Martin Oliver looks into the cause, the tests, the drugs, and emerging natural preventative measures.
A major malady of the modern era, Alzheimer’s disease is a common form of dementia with a range of distressing effects on sufferers, their carers and their families.
Usually regarded as incurable, nuggets of information are coming to light about breakthroughs on how to prevent it, slow its development and even reverse it in its earlier stages.
The characteristic symptoms include memory loss, cognitive decline, disorientation, and negative personality changes.
Chronic inflammation of the brain is considered to be the cause of Alzheimer’s.
It is also speculated that it is a form of autoimmune disease, where the body is attacked by its own immune system. One physical sign is in the form of beta-amyloid plaques, which are clumps of protein that accumulate in the brain up to 15 to 20 years before symptoms first appear. Another is brain shrinkage through loss of tissue in critical areas. Both can be detected on MRI scans.
‘Within two decades, Alzheimer’s alone is expected to represent one per cent of Australia’s national GDP’
Prevalence of Alzheimer’s is on the rise. In Australia, together with dementia, it represents the second leading cause of death after heart disease, affecting about 350,000 Australians. Globally, about a hundred million cases are expected by 2050. Inevitably, the cost to individuals, society, the health system, and the taxpayer is steep; within two decades Alzheimer’s alone is expected to represent one per cent of Australia’s national GDP as the ageing population increases.
Typically, it is managed using pharmaceuticals, especially cholinesterase inhibitors with possible unpleasant side-effects such as Donepezil, Rivastigmine, and Galantamine. But so far, drugs have notably failed in yielding a breakthrough in treating and reversing the condition.
Prevention better than cure
Avoiding or delaying a major debilitating condition such as Alzheimer’s is far more preferable to trying to tackle it once it has developed. One reason is because information about reversing Alzheimer’s is not provided through medical channels, and many of those affected will not have access to it. Older people may be too conservative or cautious to try a simple therapeutic regime, and if it has progressed too far, may not be capable of initiating one. However, even a one-year delay in onset would increase the quality of life for millions of people and save billions of dollars.
It’s good to start with diet. Important nutrients include B-vitamins, Vitamin K, choline, and antioxidants. Greens are rich in folate (vitamin B9), and spinach also has both B6 and the brain-boosting antioxidant lutein. Broccoli is a source of Vitamin K, which enhances cognitive abilities, and choline, which improves memory. A now popular antioxidant is green tea. Berries and cherries are rich in anthocyanins.
The natural health-oriented neurologist, Doctor David Perlmutter, author of the book Grain Brain, regards sugar, and gluten and gliadin from grains, as key causes of Alzheimer’s. Too much sugar in the diet and high blood sugar levels are to be avoided as they have the effect of shrinking the brain. Perlmutter prioritises getting a good amount of vitamin D, and maintaining healthy cholesterol levels.
Fats are another important area. During the second half of the 20th century they came to be generally seen as unhealthy, but now there is growing recognition that fats are good for the brain, and conversely a very low fat diet can be a disaster for brain health.
Fats to avoid are trans and hydrogenated fats from processed foods, which have an inflammatory effect on the brain.
Olive oil contains a substance called oleocanthal that helps to break down beta-amyloid plaques. Walnuts are a source of Omega-3 oils, and are the only nut source of alpha-lipoic acid, a good brain antioxidant. Aim to include DHA-rich oils, either from oily fish such as salmon, mackerel, sardines, or from a fish oil supplement.
To help prevent Alzheimer’s, recommended supplements include folic acid, B12, CoQ10, magnesium, fish oil, and resveratrol, which has the important property of restoring the integrity of the blood-brain barrier.
‘High levels of homocysteine are considered a risk factor for Alzheimer’s and heart disease… a homocysteine test can be arranged via a GP’
The British educational charity, Food for the Brain, is looking at problems linked to the amino acid homocysteine in the body. High levels of this substance are considered a risk factor for Alzheimer’s and heart disease. Methylation is an important body process for good health, and excess homocysteine generally indicates that methylation is not occurring as efficiently as it could.
While 5-15 micromoles per litre (µmol/L) are often considered a normal range in the blood, Food for the Brain sets a danger level above 9.5 micromoles per litre (µmol/L), beyond which brain shrinkage is accelerated. In Australia, a homocysteine test can be arranged via a GP.
Higher homocysteine concentrations are typically correlated to depleted B-vitamin levels, exacerbated by factors such as processed foods, alcohol, coffee and pharmaceuticals. Following blood testing, those above 50 years of age and who exceed the risk threshold are encouraged to take a short online cognitive test, followed by a regime of high-dose B-vitamin therapy. Daily supplementation is typically set at 20mg of B6, 500mcg of B12, and 800mcg of folic acid, all in tablet form.
Vitamin B12 and Omega-3
This regime can reduce homocysteine quickly, and there is some research to back up its effectiveness. A 2012 study in the International Journal of Geriatric Psychiatry identified a 30 to 73 per cent reduction in brain shrinkage, with the highest benefit among participants who started with good Omega-3 levels. While a B-vitamin boost is a good preventative, it can also go further and arrest the disease’s development.
Many Australians are low in vitamin B12, manifesting in symptoms that can mirror those of Alzheimer’s disease. This makes correct diagnosis important. When raising B12 levels, injections and sublingual sprays are considered to be more effective than tablets.
Other preventative suggestions include:
- Link up with friends, and maintain social connections.
- Engage in brain stimulation via games, puzzles, changing one’s habits, and learning something new that creates neural pathways.
- Take regular exercise, which reduces the risk by up to 50 per cent.
- Ensure that you get enough sleep.
- Make time for relaxation and relief of stress.
- Don’t overdo hygiene, and the use of antibacterial products, as this inhibits the body from being colonised with friendly microbes, and depresses the immune system.
Reversing the condition
More controversial than prevention is the notion of reversing Alzheimer’s, as this more directly contradicts mainstream medical wisdom. Alzheimer’s Australia and other similar charities typically have partnership and funding arrangements with the pharmaceutical sector, and unsurprisingly downplay natural alternatives. Part of this comes down in many cases to a lack of scientific evidence. With natural substances being unpatentable, there is little economic incentive to fund clinical trials. If embarking on an attempt to tackle existing Alzheimer’s, it is wise to start early, as mild symptoms are far easier to address than those that are more pronounced.
Coconut oil was first championed by physician Dr Mary Newport, who claimed that it reversed her husband Steve’s Alzheimer’s. However, it is controversial, and there are differing views about its effectiveness. The key ingredient is medium-chain triglycerides that increase the body’s production of an important brain fuel known as ketones. Coconut oil is the most concentrated source of these triglycerides.
Cheap to try, a suggestion is to increase dosage up to around two tablespoons per day. It is easy to add to other foods such as breakfast cereals, and should ideally be organic. One concern that has been raised is its high (87 per cent) saturated fat content, but this is certainly not a health issue for South Pacific islanders who obtain a substantial portion of their calories from this oil.
Similar is a ketogenic diet, good for Alzheimer’s and Type 2 diabetes, which supplies the body with ketones. It is rich in fat, contains an average amount of protein, and has few carbohydrates.
‘An active ingredient in Turmeric is curcumin, which removes amyloid plaques and is available in supplement form’
Turmeric has been found to benefit dementia, and has a stronger body of scientific evidence to support it. Alzheimer’s is rare in India, and an important factor is likely to be the sizeable turmeric intake. An active ingredient in Turmeric is curcumin, which removes amyloid plaques and is available in supplement form. Another component, ar-turmerone, encourages growth of natural stem cells.
Because turmeric has a low bioavailability, it is good to combine it with other foods that boost its uptake. One way to do this is to make ‘golden paste’ by mixing it with an oil such as coconut oil, and ground black pepper, which increases its bioavailability by up to 20-fold. A suggested dose for golden paste is half a teaspoon, three times a day.
Cocoa has also been suggested due to its antioxidant flavonoids that create improvements in cognitive skills. It is good as a preventative, and may also be used as a treatment. To maximise flavonoid content, natural and minimally processed cacao is probably the best source.
A trial in Iran with a probiotic containing lactobacillus and bifidobacterium involved 52 people with severe Alzheimer’s taking it for 12 weeks. The outcome was an improvement in cognitive test outcomes for the subjects, while results for those on a placebo declined. The beneficial effect seen in Iran’s trial underscores the growing recognition of the gut-brain connection.
Cannabis, in the form of medical marijuana, is looking promising too. A 2016 study from Aging and Mechanisms of Disease found that the THC in marijuana has the effect of removing plaques and reducing inflammation. Researchers were drawn to look into cannabis because of the presence of marijuana-like brain chemicals known as endocannabinoids. Medical marijuana has been legalised in Australia, but state regulatory frameworks are still being worked out.
Neurotoxic metals identified
Medical journalist Dr Morton Walker considers that an accumulation of six different neurotoxic metals in the brain is a cause of Alzheimer’s. The six metals identified are: aluminium, mercury, lead, cadmium, iron and manganese. Mainstream science is increasingly in agreement. In addition to curbing further exposures, existing aggregations of these metals can be chelated out of the body using substances such as EDTA, or natural chelators such as chlorella and coriander leaf, which and are sometimes recommended to be taken together.
Dale Bredesen from UCLA in California has pioneered the MEND Protocol, a complex multi-faceted Alzheimer’s strategy involving diet, supplements, brain training, lifestyle changes, and exercise. A small clinical trial reported in the peer-reviewed journal Aging in 2014 found that nine of ten subjects experienced a benefit, and suggested that good outcomes would have been more likely if symptoms had been less advanced. It has been speculated that spending a longer period on this protocol could result in a sustained improvement.
When tackling this topic, it is important to retain an open mind, unlike Google, which took the remarkable step of shutting down its promotion of a 2016 Alzheimer’s prevention summit, arguing that the condition cannot be prevented. In reaching this conclusion, they chose to side with authorities that have chosen to be dismissive of prevention strategies. This highlights the importance of being able to access information about promising solutions, regardless of who approves.
Martin Oliver is a writer and researcher based in Lismore, NSW.
Dr David Perlmutter, www.drperlmutter.com
Food for the Brain, www.foodforthebrain.org
MEND Protocol, www.museslabs.com/individuals