You can do a lot for yourself, for your own brain and memory health. You can improve your own memory by attending to clearly identified details of diet, lifestyle choices, and getting serious about some crucial supplements. I'll divide up your work for you into three separate articles, let's see where we're going.
Dr. Dale Bredesen, of the University of California, Los Angeles, has done the most impressive work in the area of treating patients with memory and cognitive impairment due to Alzheimer's Disease. Prior to his work, no drug, no program has shown more than a slight benefit in this area, at best perhaps a slow progress in the ravages of this devastating disease. Dr. Bredesen’s approach, contrary to that of pharmaceutical companies hoping for a silver bullet, is to treat Alzheimer’s as a problem with multiple interacting causes, a roof with thirty holes, as he likes to say. In his continuing work, I think the number of holes is up to forty, but plugging any 25-30 holes is likely to produce amazing benefits, if dementia has not progressed beyond a point of no return. Even severe dementia is likely to see some benefit, if not the miraculous results of his 9 patients (of 10) with remarkable improvement.
Folks have asked me for the details, because you CAN do this program without the guidance of Dr. Bredesen. But, it’s highly unlikely that you can do this program on your own IF you really need it. If you are hoping to prevent Alzheimers (perhaps you’re at high risk), but as of yet have no symptoms, YES, you can do this program entirely on your own. If you are already forgetful, enlist the help of a friend or family member. Create a checklist or a calendar: keep track and ask for a second set of eyes. The program will not work if you forget it half the time.
Before you start, find some objective way to assess your cognitive skills. The online Alzheimer’s Reading Room offers five choices of tests, each of which is a good way to assess your memory and cognitive skills. If you are not fully computer savvy, ask for help getting to the form, download and print it, and ask someone else to score it for you if you have any doubts. You are obtaining a baseline that you can re-evaluate after 3 months, 6 months, etc. on the program. You might see some improvement after just a couple weeks, but truly the differences will continue to accumulate over months and years. I like the SAGE test the best.
Now, getting down to work.
To start with, you need to obtain some lab tests from either your own physician or from a direct access lab such as Direct Labs. All these lab tests should be drawn after an overnight fast, drink plenty of water, and have the labs drawn by 9 a.m. at the latest. Earlier is better.
- Homocysteine
- Fasting blood sugar
- Hemoglobin A1C
- B12 level
- hsCRP
- Albumin and globulin levels (or albumin and total protein, assume globulin is the difference)
- Fasting insulin
- 24(OH) D3
- Serum or plasma zinc and copper levels
- TSH, Free T3 and Free T4
- Pregnenolone and Cortisol
- Testosterone and Estradiol
Overachievers can also figure out a way to monitor blood ketone levels. I use the Precision Xtra finger-stick system, enables me to check glucose or ketones. I buy the ketone strips for a few dollars each from Canada, rather than $5 each from the US (but don’t forget we have the best health care system in the world.) There are also breath meters available that are more expensive, but then no expensive strips to buy.
Lifestyle Changes
While you’re waiting for your lab results, you can start modifying your lifestyle, making the brain healthy choices that follow:
- Anti-inflammatory diet. Reduce the inflammatory effect of your diet: EAT REAL FOOD. No processed foods, no or low sugar, no vegetable oils or trans fats, very low grain, and, in my book, gluten free. (You like ice cream? Choose: brain? ..ice cream? …brain?…ice cream? Your choice! No, seriously: you can have a treat like ice cream or gluten-free lemon pie, but think once a week, not once a day.) No foods that come in packages, cans; find a way to love cooking again! (or for the first time)
- Eating window 12 hours or less. Eat within a 12-hour window each day, or less! Every night, stop eating for three hours before going to bed, and maintain a 12 hour fast (at least) every night. (Let’s say you eat a 7 p.m. dinner: if you wake at 6 a.m., a non-caloric cup of tea is fine, but delay breakfast until after 7 a.m.)
- Eight hours of sleep every night. How is that sleep of yours? You want to get 8 (eight!) hours of sleep a night for your brain. A distant second choice is less than 8, plus a nap to equal a total of 8 hours in a 24 hour period. See my long list of suggestions here if you have any sleep troubles. Start with a 0.5 mg dose of melatonin at bedtime, and if that doesn’t get you to sleep, move on to the other suggestions. If you still can’t sleep, you need to look into a sleep evaluation: even non-snoring folks can have sleep apnea which feels like insomnia, when your body wakes you up to get you breathing again.
- Regular exercise! Schedule exercise you like, 30-60 minutes daily, 4-6 days a week. Put together a rotating program that includes “just moving” (walking, cycling, or rowing at a moderate pace, preferably outside), and then twice a week add in some intervals (doing something safe for you, work as hard as you can for 30 seconds, rest for a couple minutes; repeat 4-8 times) and some heavy work (lift weights with a trainer, or do body-weight exercises such as push-ups or squats).
- Brain challenge. Now exercise your brain: are you learning something? Reading is great, but do something challenging. Online programs such as Lumosity are fine; Posit (Brain HQ) is another program.
- Feed your brain. Finally, add in some brain-healthy supplements that are good for every brain, regardless of the results of your blood tests. Let's go through them one at a time.
Curcumin and Ashwaganda. Both of these herbal-based supplements are thought to reduce the formation of amyloid Beta in the brain. Long a staple of Indian cooking as turmeric, and associated with many health benefits in that form, the biologically active curcumin portion of turmeric has been isolated and studied in its effect on brain function. Curcumin is credited with effective and helpful anti-inflammatory effects in the setting of many chronic diseases, and is a reasonable and safe supplement that shows promise in the area of cognitive function. The supplement I take is Integrative Therapeutics Thercurmin, taken as directed. Acting in a similar vein, the herb known popularly as Ashwaganda demonstrated significant beneficial effects studied in the mouse model of Alzheimer's. I like the liquid form from Gaia Herbs that can be mixed into water, or taken directly: less pills and capsules to swallow is a plus in my book.
Magnesium for the brain. Magnesium is a helpful mineral throughout the body, but a particular form, magnesium-l-threonate, available from Designs for Health as NeuroMag is particularly brain-active, helping brains to both focus and to relax, depending on the context and how tired you are! 2-4 capsules a day, depending on the effect you notice.
Particularly important for ApoE 4 folks. Resveratrol is observed to normalize an imbalance in sirtuins (key brain proteins) observed in people with the ApoE4 genotype. Pure Encapsulations Resveratrol Extra provides a generous amount of resveratrol, taking 2-4 capsules daily with meals.
Finally, fish oil! I imagine you've heard of the benefits of fish oil or omega 3 fatty acids for your brain, and you are right, they are very important! The two essential omega 3 fatty acids are EPA and DHA, and particularly the EPA comes only from animal products, particularly fish oil. (DHA is synthesized by some algae.) Although the DHA component is thought to be the most brain-active, it is important to provide the EPA and DHA in a ratio of 3/2. One of the most important functions of omega 3's is to clean up after any inflammation caused by excessive omega 6's in the diet, but you have already cleaned that up yourself, way at the top of the page, by reducing the inflammatory potential of your diet. If your diet has been very inflammatory, you might double your dose, temporarily, but a good ongoing dose of omega 3's is 1500 mg a day. My fave is Barlean's Omega Three Fish Oil, the key lime flavor, thank you.
Whew, that is a lot to start with! If your head is not spinning, you probably don't need any extra brain attention. If your head is spinning, that's fine, you can keep referring to this article as much as you wish. I suggest you create your own log, notebook, or checklist to keep track of what you're doing.
In the next article, we'll review your lab tests and make some adjustments as needed. Some of these, to yield optimal results, will require a cooperative physician and prescriptions, but we'll get to that next time. In the final article, I'll wrap it all up, cover the last of the self care steps you can take. And remember, if you JUST do all of the step that you can do yourself, without the doctor prescriptions, you will be plugging up the great majority of any potential "leaky holes in your roof!"
