Caring for a loved one with Alzheimer’s disease is an ongoing struggle. Sometimes, you might feel like it only gets worse.
Dr. Amen and his wife, Tana Amen, have created the Brain Warrior’s Way podcast to help educate those with mental illness and those helping loved ones with mental illness. They share the message that there is always hope.
How to Treat Alzheimer’s: Interview with Dale Bredesen
June is Alzheimer’s Awareness Month, and on this episode of Brain Warrior’s Way, Dr. Amen is honored to have Dr. Dale Bredesen speak as his guest.
Dr. Bredesen is an internationally recognized expert in Alzheimer’s disease and the mechanisms that underlie it. As a Caltech graduate with a medical degree from Duke, he served as Chief Resident in Neurology at UC San Francisco. His international acclaim came with publishing a study showing he could reverse Alzheimer’s disease.
Alzheimer’s is a debilitating brain disease that progressively destroys memory and thinking skills, most commonly in older adults. It has so far been considered an irreversible illness, but new research lead by forward thinkers such as Dr. Bredesen bring us closer to understanding this complex disease in order to cure it. His book, “The End of Alzheimer’s,” was published in August 2017.
DR. AMEN: Welcome Dale, such a joy to have you help tell our audience about “The End of Alzheimer’s.” So both you and I are considered mavericks, that we think outside of the box. When did this become purposeful for you? When did this mission really start?
DR. BREDESEN: Thanks Danny, so let me start by saying I really appreciate your work in psychiatry because you are asking how these diseases actually occur instead of just saying that we’re gonna follow some arbitrary rules. You’re saying, “what is the neurophysiology of psychiatric diseases,” and I think that’s huge and that’s exactly what should happen in the 21st century.
I came from probably a fairly similar background to you, being trained classically and I’ve spent my whole career in academia. We wanted to ask a fundamental question, which is, “why do neurons degenerate?” We’ve spent 30 years in the lab asking the basic molecular biology and genetics of neurodegeneration and what happened over all those years is that we saw this problem is a multifaceted problem. It’s not a simple thing like pneumococcal pneumonia. As you know, we were pretty much all dying a hundred years ago of these infectious illnesses, but now you get the pneumococcus, you’re okay. You get the TB, you can kill it with a drug, you’re fine. These complex chronic illnesses – Alzheimer’s, Parkinson’s, Cancer, Cardiovascular disease, psychiatric diseases – they have more than one component.
We could see there were many many different inputs, so we published over 220 papers on various aspects of Alzheimer’s when we realized at some point, “hey, wait a minute, there’s a bigger picture here.” We tell the patients, “imagine you have a roof with 36 holes in it,” because we initially identified 36 different contributors. Maybe you have to cover all those holes to make a big difference, and that’s exactly what happens with the human patients.
Unlike infectious illnesses, Dr. Bredesen explains these psychiatric and neurodegenerative diseases, including Alzheimer’s, are multifaceted problems for our bodies to deal with and cannot be treated with one solution, such with an antibiotic.
Initially, Dr. Bredesen found 36 different contributors to Alzheimer’s through his research. Later, Dr. Bredesen describes how most patients have between 10 and 25 contributors to their Alzheimer’s diagnosis. This means in order to come up with a holistic solution, each contributor must be evaluated for the patient.
When it comes to tuberculosis, for example, we have a simpler solution in the form of a drug, but for a neurodegenerative disease such as Alzheimer’s, you must approach treatment through many individual problems before the patient can heal.
Alzheimer’s Disease & Roads to Devastation
DR. AMEN: So, many years ago when I started looking at the brain, we used a couple of studies here, with the most important one to us being SPECT that looks at blood flow and activity almost right away. I went, “oh, ADD is not one thing, depression is not one thing, bipolar disorder is not one thing, schizophrenia is not one thing,” and what you’re saying is Alzheimer’s is clearly not one thing and it’s got many different roads to devastation, and if you’re gonna prevent it, reverse it, slow it, you actually have to attack all of the risk factors.
DR. BREDESEN: When we started looking at larger datasets instead of simply looking at sodium and potassium and that kind of usual stuff, we found that for people with cognitive decline or risk from cognitive decline, they fell into groups. And we published this a few years ago, so you can see people who have dementia are associated with chronic inflammation, which we call type 1 or inflammatory Alzheimer’s. And people who have problems with trophic loss so that you’ve got a situation where you’re withdrawing trophic support, be it from estradiol, vitamin D, B12, testosterone, what have you, that is associated with cognitive decline, or what we call type 2. Or, people who have essentially sugar toxicity we call type 1.5 because it has both some inflammation and also trophic loss and insulin resistance. And then we also found a subgroup of people whose main problem is toxic exposure, be it from biotoxins like mycotoxins, or things like mercury, you can see that these people have the decline and until you treat that and remove it you will not see improvement.
So the big surprise was what we call Alzheimer’s disease is actually a protective response surprisingly to these different insults.
In recent years, the medical field has begun to understand Alzheimer’s as a disease with many causes. Similar to Dr. Amen’s research in ADD with brain SPECT imaging, the body can show physical damage differently depending on patients with the same diagnosis of a mental illness. This has lead Dr. Amen to apply treatment seven different ways for the seven types of ADD he observes in the brain.
Similarly, Dr. Bredesen has found that by categorizing patients into types he can begin to treat patients with solutions that show improvement. These contributors are complex and include chronic inflammation from a variety of causes as well as toxic exposure.
What’s unique is that Dr. Bredesen views these contributors as part of the body’s natural protective response. By measuring these contributors, he has begun to understand how the body is reacting to guard itself. Dr. Bredesen believes that is the key to solving Alzheimer’s disease – identifying the body’s natural reaction to what it interprets as an insult, and then removing those insults from the patient’s environment and body.
Dr. Amen and Dr. Bredesen go on to discuss amyloid as a possible contributor to Alzheimer’s disease, which is a type of protein that has been observed deposited more often in patients with Alzheimer’s.
Amyloid & Genetic Alzheimer’s
DR. AMEN: So talk more about that, I mean, that’s revolutionary. I’m involved in imaging and so I’ve talked a lot to my friends at GE, they make the medicine we use for doing SPECT scans, but they also make the amyloid imaging agent and I think they spent a hundred million dollars developing it and I’m like, “SPECT will actually give you more information that sort of says Alzheimer’s or not.” What you’re saying is actually different, that if you have a high amyloid load, yes, you could be on your way to Alzheimer’s disease, but amyloid is not the cause, it’s the reaction.
DR. BREDESEN: It is the reaction. So what happens is, and there are very nice studies out of Harvard on this, amyloid has turned out to be an antimicrobial. So you are producing this because it damages microbes. You are producing this because it responds to inflammation.
So, my point is it’s all well and good to think about removing the amyloid, but more important, let’s think about removing the causes and there are often many contributors. We typically find 10 to 25 contributors for each person, so don’t take the amyloid away until you take the inducers of the amyloid away, and we’ve had a number of people come through who had their amyloid removed by antibodies who did much worse when they had that removed, so you want to remove the cause – the inducers, first.
DR. AMEN: Are there any studies showing that removing the amyloid in humans improves cognitive function?
DR. BREDESEN: No, not to date, and there have been many attempts, as you know.
I think the best suggestion for the theory, of course, would be the people who have mutations. With the rare people who have mutations in the APP gene, that leads to an increase in amyloid and to develop familial Alzheimer’s, however, I think the problem has been that people want to make this simple so they say, “is amyloid the cause, yes or no?” instead of saying “isn’t it more likely that amyloid is part of the overall story?” but it’s not the entire story.
I think that’s what we’re seeing here in fact, again, it is a protective response that is associated with a downsizing of your overall neuronal network and so when we look at the parent of amyloid VIII, the amyloid precursor protein, we can see directly in a molecular way, what feeds into whether it’s going to be on the amyloid side or whether it’s going to be on the anti-amyloid side and the really interesting thing is that the amyloid precursor protein can be cleaved in two opposing ways. So literally it can support neurite growth and synapse formation or neurite retraction and synapse loss, so it literally can make amyloid and be part of the downsizing of Alzheimer’s, or it can go the other direction and support synapse formation. It is literally a molecular switch.
There are studies pursuing whether or not removing amyloid in humans improves cognitive function, but Dr. Bredesen believes these will continue to falter with solving Alzheimer’s disease until we are able to better understand how the build up occurs.
This is a complex issue: identifying patients who have this abnormal buildup, identifying how it occured, and providing a solution that shows improvement for an Alzheimer’s diagnosis. This is discussed as just one possible contributor towards the overall illness, and a patient typically has between 10 and 25 contributors that must be addressed before showing improvement.
Practical Takeaways to End Alzheimer’s
DR. AMEN: So, let’s talk about the practical takeaways from “ The End of Alzheimer’s.” What are things people can do today to protect their minds or even get it back if they think it’s headed for trouble?
DR. BREDESEN: Absolutely. So you know the key here is that this disease should be a rare disease. It’s now the third leading cause of death in the U.S. Dementia is the number one cause of death in the UK, so this is a huge and common problem and it actually should be a rare problem, so we recommend that people actually get their numbers checked, to get their cognoscopy, and then you can see. So if you have a high HSCRP, you have ongoing inflammation. You need to reduce that and it’s not good enough just to say, “I’m gonna take an anti-inflammatory.” What you have to find out is what’s causing your inflammation. Is it part of metabolic syndrome? Is it part of a response to mycotoxins? To mold produced toxins as you mentioned? Is it part of a response to a specific pathogen? So you need to understand that, and of course your practitioner can help you with that, especially if they’re trained to do so.
DR. AMEN: Although, let me just interrupt you. Most people’s practitioners are not trained in functional medicine or integrative medicine, and so it’s very important to work with someone who has a sense you’re a whole person, you’re an integrated person and if you have depression, it does not mean you have a prozac deficiency. So, getting the right kind of help, we also did an interesting study here where we screened 50 consecutive patients who are not taking fish oil. We did an omega-3 index on them and 49 of them had low or suboptimal levels. It’s stunning. That’s another cause of inflammation.
DR. BREDESEN: Absolutely. Of course you know most of us have too high omega-6 and too low omega-3, so yes, part of this is we are giving ourselves this industrial associated disease. We’re living in a toxic world. We’re living in a world that has depleted soils. We’re living in a world where most of us have too low omega-3s.
So we are to some extent giving ourselves Alzheimer’s disease or at least a very high risk for Alzheimer’s disease. So what we need to do is ferret out all the things that are contributing. So as you said, what can you do, practically check out your HSCRP and address that. Check out your fasting insulin. If you’re fasting insulin is over five, you’re developing insulin resistance and that is a contributor to dementia and you can address that. Check out if you have exposure to metals. If you want to make more amyloid, give yourself plenty of copper or mercury and you will make more amyloid. So you want to understand whether you’ve got those exposures.
In the end, Dr. Bredesen recommends a “cognoscopy” to begin identifying a patient’s main contributors, a series of assessments Dr. Bredesen has defined with MPI Cognition. Once a contributor is measured, such as HSCRP or high-sensitivity C-reactive protein, your doctor can assess how this contributor occured. It is not enough to provide a solution to the inflammation, but your doctor must also investigate why it happened.
Dr. Amen expresses how many practitioners do not take an integrative approach to medicine, and it is very common to find a doctor will prescribe a drug to help with symptoms but it is essential to find a doctor who understands the importance of helping you find the cause.
This is related to the toxicity in our environment, and Dr. Bredesen calls this industrial associated disease. Exposure to metals, such as copper and mercury, is an additional contributor to Alzheimer’s disease, and a patient’s symptoms will not likely improve until all contributors are identified and treated for. Patients with Alzheimer’s disease should seek help from doctors who understand this connection.
Toxins & Herbal Supplements for Stress
DR. AMEN: So the T in BRIGHT MINDS, our program for helping heal mental health issues and strengthen memory, stands for “toxins.”
So we’ve talked about that a little but, when I first started doing imaging, I was the director of a dual diagnosis unit which is a psychiatric hospital unit that takes care of drug addicts, and I would bring the bad scans home to my children and effectively induce anxiety disorders in all four of them about substance abuse, and that’s why I’ve always been suspicious of “marijuana is good for your brain.”
We published a study on a thousand pot smokers showing every area of the brain was lower, especially the hippocampus. And alcohol is related to seven different kinds of cancer, and chemotherapy is bad for your brain, so in my mind less is better, but I’d be interested in your thoughts on it.
I spoke at the Alzheimer’s Association here in Orange County and they had alcohol as one of the refreshments and, you know, I’m always polite when I go places. Internally, I was like “Seriously?” We don’t love our brains as much as we should.
DR. BREDESEN: It’s a really good point, and then for so many people this is an important part of their lives, and of course without it there’s an increase in cortisol, so I think you have to kind of balance it. Along those same lines, what do you recommend as far as CBD oil?
DR. AMEN: You know, there’s a new study out of NYU showing it helped decrease seizure activity in children. It’s not been legal long enough for us to really have good studies with it, and there’s so many other things to help you relax, as you know, both you and I are huge fans of meditation. I’m a huge fan of hypnosis and self-hypnosis.
But I also like saffron, one of my favorite spices, to improve your mood and decrease stress, relax. Ralora is another one that blocks cortisol. You know and our listeners know we founded BrainMD, our supplement company, and I got interested in it because a lot of the medications I use to lower your stress and anxiety were just flat-out toxic for brain function. So whether it’s Xanax, Adavan, Valium or Klonopin, you know, it’s very rare I prescribe them anymore because they cause overall decreased blood flow to your brain.
DR. BREDESEN: Yeah, look at the remarkable things you have with the herbs, I mean, look what you have from bacopa to rhodiola, these things can be very helpful, and why are you out there prescribing a drug?
DR. AMEN: Right, at least you know, I mean, here at Amen Clinics we’re not opposed to drugs, we’re just opposed to that’s the first and only thing you do when there’s so many other things, including rhodiola, ginseng, ashwagandha and green tea extract, and it works so well. It doesn’t amp you like Adderall, it gives you focus while at the same time decreasing stress, so you know, I’m just a huge fan of other ways to think about helping people.
There’s an interesting line drawn between toxins and herbs where Dr. Bredesen describes how people find ways to reduce stress and cortisol, turning to ingredients such as CBD oil for relief, while Dr. Amen believes “less is better” when it comes to marijuana and alcohol, favoring meditation, hypnosis and several herbs including saffron, ashwagandha and ginseng.
Both experts are unique in their style of practicing medicine as mavericks in their field.
Call us today at 888-288-9834 or tell us more online for availability at a clinic near you, and watch the video below on the full discussion of “The End of Alzheimer’s” with Dr. Dale Bredesen.