September is World Alzheimer’s Month. A time to raise awareness, education, and resources for the 44 million people in the world with Alzheimer’s Disease (AD). Like my mother who is eighty-three but if you ask her age, she’ll say “I just wake every morning and decide what age I want to be today.” So, in honor of her positive outlook, I’ll explore the lifestyle and nutritional factors as well as natural medicines that have been found to delay the onset or slow progression of age-related memory loss and AD. I’ll also touch on a few things you might want to test and avoid.
Good news: by the time folks reach 85 years-old, half will have avoided Alzheimer’s disease. Risk is determined by genetics in only one-quarter of those affected. But to greater degree, like cancer and diabetes, risk is influenced by lifestyle factors, toxic exposures, head trauma, sleep apnea, the health of our digestive flora and inflammation. These are all things that can be changed. That is great news!
While the cure has eluded drug researchers who spend billions of dollars annually, experts in functional/naturopathic medicine approach it less by trying to find natural anti-plaquing agents and more by understanding and managing the brain’s metabolism, detoxification, and inflammatory pathways.
Some considering dementia to be like “Diabetes of the Brain” or Type 3 Diabetes and recommend high fat, low carb diets rich in fish, coconut and walnuts that lower the blood sugar. They refer to research demonstrating the correlation of high A1C (3-month blood sugar blood test) and development of AD. (To read more… https://drhyman.com/blog/2016/02/12/why-alzheimers-is-now-considered-type-3-diabetes/)
Others consider AD a biotoxin illness and a failure of the brain to manage toxins suggesting a lifestyle void of chemicals like solvents, testing for heavy metal toxins like aluminum, cleansing support and an anti-oxidant rich plant-based organic diet void of GMO’s, bad fats, alcohol, preservatives, and dyes. (Want more?….. https://www.omicsonline.org/open-access/natural-and-synthetic-neurotoxins-in-our-environment-fromalzheimers-disease-ad-to-autism-spectrum-disorder-asd-2161-0460-1000249.php?aid=78734)
Some, consider AD, like coronary artery disease, to be related to inflammation and recommend food and supplements that lower inflammatory chemicals like tumor necrosis factor and interleukin 1 beta. They suggest hypo-allergenic, anti-inflammatory diets that promote healthy gut microbiome, limit or avoid gluten, dairy, sugar, and nightshades and with added turmeric, fish and green tea. (Read more on the role of immune cytokines and AD- https://translationalneurodegeneration.biomedcentral.com/articles/10.1186/s40035-016-0054-4)
Others emphasize the role of the digestive flora or microbiome in the health of the nervous system as a key factor writing many articles on the gut: brain axis. You can check your microbiome with a digestive stool analysis like the GI Map or GI Effects stool tests. (More on microbiome and memory? https://www.ncbi.nlm.nih.gov/pubmed/28372330; https://www.news-medical.net/health/Alzheimers-Disease-and-the-Microbiome.aspx)
Naturopathic doctors and functional medicine practitioners agree that each person has their own combination of factors that lead to diminished brain function and a unique, personalized approach is recommended to reduce one’s risk or slow progression. For some, a naturopathic support plan might include healing from past brain trauma, neuroinflammation from past infection, treating sleep apnea or resolving blood sugar issues, for others it might focus on detoxification, gut microbiome or limiting inflammatory factors.
Whatever the perspective on causation, most experts agree that healthy sleep, social connection, physical exercise, diversity of gut flora and intellectual stimulation have been accepted as activities that slow the onset and progression of AD in part, by promoting the production of BDNF, or brain-derived neurotrophic factor, that enhances the growth and connection between new brain cells. (BDNF? https://jamanetwork.com/journals/jamaneurology/fullarticle/1779513)
Well, I can only write so much about the positive things, sorry mom – here is some bad news from a positive perspective. Drugs such as proton-pump inhibitors for acid reflux and some sleeping pills have been found to increase the risk of AD. So, avoiding regular use may help reduce one’s risk of AD. Studies published in JAMA Network Open and The Journal of the AMA found more problem drugs – in fact, the two most common Alzheimer’s medications (memantine and cholinesterase inhibitors) were found to increase the rate of cognitive decline not reduce it as expected. The positive slant on is that in the memantine (Aricept) study, vitamin E had a positive impact on cognition (unless you took it with the drug). Positive slant – take vitamin E?! (Dr. Perlmutter, functional medicine expert, writes more in this subject at: https://www.drperlmutter.com/the-failure-of-alzheimers-drugs/)
Back to being positive! The following are just a few of the many natural therapeutics that may be helpful to anyone with a goal of memory enhancement. For those who love someone who already suffers from significant memory loss, a friend suggested that we consider Guwande’s recommendation in Being Mortal – find out what they love most and try to provide it often. For my mom, it laughter, little tiny flowers on green moss and anything chocolate. She is easy to love and our son makes her laugh, the wonderful gardener at Bartlett Woods provides the flowers and not a day goes by that she doesn’t enjoy chocolate! For me, as my risk is higher than others for AD, I exercise and do yoga daily, eat an anti-oxidant rich anti-inflammatory organic diet high in good fats, drink green tea, take fish oil, Chinese herbs for memory, Curcumin and do the Ampcoil (PEMF device) frequently on Brain Reboot setting.
More things to consider for those desiring to improve memory or slow memory decline:
Exercise that is frequent but low or high intensity, combined aerobic and non-aerobic or aerobic alone have a positive impact on memory decline in the healthy study patients and slowed AD memory loss. (For more information: https://www.ncbi.nlm.nih.gov/pubmed/26607411.)
Nutritional Supplements that might be recommended for the prevention and treatment of memory loss:
Fish oil – especially DHA form has been found to limit the effect of the APOE4 gene expression that can increase one’s risk of AD. Increasing dietary polyunsaturated fatty acids from fish and seeds like Flax are also encouraged as those with the lowest amount dietary omega 3 oils have a higher risk of AD and those who ate even one meal of fish weekly for a year slowed their cognitive decline. For more information http://depts.washington.edu/mbwc/news/article/fish-oil-and-seafood-for-brain-health-whats-the-evidence.
MCT oil (medium-chain triglyceride oil) is a nutritional supplement often extracted from coconut that is naturally increased in those eating a high fat/low carb diet like Paleo or Ketogenic that has become popular in liquid and capsules. MCT oil supplements or eating a diet higher in fat and lower in carbs can help those with AD who have deficits in being able to make brain fuel from carbs or those with brain glucose uptake problems who need ketones as an alternative fuel. Those taking 20-70 grams per day of medium-chain triglycerides daily were found to delay memory decline. While a comprehensive study is lacking, one review shares the existing data: https://www.ncbi.nlm.nih.gov/pubmed/26766547.
Cytidine choline – This nutritional supplement has been studied extensively to help heal from brain injury and can improve memory as it increases acetylcholine, the chemical in our brain that helps pass signals from one neuron to the next. Those who eat a diet high in choline perform better on cognitive tests. A choline-rich diet would include soy foods such as organic miso, tofu or edamame as well as eggs and fish. The nutritional supplement Cytidine choline in a range of 500 – 2,500 mg is often suggested. (A nice review of this can be found at https://www.health.harvard.edu/staying-healthy/a-possible-brain-food-that-youve-probably-never-heard-of.)
Other nutritional supplements that are often recommended but are not always safe for anyone include vinpocetine, Bacopa and Huperzine A, resveratrol, alpha-lipoic acid, vitamin D, Rhodiola, Evergreen Pearls (Chinese herbal). There are also data on how helpful pulsed electromagnetic field frequencies (as delivered by the Ampcoil) have therapeutic potential for those with dementia. (For more go to https://www.tandfonline.com/doi/abs/10.1080/15368378.2019.1591437?af=R&journalCode=iebm20)
If you are concerned about your memory, a simple screening can help you decide if you need to see a neurologist: https://alzfdn.org/memory-screening/what-is-memory-screening/.
Laboratory tests to consider:
Fasting blood sugar, insulin and hemoglobin A1C help identify elevated blood sugar; inflammatory markers like ESR and CRP may be helpful; cholesterol or lipid panel looking for triglycerides which indicate excess carbs in the diet; digestive flora assessment like GI Map or GI Effects stool test to check the gut:brain axis; sleep study to rule out apnea; challenged heavy metal urinalysis to look for lead or aluminum; essential fatty acid evaluation to ensure proper DHA levels; genetics testing for those with a family history.
The genetics of Alzheimer’s is still to be fully developed. Only 1% of those with AD have inherited a gene mutation that causes early, familiar AD. However, the APOE gene can influence one’s risk for preventing AD or for developing the more common, late-onset AD. The simple blood test tells us which gene alleles you carry. E2 is known as preventative reducing one’s risk by up to 40%. Allele E3 has no influence either way. Having the APOE4 allele(s), found in 10-15%, may increase the risk and lower the age of onset by 2-3 times for those with one and up to 12 times for those with two alleles. For more information: https://www.alzdiscovery.org/cognitive-vitality/article/what-apoe-means-for-your-health.
Before taking the above supplements, please see Dr. Barb or Dr. Deb or your licensed ND. If you are concerned about your memory, see your doctor to get a memory screen. For support for those who love someone with AD, contact the Alzheimer’s Association at alz.org and go to: https://www.nia.nih.gov/health/getting-help-alzheimers-caregiving or for a natural approach go to https://www.nia.nih.gov/health/getting-help-alzheimers-caregiving. Stay positive!
Dr. Barb MacDonald, ND, LAc is a licensed naturopathic doctor, acupuncturist, Chinese herbalist practicing at Camden Whole Health – she is also an optimist!
To schedule an appointment, call Camden Whole Health at 207-230-1131.