How to Reverse Alzheimer's Disease

What I see is that there are other people who kind of prove that the concept works because they go in and out of it , and we had a gentleman recently who you know . When he's in ketosis he remembers his grandchildren's names .

We get to witness the awe-inspiring story of Linda , whose battle with dementia was dramatically turned around , offering hope that brain health can be rejuvenated through comprehensive lifestyle changes . In this episode , we confront the unsettling reality of dementia's progression and the influence of genetic factors like the ApoE4 allele .

We challenge the myopic focus of mainstream research on beta amyloid plaques in Alzheimer's , advocating for a broader scope that incorporates managing inflammation , infections , nutrient deficiencies and essential lifestyle factors such as diet and exercise .

Concluding this powerful dialogue , we share the staggering success rates from studies where participants have shown measurable cognitive improvements using Dr Bredesen's protocol . This episode isn't just about the promise of cognitive health . It's an invitation to us all to join a movement that's redefining what it means to age with strength and clarity of mind .

This episode is brought to you by Elm Nutra , maker of the Prolonged Fasting Mimicking Diet . If you'd like to try it , use the link in the show notes for 20% off . And now please enjoy this week's episode .

And then , on the other side of my naturopathic training , you know where we're very much thinking about things from a complex system science perspective , from a treat the cause perspective , treat the whole perspective .

I met Dr Dale Bredesen , or rather I heard a lecture of his at a conference and I was highly intrigued because he was describing bringing that complex system science approach to dementia and getting great results . And so , although I was skeptical , I went to his training and then was on the list of providers who had been trained by him .

And so , sure enough , I had people show up in my clinic and one of my first patients her name is Linda she came in with her husband and she had a MOCA score of two . So the MOCA is the Montreal Cognitive Assessment that we use to quantify the degree of someone's cognitive decline , and hers was quite progressed , so her handwriting was affected .

She could only answer me with one word sentences , with just a yes or no to very simple questions . And although you could see that she had progressed quite severely with dementia and Alzheimer's , you could see the brightness of her personality . She had this great big smile and bright clothing and this black leather studded purse .

And her husband was just so dedicated and much more confident in this Bredesen approach than I was at that stage . They took everything and ran with it . They dove in completely . They did not just dip their toes in the water . With this approach she got out of a moldy bedroom .

They actually just moved from their bedroom that was moldy into their living room and they started ballroom dancing four times a week . She got on the bioidentical hormone replacement . She got all of her dental work done . She got on the bioidentical hormone replacement . She got all of her dental work done .

She got on all the supplements that I recommended and they got into ketosis and they did it together and just six weeks later her MOCA score was now a seven . So this MOCA score is on a scale of 30 , and 30 is perfect . Normal is about 26 or above and when you're at a two , this is very severe disease .

Now , when you're at a two , this is very severe disease . Now , when you're at a seven , it's still severe disease . But it meant that she was talking in sentences . It meant that she could bicker with her husband about something that had happened the night before . Her life had changed .

Her experience of the world had changed in just six weeks , and so when I saw this happen for Linda , my first thought was well wait , what did we do wrong six weeks ago ? Did we ? Was it a bad day for her , and is this just a good day ? But no , her husband said how dramatically she had already changed .

And what I realized by the end of that visit was , if this was possible for Linda , what was possible for everyone else ? Who was possible for Linda ? What was possible for everyone else who was less far along the path of dementia , somebody who maybe had genetic risk but didn't even have any symptoms yet ? Could they prevent this from ever happening ?

And , at the very least , could we delay progression and , hopefully , could we reverse it for even more people . So you can imagine that from that moment could we reverse it for even more people .

So you can imagine that from that moment , I have essentially committed my life to changing the narrative and getting this type of medicine out there and to make it practical and accessible to as many people as possible .

So I can understand how , with that as your first experiment , you would be very excited about the potential .

The younger their cells are , the younger we are , and really that's a big part of this approach . This is a longevity-centric summit and it's about our cells being younger , not just our chronological age , and that's what makes everything kind of spin in this virtuous cycle rather than that downhill spiral .

And then the other thing that drives my confidence is , of course , how far along in the disease process . So when it's early on but still measurable cognitive decline , it's much cheaper , easier and simpler to get that reversal versus those later stages .

Of course now I'm going to blank on the name , but it's essentially the premise of it . I'll remember it . The premise of the whole book is that our mindset as it relates to aging is extremely important and that we can actually live seven years longer if we have a positive association with aging .

And she describes aging in Confucius cultures like Japan and China , and then also in the American deaf community , where aged people are revered so the older you are , the more wisdom and experience you have to share , and that this is highly valued in those communities .

And when you see that you don't get the typical declines that we expect in a standard American culture of declines in measurable things like hormones , in cognition , in how much we exercise and all of these things , when you expect that it's only going to get better , that's actually what happens , and so these are really exciting insights , I think , about how we age

and the control that we have . She also reports that in her research

. People with the ApoE4 genes . This means that they have extra risk of developing dementia . I'll kind of break this down and go on a tangent for a minute , just so everybody understands what I'm talking about . So the ApoE genes are associated with fat metabolism and there's essentially three options and you get two of them one from mom , one from dad .

You can have a two , three or four , and if you have twos you actually get some benefit , you get some reduction . Or four , and if you have twos you actually get some benefit , you get some reduction in risk . And if you have threes you also have less risk .

But if you have fours , if mom or dad has given you a four , or if you have a four , four , a mom and dad have given you a four , you have a highly increased risk of developing dementia . Um , this risk can go up to 50% one in two chance of developing dementia in your lifetime if you have a 4-4 .

And then if you have a 3-4 , you have a third , one in three chance of developing dementia , where the normal population has a 13% chance of developing dementia . And if you have a two in there , you have that a 9% chance of developing dementia . And if you have a two in there , you have that a 9% chance of developing dementia .

So what we are essentially looking at is that increase in risk from 13 to 50% with that ApoE4-4 status . Now Becca Levy in her book describes how that risk is completely eliminated if you have a positive association with aging .

So if you're channeling I always think of channeling Betty White If we can just channel that , imagine that we're gonna live that life of humor and engagement and productivity and community into our 90s and beyond . Then we can live longer , healthier , happier lives with better cognitive function .

And so purpose feeds into that epigenetic model where we have the ability to influence our aging process .

I think another misconception around Alzheimer's that's really important to point out is that beta amyloid plaques have been sort of the smoking gun . The issue that we point to as the cause of Alzheimer's , and in fact what we know about Alzheimer's , is that that's not the full story .

Although there's clearly a correlation between amyloid plaques , tau proteins and incidents of dementia , those are not necessarily the causal factors . And when we think about causal factors , these things are much more within our control , right ? Beta amyloid plaque like what is that ? What does that even mean ? How do I control that ?

It feels very much outside of us and we're sitting here waiting for science to save us , to give us that magic pill or that magic IV , when in fact I think that's been a little bit misguided , because this is a multifactorial disease , a very complex disease that requires a more complex solution to meet it .

And so that's where I go back to this very systematic but more comprehensive approach that's described by Dr Dale Bredesen who I'm sure is on your summit , I hope and essentially what we're doing is we're describing what are all of the things .

We're not only describing but assessing what are all of the things that might impact neuronal or brain cell function and how do we optimize for that ? So what are the toxins doing ? What you know are there , are the toxins doing ? Are there too many ? Are there too little ? Right ? Are we getting them in and out ? Are they flushing through the system ?

So , toxins , infections , is there an infectious burden that is causing inflammation ? Are there enough nutrients to get those toxins and infections and other things that might trigger inflammation out of the system and keep our systems , even the basic metabolic waste that every cell creates ?

Can we get that out of the system so it doesn't get caught up in there and create inflammation ? And then , is there structurally ? Is there blood flow in and out of the brain ? Right ? Can you get oxygen to your brain at night ? Do you have sleep apnea ? Have you been hit over the head with a baseball bat at some point in your life ?

I mean , this literally comes up in my office and my practice and so certainly traumatic brain injuries will contribute to inflammation in the brain . And then also we talked about stress a little bit already , but stressors can also .

Having too much cortisol , although it's anti-inflammatory , over time can create imbalances certainly in those stress hormones in the brain and reduce the size of the hippocampus directly . So there's a big connection between stress .

We've all kind of been in that situation of either not getting enough sleep or feeling under pressure and not being able to make our brains work right . We can't spit out what we're trying to say , and many , many of us can relate to that experience of feeling under stress and not feeling like we can remember well .

And so those are more or less that , plus signaling hormones . So things like peptides , stress hormones , sex hormones , vitamin D , thyroid hormones all of these signals are really important

. And then of course , diet I kind of put in that category of both signaling and nutrients is that we need to eat the right things beyond a relatively anti-inflammatory diet , or at least not a pro-inflammatory diet so that our cells can be made . They can use those building blocks to literally create the structure of our cells in an anti-inflammatory way .

There's so many pieces of this . Exercise of course helps with with reducing inflammation and being enough stress right . If we're couch potatoes and we're just laying around , there's not enough stress on the body for there to be engagement that's going to keep us moving and going and blood flowing . Same thing with brain engagement .

We need enough of it , but not too much . It can't be so much that we give up , but we want enough brain engagement that we work that muscle .

You know , I feel so fortunate to work with Dr Bredesen and be supported by him as a mentor and to be so clued into his work , and so I have really done my best I'm shamelessly riding his coattails here to plug the gaps of his work by making this more accessible and more practical , I guess , for people , because it is hard , and when we talk about changing

diet , changing the environment , exercising more , this can be a full-time job , scheduling , a sleep study All of these pieces require a lot of cognitive work , and for many people with full cognitive capacity , making these changes in their busy lives is challenging , and so what we've aimed to do is essentially reduce the friction , and I've done that in a couple of

ways , and one is through Murama , which is a residential care facility for the elderly located here in San Diego County . Although we are quickly expanding , we're partnering with a group in Wichita , kansas we just announced that this week and so really excited to be able to help more people .

We've had a waiting list for well over a year , and this is an immersive experience , so I get how challenging it is . I live this lifestyle myself , and it can often feel like a burden . However , it feels so good to be in ketosis , to be eating good food , to be exercising regularly and getting good sleep , having your brain engaged , being in community .

All of those things are so valuable and I love watching people . It's just an absolute privilege and so much fun watching people get the benefits of it , and I get how challenging it can be to do on your own at home , so we take care of it for you when you or your loved one moves into Marama or our partner facilities . And that is just .

I mean doing that and seeing those beautiful souls just thriving is the privilege of my life . It's so fun .

And then we also offer the Marama at home course , because not everybody can make it to San Diego right , there are all kinds of constraints , and my goal really is to make senior living facilities like that obsolete , because I would love for people to stay in at home in the fabric of their community , where the people they love are right there , be able to work

, continue to work and also , most importantly , as I mentioned , my confidence is higher when people intervene in this disease process earlier on , and so , instead of waiting to need to go to a place like Marama , do all of these things at home . So we help support people through that with the Marama at Home course it's just maramaathomecom .

It's a 12-module course where I break it down and take you through everything that we're doing at Marama day-to-day . We give you the daily schedules , tell you about the equipment we have and then you can create as much of that at home as possible and get all of the benefits there .

We offer additional coaching and I will even go to people's homes here and there when I have time and when that allows , and that's really really , really fun for me . I absolutely love it .

Now I'm not suggesting that you get into ketosis forever , but for somebody struggling with cognitive decline today , I would recommend being in ketosis for three to six months . Now work with their provider to make sure that this is absolutely safe for you . There are certain conditions , like kidney issues .

Potentially if you've had gallstones or gallbladder issues , this can be a little bit more challenging and you might want to work with a health coach . If your cholesterol is high , don't worry too much . We can usually actually get good results over time and lower your cholesterol through a ketogenic diet that includes lots of fiber , lots of veggies .

So what we're looking for here is to basically flip the switch of your metabolism from burning sugar for fuel to burning fat for fuel , and your brain loves this .

So your brain , preferentially , will burn fat instead of sugar for fuel and as we age , one of the things that seems to happen pretty consistently is that we lose insulin resistance and we lose efficiency when it comes to turning sugar or glucose into ATP or the fuel our cells run on .

And so when we just change out the fuel , we get more efficiency in creating that fuel and creating the energy that our brain needs to run , and through that there can be more repair , more regeneration , clearer thought patterns , less fatigue . It's really amazing to watch , I'll tell you that , some of my patients .

They come in and they kind of look like wilted flowers and they get into ketosis and they just sort of start to blossom . They're standing up straighter . You can see that there's more energy . They're much more engaged in conversation . It's really , really fun to watch . And so what we do there is it's carbohydrate restriction .

Many people will need to get to around 30 grams of carbs , restricted to 30 grams of carbohydrates a day , and it's lots of emphasis on veggies , leafy green veggies , the non-starchy veggies , your all of your cruciferous , your Brussels sprouts , your cauliflower broccoli , your charred kale arugula I mean cauliflower broccoli , your chard kale arugula , I mean the list goes

on and on . I I'm often in ketosis and it feels great , um , and I don't feel restricted , heavy in fats , lots of coconut oil , olive oil , and I don't have people restrict dairy , unless of course they are sensitive to it . Then of course , if you're lactose intolerant or otherwise sensitive to dairy , absolutely restrict that .

And then plenty of animal protein , some nuts and seeds and all of the spices basically anything that won't raise blood sugar is on the yes list and there is a lot of yummy , yummy stuff you can put on there .

Those can be anything from like Skittles or a Snickers bar to breads , pastas , even things like fruit that are often considered very healthy , and I think fruit is very seasonal fruit very healthy , starchy veggies very healthy , like beets and carrots and butternut squash say very healthy things .

But if we want to achieve the goal of ketosis , then what we want to do is restrict those carbohydrates or sugars completely .

They are fully and totally committed and they just do whatever it takes to get into ketosis , to optimize their diet , their sleep , their exercise , and it's . It's really impressive .

What I see is that , um , there are other people who kind of prove that the concept works because they go in and out of it , and we had a gentleman recently who you know , when he's in ketosis , he remembers his grandchildren's names , and when he's not , he doesn't .

And you can kind of see this switch go on and off and it really , I think , is a resource utilization issue for him . Particularly when he's getting that fuel to his brain , he can remember really important things , and when he's not , he stops remembering . And so many people will report this .

Of course , the holidays come up and they kind of fall off the wagon or they're traveling . They fall off the wagon , but they get those benefits back often , if they can get right back to it .

I would propose is that , yeah , we can prevent and at least delay the onset of cognitive decline when people are adopting this , this diet and this lifestyle , and also , I think , doing the medical component is important , but it's kind of the icing on the cake . The 80 , 20 is definitely in the lifestyle component from , in my opinion and from what I've seen .

So um and and again , as I mentioned , when we have people with mochas in the twenties , we get complete reversal .

We see them go back to 30 , go back to getting perfect scores , and so my confidence is much higher when we can intervene then and that you could almost consider prevention because their diagnosis would be mild cognitive impairment and they're not progressing to Alzheimer's the way you would expect .

So what I recommend is kind of thinking of exercise in four categories your aerobic , your strength training , your dual task exercise and I'll talk more about each of these and then your contrast oxygen therapy .

And so at a very minimum , you want to be doing aerobic exercise and strength training exercise and that aerobic exercise the definition here is going to come from the Framingham trial and this is 200 minutes a week at your target heart rate .

So this is give or take four kind of four one hour um classes or one hour bike rides , one hour jog run , kind of things .

You want to get your heart rate up to moderate rate and the way you calculate this is 220 minus your age , and you take that number , your max heart rate , and multiply it by 0.75 or 75% and 0.85 , 85% of that max heart rate , and you get your target heart rate between 75 and 85% of that max heart rate . You want to be there for 200 minutes a week .

So if your walk does that , then fantastic , you're doing good work . If not , then we've got to up the antsy and get your heart pumping a little bit more to get that extra blood flow to your brain . So that's aerobic exercise . Hopefully many of you listening can check that box and you're getting that

. Strength training is the next one . We want to be growing muscle because muscle sends a lot of those great signals to the brain , like testosterone and BDNF to the brain to support neurotrophic effects . So the both growth and the connections neuroplastic effects between um , between the different neurons .

So we want to be getting those signals through strength training exercise and this can be lifting weights or it could be yoga or Pilates or um you know anything that helps engage your muscles , climbing .

There are lots of functional , fun exercises that different people can do and sometimes for some people it's chair yoga and for other people it's PT or OT exercises . There's a whole spectrum . We just want to meet you at your edge there . And then dual task exercises .

This is a little bit newer in the , in the research and many people have not heard of this , but there's massive amounts of benefit of combining cognitive exercise with strength or or aerobic exercise .

So for someone this might be as simple as going to a class like yoga , pilates , zumba , something where you're being cued by the instructor , if that engages your brain significantly .

If you're not checked out like if I go to Pilates and she's like bring your right arm down to your left hip , like I can kind of be checked out , thinking about work or other things that's not engaging for me . But for somebody else sometimes it's really hard to put together those pieces of the cues while you're exercising . That's great , that works .

For other people , what they'll do is they'll go for a run and they'll be listening to a podcast . They'll pause the podcast and repeat back what they just learned .

For someone else , they might have a granddaughter quiz them on the names of all their great grandchildren , or on the birthdays of all their great-grandchildren , or on the birthdays of all their great-grandchildren , or on the presidents from start to finish , or the 50 states and the capitals .

Right , you can get creative math problems about how you engage your brain while you're exercising .

I don't know exactly what's going on , but I know that it works and that there's data out there that proves this and there's good data from the TBI clinics and also from Parkinson's research this dual task . So if anybody's looking for some of these , if you Google or go to YouTube and search for dual task exercises , you will see a bunch of examples come up .

Great , great .

Air that we breathe day to day is about 20% oxygen , and through the LivO2 system you concentrate oxygen and get it up to about 80% oxygen , um , what you're breathing while you're exercising . And then you go to negative and you go back and forth between positive and negative , and that negative oxygen is about 8% .

So you go from 80% to 8% , when what we typically breathe is 20% . And in going back and forth , what you get is vasodilation , um , so all of your blood vessels get really , really big when they're feeling starved of oxygen .

This is as the carbon dioxide goes up , and then you flip the switch and you get this concentrated oxygen that goes into the lungs and then is very quickly able to glom onto those red blood cells and deliver oxygen to the tissues through those great big , expanded blood vessels . So you get pressure changes , you get a little bit of stress on the system .

I'm sure you have lots of speakers discussing the hormetic effect , so you put a little stress on the system and what you expect is a more resilient , healthier system . And part of that is by getting rid of senescent cells and also signaling the system to produce more mitochondria , which is where that fuel or ATP is created in the cells .

And so as we stress the system a little bit , by going back and forth between positive and negative O2 , we get some of those amazing benefits too , we get some of those amazing benefits .

And so if that means nine hours for one person or 10 hours for one person , maybe even temporarily , certainly for teenagers , then enjoy that , get that rest . If , for you , you've not just gotten by on seven hours , but if you can wake up without an alarm , feeling rested after seven hours , that might be enough for you .

I have had the pleasure of interviewing Dr Michael Bruce I don't know if you're having him on , but he's the sleep doc and he talks about the importance of consistency going to bed within about a 15 minute window , the same time every night , and when you're not basically creating jet lag by going to bed at 9 am , 9 pm one night and 2 am the next night ,

when you're not shifting your bedtime too dramatically , you start to get much more efficient sleep , and so getting the right amount of sleep is certainly important prioritizing sleep , thinking of it as an investment in your health and also being absolutely sure that you don't have sleep apnea and if you have any amount of sleep apnea , even if you've had a sleep doc

tell you that it's mild . I recommend treating any apoptic events relatively aggressively through either mouth tape . You know , if you snore , maybe the nasal breathe right Strips actually do . Just use the SomniFix and the breathe right Strips , because the adhesive on the generics is not great and so they don't tend to work as well .

And then there are mouth guards that you can use from specialty dentists , and then , of course , the CPAPs or the APAPs , the alternating pressure devices that you can use from specialty dentists . And then , of course , the CPAPs or the APAPs , the alternating pressure devices that you can use for sleep . And I , if you have apnea , please use that .

If you have one that's been sitting in the corner and you can't get it to fit right , or you you haven't been using it regularly , please , please , please , get that fit , get a different one , do what you need to do to aggressively treat that sleep apnea , because if you have apnea , if you're having those events at night , it's essentially like having mild brain

damage every night , and as a brain doctor I'm not okay with that ever .

Do you have data on results that you've gotten or can you share any data that's out there on a reversal of Alzheimer's , slowing it down ?

So Dr Bredesen and his team Kat Toops is the primary author on that the first author on the paper that was published in July of 2022 in the Journal of Alzheimer's Disease , the paper that was published in July of 2022 in the Journal of Alzheimer's Disease and what they showed was that 84% of participants who did this Bredesen approach had a reversal measurable

reversal in their cognitive decline , in their dementia , and I would say that . So we took a group , a cohort in my office , and we're looking forward to submitting that paper very soon . We took 23 participants through six months of intervention the Bredesen paper . They did nine months of intervention . We took participants with MOCA's between 12 and 23 .

So this is definitely measurable cognitive decline , significant measurable cognitive decline , and we had results that were relatively similar .

So , and what you would expect , it wasn't quite at 84% , but we're really excited to publish that work and I'm really excited to be able to say publicly exactly what my expectations are when someone with a MOCA score between 12 and 23 comes in in six months and the results that we get .

And I'm wondering , given this evidence , given this approach and how it seems to be so helpful , why , and also given how everybody is so fearful of Alzheimer's why isn't this information more shown on the news programs and people being made aware of it ?

We have been down a rabbit hole chasing this hypothesis that beta amyloid plaques are responsible for Alzheimer's , and it's a dead end . It's not getting us where we need to be . There was just this week there was another monoclonal antibody that came out , and it's like getting us where we need to be .

There was just this week there was another monoclonal antibody that came out and it's like promising results . You know this is all over the news . What it does and at its best , is it slows the progression of a torturous disease .

Essentially , they're saying here pay tens of thousands of dollars a year , medicare for this , taxpayers for this very expensive drug that makes the torture for people , not just the person suffering with the disease , but also their caregivers and their loved ones and their families that are on this long path to go . Goodbye , it says . Enjoy this longer .

Awesome , like . What value does that bring to society ? I get so upset about this , I'm sorry , and then I just get back to work , because I can't focus on this part too much . So many dollars literally $1.6 billion last year alone , in 2021 alone , went to studying the beta amyloid plaque hypothesis and much of that .

Some of that I don't want to overstate it , but much of that was based on a 2006 paper that was published by Nature that said that these amyloid plaques were the smoking gun connecting them to cognition . Amyloid plaques have been used as a surrogate marker .

What do we really care about someone's ability to use the bathroom on their own , to go grocery shopping , to drive , to maintain an independent life , to have a conversation with their friends , to remember their children's names ? That's what we care about .

We don't really care how much beta amyloid plaque there is unless it's connected to cognitive function , and there was a paper in 2006 that was published a mouse trial out of the university of Minnesota that connected cognitive decline with amyloid plaques . Well , we found out this summer that it was completely fraudulent .

It is maddening to think about , you know , and there's good and bad actors in every field , but to think that so many taxpayer dollars have been dedicated to this hypothesis when it's based on fraudulent data .

You have to hope that there's something good that will come out of this amyloid plaque rabbit hole that we've spent so much time and smart people's money and energy on , but I don't know like the 99.6% of the research trials that are done on that they fail .

That was one case study , it was one individual and Alzheimer's his mentor , published a textbook and he had a new textbook psychiatry is what it was called and that was published in 2000 or , excuse me , in 1907 , I believe , or 1908 . And he needed new information to put in the textbook . So he took that case study and put it in the textbook .

You guys both know the medical world . You don't put case studies in textbooks . You put the data in textbooks after it's been validated and it's gone through scientific rigor . So that was kind of the first elevation .

And then several times since then , for very political reasons , for marketing , really not for scientific reasons Alzheimer's has been elevated in a way that does not serve the public and people who are suffering with this disease through multiple channels , and I could talk about this for way too long .

and take advantage of it .

It's marama M-A-R-A-M-A maramaexperiencecom , and I'm looking forward to hearing from you and we'd be delighted to be of service .

Like I said , I think diet is probably 50% , that's 50% of the heavy lifting of this approach , and the ketogenic diet a highly plant involved ketogenic diet is what I think works best , and so we're going to give away a free keto diet guide and you'll have access to that through the summit , and I wish you well and please send us any questions you have about

that . We have coaching available if you wanna just dive into the diet piece as well .

The use of this information is at their own users risk .

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