was diagnosed with ALS,

you started to fight for a cause again, didn't you?

Like you had done with MS before,

but now it was part of your family's life.

Yes, I was receiving phone calls of people that had ALS

or family members who called me and said,

my spouse, my mother, my father, whatever, has died.

And were you surprised?

Completely, I mean,

I never heard the word in our community, ever.

I mean, we definitely got the discussion going on

here in Ashtabula County.

People are talking about ALS today.

Mike started a project

to track ALS cases in Conneaut,

not sure if life was better here.

He named the project the Vincina Protocol after his wife.

Soon he learned that many families

in this quaint little town were struck by the disease.

Now of course there's also this discussion

with cyanobacteria in Lake Erie

and other things in the water that also comes in here.

And at this particular moment our health department

does not want to talk about cyanobacteria.

They don't believe it's an issue

and they don't want to talk about it.

It's not easy, is it,

when you're looking for those answers?

It's very frustrating, I mean,

I did not understand the political domain,

and how sensitive even our local politicians,

even though they had nothing to do with the problem,

it's almost as though they have been told

that they cannot talk about this issue.

The map Mike produced

based on his own research is alarming.

It is the first picture of what could be an ALS hotspot

along the shores of Lake Erie.

He's urging the scientists to complete what he has started.

We believe today as just private citizens,

everything that we're hearing.

We have an issue in Lake Erie that's not being talked about.

People are choking to death.

It's a sad story,

but they don't believe it's going to affect them,

and they're basically correct.

It's a small percentage of people that this is affecting,

but it is affecting people, and that's what's important.

And you don't know who it's gonna hit.

It is definitely a flip of the coin.

So the eating shouldn't be

that much of a problem. Eating's not a problem,

I do sometimes get something.

It's a situation taken very seriously

by specialist Erik Pioro at the Cleveland Clinic.

He diagnosed Vincina's ALS

and cared for her during her illness.

Today he's seeing Nicole Crawford,

one of many new ALS patients.

Tap right here.

He keeps an eye on

the progression of the illness, offers comfort and support,

but is unable to cure or halt the disease.

(elevator dinging)

I'm eager to meet Erik Pioro,

a dedicated specialist who has started to ask questions

and do research to find a reason

behind what seems to be hotspots of ALS in Ohio

and the region he serves.

You are actually creating digital records

of all your patients and all the information

which could be really useful for you in this case.

That's right, it is,

because one of the things that we've been looking at,

and I've been particularly interested in

and seeing kind of a preponderance, if you will,

of patients that may be coming from

this northern, northwestern part

of Ohio and surrounding states,

kind of along the Great Lakes area.

And not infrequently they'll be coming from these areas

that I often wonder, you know,

is there something that they may be exposed to

in some of these regions.

(dramatic music)

Thanks to the digital records

kept at the clinic,

Erik and his team of scientists have now plotted

more than a thousand ALS cases on the map.

Mike's fear is confirmed,

there are clear indications of hotspots.

The scientists' work is preliminary,

and funding is now needed to dig deeper.

The alarm bell has definitely been rung.

(moves into gentle ambient music)

A lake in New Hampshire, U.S.A.

The fog is not only beautiful,

it also shrouds the next piece in the toxic puzzle.

I wanted to understand why there might be

a higher incidence of ALS around Lake Mascoma

in Enfield, New Hampshire,

and we didn't know really why we were seeing

a grouping of patients around this lake.

Three of those patients were

over a six-month period in one year, they were diagnosed.

So we went to limnologists, experts on water biology,

and were told that, amongst other things,

that Lake Mascoma had frequent sign of bacterial blooms.

And then we went to the literature

and looked and found

that lo and behold cyanobacteria

were a potential link to ALS in Guam,

where there was a risk of, about 150-fold higher risk

of developing ALS than the rest of the world.

In Lake Mascoma it was

about 25 to 40 times higher than expected.

It's kind of alarming.

We've since found about 11 clusters in northern New England.

All of them have six or more cases.

Almost all of those clusters are very close to water bodies

that have had sign of bacterial blooms.

So you can imagine if you're living on a lake

that has a frequent annual sign of bacterial blooms,

you might easily be exposed on a chronic basis

to microorganisms that are in the air.

I decide to visit with Dr. Stommel's team

working at the lake.

Alexander Beltil and Patricia Hennigan samples the lakes.

What we're trying to do

is see how much people are actually breathing in

and what people's exposures are.

So if we take this into consideration

in the lung capacity of a person,

we can actually figure out,

depending on which water body and what day,

how much people are breathing in.

(metal clanging)

See where it sits first.

Okay.

'Cause I don't remember how far.

That's just about right, I'll bet.

It's a revolutionary approach

measuring cyanobacteria in the air rather than in the water.

And we've looked at a few lung samples,

including an ALS patient,

and he lived along the shore here.

And unfortunately he had a very aggressive form of ALS

and didn't live long, but he died during a bloom,

and we did get an autopsy.

And we were able to find some cyanobacteria in his lungs.

It's certainly worrisome that you're finding

these potentially toxic microorganisms in the lungs,

but if you have an active bloom I would be concerned

that it might be a possible

risk factor for neuro-degeneration.

(dramatic music)

The satellites also monitor

the situation in the Baltic Sea.

Cyanobacterial blooms are severe,

and paint an almost Van Gogh-like image

near the Swedish island of Gotland.

Pollution from nine countries feeds the blooms

that spread with the currents.

It's at least as bad as in the U.S.A.

But people seem to enjoy their short summer,

unaware of the acute dangers, or don't they care?

Scientists, however, have long been aware

of the accelerating situation in the Baltic.

(speaking in foreign language)

Paul Cox is visiting,

searching for more pieces to the toxic puzzle.

Oh, now we're going down. Okay.

The plankton net is lowered

through the soup of cyanobacteria.

Do you think there is a bloom down here but lower?

I think they are sort of quite dispersed

through the water column like this.

So there's not a single layer

like that. Sometimes there can be

quite a layer. Oh, look, we have a lot more

here than that.

(speaking in foreign language) (laughing)

Brigitta Bergman and Sara Reedberg

are not surprised when they see the result.

They've seen this for years.

But for Paul Cox this is worrying.

Wow! (laughs) That's bigger.

This is Baltic cyanobacteria,

and I think what really amazes me

is that the boat hasn't moved.

We just put this down 10 meters, pulled it up,

and we have the equivalent of,

I would call it Baltic pea soup, is that fair?

Three species of cyanobacteria here.

(ominous ambient music)

Back at Stockholm University's Baltic Sea lab,

Paul voices his concerns.

So here's the big question, Brigitta,

the Karolinska Institute shows that ALS

is actually increasing in Sweden.

So the question is, is it increasing

because there's more exposure to cyanobacteria?

Well, that's a very good question,

and yes, there is a risk that increase in blooms

will cause an increase in ALS.

And then you also have the risk of water,

drinking water reservoirs may be affected by BMAA too.

And we have a huge number of lakes in Sweden

that have blooms of cyanobacteria as well

and have fishes and so on.

So, yeah, there is definitely a possibility

that there is a connection between these two phenomena,

bigger blooms, more ALS. More ALS.

Like he does wherever he travels,

Paul collects material for analysis,

and he soon learns that the level of toxic BMAA

in this sample is very high.

The cyanobacteria release BMAA

and then they all die.

It's sort of like mass suicide.

They washed up along the beach here,

they're dry, so it's dried up here,

but still we see some potential

for green life here underneath.

Perhaps at the low level

the BMAAs produced in the cyanobacteria

doesn't make that big a threat,

but if it starts accumulating in fish and we eat the fish

then it's a big problem.

But what is it that we can learn from the scientists here

that you haven't seen in other parts of the world?

Or how do these things connect to what you have seen?

What the scientists are bringing here

to the table in the Baltic

is putting the ecosystem together,

from cyanobacteria to zooplankton

to small fish to bigger fish, bottom-dwelling fish,

and we have here a clear exposure of BMAA for human beings.

No place is spared.

In Australia, the local radio

transmits stern warnings from the government.

It's 19 past nine.

Many of our region's popular river destinations

are now affected by the blue-green algae outbreak

which stretches hundreds of kilometers

along the Murray River.

And we're hearing reports

that some people are ignoring the advice

to keep clear of the potentially toxic water,

and wakeboarding and water skiing anyway.

If you're thinking about doing the same thing, think again.

Rachel Dunlop has been researching the links

between blue-green algae toxins and illnesses

like Alzheimer's and motor neurone disease.

So I was concerned to see that people didn't seem

to either understand the potential toxicity

of something like this or they just ignored the warnings.

And indeed some people even swim in algal infested waters

because they're not aware it might be a risk.

Toxic blooms are everywhere,

and irrigation canals distribute the water to many fields.

And in addition to the fact that BMAA is found in seafood,

it can also be found in things like wheat.

And this was revealed in a report published last year

showing that if you watered wheat with irrigation water

that is contaminated with this toxin,

it can actually get stuck into the proteins at the weight,

so then that can get into the food chain

and that's where you can become exposed to BMAA.

Now in Australia, we're currently investigating what appears

to be a hotspot or a cluster of motor neuron disease

in the areas in New South Wales

that include Griffith and Leeton in Riverina region.

And this is where a lot of crops are growing,

a lot of crops are irrigated from rivers,

and so this might be an area where people

are getting exposed to this algal toxin.

We should be cautious about alerting people

to the issue of blue-green algal blooms

because BMAA is not always present in algal blooms,

it depends on the conditions.

Obviously, not everyone who's exposed

to this toxin is going to get motor neuron disease,

otherwise we'd all have it,

since the toxin is almost everywhere in this country.

So clearly people need other forms of susceptibility

in order to contract ALS.

So probably a genetic susceptibility,

and other susceptibilities that we don't know about yet.

So we don't want to be scaremongering about this,

we just want people to be aware that this is an issue

so they can reduce their risk as much as possible.

(waterfall splashing) (gentle music)

Okinawa, Japan.

It really hit me outta the blue

'cause I had gone to all the villages

where there's a very high rate of ALS and Alzheimer's.

One day I thought, why don't I find villages

where there's no record of the disease.

So I thought I'd search here,

because if the people are 100, 105, 104 years old,

then they still may have some sort

of intact neurological system.

I knew when I came here that they were old.

What I didn't realize before I came here

was that they have total recall of their lives,

they move like ballerinas,

they have this fluidity of motion.

(speaking in foreign language)

The serenity of the Ogimi village is striking.

The aging population tends to its gardens and orchards.

Plants are harvested for taste, of course,

but at the same time they create an unusually healthy diet.

Even if Paul finds interesting

answers among the local farmers,

it's in a kitchen and local restaurant

this ethnobotanist feels right at home.

To see how people use plants in their cooking

is exactly how ethnobotanists seek their answers.

He analyzes complete dinners, weighs the ingredients,

and in the lab back home,

he looks for interesting substances.

It's all about connecting the dots,

laying the puzzle pieces out.

(soft orchestral music)

Well, I'm watching a 97 year old woman, Tyra Sumiko,

who is collecting seaweeds on the beach.

She comes out every day to collect them, dries them,

and then uses them in her cooking and her diet.

As astonished as an ethnobotanist,

see they're using all these different species of seaweeds.

They're getting their major caloric

content from tofu, not rice.

I just saw a lot of differences between this culture

and the rest of Japan that really struck me.

I tried to figure out what are the most

frequent parts of their diet,

what do they eat the most frequently,

and then about this time we started

having our laboratory work showing

that L-serine plays an important role.

So I took their diet back to the Jackson Hole laboratories,

screened it for L-serine, and we were blown away.

It was off the charts in terms of L-serine.

(speaking in foreign language)

These people are eating a remarkably

loaded diet in the amino acid L-serine.

After many trips to Okinawa,

Paul asked me to join him there.

He believes he has found a vital piece

of his puzzle in this small village.

I guess barely subtropic.

If the substance L-serine in their diet

really counteracts the toxic BMAA,

then the local food market will add to the story.

Yeah, so people stop here in this little market.

They come up to Ogimi.

It's just filled with all these amazing things in here,

you know, that the local people eat,

for example, this is called kombu.

This comes clear from Hokkaido,

maybe 1,200 kilometers to the north,

and they've had a historical

trade with Hokkaido on this.

But it's used in a lot of their festivals,

a lot of their special feasts.

This is extremely rich in L-serine.

It is? Oh, yeah.

Let's buy that one.

There's a lot you can buy here, isn't it?

So these are sweet potatoes.

They call 'em in their language beni imo.

Again, extremely high in L-serine.

But is it the same sweet potato

that you can find in North America or?

It's a different sort of type,

but we've tested the ones in North America,

has enough serine in it that from now on,

when I'm ordering the hamburger

I have asked for sweet potato fries.

But for them, they don't pick and eat

those things because they know that,

they just happen

to be part of their diet. No, they just happen

to have this diet.

They don't know anything about L-serine.

So basically we're looking here,

it looks like I guess like an agricultural market,

what I see here is a pharmacy of neuro protection.

Amazing.

You know, we have cellular culture.

We have fruit flies and now other laboratory animals,

but to see something happening in people

really made me a believer.

These people have taught me that you can live a full life,

100 years, 110 years, some of them,

and have complete access to all your memories,

to be able to make short-term memories,

to move like a ballerina, and it's incredible visiting them.

(speaking in foreign language)

They're beatin' me.

They're a lot better than I am at this.

They're all laughing at me.

(speaking in foreign language)

L-serine ties all this together.

And I think that within 10 or 20 years' time

people will be taking much,

much more L-serine than they are today.

(gentle ambient music)

In Paris, Victor goes through a daily routine

in mixing L-serine powder with fruit for Ellie.

L-serine is not a medicine from the pharmacy,

but a food supplement bought on the Internet.

Ellie is sure this is a matter of life or death for her.

Thank you.

All good. Okay.

I always felt like the cure for ALS

is gonna come out of left field.

Because the regular doctors have had

since the 1800s to try to figure this out,

and they just can't figure it out.

And I also think that nature

can cause disease,

but there's also a cure in nature somewhere.

Hello, there.

Bonjour, bonjour.

I'm Paul Cox here to see Ellie, is that okay?

It's okay. Thank you, thank you.

Nice to see you.

Pleasure to see you, yeah.

Mister Cox!

Hey! Oh, my

god! Nice to see you, Ellie.

My hero has arrived!

Nice to see you.

The first time I ever was introduced to Paul Cox,

my thoughts were, I'm already so far gone,

what can it hurt?

Why not look for outside resources?

Well, when you're this sick,

there is never too much hope.

Briefly tell me what your experience

has been with L-serine.

In the beginning I had to have

my breathing machine 24 hours a day,

could not even take it off barely to blow my nose.

I would gasp, gasp for breath.

It was horrible.

Within, I think I started it in June,

by July I could sit a whole day without it.

Oh, really? I was breathing,

like none of this, just breathing like it was a miracle.

At this point, Ellie, unfortunately,

I don't think we can reverse it,

someday somebody will, God willing, right,

but then what you're teaching me

is that you've expressed there

was some regain in functionality.

Absolutely, with my breathing.

With your breathing, you can breathe stronger.

Totally.

Totally, okay.

I mean, like,

but also just like a overall feeling of goodness.

(chuckles) That's great! Strength, like,

I feel like I have inner strength.

Even though these legs aren't moving,

I still feel like they're strong legs.

Yeah, yeah, yeah.

It's strange.

I feel like a million bucks.

You feel like a million bucks?

I know that sounds crazy.

No, that's great!

But I feel like a million bucks.

This is a true partnership,

where both learn from each other's experiences.

(light orchestral music)

My next stop is Miami, Florida.

At the university they house one of the largest archives

of brains donated by people who have died

from ALS, Alzheimer's, and Parkinson's.

Deborah Mash and David Davis are part of Paul's consortium.

Let's begin the processing then,

and be very interesting if we can look

at the frozen hemisphere and see if

there's any BMAA that we can detect.

It's a great detective story.

Why would there be BMAA in the brains

of people who died with ALS and Alzheimer's

who grew up in North America?

What could be a potential environmental source?

That led us immediately to question the marine food web.

So we went back to our colleagues,

to Larry Brand and our colleagues at the marine school,

and they were the ones who pieced together that story.

(soaring ambient music)

So basically the Keys starts here then.

Right, all the way down about 100 miles.

But even if the water out here is

fairly clean most of the time,

you still have problems with algae blooms?

Yes.

And even under most conditions,

even those toxic species are in low abundance.

So you're not gonna see much of a toxin,

it's not gonna really have an effect.

But under certain conditions,

you can have a large bloom of just this one species.

At that point now you have a high concentration

of toxins that can kill a lot of organisms,

can kill people, or make people sick and so on.

When you say it can kill people,

I mean what does it take,

swimming in the water of the Florida coast or?

Well, no.

Generally eating the seafood.

Clams, you know, mollusks in general,

they're filter feeding the algae out of the water.

The vast majority of the algae are nutritious,

they depend upon it for their food.

If you have a algal bloom of a toxic species,

all of sudden they acquire all this toxin,

they can't get rid of the toxin.

When you're eating that BMAA-laden fish,

you don't taste it, you don't smell it,

you're not getting any immediate symptoms.

So you're gonna continue eating those fish.

You're not gonna know for 10 or 20 years.

So that's much worse.

As a scientists I can only say,

here's the evidence that we've got, you're taking a risk.

I can't be absolutely certain that you're gonna

Alzheimer's 20 years from now, but you're taking a risk.

It's a risk I would not take myself.

Florida was to deliver

yet another piece of the puzzle,

unfortunately, this also involves the marine food web.

Dolphins are seen swimming where

they should not normally be found.

They seem disoriented, lost,

not unlike people with Alzheimer's disease,

who also experience similar problems.

Sometimes these dolphins end up dying on the beaches.

Scientists taking care of the dead dolphins

provide the research team with brain tissues,

both from dolphins that have been stranded,

and from dolphins that have died in boating accidents.

When Deborah Mash analyzes the brain tissues,

she doesn't know which sample comes from which dolphin.

She is blinded to the source of her samples.

We've always had dolphin strandings.

Okay, that has occurred.

And people have a bunch of theories

about why that can happen.

Again, Larry Brand brings us some dolphin brains.

We look at the data.

I think Paul Cox was in town that time.

I go, I break the blind,

I look and I go, I don't believe it.

I don't believe it.

All the ones that were stranded had BMAA.

The accidental kills did not.

I said I don't believe this.

You could not make that data up.

And again, we were blinded to condition.

And we figure out that these apex predators have BMAA.

Apex meaning they are high up

in the food chain? They're just like we are.

We're an apex predator, you and me.

Sharks and dolphins, apex predators.

So again, you don't wanna overstate your data,

but now we had that piece of the puzzle.

(dramatic ambient music)

It's a scary thought.

Do dolphins actually die from Alzheimer's

or a similar illness that breaks down their brains

when Florida waters clog up with toxic cyanobacteria?

In the city of Stuart, along Florida's east coast,

cyanobacteria forced the governor

to declare a state of emergency.

Algae anxiety running high tonight.

New video of blue-green algae on the Treasure Coast.

Look at more of this mess.

Our News Channel Five crew spotting some dead fish

in the algae near Alice Street

not far from the Roosevelt Bridge.

Fears tonight that more sights like this are to come.

Now residents have also been getting little

face masks like these to protect themselves.

We've been getting some as well.

I've been wearing them today when we're around the water,

not only to diffuse the smell a little bit,

it really doesn't help much,

but mainly to protect ourselves from

the possible toxins that are released from this algae.

Martin County commissioners are demanding

the St. Lucie Locks be closed immediately,

but that's ultimately up to the Army Corps of Engineers,

and it always worries a swollen Lake Okeechobee

in rainy season could break through

the old earth and dikes surrounding them.

As you see what amounts to more than

a billon gallons a day of water pumping through those locks.

(water splashing)

The source of the coastal

disaster is Lake Okeechobee.

(ominous ambient music)

Behind the levees, polluted water

from the surrounding sugar cane fields

nourish the water and cause the cyanobacteria to bloom.

Arriving in the middle of the bloom,

Paul Cox takes no chances.

I guess people might think

I'm overreacting to have a dust mask,

but we know from Doctor Stommel's work at Dartmouth

that people can potentially inhale in these toxins.

Being out in this green muck all day has been really tough.

(ominous orchestral music)

There's clearly one species

of toxic cyanobacteria, maybe more.

Analysis of this sample

actually shows three toxic species of cyanobacteria.

What's really worried is I'm out in full protective gear

and I can see people and children

out bathing, fishing, picnicking.

So I'm really concerned.

I spoke to the County Commissioner

in Martin County, Florida.

They held an emergency meeting for the population.

State health officials were prevented from coming.

There seems to be a political issue.

I don't understand.

People should not be exposed to cyanobacteria.

Word needs to get out that these toxins are very dangerous.

(light orchestral music)

Upon receiving worrying news from Paris,

Paul immediately left to meet with Ellie O'Connell,

who'd been admitted to hospital for care.

The hospital did not allow Ellie

to continue to eat the L-serine,

as it was not a registered drug, but a food supplement.

Her situation quickly worsened.

She could no longer swallow, no longer eat or drink,

her life hung in the balance.

Well. It's two to five.

She had demanded

to be released from the hospital,

and when they met she'd eaten the L-serine for a week now

and there is a turn for the better.

Typical patients do.

Yeah, well six weeks not able to swallow soup

and then suddenly you take serine,

and you're able to swallow some soup.

That makes me happy. It's the honest

to God's truth.

Oh, that's great.

Looks like it may have helped.

It absolutely, absolutely helped a thousand percent.

I do know it for sure.

I do, but I'll never, I can promise,

I'll never stop again.

(laughing)

I've been so moved by my interaction

with the few patients who have

on an experimental basis taken this drug.

It's been thrilling to me

to see those patients that feel that

L-serine has improved their health,

that it slowed the progression,

that it's given them more time with their loved ones.

The puzzle pieces are falling into place.

David Davis has found the toxic BMAA

only in brains from people who died from ALS,

not in corresponding controls.

He now slices thin layers of brain tissue

from primates which have been fed food laced with BMAA.

Only primates have the same brain

and nervous systems as we have.

It's a crucial experiment.

If he can prove a direct link between

the toxin and brain damage,

it will be the biggest breakthrough yet.

These are actually the alpha syns.

Oh, that's alpha synuclein.

Have Cox and his team

finally been able to prove the connection between

BMAA and cell damage in an animal model with primates?

What I'd really like to do before

we see the results of the experiment,

is look at a human Alzheimer's brain.

Can you zoom in and show me some

neurofibrillary tangles, some tangles or?

Sure, I'm gonna zoom in on the hippocampus.

Okay, go ahead, right in the hippocampus.

This is an area affected by Alzheimer's disease.

Okay.

And I'm seeing here.

Well, it looks like we have some dead neurons in here

that are filled with tau.

That's correct.

So this basically is the classical

picture of Alzheimer's disease.

This is in renal cortex of a vervet, treated.

When it was fed BMAA.

Yeah. Okay, now, wow!

(chuckles) Sorry.

That's amazing.

'Cause it looks to me like we've got

neurons here filled with tau.

Correct. Just like

in the Alzheimer's patient.

We're seeing neurofibrillary tangles, these long.

And this has never been seen before ever in an animal?

No. Wow!

(laugh) Sorry!

I think that's amazing.

This means that we were right.

(laughs) We're right, wow.

Fantastic.

When we saw the images,

we had our computers hooked up with Miami Brain Bank,

us in Jackson Hole, my team,

neuroscience associates in Tennessee,

we're all looking at the images

at the same time for the neuropathology.

And you coulda heard a pin drop

because all of a sudden, all of us saw beta-amyloid plaques,

we saw neurofibrillary tangles.

Dr. Switzer in Tennessee said,

"Who put in these Alzheimer's patient slides?"

and I said "Those are not Alzheimer's patients.

"Those are the experimental animals."

He says, "No, no, no, this must be Alzheimer's."

And we're saying, no, these are not Alzheimer's patients.

So what happened here,

and what I think is so stunning to us,

is we began looking really at a problem

experienced by a few villages

in a very remote island in the Pacific,

and trying to understand what triggered

this disease in these people.

We then found out that the toxin they're

exposed to occurs all around the world.

You could be exposed to it sitting up in Lake Erie.

You could be sitting in Stockholm and be exposed to this.

I mean, that was terrifying to us,

and now to suddenly realize this

includes not just ALS pathology,

but Alzheimer's pathology,

and with we add age, Parkinson's pathology.

That was staggering to us.

It is an astonishing breakthrough.

Increase motor activity.

And hyperarousal.

For the botanist Paul Cox,

it's important that brain experts confirm the findings.

Can we credibly say

that there could be a relationship.

We assume, based on your seminal observations,

that we've been exposed to BMAA throughout.

Throughout life.

Throughout life. Yeah.

To my knowledge, this is the first demonstration

of a naturalistic model of a human disorder.

Wow!

Why do you say that?

Because there's nothing in nature

that gives us that effect.

That's black and white.

Seeing is believing.

It's a big moment.

Paul has prepared the text for scientific publication.

BMAA induced formation of beta-amyloid plaques.

The words environmental toxin

and Alzheimer's stand out.

But you have been talking about

ALS, and BMAA, and cyanobacteria for years,

but now you introduce the word Alzheimer's in it?

Yeah.

That's big news.

I mean, it's been suggested that smoking, air pollution,

exposure to organic solvents may increase the risk

of Alzheimer's disease, but the data aren't clear.

Here we have experimental proof

that exposure to a specific environmental toxin

can trigger Alzheimer's disease.

That's a big deal.

Before there is a public announcement of the results,

Paul meets with his colleagues from around the world

at their annual get together.

(scientists chattering)

Here I meet them all again,

the scientists I have met and filmed with for a few years.

It's almost like a school reunion

where people are eager to talk about their latest results,

and surely also follow up on life in general.

They arrive from around the world.

From Sweden, Australia, Qatar, Florida,

Wyoming, Wisconsin, and New Hampshire,

and they come from France and South Africa.

I was actually sort of depressed

the day before because I just

didn't know how people would receive it.

Everybody here has done a lotta work on this.

It's been a real thrill for me to part of the consortium

and see all the super things you're doing.

What we discovered really blew our minds.

And we found an extraordinarily high significance.

Chronic exposure to BMAA triggers the formation

of neurofibrillary tangles.

And this to me,

if I can just parenthetically insert,

suggests we may have a public health crisis.

We don't know how high a dose you need

before you start affecting 50% of the population.

(scientists applauding)

It's a masterful teamwork,

and a great result accepted by

the greater scientific community.

In Miami I have made an appointment with Walter Bradley,

a world-leading neurologist,

who himself has spent a lifetime

trying to find the missing piece in the ALS puzzle.

So you call this a game changer.

It's a major step forward.

The step forward that everyone has

been asking for for a very long time, and now it is here.

How does the field, any field,

look at an outsider coming in?

And of course they're skeptical.

Some of the people who've had their careers vested in this

are not just skeptical, they're threatened.

And so there are the significant problems

that happen for somebody coming from outside the field.

That's the pushback that he has

suffered all the way through.

His track record nevertheless,

makes it clear that those people were Luddites,

(laughs) were resisting something

that in the end should not have been resisted.

(dramatic ambient music)

But there is an elephant in the room,

or maybe I should say an elephant in my food store.

And unfortunately it takes me to the section

of the store where I normally look

for the healthy and important items.

This is spirulina juice.

Spirulina is the commercial name for

a group of cyanobacteria, yes cyanobacteria,

the same stuff that we have been

looking at in Lake Erie, along the Florida coast,

the Baltic Sea, and all the other places

we visited for this film project.

The weird thing is that there is no testing

of commercial products looking for the BMAA

before this hits the shelves in the food stores.

And searching the Internet I will find

spirulina in all forms such as juice,

powder, gel caps, and tablets.

But scientists in Canada have now presented breakthrough

information about the toxic BMAA in spirulina products,

because what they have found is a call to action.

They conclude,

not all spirulina products tested positive for BMAA,

but raw material samples of unprocessed spirulina

all tested positive for BMAA.

So maybe this glass of spirulina juice

doesn't contain toxic material, but another product will.

I have no way of knowing.

Is it worth playing Russian roulette with our health

knowing there is a risk to get ALS or Alzheimer's.

(mysterious ambient music)

This could be the end of a journey

that has lasted for four years.

I have followed and questioned Paul at every turn.

None of us knew where the science would lead us,

and none of us knew which stories we would tell,

or which people we would meet.

I have had reasons to contemplate

over the work done by scientists,

and which role they play in society.

While some have found reasons

to be part of a public discussion,

others insist on restraint with comments

that can worry and create conflict.

It's the structure of scientific revolutions.

You have to take a risk.

Paul's a risk-taker.

I've seen the puzzle pieces go down,

and every time Paul puts another piece of that puzzle down,

or something in my laboratory fits in his puzzle,

you double down, you know.

So I've been playing this poker game for a while

right alongside of Paul Cox.

I think he's a winner.

The toxic puzzle has many pieces.

One by one they've fallen into place.

Science has opened up doors to a future

which is both threatening, and yet promising.

This is like a slow toxin,

and it's a silent killer in a sense

because we don't know that it's

in the water that we're drinking,

we don't know it's in the food that we're eating.

But we now know that it can cause

these neurodegenerative conditions like Alzheimer's disease.

Their work has created hope,

hope for ALS patients and their families.

Now we're talking about Alzheimer's disease.

For people who reach the age of 85,

there's a 50-50 chance they're gonna

have Alzheimer's disease.

And Alzheimer's disease is taking millions of people,

and it's costing trillion of dollars.

We now know that changing our diet

can prevent the toxins from destroying our brains.

We need to keep the hope.

We need to keep up being hopeful

that we're gonna solve this puzzle.

And it really is a big, big puzzle

that we're finding little pieces to,

and trying to see pictures

to make the whole understandable.

We're getting there, slowly but surely.

Maybe soon a scientist

will lay down the missing piece,

allowing us to bring back our loved ones

from the darkness of brain disorders,

regain lucidity, and perfect health.

Are we closer to a cure?

I would say, I don't want to use the word cure,

but I think we're close to prevention,

and that's better than a cure.

My real hope is that this can open a new avenue,

a new way of thinking about these illnesses,

and might shed not only new scientific insight,

but give patients hope.

Well, when you're this sick,

there is never too much hope.

You know, if you told me to lick a tree,

I probably would.

Yeah, I put all my hope in Paul,

'cause he's the only one that's ever given me

like any inch of hope.

Hope is what will complete

and negate the toxic puzzle.

(somber piano music)