Book Review – The End of Alzheimer’s

Book Review – The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline by Dale E. Bredesen, MD.

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

older couple taking a walkAlzheimer’s disease is a grim disease that causes both the mind and body to deteriorate. In 1906, Dr. Aloysius Alzheimer identified plaques in the brain autopsy of a patient who had suffered from dementia, and in doing so he discovered what is generally thought to cause the symptoms of the disease that bears his name. These plaques, made from a protein called amyloid-beta, are thought to interfere with the functioning of our brains.

Since Dr. Alzheimer’s discovery over a century ago, the focus has not been in pinpointing the cause of Alzheimer’s disease, but rather in finding an effective treatment for the related symptoms. Theoretically, if we can find a drug that will stop the formation or contribute to the removal of plaques in the brain, we will be able to prevent or reverse the development of the symptoms associated with Alzheimer’s disease. We have been using this line of thinking to develop drugs since the 1980s, without success.

Dr. Dale Bredesen has turned this thinking upside down. His book, The End of Alzheimer’s, poses the questions: What if the amyloid proteins are there to protect the brain rather than disrupt the brain? Is it only when plaque formation is excessive that it interferes with nervous tissue signaling?

A Leaky Roof

Dr. Bredesen uses the metaphor of a leaky roof for Alzheimer’s disease. The roof has approximately 36 “holes,” though a few more may yet be identified. These holes signify the number of contributors he and his team have identified as playing a role in the development of dementia and Alzheimer’s disease.

The size of the holes—that is, the probability of developing Alzheimer’s disease–depends on the impact of genetics and the environment. Because each hole is a different size (depending on genetics and other factors) for each person, not every single hole needs to be patched; however, if you only patch one hole in the roof, you will still have a leaky roof. Our pharmaceutical model only has touched on one pathway—trying to stop the formation of plaques—and overlooked other possible causes, which is why our attempts at treating Alzheimer’s disease have failed.

What Causes Amyloid Production?

Among the 36 “holes” that contribute to developing Alzheimer’s disease, there are three major categories. These categories contain conditions that can be grouped together. The three major categories are inflammation, deficiencies in hormones or nutrients, and exposure to stress or environmental toxins. All of these conditions force the body to defend the brain by producing amyloid plaques, thus leading to Alzheimer’s disease.

Inflammation is the first category that may increase amyloid production. While inflammation is often related to infection, it may be caused by other things such as food or food sensitivities. Dr. Bredesen uses the example of ingesting trans-fats or sugar, substances that are known to be inflammatory.

The second category includes hormones and nutrient deficiencies and imbalances that interfere with neuronal repair in the brain. For example, vitamin D deficiency may be a critical trigger for amyloid production. See below for a more detailed description of this category.

The third category includes exposure to significant stress, poisoning with heavy metals and mold toxins, or other environmental or chemical exposures. Even the stress of menopause may instigate the disease. Because this category tends to present psychological symptoms (such as depression), which mask the symptoms of Alzheimer’s disease, these contributors can be easily missed.

Alzheimer’s Disease By the Numbers

The Alzheimer’s Association has gathered these statistics about this increasingly-prevalent disease:

  • An estimated one in ten of people over the age of 65 is affected.
  • Two-thirds of those diagnosed are women.
  • It is the sixth leading cause of death in the United States.
  • Life expectancy after diagnosis is 4 to 8 years.
  • The cost of care for Alzheimer’s disease and other dementias in the United States is estimated at $277 billion for 2018 alone.
  • One-third of seniors die with Alzheimer’s disease or another form of dementia.
  • 7 million Americans are living with dementia as of 2018.
  • In the United States, every 65 seconds a patient is diagnosed with Alzheimer’s disease.

Hormones Are a Key

As mentioned above, some of Dr. Bredesen’s findings show that the key to preventing or recovering from Alzheimer’s disease may be restoring depleted hormone levels. Of the 36 and more contributors identified, several involve hormonal imbalance. Dr. Bredesen states, “Reaching optimal hormone levels is one of the most effective and most critical parts of ReCODE (reversing cognitive decline protocol).” Based on his observations, Dr. Bredesen recommends optimizing:

  • Insulin secretion and signaling
  • Estradiol
  • Progesterone
  • The ratio of progesterone to estradiol
  • Free T3 (the active thyroid hormone liothyronine)
  • Free T4 (the thyroid hormone thyroxine which is the precursor to T3)
  • Thyroid stimulating hormone (TSH), made by the pituitary gland to stimulate the thyroid gland to produce T3 and T4
  • Pregnenolone
  • Testosterone
  • Cortisol
  • Dehydroepiandrosterone (DHEA)

Dr. Bredesen takes great care to explain the development of his ideas and the work in his laboratory. With decades of research behind him, he presents a theory addressing everything we do know about Alzheimer’s disease, and as a researcher and physician, he has been able to practically apply this theory to successfully treat patients.

Connection with Insulin

Another contributor to inflammation—and by extension, developing Alzheimer’s disease—is insulin resistance. Insulin resistance, metabolic syndrome, and diabetes all involve abnormally high levels of insulin. Some even call Alzheimer’s disease “Type 3 diabetes” because of the problems high insulin levels cause the brain. Dr. Bredesen explains that the enzyme, insulin degrading enzyme (IDE), helps us break down excessive insulin. This same enzyme can break down amyloid. If we follow a lifestyle and eating program that constantly elevates insulin, IDE may not be available in amounts needed to break down and help stop amyloid overproduction.

Sex, Adrenal, and Thyroid Hormones

A common factor of aging is the depletion of adrenal hormones (although cortisol is sometimes high), sex hormones, and thyroid hormones. The loss of hormones parallels an increased risk of Alzheimer’s disease as we age.

For each of the markers that Dr. Bredesen has identified, he also describes how to test or evaluate hormone levels, and presents what he believes are the optimal parameters. Replenishing these depleted hormones may help patients prevent or recover from Alzheimer’s disease. To restore proper hormone function, bioidentical rather than synthetic hormone replacement must be used, as bioidentical hormones are equivalent in structure to the hormones our own bodies make.

Diagnosing Alzheimer's Disease

Alzheimer’s disease used to be diagnosed only after the patient had died. An autopsy would reveal the presence of amyloid plaques, explaining the decline in the patient’s health and eventual death. Now we have testing that can identify the presence of plaques during the patient’s own lifetime. These include scans of the retina, brain scans, and checking the cerebral spinal fluid. A genetic test for Apolipoprotein (APO)E also shows potential to predict susceptibility to this disease.

Mending the Holes in the Roof

Alzheimer’s disease does not follow the “one disease, one treatment” model our current medical system relies upon. Each patient should be evaluated for their individual needs. Successfully treating Alzheimer’s must involve a personalized, complex therapy program, but the reward—giving patients the ability to reclaim their brains and their lives—makes the effort more than worthwhile. The End of Alzheimer’s presents an opportunity to forestall and correct the onslaught of this devastating disease. Thanks to his groundbreaking work, dedication to making this information available, and training practitioners to use his guidelines, Dr. Bredesen demonstrates that patients with Alzheimer’s disease do have treatment options.

© 2018 Women’s International Pharmacy

Edited by Michelle Violi, PharmD; Women’s International Pharmacy

For any questions about this article, please e-mail

Carol Petersen at carol@womensinternational.com

Book Review – The End of Alzheimer’s2018-10-08T10:45:16+00:00

Diabetes and Osteoperosis

Diabetes and Osteoporosis: Is Vitamin D the Missing Link?

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

 

Studies suggest that osteoporosis and bone fractures are a significant and under-reported complication of Diabetes Mellitus (DM). An increase in osteopenia and bone fracture risk, coupled with a decrease in bone mineral density (BMD), is well documented in diabetics with little or no insulin production (Type I).

This same risk in diabetics with insulin resistance (Type II) is more uncertain. Even though Type II diabetics have a higher BMD than the non-diabetic population, both Type II and Type I diabetics have an increased risk of experiencing an osteoporosis-related fracture.

There may be more than just low BMD involved. Cytokines are substances made in immune system cells that have negative effects in both diabetes and osteoporosis. Vitamin D is known to be beneficial to the immune system as well as helpful in maintaining bone health.

Scientists have recently theorized that vitamin D may be beneficial in preventing Type I and Type II diabetes. Epidemiological studies have demonstrated that high doses of vitamin D are associated with a decreased risk of Type I diabetes when cod liver oil is given to babies or mothers in their third trimester.

Multiple studies suggest that vitamin D has a positive effect on pancreatic cells as well as on insulin production, secretion, and sensitivity. Higher blood levels of vitamin D3 are associated with a lower risk of metabolic syndrome in Type II diabetics. Poor blood sugar control has been observed during the winter months when vitamin D from the sun is less available.

Wouldn’t it be wonderful if vitamin D could help build strong bones while combating diabetes at the same time? Further research is warranted.

  • Leidig-Bruckner G, et al. Prevalence and Determinants of Osteoporosis in Patients with Type I and Type 2 Diabetes Mellitus. BMC Endocr Disord 2014;14(33):1-13.
  • Chau DL, Edelman SV. Osteoporosis and Diabetes. Clinical Diabetes. 2002;20(3):153-157.
  •  Brown SA, Sharpless JL. Osteoporosis: An Under-appreciated Complication of Diabetes. Clinical Diabetes. 2004;22(1):10-20.
  • Harinarayan CV. Vitamin D and Diabetes Mellitus. Hormones. 2014;13(2):163-181.
  • National Institutes of Health. What People with Diabetes Need to Know About Osteoporosis. https://www.niams.nih.gov.
Diabetes and Osteoperosis2017-12-13T12:42:53+00:00

Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD

Book Review – Heart Attacks, Heart Failure and Diabetes: Prevention and Treatment by Mark Starr, MD(H)

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

 

Dr. Mark Starr, the author of a classic book titled Hypothyroidism Type 2: The Epidemic, recently published a book called Heart Attacks, Heart Failure, and Diabetes: Prevention and Treatment.

You may ask, “Why is this relevant to thyroid disease?” The reason is that Dr. Starr relies heavily on the research of Dr. Broda Barnes, a pioneer in the treatment of thyroid disease, for this new book. Dr. Barnes detailed much of his research in Hypothyroidism, the Unsuspected Illness, a book published in 1976 that continues to be a mind opener for anyone interested in thyroid issues. Dr. Barnes also published a lesser known book that same year called Solved: the Riddle of Heart Attacks. (For more information on Dr. Barnes’ life work, visit https://www.brodabarnes.org/.)

One would think that the field of medicine would have evolved significantly since 1976, providing us with more insight and better treatments. Sadly, this is not the case, and we find ourselves revisiting history for enlightenment.

Dr. Starr’s new book is a touchstone back to the very careful research provided by some of the giants in medical observations and research. He goes back as far as 1918 to Dr. Hermann Zondek’s profound work, which demonstrated that the enlarged heart in congestive heart failure can and does shrink back down to normal size when the underlying hypothyroidism is treated.

Dr. Starr notes that hypothyroidism and diabetes also go hand in hand. In fact, he contends that appropriate thyroid treatment can prevent the development of many of the secondary problems of diabetes, such as blindness, atherosclerosis and neuropathies.

One of the highlights of Dr. Starr’s new book is a thorough discussion of the limitations of using TSH (thyroid stimulating hormone) as an indicator of hypothyroidism. The thyroid gland produces 4 thyroid hormones: T1, T2, T3, and T4. The majority of the hormone produced is T4, which has very weak activity. The primary action from thyroid hormones comes from T3. In order to increase the availability of T3, enzymes in the body work to remove an iodine molecule from T4 to create T3.

As it turns out, there are separate enzymes at work in the pituitary gland, where TSH is produced, and the rest of the body. Because of these separate enzyme-producing systems, the amount of active T3 in the pituitary gland can be as much as 1000 times the amount of T3 available to the rest of the body. The production of TSH will stay low until the pituitary T3 is also exhausted. The result is that the body can be in a low thyroid state, with significant symptoms, for a long time before TSH levels are signaled to increase.

There is no better teacher than personal experience. Dr. Starr relates his own health struggle with untreated (at first!) hypothyroidism, and also shares some of his patients’ experiences.

This book serves as a reminder of the fundamental nature of thyroid function in diseases that are of epidemic proportions today. If you happen to start with this book, it will likely whet your appetite for even more of the type of information offered in his first book.

  • Starr M. Heart Attacks, Heart Failure, and Diabetes. Irvine, CA: New Voice Publications; 2014.
  • Starr M. Hypothyroidism Type 2: The Epidemic. Columbia, MO: Mark Starr Trust; 2005.
  • Broda BO. Hypothyroidism: The Unsuspected Illness. New York, NY: Harper; 1976.
  • Broda O. Barnes M.D., Research Foundation Inc. https://www.brodabarnes.org/.
Book Review: Heart Attacks, Heart Failure and Diabetes by Mark Starr, MD2017-12-13T12:44:39+00:00

Blood Sugar and the Aging Brain

Blood Sugar and the Aging Brain

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

 

Alzheimer’s Disease is sometimes called the “Disease of the Baby Boomers.” So it is not surprising that current brain research is focusing on this disorder.

A recent study on blood sugar levels and brain deterioration by Dr. Cherbuin and associates looked at 266 healthy, non-diabetic individuals, ages 60-64. The results indicated that high normal-fasting blood sugar levels were associated with brain wasting, particularly in areas relevant to aging. In another study, abnormally high blood sugar levels were associated with shrinkage of parts of the teenage brain as well.

Low testosterone, as well as high cortisol levels and estrogen/progesterone imbalances, can also lead to blood sugar/insulin disturbances.

Although more research needs to be done, controlling blood sugar levels through a healthy diet and exercise may prove to be beneficial in maintaining healthy brain function throughout life.

  • Cherbuin N, et al. Higher normal fasting plasma glucose is associated with hippocampal atrophy: The PATH Study. Neurology. 2012 Sep 4;79(10):1019-26. doi: 10.1212/WNL.0b013e31826846de.
  • Yau PL, et al. Obesity and Metabolic Syndrome and Functional and Structural Brain Impairments in Adolescence. Pediatrics. 2012 Oct; 130(4).
Blood Sugar and the Aging Brain2018-04-03T16:59:57+00:00

Diabetes and Testosterone

Diabetes and Testosterone

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

 

A testosterone deficiency has long been suspected in people with diabetes. A recent study concluded that males with sexual performance issues and/or abdominal obesity and metabolic diseases should be tested for low testosterone and treated accordingly.

A literature review examined the effects of testosterone therapy on patients with metabolic syndrome and found that they exhibited decreased fasting blood sugar, waist measurement, and triglyceride levels. In addition, insulin-dependent diabetic women with no menstrual cycle were found to have significantly lower levels of testosterone than cycling diabetic and non-diabetic women.

Diabetic men and women may want to have their testosterone level evaluated in light of the above findings.

Diabetes and Testosterone2018-04-04T13:17:39+00:00

Progesterone is the Key to Stabilizing Insulin Levels

Progesterone is the Key to Stabilizing Insulin Levels

Written by Kathy Lynch, PharmD – Women’s International Pharmacy

Healthy aging proponents are focusing more and more on one–if not THE–key component of aging: controlling blood sugar and insulin levels. Michael E. Platt, MD believes that the primary cause of high insulin is declining progesterone, the hormone predominantly involved in controlling and stabilizing insulin. Progesterone also helps prevent low blood sugar episodes. Dr. Platt treats both men and women with progesterone for these purposes, elaborating on the dose in his book, The Miracle of Bio-Identical Hormones.

Progesterone is the Key to Stabilizing Insulin Levels2018-04-04T17:20:45+00:00