A Multi-modality Approach to Alzheimer’s
It has been over 100 years since Dr. Alois Alzheimer, a German psychiatrist, first described a patient with the advanced neurodegenerative brain disease that today bears his name. Since that time, Alzheimer’s disease has been without an effective treatment. That may be changing.
Recent research under the direction of Dale Bredesen, MD, being conducted jointly at the UCLA Mary S. Easton Center for Alzheimer’s Disease Research and The Buck Institute for Research on Aging is showing promise for reversing cognitive decline. It is the first study to suggest that memory loss may be reversed and the improvement may in fact be sustained.
Using an approach which Dr. Bredesen calls systems therapeutics, a 36-point program is put in place that includes (but is not limited to):
- reducing simple carbohydrate intake;
- increasing ketogenesis including fasting at least 12 hours between dinner and breakfast;
- maintaining HbA1c below 5.5;
- keeping C-Reactive protein (CRP) below 1.0 with curcumin, omega 3s and specialized pro-resolving mediators;
- optimizing vitamin D levels;
- optimizing antioxidant status using CoQ10, alpha lipoic acid, PQQ, N-acetyl cysteine, resveratrol, ascorbate, and acetyl-L-carnitine;
- optimizing levels of methyl B12, MTHF, P5P;
- reducing or eliminating consumption of grains (especially gluten-containing grains);
- practicing brain stimulation exercises and neurofeedback;
- optimizing hormone levels including thyroid, cortisol, progesterone, DHEA, testosterone and estradiol;
- evaluating and treating for heavy metal toxicity;
- assessing gut health;
- exercising 4-6 times per week for 30-60 minutes;
- optimizing sleep including at least 8 hours of sleep per night with melatonin and tryptophan, if needed;
- reducing stress with personalized yoga, meditation or music;
- keeping homocysteine levels below 7;
- adding sources of good fats such as omega 3 and coconut oil.
Dr. Bredesen and his team were able to demonstrate improvement in nine out of 10 participants using this comprehensive, multi-modality approach. In the case of Alzheimer’s disease, Bredesen notes that there is not one drug that has been developed that stops or even slows the progression of the disease, and drugs have only modest effects on the symptoms. In the past decade alone, hundreds of clinical trials have been conducted for Alzheimer’s without success at an aggregate cost of over a billion dollars. A broader based therapeutic approach, rather than a single drug which aims at a single target, may be more effective for the treatment of cognitive decline due to Alzheimer’s.
Alzheimer’s results from the accumulation of sticky plaques in the brain called amyloid beta. According to Dr. Bredesen, plaque formation is a natural protective response of the brain to injury. It is his opinion that the process of amyloid plaque formation is attributed primarily to three main metabolic processes:
- Inflammation in the brain can be triggered by high blood sugar, which results in the formation of something called advanced glycation end products (elevated HbA1c). Inflammation can also be caused by chronic viral infections, oral bacterial infections, Lyme disease, mold infection or toxins, and increased intestinal permeability (leaky gut).
- Loss of trophic support due to low levels of hormones (growth hormone, testosterone, estradiol, progesterone, tri-iodothyronine (T3) and low levels of certain key nutrients including Vitamin D, magnesium, Vitamins A, B5, B6, B9, B12, C, and E).
- Exposure to toxins, including high levels of divalent metals such as mercury (from dental amalgams and fish), cadmium, lead and aluminum.
Other factors such as sleep apnea, vascular insufficiency (stroke), and traumatic head injuries can also trigger neuro-inflammation and amyloid plaque formation. Any person can have any combination of these causes. Identifying which factors apply to each individual with cognitive decline and addressing them may lead to improvement in cognitive function if caught early enough.
Alzheimer’s disease is on the rise, with recent estimates suggesting that it has become the third leading cause of death in the U.S. behind cardiovascular disease and cancer. Currently, it affects approximately 5.4 million Americans and 30 million people globally. It has been estimated that by 2050, 13 million Americans will have the disease, leading to a potential bankruptcy of the Medicare system.
Early detection and proper diagnosis of cognitive decline due to Alzheimer’s is the key for the best possible clinical outcome. According to Dr. Bredesen, genetic testing for the ApoE4 gene is critical for assessing your risk for Alzheimer’s. If you carry one copy of this gene, your lifetime risk is increased by 30%; with two copies, it increases to between 50-90%. This can be determined by a simple blood test.
New imaging techniques using functional and volumetric MRI scanning is also helping to assess earlier changes caused by Alzheimer’s and other neurodegenerative diseases.
Be sure to consult your health care provider before beginning this or any related program.
Dr. John Dixon can be reached at the Natural Medicine Group (760) 345.7300.
Sources: 1) Institute for Functional Medicine’s Reversing Cognitive Decline Conference, D. Bredesen; March 2017 2) Aging, September 2014, Vol. 6 No. 9; 3)www.buckinstitute.org/buck-news/memory-loss-associated -with-Alzheimer’s-reversed; 4) www.hartclinic.com.au-the-bredesen-protocol.