David Perlmutter, MD engagement report
@DavidPerlmutter - 82K followers on X
Measured over 42 original posts from a 30-day window, last computed on September 4, 2026.
Engagement
A typical post picks up 18 interactions against 82K followers, an engagement rate of 0.022%. Measured over 42 original posts, its engagement rate beats 25% of 6,874 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 2.5K times each, and 0.73% of those impressions turn into an interaction. That is about 3.00% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 1.9 posts a day over the last 30 days, with activity on almost every day in the window. Most posts go out around 16:00 UTC, and Thursday is the busiest day of the week. Of the 42 posts sampled, 7% carry an image or video and 83% link out. The account's strongest tracked post pulled 40 interactions, about 2.2x its own typical post.
Measured over 42 original posts from a 30-day window, last computed on September 4, 2026.
Compared with accounts its own size
David Perlmutter, MD's engagement rate beats 25% of the tracked X accounts closest to it in follower count (6,874 accounts, accounts of similar size (decile 4 of 10)). A percentile is spread evenly by construction, so 50 really is the middle of that group and 90 really is its top tenth.
On engagement per impression rather than per follower it beats 32% of the same group. When those two numbers disagree, the gap is about how far its posts travel rather than how people react to them.
Where this sits in the catalog
At 0.022%, David Perlmutter, MD sits above the 25th percentile of the 66,536 accounts in this comparison. That places it in the below the median band, which runs 0.016% to 0.1%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.002% |
| 25th percentile | 0.016% |
| 50th percentile | 0.1% |
| 75th percentile | 0.5% |
| 90th percentile | 2.09% |
| 99th percentile | 119.7% |
This ruler is the whole measured catalog, not a size-matched group: it shows where the raw rate falls across every account we can measure, all of which are large. For a like-for-like comparison, read the size-band percentile above instead. See how the bands are built
Posting timing
This account posts most often around 16:00 UTC, and Thursday is its busiest day of the week. The bars below are the catalog-wide pattern, with this account's own busiest slot marked. They do not show how this account performs at each hour: we keep one aggregate per account, not one per hour, so that measurement does not exist in our data.
Show engagement by hour posted, utc as a table
| Hour (UTC) | Vs author median | Posts |
|---|---|---|
| 00:00 UTC | -1% | 89K |
| 01:00 UTC | -2% | 90K |
| 02:00 UTC | -3% | 88K |
| 03:00 UTC | -4% | 94K |
| 04:00 UTC | -5% | 76K |
| 05:00 UTC | -4% | 75K |
| 06:00 UTC | -5% | 86K |
| 07:00 UTC | -5% | 93K |
| 08:00 UTC | -4% | 108K |
| 09:00 UTC | -4% | 124K |
| 10:00 UTC | -3% | 129K |
| 11:00 UTC | -3% | 141K |
| 12:00 UTC | -3% | 154K |
| 13:00 UTC | -3% | 167K |
| 14:00 UTC | -4% | 173K |
| 15:00 UTC | -2% | 176K |
| 16:00 UTC | -3% | 171K |
| 17:00 UTC | -3% | 159K |
| 18:00 UTC | -2% | 149K |
| 19:00 UTC | -2% | 141K |
| 20:00 UTC | -1% | 131K |
| 21:00 UTC | 0% | 116K |
| 22:00 UTC | -2% | 100K |
| 23:00 UTC | -1% | 90K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +5% | 393K |
| Monday | +1% | 483K |
| Tuesday | -2% | 520K |
| Wednesday | -3% | 472K |
| Thursday | -2% | 430K |
| Friday | -3% | 447K |
| Saturday | +2% | 393K |
Formats this account uses
Its own posting mix on the left, and what each of those formats does across every account we track on the right. Only formats where the effect clears our publish test appear here, so an empty row is a format we could not measure rather than one that does nothing.
| Format | This account | Catalog effect | 95% interval | Accounts behind it |
|---|---|---|---|---|
| Image or video | 7% of posts | +111% | +108% to +115% | 34K |
| Outbound link | 83% of posts | -41% | -42% to -40% | 32K |
| Typical length | - | +15% | +14% to +16% | 32K |
- 7% of this account's sampled posts carry an image or video. Across the catalog, posts with an image or video run 111% above the same accounts' other posts.
- 83% of its posts carry a link off X. Across the catalog, posts with an outbound link run 41% below the same accounts' other posts, so a large share of this account's output sits in the weakest bucket we measure.
- Its average post runs 358 characters, which falls in the over 280 characters band. Across the catalog, posts over 280 characters run 15% above the same accounts' other posts.
These are catalog-wide differences applied to this account's own posting mix, not a measurement of how each format performs for this account specifically. We keep one median per account, not one per format per account, so the second thing is not something this data can tell you.
Best tweets
- Aug 12, 20262.2x their median
Fiber never reaches your brain, yet it may be one of the most important nutrients for keeping it healthy. Why? Because fiber feeds the microbes living in your gut. In return, those microbes produce compounds that help regulate inflammation, support the integrity of the gut lining, and influence the immune and nervous systems. The health of your gut microbiome and the health of your brain are deeply connected. https://t.co/sDNTYCltYr
- Aug 28, 20262.1x their median
We’ve been looking at Alzheimer’s all wrong. In this piece in @KatieCouric Media, I discuss how microglia can either protect the brain or drive chronic inflammation, and what you can do now to support your cognitive future. https://t.co/N0KoLHcXqc
- Aug 19, 20262.1x their median
What if the brain’s immune cells are one of the most important links between daily choices and long-term cognitive health? In my latest contribution to Biohack Yourself, I explore how microglia respond to sleep, exercise, metabolism, stress, and other signals that may shape brain resilience over time. Read the full article: https://t.co/QbRsxedULX
- Aug 18, 20261.9x their median
Today, Brain Defenders is officially available. After more than 40 years of research, clinical experience, and asking different questions about Alzheimer’s disease, this book feels like the culmination of everything I’ve learned about protecting cognitive health for the long term. I truly believe it’s some of the most important work I’ve done. Your brain’s future is not predetermined. You have more agency over your cognitive health than you may have been led to believe. I hope you’ll join me for this next chapter in protecting your brain. Order your copy: https://t.co/AZq6ZXF9l9
- Aug 24, 20261.9x their median
We need to stop waiting for a cure for Alzheimer's and start building brain resilience today. I shared exactly why with The Editor's Edit by Maryam Lieberman: https://t.co/Htsv8Kzzr4
- Aug 16, 20261.8x their median
After decades of disappointment, it’s time to admit that Alzheimer’s drugs have not delivered on their promise. In my new book, Brain Defenders, I explore a new way of thinking about Alzheimer’s disease and the factors that shape brain resilience. Today is one of the last days to pre-order and get access to 5 exclusive bonuses I created to help you put some of the science into action right away. The book comes out in 2 days. Preorder here: https://t.co/AZq6ZXF9l9
- Aug 23, 20261.6x their median
We spend nearly a third of our lives asleep. The brain uses that time to strengthen memories, regulate inflammation, and clear metabolic waste. Growing evidence suggests poor sleep may be intertwined with Alzheimer’s disease years before symptoms appear. This is exactly why Brain Defenders places sleep at the center of the conversation about prevention. https://t.co/G9Z9XOTbwl
- Aug 15, 20261.6x their median
Alzheimer’s drugs have been treating the debris while ignoring the fire. For decades, the conversation has centered on amyloid plaques. But amyloid plaques are the wrong focus. In Brain Defenders, I argue that one of the deeper questions is what causes the brain’s immune system, especially the microglia, to shift from defending the brain to driving damage. Because microglia are meant to protect us. So the question is: how do we support the brain’s immune system so those cells can help preserve cognitive function instead of contributing to decline? The book comes out in 3 days. This is your last chance to pre-order and receive the full bonus package at no additional cost: a video mini-course, an expert audio series, a room-by-room environmental toxins checklist, the first chapter and glossary bundle with curated partner offers, and a seat at my live Q&A. Pre-order here: https://t.co/AZq6ZXF9l9
- Aug 25, 2026
I connected with @DocCarnahan to discuss why Alzheimer's and Parkinson's disease begin decades before symptoms appear, why inflammation and insulin resistance are major drivers of neurodegeneration, and what we can do today to protect lifelong brain health. https://t.co/3UGz44q8EZ
- Aug 20, 2026
In the newest episode of The Empowering Neurologist, I sit down with @EmmaHeming, caregiver advocate and wife of Bruce Willis, and Dr. Nicole Beurkens, a psychologist and nutrition specialist with nearly three decades of clinical experience. Together, they unpack why women are disproportionately affected by Alzheimer's, and the surprising hormonal window Emma calls the "silent gap." Because Alzheimer's isn't a disease of aging. It's a disease of decades. And that changes what's possible. https://t.co/cf84v1qxkY
Ranked by total interactions across everything we have tracked for this account, which is a longer history than the 30-day window the rates above use. The multiple compares each post to this account's own median.
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Reading these numbers
A typical post picks up 18 interactions against 82K followers, an engagement rate of 0.022%. Measured over 42 original posts, its engagement rate beats 25% of 6,874 tracked accounts of a similar size, which puts it in the middle of its size range rather than at either end. Posts are seen about 2.5K times each, and 0.73% of those impressions turn into an interaction. That is about 3.00% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 1.9 posts a day over the last 30 days, with activity on almost every day in the window. Most posts go out around 16:00 UTC, and Thursday is the busiest day of the week. Of the 42 posts sampled, 7% carry an image or video and 83% link out. The account's strongest tracked post pulled 40 interactions, about 2.2x its own typical post.
- What is David Perlmutter, MD's engagement rate on X?
- David Perlmutter, MD (@DavidPerlmutter) has an engagement rate of 0.022%, based on the median interactions across 42 original posts from the last 30 days against 82,293 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
- Is that a good engagement rate?
- At 0.022%, David Perlmutter, MD sits above the 25th percentile of the 66,536 accounts in this comparison. Those comparison accounts are all large ones, because our scanning cadence is weighted towards big accounts, so this is a ranking among peers of similar scale rather than a ranking across X.
- Does @DavidPerlmutter have real engagement?
- Its engagement rate beats 25% of the tracked X accounts closest to it in follower count (6,874 accounts), which puts it in the middle of its size range group. Ranking inside a size band matters because engagement rate falls as accounts grow, so a raw rate would mostly re-measure the follower count. It is a starting point for a look at follower quality, not a verdict on it.
- When does @DavidPerlmutter post?
- Most posts go out around 16:00 UTC, and Thursday is its busiest day, at roughly 1.9 posts per day across the measured window.