Dr. Bray Links

Friday, March 25, 2016

Getting to a cure for Alzheimer's

For anyone caring for someone with Alzheimer's Disease or even anyone with early cognitive decline, I strongly suggest taking a look into Dr. Bredesen's work on the MEND program. This was recently highlighted at the Cleveland Clinic Functional Medicine Grand Rounds.

"The Cleveland Clinic Center for Functional Medicine and the Institute for Functional Medicine (IFM) have collaborated to produce a special free, live-streamed Grand Rounds featuring Dr. Bredesen speaking on 21st Century Medicine and the Reversal of Cognitive Decline in Alzheimer Disease. 
The research performed by Dale Bredesen, MD, has opened the door to a new therapeutic approach for patients with Alzheimer disease. On March 15 at the Cleveland Clinic, Dr. Bredesen will present his innovative protocol for reversing memory loss— and sustaining this improvement — using a complex, 36-point therapeutic program that involves comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry."
Dr. Bredesen’s novel insights into the fundamental nature of Alzheimer’s disease recently attracted an investment of $3.5 million toward a $10 million goal for initial clinical trials of these new therapeutics.  This generous support came from the private venture capitalist Douglas Rosenberg, who is helping to fund the Alzheimer’s Drug Discovery Network, centered at the Buck Institute.  The unit is screening drug candidates to find those that can preserve a healthy balance in the signaling pathways that support memory. Dr. Bredesen’s work on nerve cell signaling is also the focus of a collaboration between the Buck Institute and BioMarin Pharmaceuticals, Inc., which is seeking treatments for a rare form of Alzheimer’s disease, early onset Familial Alzheimer’s Disease (eFAD), which may develop in people as young as 30 years of age.


MEND: 25-Step Memory Program

Optimize diet: minimize simple carbohydrates, minimize inflammation.Patients given choice of several low glycemic, low inflammatory, low grain diets.Minimize inflammation, minimize insulin resistance.
Enhance autophagy, ketogenesisFast 12 hr each night, including 3 hr prior to bedtime.Reduce insulin levels, reduce Aβ.
Reduce stressPersonalized—yoga or meditation or music, etc.Reduction of cortisol, CRF, stress axis.
Optimize sleep8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.
Exercise30-60' per day, 4-6 days/wk
Brain stimulationPosit or related
Homocysteine <7Me-B12, MTHF, P5P; TMG if necessary
Serum B12 >500Me-B12
CRP <1.0; A/G >1.5Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygieneCritical role of inflammation in AD
Fasting insulin <7; HgbA1c <5.5Diet as aboveType II diabetes-AD relationship
Hormone balanceOptimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol
GI healthRepair if needed; prebiotics and probioticsAvoid inflammation, autoimmunity
Reduction of AβCurcumin, Ashwagandha
Cognitive enhancementBacopa monniera, MgT
25OH-D3 = 50-100ng/mlVitamins D3, K2
Increase NGFH. erinaceus or ALCAR
Provide synaptic structural componentsCiticoline, DHA
Optimize antioxidantsMixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid
Optimize Zn:fCu ratioDepends on values obtained
Ensure nocturnal oxygenationExclude or treat sleep apnea
Optimize mitochondrial functionCoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine
Increase focusPantothenic acidAcetylcholine synthesis requirement
Increase SirT1 functionResveratrol
Exclude heavy metal toxicityEvaluate Hg, Pb, Cd; chelate if indicatedCNS effects of heavy metals
MCT effectsCoconut oil or Axona
Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan


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