A CURE FOR ALZHEIMER’S?
Could this be the breakthrough we’ve been waiting for?
‘We fear Alzheimer’s like we fear no other disease,’ writes Professor of Neurology and MD Dale Bredesen. And with good reason. ‘First, it is the only one – let me repeat that – the only one of the nation’s 10 most common causes of death for which there is no effective treatment. And by “effective”, I’m setting the bar pretty low. If we had a drug or other intervention that made people with Alzheimer’s disease even a little better, never mind curing the disease, I’d sing its praises to the rooftops. ‘The second reason Alzheimer’s disease inspires such dread is because it’s not “only” fatal,’ he writes. ‘As the old joke has it, life is fatal. Alzheimer’s is worse than fatal. For years and sometimes decades before it opens the door to the Grim Reaper, Alzheimer’s disease robs its victims of their very humanity and terrorises their families. Their memories, their capacity for thought, their ability to live full and independent lives – all gone, in a grim and unrelenting descent into a mental abyss where they no longer know their loved ones, their past, the world or themselves.’
The World Health Organisation reports that there are about 50 million people living with dementia worldwide, and nearly 10 million new cases every year. And the Alzheimer’s Association paints an equally dark picture when it comes to the treatment of the disease.
‘A genuinely new Alzheimer’s drug has not been approved since 2003, and the currently approved Alzheimer’s medications are ineffective in stopping or slowing the course of the disease,’ said Maria Carrillo, the association’s chief science officer, in a 2016 statement. There are four drugs on the market, but although they ‘may help lessen symptoms, such as memory loss and confusion’… they do so only ‘for a limited time’.
The US FDA (Food and Drug Administration) tested 244 experimental drugs between 2000 and 2010 – out of which only one was approved.
Back in 1995, scientists discovered a DNA mutation that causes the disease to
‘Everyone knows a cancer survivor. No one knows an Alzheimer’s survivor.’
develop in middle age. (Remember
Still Alice, the 2014 film about a woman in her 50s getting Alzheimer’s?) But even that ‘has not led to the development of a single Alzheimer’s drug’ writes Dr Bredesen.
Alzheimer’s also stands out as a particularly devastating diagnosis for another reason, he says.
‘In virtually every other disease, there is a strong sense that research is on the right track, that the basics are understood, that although nature will keep throwing curveballs at us, she has revealed to us the fundamental rules of the game. Not so with Alzheimer’s.’
A TREATMENT PLAN
So here’s where the groundbreaking bit comes in, and it all centres on one fundamental discovery. According to Dr Bredesen, Alzheimer’s is not caused by the brain ‘malfunctioning’, nor is it like an autoimmune disease, where the immune system attacks the body’s own cells; it’s actually caused by ‘an otherwise normal brain-housekeeping process… gone haywire’ he writes.
‘Alzheimer’s disease is what happens when the brain struggles to defend itself against inflammation, to function despite a shortage of beneficial compounds, or to fight an influx of toxic substances.’
Dr Bredesen has developed a protocol named reCODE (short for ‘reversal of cognitive decline’) which has shown amazing results in the prevention and reversal of the effects of Alzheimer’s. Over 200 patients have been successfully treated, and he has trained more than 450 physicians, neuropsychologists, nurses, health coaches, and nutritional therapists from seven different countries in the reCODE approach.
Instead of a miracle drug, it’s an intensive treatment plan involving blood tests and possibly genetic testing if you’re in the grips of the disease. If you’re not, it can still be helpful in terms of prevention, with lifestyle changes.
‘There is a perhaps less obvious group for whom this book can be life-changing: everyone past the age of 40,’ writes Dr Bredesen. Scary as it sounds, when it comes to brain ageing, he says, ‘the downhill slide begins at about 40’.
PATIENT ZERO
In 2012, Kristin was on the verge of committing suicide. Having watched her mother slip away over the course of 18 years, she knew what lay ahead when she herself was diagnosed with ‘memory problems’ at 67. She got lost while driving (even along familiar routes), called her pets by the wrong names and had trouble finding the light switches in her own home. She’d already had to resign from her job, having lost the ability to remember numbers, analyse data and recall what was in the documents she had just read.
She called her friend Barbara and told her about her plans to end her life. Fortunately, Barbara had heard about new research being done on Alzheimer’s, and suggested she contact The Buck Institute for Research on Aging in California. Kristin soon found herself in Dr Bredesen’s office.
‘We talked for hours,’ he writes. ‘I could offer her no guarantee, no example of any patient who had used the protocol – nothing more than diagrams, theory and data from transgenic mice.’
Kristin signed up regardless, and began what would become the reCODE protocol. Three months into treatment, she phoned Dr Bredesen to report that she was back at work, driving without losing her way, she could remember phone numbers and was feeling better than she had in years.
‘Kristin, who is now 73, has been on reCODE for five years,’ he writes. ‘She still works full-time, travels the world and continues to be asymptomatic.’ Interestingly, she’s gone off the programme a few times for brief periods, and each time her cognition started to decline until she resumed reCODE, which goes to show that this is not a quick fix – it’s a maintenance plan.
COMING OUT OF THE FOG
The biggest problem when it comes to Alzheimer’s, says Dr Bredesen, is that people tend to ignore the early signs, even though the lead-up to full-blown Alzheimer’s can take 15 to 20 years.
‘Alzheimer’s is a sneaky, seductive reaper,’ he writes, ‘and we go for years ignoring our minor slip-ups and “senior moments” before realising too late that yes, it really is Alzheimer’s.’
Before you freak out about not remembering the name of that movie you saw last week, take note: momentary lapses are not always indicative of early Alzheimer’s – but the point is that they could be.
Eleanor was only 40 when she started noticing a decline in her mental capabilities. Because her dad had Alzheimer’s, she recognised her ‘slip-ups’ as early signs of dementia. She was starting to struggle with a number of symptoms, such as:
1 Facial blindness
Around the time she turned 40, Eleanor was having difficulty recognising and remembering people’s faces. Prosopagnosia, as it’s called, was the first sign she picked up on, although she didn’t connect it to dementia at first. She thought it was due to fatigue or a learning disability.
2 Declining mental clarity
‘I started experiencing a growing mental “fatigue”, especially after three or four pm. I mistakenly thought I was just very tired.’
Eleanor also found that she had trouble remembering what she’d just read, following a complicated movie plot and contributing to group conversations, especially if it was on a complex topic.
‘I’d formulate my comment in my head… and repeat it over and over until I spoke, just to make sure I said it right or that I didn’t forget what I was going to say.’
3 Diminishing vocabulary, and mixing up words
Where she would once have said that someone was ‘pugnacious’ or ‘truculent’, Eleanor would call them ‘aggressive’ instead. Or she would call someone ‘very social’ where she would ordinarily have used the word ‘gregarious’. This symptom, she says, was something only she noticed. Another more obvious sign was using the wrong word entirely. On one occasion, she called for her dog Juno in the yard, shouting ‘Chilli!’ (‘what I was making for dinner’ she explains) instead of calling the dog’s name.
4 Feeling anxious about driving
Eleanor was so overwhelmed by the other cars, traffic signs and pedestrians that driving seemed like a mammoth task.
5 Difficulty remembering tasks and appointments
She struggled to keep track of items on her to-do list and the times and dates of appointments, Other early signs included difficulty sleeping, no longer feeling energised after drinking coffee, and having trouble speaking languages she had once been proficient in. Eleanor started on the reCODE programme in early 2015 and noticed improvements within six months. She’s actually regained her mental abilities, and is able to report on her experience.
‘I want to articulate what it felt like to be in the “fog” of early cognitive decline, something I feel I have a special perspective on because I climbed out of it,’ she says. ‘[It’s like the] feeling you get when you’re wearing headphones and trying to talk to someone next to you. It sounds muffled and you feel more distant from others… it felt like I had a film-like gauze over my brain that kept me from really connecting with others and from being able to engage in normal conversational back-and-forths.’
That she’s now able to identify and discuss her symptoms is remarkable to Eleanor.
‘I couldn’t have told anyone that all these things were problems last year,’ she says. ‘I couldn’t put it all together. I just thought things were sometimes “fuzzy”… The changes come on so slowly that you don’t really notice, and the mental fatigue is so powerful, it makes you think you are just exhausted or burned out.’
THE reCODE PROGRAMME
So what does the programme actually involve? Summing it up in one article is near impossible – Dr Bredesen wrote a whole book adding that she ‘was becoming very anxious… about not being able to keep track of everything going on in my life’.
about it, after all. But here are some of the basics:
A Ketoflex 12/3 diet
Dr Bredesen calls this ‘The AntiAlzheimer’s Diet’. Basically, it’s a high-fat, low-carb eating plan. ‘Keto’ refers to ketosis, the process by which your body burns fat for energy; this usually happens when it’s running low on carbs.
‘Mild ketosis is optimal for cognitive function: beta-hydroxybutyrate increases production of the important neuron-and-synapse-supporting molecule BDNF (brainderived neurotrophic factor), among other effects,’ he writes.
The ‘flex’ in ketoflex refers to a flexitarian diet that’s mostly plant-based with an emphasis on non-starchy veg. Some fish, poultry and (grass-fed) red meat is fine, but Dr Bredesen stresses that ‘meat is a condiment, not a main course’ – you shouldn’t eat more than 1g of protein for every kilogram that you weigh. Some fish contain high levels of mercury and should be avoided. Stick to SMASH: salmon, mackerel, anchovies, sardines and herrings. Gluten is out, dairy is out and sugar is a complete no-no.
The 12 refers to the minimum number of hours you need to fast overnight and the 3 refers to the hours you need to fast between dinner and bedtime. So if you’re having dinner at 7pm, you shouldn’t have breakfast before 7am, and you shouldn’t eat for at least three hours before going to bed. (No late-night snacks!)
Fasting for 12-16 hours has several benefits: it keeps your insulin level from spiking (which contributes to insulin resistance); promotes autophagy (a process during which cells recycle components and destroy damaged proteins); and depletes the liver’s stores of glycogen – which can help push your body into ketosis.
Other than that, a probiotic and prebiotic is recommended, as well as supplements, depending on the results of your blood tests – there’s a list in the book.
Exercise
Dr Bredesen recommends a combo of aerobic exercise and weight training: 45-60 minutes a day, four or five days a week.
‘Work up to this slowly, stretch out, and take care of your joints!’
Sleep
Seemingly obvious – but we still don’t seem to get enough.
‘Try to get as close to eight hours of sleep per night as possible, without using sleeping pills,’ Dr Bredesen says. (They can compromise cognitive function.)
Resolve inflammation
Whether it’s caused by poor diet or chronic infections, resolving the cause of inflammation is critical.
Heal the gut
It’s said that your gut is your second brain, so this one should come as no surprise. Healing the gut, says Dr Bredesen, is a key strategy in preventing and reversing cognitive decline. If you have food sensitivities, experience bloating, constipation or loose stools, it’s likely you have leaky gut. Besides cutting out potential triggers (such as gluten, sugar, alcohol and antibiotics) there are a few things you can eat or drink to promote a healthy gut. Bone broth is one, but you can also take colostrum or L-glutamine, or try the SCD diet, which uses specific carbohydrates to heal the gut.
Remove toxins
‘Detoxification may be the most difficult part of reCODE,’ writes Dr Bredesen. There are many ways in which you could be exposed to toxins. The list includes mould in your home, processed foods, fish high in mercury, alcohol, constipation, not drinking enough water, tick bites and medication.
Balance hormones
Here’s where it starts to get tricky.
‘Reaching optimal hormone levels is one of the most effective and critical parts of reCODE, but it’s also one of the most controversial and difficult to optimise,’ writes Dr Bredesen. You’ll need to work with your doctor on this one.
There are 36 factors in total, so reCODE is quite a process. Dr Bredesen is often asked to narrow down the list to what is most important. ‘Is it the nutrition? Hormones? Addressing inflammation? The answer is this: obtain a thorough evaluation.’ Once you have concrete lab values, you can see where to focus your efforts.