We have known how to use lifestyle changes to reduce the risk of cognitive decline and dementia for some time now. But, we have not figured out how to reverse the symptoms of dementia once they appear. Until now!
In a new book, written for a general audience, Dr. Dale E. Bredesen describes a protocol that, for the first time, is able to reverse the symptoms of Alzheimer’s. Over a hundred patients have undergone the Bredesen Protocol, or ReCODE (reversal of cognitive decline) and have experienced varying degrees of sustained remission of Alzheimer’s symptoms. These are limited results that need to be replicated. Nevertheless, they are extraordinary. There is finally a ray of hope in a field that has seen decades of dark disappointments.
Why does the Bredesen approach work, while all other attempts to treat Alzheimer’s have failed? It works because Bredesen has shaken free from the dogma of the so-called “amyloid hypothesis” that regards the presence of amyloid as the singular cause of the disease. Rather than follow the herd, he has followed the science.
Bredesen has recognized that Alzheimer’s is a complex disease with multiple causes. He has spent 30+ years analyzing the multiple causes and has developed a multi-factorial approach that addresses each one of them. He has combines a strong background in mainstream medicine and research with innovative insights from functional and integrative medicine.
THE BREDESEN PROTOCOL
In very stark terms, cognitive decline and dementia occur when synapses die faster than they can be replaced. Negative plastic change at the synaptic level outpaces positive plastic change. When the damage reaches a critical tipping point, the brain is unable to function properly and begins to decline. A negative spiral of self-reinforcing damage is initiated. The Bredesen Protocol pinpoints the sources of the damage and, one-by-one, works to correct them.
Bredesen’s interventions include lifestyle changes that parallel MINDRAMP’s CogWheels of Brain Health. But his protocols go farther to include specialized testing and analysis that can only be done by a trained clinician. To date Bredesen and his collaborators have identified 36 unique factors that contribute to cognitive decline and dementia. Each of Bredesen’s patients is tested to determine his or her genetic, chemical, hormonal, metabolic and toxic profiles, searching for abnormal levels. Each protocol then creates targeted interventions to rebalance and then optimize the identified abnormalities. This is the essence of precision medicine (see below).
Bredesen has identified three sub-types of Alzheimer’s that behave in different ways and, therefore, need different types of protocols.
- Inflammatory - There is an inflammatory type that is characterized by chronic systemic inflammation.
- Atrophic - An atrophic type* is characterized by insufficient nutrients to feed and nurture brain cells.
- Toxic - The final type, the hardest to combat, is a toxic type, characterized by the presence of toxic substances that compromise brain and body systems.
Currently, 450 physicians have been trained to conduct the protocol. Bredesen’s approach incorporates many of the innovations being developed in the emerging fields of Functional Medicine and Precision Medicine. (See below)
* Norman Doidge, author of The Brain That Changes Itself and The Brain’s Way of Healing, has a terrific review of the Bredesen Protocol on his blog. Doidge uses this term “atrophic” to describe Bredesen’s Type 2 Alzheimer’s. I don’t think Bredesen uses the term, but I like it. http://www.normandoidge.com/?page_id=702
FUNCTIONAL & PRECISION MEDICINE
Functional Medicine is based on systems biology (see below). It is an individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness.
Functional medicine requires a detailed understanding of each patient’s genetic, biochemical, and lifestyle factors and leverages that data to direct personalized treatment plans that lead to improved patient outcomes.
For more see the website for the Institute for Functional Medicine at: https://www.ifm.org/
Precision Medicine – This approach was popularized when President Obama announced the Precision Medicine Initiative in his State of the Union Address in 2015.
The U.S. National Institutes of Health defines precision medicine as “en emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person.” The term describes the ability to precisely tailor diagnosis, prognosis and treatment to each individual patient.
THE NEW VOCABULARY OF PRECISION MEDICINE
Precision medicine seems to have developed its own unique vocabulary, using words and phrases that reveal the unique characteristics of the approach. I discovered the following in a publication called “Advancing Precision Medicine,” produced by Science/AAAS (American Association for the Advancement of Science) and sponsored by Olink Proetomics.
Systems medicine – Systems medicine is an interdisciplinary field of study that looks at the systems of the human body as part of an integrated whole, incorporating biochemical, physiological, and environment interactions. The defining feature of systems medicine is the collection of diverse longitudinal data (biomarkers) for each individual. Systems medicine believes that all body systems work together synergistically and the whole (full body) is greater than the sum of the parts (individual organs or systems).
Biomarkers - According to the WHO, a biomarker is “any substance, structure or process that can be measured in the body or its products and influence or predict the incidence of outcome or disease.” [This sentence is odd, but I think you get the idea.] Precision medicine is most interested in “circulating biomarkers,” such as hormones, cytokines and metabolites that can be assessed in blood, urine and other bodily fluids, using minimally invasive methods. Biomarkers make it possible to diagnose, treat and monitor illness.
’omics – This is a suffix that suggests the study of a broad array of factors. For example, genomics is the study of the full range of genes in an organism. The suffix is now being used to describe arrays of other biomarkers besides genes. For example, the study of RNA transcription factors (transcriptomics), of proteins (proteomics), or metabolites (metabolomics).
“Personal dense, dynamic data clouds” of data – Lee Hood, who is considered by many to be the father of systems biology, says that systems medicine seeks to unravel the complexities of human biology and disease by examining as broad an array of information as possible about the biomarkers that determine health and illness.
He collects “personal, dense, dynamic data clouds:” Personal because each set of data is unique to each individual, dense because of the high number of measurements taken, dynamic because the data and patient are monitored across time. “These clouds are like the Hubble Telescope,” says Hood, “they give us a resolution we haven’t seen before of the multi-‘omic statistical correlations that are the determinants of wellness and disease.”
The Quantified Self – When a data cloud is developed for an individual, the status of each of their biomarkers can be quantified and evaluated. This goes way beyond the standard blood tests now give. This vast quantification of biomarkers enables practitioners to make precise diagnoses and prescribe highly targeted interventions that address the root causes of disease.
Predictive, Preventive, Personal, Participatory – Hood sees precision medicine as having these four key qualities.
AMYLOID IS NOT THE VILLAIN
Mainstream medical researchers and funders have mistakenly fixated on amyloid as the villain and have sought to find a single intervention – a magic bullet – that will rid the body of amyloid and, thereby cure dementia.
The amyloid approach has two fundamental problems.
First, amyloid is not the cause of Alzheimer’s. Amyloid is, in fact, the brain’s way of protecting itself from infection. Researchers Rudolph Tansy and Robert Moor have published research showing that amyloid plagues form a net around pathogens that invade the brain that keep them from doing harm. Efforts to remove amyloid can put the brain at greater risk. In a severely compromised brain, amyloid production gets out of control and adds to the problem. But this is a symptom of the disease, not the cause.
The second problem with the amyloid approach is that it suggests a monotherapeutic solution – the magic bullet. But, decades of work and billions of dollars have demonstrated that monotherapies don’t work. Why? They fail because neurodegenerative diseases are complex, multi-factorial conditions. Dementia is caused by a broad array of problems that confront the brain and the body. And, these conditions vary from patient to patient.