I have felt very hopeful and excited the last couple of weeks after attending the Institute of Functional Medicine’s Advanced Clinical Training Program for Reversing Cognitive Decline in collaboration with MPI Cognition. Here I learned about the remarkable things Dr.Bredesen is doing in his research and through his ReCode program for people with Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI) or Subjective Cognitive Impairment (SCI). This program is giving hope to those who thought there was no hope also to those who are fearful about their future. In the past we have been told that once you lose brain cells that they are gone and will not return. We now know that neurogenesis or the growth of new brain cells is possible.
I have seen people over and over in my practice who are concerned about their memory and I have been short on advise to give them other than exercise. The medication and conventional treatments available are greatly inadequate and generally not effective with significant side effects. Now I feel encouraged and equipped with a larger tool box. I am excited to be able to offer his program soon in my office. I wanted to share some of the information that I learned in the program.
Dr.Bredesen described 6 types of AD, MCI or SCI at our conference. He also talks about this is in his new book The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline which I highly recommend everyone to read.
• Type 1is inflammatory or “hot” – This is characterized by inflammation. Often these people hold at least one copy of the APOE 4 gene allele so this type tends to run in families. Many times there are other disease processes such as cardiovascular disease and arthritic related disorders. This type begins with loss of ability to store new information. Structurally these people will have a loss of hippocampal volume. The hippocampus is the area of the brain where experiences are turned into memory. There are certain laboratory characteristics that can suggest this type of memory impairment. Lab values which support inflammation are usually elevated in this type. These lab values can also be present in other types.
• Type 2 is atrophic or “cold” – This is characterized by a loss of trophic (hormonal and nutrient) support. This type is also characterized by the lose of the ability to form new memories. These people may not have any evidence of inflammation on laboratory examination but what is shown in the labs are a low levels of hormones such as thyroid, sex hormones (testosterone, progesterone, and estrogen), adrenal hormones, etc. There may also be low levels of vitamin D which is a pro hormone (not a vitamin) or other low nutrient levels.
• Type 1.5 glycotoxic or “sweet” – This is termed type 1.5 due to is a combination of type 1 and type 2. These people generally have insulin resistance or impaired blood sugars so they have lost the trophic support of insulin being a neurotrophic hormone. The brain becomes resistant to insulin. Yes this does apply to those with diabetes but you do not have to have full blown diabetes to experience the cognitive decline. In this group of people there may just be mildly elevated blood glucose levels or insulin levels that are too high due to insulin resistance. We will also see evidence of inflammation in this type.
• Type 3 is toxic or “vile” – People with this type of cognitive impairment are generally APOE3/3 genotype and are younger. We can see this type typically with people in their 40s and 50s. It is characterized by the lose of ability to organize, calculate, and find words. They may be depressed as well. These people many times retain short term memory at least in the beginning. They usually have high levels of toxic chemicals in their system that have accumulated over time. This may be missed by healthcare practitioners if not tested for correctly such as heavy metals or molds. Heavy metals may not test positive if a chelating agent was not given prior to testing to drive them out of the tissues. We also see chronic infections in these people which may be hidden such as gut infections, dental infections, chronic sinus infections, lyme disease, etc. Type 3 is the hardest type to treat due to several things have to been taken into consideration such as removing the toxic source and/or treating the hidden or underlying infections.
• Type 4 is vascular or “Pale” – Represents problems with blood flow to the brain.
• Type 5 is traumatic or “Dazed” – Occurs due to trauma to the brain such as concussions.
In our training, Dr.Bredesen and other Functional Medicine doctors focused on the first 4 listed here. They discussed contributing factors, genetic influences, testing recommendations, and treatment protocols. The exciting part of conference and studies presented was that there are very effective treatments that have profound results unlike what the pharmaceutical industry has given us thus far. These treatments are without side effects and are totally available to everyone. The treatments do however require a motivated patient and / or caretaker who is willing to totally change their eating habits, exercise habits, and lifestyle habits. There are several aspects to the treatment protocols and are a bit different for each type. The treatments are synergic meaning that they have more of an impact when done together than each one of them has alone. Dr.Bredesen likes to say that treating cognitive decline is like trying to keep a room that has 34 holes in the roof from flooding. If you patch one hole (or only use one aspect of the protocol) then the room will still get flooded quickly but if you patch 30 of the holes then the room will not get flooded as quickly.
The ReCode protocol requires numerous tests and an evaluation by a provider to determine which type or types the person is experiencing. After typing then treatments include
▪ Diet and a specific eating plan. Non-processed, high nutrient, low in refined carbs, and high in healthy fats. Limiting toxic foods are extremely important.
▪ Periods of fasting daily – this is individualized by APOE status.
▪ Exercise regimen. Exercise releases a hormone, BDNF, in the brain that is like fertilizer for brain cells. Exercise cannot be emphasized enough!
▪ Daily cognitive exercises.
▪ Mediation is highly encouraged.
▪ Removing source of toxins and / or causes of infections.
▪ Detoxification protocols including infrared sauna treatments.
▪ Correcting hormonal dysfunction – optimizing hormones.
▪ Targeted supplements for each type.
▪ Stress management.
▪ Quality sleep is essential for repairing the brain! Sleeping without electronics and in a dark cool room promotes quality sleep. During sleep our brain cells clear out and repair from the day, a processed called glymphatic drainage.
Cognitive health is to me is an extremely valuable tool for a meaningful, fulfilled life. This year I have made brain health and detoxification my passions to study and learn. After all that I have studied, I do not take these lifestyle modifications lightly. We all need to take a look at our habits and see where we can improve. The earlier these changes can be made the better! The wonderful part of these changes are that they encourage general health and vitality. Many times, your energy and zest for life will return. The best part is that most of lifestyle modifications are free and totally without ill side effects!
Until next time,