There are simple illnesses and there are complex illnesses. Pneumonia is an example of a simple illness. It usually has one dominant contributor, like the bacteria streptococcus pneumoniae, and therefore a single treatment like penicillin can kill the bacteria and cure the problem.
But complex illnesses have many contributors, and none of them are dominant. To deal effectively with a complex illness—to prevent, slow or reverse it—you have to identify and address multiple factors. Alzheimer’s disease (AD) is a complex illness.
There are many factors that can trigger the amyloid plaques and tau tangles that damage neurons and produce the memory loss, language problems, confusion, mood swings, and other symptoms of AD. But conventional care for AD usually overlooks these multiple factors, with doctors telling patients, “There is not much we can do.”
This hopelessness is false. In the majority of cases of cognitive decline and AD, triggers can be detected and treated. This approach is called precision or personalized medicine. It identifies and corrects the triggers of a particular individual. And science is proving that it works.
In a paper published in the August 6, 2024, issue of Biomedicines, a team of scientists reported “sustained cognitive improvement” for more than a decade in AD patients treated with a personalized protocol.
In a study of 255 people, also published in Biomedicines, enrolling in a precision medicine protocol for cognitive decline significantly improved or stabilized cognitive scores after a few months of treatment. In research published in the Journal of Alzheimer’s Disease, 25 people with mild cognitive impairment or dementia were evaluated and treated for several triggers of cognitive decline. After nine months of treatment with a personalized, precision medical protocol, the study participants had significant improvements in cognitive ability, as rated by three tests.
The most common triggers
Almost everyone with any degree of cognitive decline—from age-related memory loss to AD—has at least one of the most common triggers. The key is getting tests to detect your triggers, and getting treatments for them. Here are some of the most important (and often overlooked) triggers in AD:
Trigger #1: Nutritional deficiencies. The most important nutrients for brain health aid in the formation and maintenance of synapses, which help send messages from neuron to neuron. They include omega-3 fats, choline, vitamin B12, vitamin D, vitamin A (retinol), and zinc.
People with vitamin D deficiency are twice as likely to develop dementia. The most protective blood level of vitamin D is between 50 and 80 ng/mL. To reach your optimal level, use the “hundreds rule”: Subtract your current level (25 is fairly typical), from your target (let’s say, 60), which equals 35—which means you would take 3,500 IU daily of vitamin D.
Vitamin D boosts the absorption of calcium, so include at least 100 micrograms of vitamin K2 to prevent the deposition of calcium in arterial walls. And to prevent toxicity, don’t exceed a daily dosage of 10,000 IU.
Trigger #2: Insulin resistance.The hormone insulin helps move blood sugar (glucose) out of the bloodstream and into cells, including brain cells. Adequate glucose is a must for brain health and cognitive health. The brain is 2 percent of body weight, but it uses 20 percent of the body’s total glucose supply. Half of all American adults have insulin resistance, which stops needed glucose from reaching cells and increases the risk of AD by 30 to 100 percent.
A fasting insulin test can detect insulin resistance, with a target range of 3 to 5 µIU/mL (micro-international units per milliliter). You’re very likely to be insulin resistant if you’re a man with a waist circumference of 40 inches or over, or a woman with a waist circumference of 35 inches or over.
There are several key ways to correct insulin resistance:
- Eat a plant-rich, fiber-rich diet, high in healthy fats and low in refined carbohydrates. Fast overnight for at least 12 hours.
- Take zinc (20 to 50 milligrams [mg] daily), which helps regulate insulin and its use.
- Reduce stress—for example, by not overscheduling or multitasking. Or for immediate relief, try a few minutes of “square breathing,” exhaling slowly through your mouth to the count of four, holding to the count of four, inhaling slowly through your nose to the count of four, and holding to the count of four.
- Take a glucose-regulating supplement, like berberine (500 mg, three times daily) or cinnamon (½ teaspoon daily).
Trigger #3: Reduced oxygen while sleeping. To function well, the brain needs oxygen. If you want to prevent, slow, or reverse cognitive decline, you must be checked for your nighttime oxygen levels. It’s easy to do on your own. Just purchase an oximeter, which you wear on your finger overnight, checking it whenever you wake up. Optimally, your “oxygen saturation” level should stay in the 96 to 98 percent range. If you’re down in the 80s or 70s, you’re doing your brain a disservice. The usual cause of reduced oxygen during sleep is sleep apnea, repeated interruptions in breathing during sleep. If oxygen levels are low, talk to your doctor about trying a dental device to improve breathing. Or use a CPAP (continuous positive airway pressure) device, which works by maintaining a continuous airflow, preventing airway collapse.
Trigger #4: Circulatory disease. Any reduction in blood flow to the brain can trigger cognitive decline. There are many ways to improve circulation, including regular aerobic exercise and strength training. Increase your movement throughout the day by getting up regularly whenever you’re sitting for hours at a time and walk around for a minute or two. For supplementation, consider beet root extract, which increases nitric oxide, a biochemical that dilates blood vessels. (Follow the dosage recommendation on the label.)
Trigger #5: Toxins. You are exposed to hundreds of toxins—from the mercury in seafood to air pollution to the benzene in paraffin candles to poisons from the black mold growing in water-damaged homes. All of these toxins affect neurons, compromising cognition.
The key is to minimize exposure, identify any toxins to which you are exposed (using a range of tests that you can discuss with your doctor, such as a urine test for chemical toxins like benzene and toluene, and the urinary test for mycotoxins), and increase the metabolism and excretion of toxins.
To increase excretion, increase glutathione, a compound the liver uses to detoxify. To do that, eat more cruciferous vegetables like broccoli and Brussel sprouts, and more onion and garlic, mushrooms, spinach, asparagus, avocados, okra, and liver.
Supplements that aid in detoxification include curcumin, N-acetylcysteine, alpha-lipoic acid, selenium, zinc, and milk thistle. (Follow the dosage recommendations on the label.)
Also, stay well hydrated, eat plentiful amounts of plant fiber, and induce sweating with exercise or by taking regular saunas.
Trigger #6: Leaky gut. The lining of the gut is a one-cell thick barrier—a barrier that’s constantly battered by toxins and stress. If the junction between cells loosens, you have what is called leaky gut, or increased intestinal permeability. The compounds that sneak through the barrier cause inflammation, which, in turn, causes neuroinflammation.
You can help protect and heal your gut lining—tightening the junction between cells—with bone broth, which is rich in glutamine, the preferred fuel of enterocytes, the cells that line the gut. Enjoy three or four servings per week. (More is not helpful.)
Trigger #7: Poor oral health. The bacteria generated by gum disease (periodontitis)—like P. gingivalis, T. denticola, and F. nucleatum—have been found in the brains of people with AD, and are linked to AD. A study published in Alzheimer’s Research & Therapy looked at 25,000 people ages 50 and older and found that people who had gum disease for 10 years or more were 70 percent more likely to develop AD.
To counter poor oral health, brush and floss regularly, and have routine dental checkups, including cleaning. You can also take an oral probiotic, a supplement of friendly bacteria that crowd out and replace the disease-causing bacteria of periodontitis.
