Revolutionary New Tests for Alzheimer’s Disease with Dr. Dale Bredesen: Rational Wellness Podcast 403

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Dr. Dale Bredesen discusses Revolutionary New tests for Alzheimer’s Disease with Dr. Ben Weitz.

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Podcast Highlights

Dr. Dale Bredesen, MD is a neurologist and an internationally recognized expert in the mechanisms of neurodegenerative diseases like Alzheimer’s Disease and the Chief Science Officer at Apollo Health. He is the author of the best selling books, The End of Alzheimer’s,  The End of Alzheimer’s Program, and The First Survivors of Alzheimer’s, and his newest book, The Ageless Brain.  Dr. Dale Bredesen’s career has been guided by a simple idea: that Alzheimer’s as we know it is not just preventable, but reversible. Thanks to a dedicated pursuit of finding the science that makes this a reality, this idea has placed Dr. Bredesen at the vanguard of neurological research and led to the discoveries that today underlie the ReCODE Report.  Dr. Bredesen offers training for doctors and practitioners in his ReCODE system at his website at ApolloHealthco.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

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Podcast Transcript

Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com.  Thanks for joining me, and let’s jump into the podcast.

Hello, Rational Wellness podcasters. Today we have an exciting interview with Dr. Dale Bredesen on the latest testing and research related to Alzheimer’s disease. Dr. Bredesen is a internationally recognized neurologist with a specialty in the mechanisms of neurodegenerative diseases.  He’s now the Senior Director of Precision Brain Health at Pacific Neuroscience Institute here in Santa Monica, and the Chief Scientific Officer at Apollo Health. To this day, the prevailing view in the medical community is still that Alzheimer’s is a degenerative neurological disease that’s ultimately fatal, and at most we can slow its progression with some of the newest monoclonal antibody drugs.  However, Dr. Dale Bredesen has shown that a Precision medicine, functional medicine approach has been able to reverse and prevent Alzheimer’s disease in the majority of cases, even when there are unfavorable genetics, such as having an APOE4 gene. Though his work has not yet received the recognition that it should, I predict once it is that Dr. Bredeson will receive a Nobel Peace Prize.  But as of now, The Alzheimer’s Society of Canada says that Dr. Bredesen’s protocol offers false hope. Dr. Dale Bredesen has published over 200 scientific studies and three books, The End of Alzheimer’s, the End of Alzheimer’s Program, and The First Survivors of Alzheimer’s, with his fourth book soon to be published, the Ageless Brain.  He has published the results of a study using his Recode Precision Medicine approach, showing that 84% of 25 patients with dementia or mild cognitive impairment improved over a nine month program. And this study was published in the Journal of Alzheimer’s Disease journal of Alzheimer’s Disease in 2022.  And this study was repeated, or this program was repeated in another study by another researcher, Dr. Heather Sandison, using this protocol in 2023 with patients with more severe dementia. Getting similar results. There’s currently a peer reviewed study being conducted in six different centers around the world using the Bredesen protocol.  Today, I would like the first part of our discussion to summarize your Precision Medicine approach to Alzheimer’s and other neurodegenerative diseases, review some of the latest developments, and then I’d like to discuss a collection of three newer blood tests that can help us to diagnose and track progress for patients with Alzheimer’s disease that, that Dr. Bredesen calls the neuro code. So Dr. Bredesen, thank you so much for joining us again.

Dr. Bredesen: Thanks, Ben. Great to talk to you.

Dr. Weitz: Have you found any increase in acceptance by the conventional neurological medical community?

Dr. Bredesen: There’s beginning to be some recognition that you can actually do something about this.  But if you go and, you know, ask 10 people on the street at random, you know, nine or 10 of them will tell you that they think that nothing can be done. And you may have seen just over the weekend there was an opinion piece by. The by a writer, Charles pillar who writes for science the, the journal, the scientific journal called Science, and he was writing about fraud and the, the amount of fraud that has gone on in Alzheimer’s research.  And this was widely read, and one of the points he made is that there’s nothing that can be done. And here’s a guy who’s reading about this all the time. And actually he and I were on Megan Kelly’s show together a few years ago, so he should have been aware of what we’re doing.  And I sent him some of our papers and he said, as soon as the his book comes out, he will you’ll get to work reading some of these and see, you know, see what he thinks.  So, you know, it, it’s unfortunate because just compassionate use dictates that when you have an untreatable disease, if you have anything that is suggestive that you should at least use what you can to hope for best outcomes for literally compassionate use. And this came up for back in the late 1940s, so about 80 year, almost 80 years ago when Dr. Dana-Farber, who is a pathologist. At the time there was no treatment effective at all for childhood leukemia. And one, and the observation that he made was that childhood leukemia seemed to get worse when people would be treated for their anemia. And one of the things, of course, that they, that was used was folate.  And so he thought, Hmm, is it possible that we could retard the development of childhood leukemia by using an anti folate?  And they started with aminopterin of course later. This led to things like methotrexate and dapsone and things like this. And although he just had a few cases and a few had been killed by the treatment, that’s how bad it was.  He had the first. Even somewhat successes in childhood leukemia. And this changed the field and now the majority of people with childhood leukemia will survive.  So, and that was published in the New England Journal of Medicine. And so people recognized at the time, Hey, this is compassionate use, you gotta start somewhere.  And even though there were people killed by the treatment, which we don’t see with Alzheimer’s treatment, with the approach we’re taking, we get people healthier. Then it was still, it turned, it was still used because we needed it, and I, I would hope that people would ultimately come to the same conclusion.

We want anything we can do to give us better outcomes. I’ll tell you though, Ben, the most important thing that we could all do is early testing. It’s just like a pap smear. It’s just like a chest x-ray, just like hemoglobin A1C and things like fasting insulin looking before you have full blown diabetes and start to have all sorts of glyco toxic problems.  You can pick it up early and do something about it, and we have the same now we have wonderful early tests for pre, literally, literally pre-Alzheimer’s disease.

Dr. Weitz: And it’s not like you’re advocating bloodletting or some of the standard care of medicine years ago that could potentially be harmful.  Even if some of those patients didn’t improve their brain health, their overall health is going to improve by eating a healthier diet and exercising and, and getting their blood sugar under control and doing some of the other factors involved in your program.

Dr. Bredesen: Yeah. And you know, the bottom line here is that there is a set in, what we spent many, many years in the lab studying what actually gives you this neurodegenerative phenomenon, whether it’s Alzheimer’s or Parkinson’s or Lewy body or frontotemporal dementia or what have you. And what we found is, there’s a whole set of signals that are synaptoblastic that are literally creating new synapses that are, that are helping you to have neuroplasticity, learning and memory, that sort of thing. Then there’s a whole set of demands, things that are pulling back, things like inflammation that are telling you, pull back, pull back. And so what happens is as long as you’re on the right side, you’ve got more supporting than you have the detractors. You’re in good shape, but as you age and as you now get exposed to various toxins and various infections and have metabolic syndrome and leaky gut and chronic sinusitis and all these things, what happens is your supply goes down, your demand goes up because of the inflammation and toxins and things like that.  And now what’s happening is your, your brain literally is switching from a connection mode to a protection mode. It is putting its resources into dealing with these various insults. I. So when you do that, of course you are now decreasing your synaptic number. You don’t notice that until, which is again, why early testing is so important.  You don’t notice that you’re decreasing synaptic number until you start to have symptoms, and that takes a while. And so the announcing, wait a minute. I could have remembered this before, or I could have done this before, or I could have been quicker [00:09:00] before, or I could have focused better before those sorts of things.

Now you’re actually seeing this effect of a reduction in the number of functional synapses in your brain. So as you said, getting in early and it’s absolutely, there are all sorts of diet and lifestyle things that can be helpful. But there’s also, beyond that, I. Knowing what to look for. There are specific chronic infections that often go undiagnosed.  Things like sleep apnea, that is a common contributor, changes in the oral microbiome. Specific biotoxins and specific metallo toxins, inorganics, organics. These are the major groups that can give you problems. So identifying those and addressing them. Often removing the source and then detoxing and things like that.  Again, and again and again. We see people, no surprise, they get back to where the supply is better than the demand, and they bring back the ability. So imagine that you had. Imagine you had [00:10:00] a, a big box and you could store, you know, a thousand, a thousand of your baseballs in there and you need your baseballs, you know, to, to play, play baseball every day.  Okay? So if you, if the box gets smaller, then you start getting smaller, you’re gonna say, okay, I can’t put any more baseballs in here, because it’s, it doesn’t, it won’t hold anymore. And so that’s what your brain actually does. It says, look I’m shrinking in terms of the synapses. And you can even see, of course, the atrophy on MRI.  When you do that, it says, okay, the first thing that goes, is the ability to add new stuff. I mean, that makes a lot of sense. Interestingly, there are two things that go at the same, pretty much the same time. One is what we always hear about the inability to store new information so people have trouble learning new things.  The great news they can still do things that they’ve learned for their rest of their lives. So there’re still quite functional. The other thing that goes is in the locus ceruleus, that is the place in your brainstem that [00:11:00] projects onto your cortex with the norepinephrine. So this is basically the stuff that is out there when you’re you know, when you’ve got adrenaline going, boom, and you’ve, so what it’s really telling you is we don’t have room to store more, and we’re not gonna let you go into turbocharge speed anymore. You can do just fine going on, put, you know, putting along at 25 or 30 miles an hour, you’re gonna be able to do a lot of stuff, but you can’t stress it out. You can’t go into this mode. And you do see people very frequently as they’re beginning cognitive decline.  They’re a little passive. They don’t have that spark. And one of the things we hear most frequently as they start to turn around is their spouse will say, wow, they’re just so much more engaged. You know, the light has come back to their eyes. They’re now able to do the things that they just couldn’t do before.

Dr. Weitz:  And you were just talking about toxins and I’m here in Santa Monica and we’ve had these horrible fires that have ravaged Los Angeles. And unfortunately for all the people who’ve lost their homes and everything else, and as these homes burned, they released all these toxic substances that spread throughout the city in the air, landed on homes, buildings, ground, everything and all this soot is liable to contain all sorts of toxins.  And ought to think seriously about making sure that we clean these toxins out. And all of us probably ought to be on some preventative detox.

Dr. Bredesen: No question about it. One thing would be, you know, take a vacation for a while if you can get away from that area. Another thing is you indicated you have some HEPA filters or have some things like that in your home to get rid of.  You want these particulates you know, as well as some of the organics, both of those to, so things like, you know, IQ Air and things like that. And they’re all sorts of different ones. I, I am, I, I’m not a representative for any of them, but a any of these things, very, very helpful. There’s Molecule, I think is another one.  And there are, there are a number of these. And then as you said, getting your detox. And then that’s a really good idea for anybody. And, you know, making sure your glutathione is up to snuff. A lot of people like to take sulforaphanes. Making sure you have plenty of fiber in your diet that helps you get rid of these toxins that are in your gut.  You’re gonna have exposure obviously through your nose. And so, just optimizing these things, having plenty of crucifer make, making sure that you can do everything possible for detox is actually not even a bad idea to check your genetics, see if you’re a good detoxer or a bad detoxer. There are a number of these groups that do this.  3X4 Genetics does this. Telex DNA, does this. I think it’s DNA life is another one. There are various ones to that make, to make sure that, see if you are a poor detoxer or a good detoxer. And then of course having a good low toxin diet, not being exposed to a lot of ultra processed foods. You know, having filtered water, doing sauna.  Sauna’s been very helpful for a lot of people sweating and then using a non-toxic soap to get rid of that sweat.  It’s been shown. I mean, the sweat contains a lot of you know, a lot of toxins that are being excreted from your body. Your body’s doing everything possible to get rid of these things. Yeah. So, and they go, as you know, they affect every organ, including your brain. So there is a lot that people can do and many things that people are not doing but a lot we can all do to minimize our toxicity.

Dr. Weitz: And one of the key ways in which your approach is different than the conventional approach is that while we all recognize that amyloid plaques and phosphorylated tau protein are often present in the brains of patients with Alzheimer’s, while the conventional neurological community has largely focused on trying to remove the amyloid plaque, right, using monoclonal antibody medications, the results of which have largely been a failure in my opinion. You have focused on the underlying metabolic, immunological, physiological reasons why the body lays down this protective plaque and these tangles.

Dr. Bredesen: Exactly. And you know, it’s a little bit like if you were called to try to improve an area where a lot of people have been killed and you get out there and you see that the police have guns, you say, okay, if we can just get rid of those police, everything will be okay.  No, that’s not the way to go. They’re there for a reason. So what, one of the things we’ve been interested in is. What is the physiological response? Everyone’s focused on the pathology. Oh my gosh, look, there’s tau. Oh my gosh, look, there’s amyloid. Let’s get rid of it. That’s not the way this works. We want to focus on the physiology.  Why is this there? And your body makes the amyloid because it surrounds and kills microbes. It is an [00:16:00] antimicrobial peptide. Tau is an antimicrobial protein. So these things are dealing with insults. Interestingly, the amyloid also binds metals, and when you have that combination of an antimicrobial and something that binds metals, that means it’s an, it’s an anti-biofilm agent because it can take apart the biofilm and kill the bugs inside.  And amyloid been shown to have antiviral effects, antifungal effects, antibacterial effects, antiparasitic effects. I mean, it’s pretty remarkable stuff. Unfortunately, of course, in the long run with inflammation, you now start decreasing the neural network. But what we are suggesting is that I. This amyloid, this response is something that can protect your brain for years, as long as there’s not a lot of inflammation there you can protect the brain for years. You can isolate these various pathogens and you can sequester them and kill them while your brain goes on functioning normally. And we know there are many people. Who die. And at autopsy they have brains with lots of amyloid but no cognitive problems. So it doesn’t make sense.  You can’t just say, this is the cause of Alzheimer’s. Sure, it’s associated with Alzheimer’s, but it’s not the only thing that causes it. So we gotta kind of separate that. And what we want to do find to remove amyloid or tau, as long as you remove the reasons they’re there first. And we have seen a number of people where they had the amyloid removed by an antibody and they got worse.  So we want to remove the cause of the problem. What are the insults? Is it metabolic syndrome? You know, is it we were talking about earlier, you know, is it a chronic sinusitis? A leaky gut. So common sleep apnea. So common changes in the oral microbiome. So common. There was a real recent, very interesting paper looking [00:18:00] at the brain’s microbiome instead of the guts or the oral microbiome.  And it turns out the brain actually has a microbiome, which I wow. Always taught that it should be sterile, but it’s not. There is a microbiome in your brain, but most of the organisms that they find in the brain are oral species. So a lot of what’s going on in your brain is related to your dentition, which is one of the reasons I think that best outcomes requires that good, well-trained dentists get involved as well.  And I think we’re, we’re beginning to understand this disease and these neurodegenerative conditions like Alzheimer’s, much better than ever before.

Dr. Weitz: It’s amazing in which the oral microbiome plays a role in heart health, in brain health. It’s incredible how all these things are connected.

Dr. Bredesen: Yep, absolutely.

Dr. Weitz: So, when it comes to diet, you advocate a keto flex diet. Can you explain what that is?

Dr. Bredesen: Yeah, so if you look at all of the different pieces, you know, what do you need? So you know that you need to increase energetics. That’s a huge, the six big players in Alzheimer’s are energetics, inflammation, toxicity.  Those are the biggest three, and then the lesser three are neurotrophins or trophic activity: that’s hormones, nutrients, and neurotrophins like NGF and BDNF, neurotransmitters, like acetylcholine. And then interestingly, stress. And as a scientist, I never used to think that stress was going to be a big deal for, for patients.  It turns out it’s a huge issue and no question it can shrink your brain, that alone. So those are the big players.

Dr. Weitz:  What is, what is, what’s the mechanism by which stress can shrink your brain?

Dr. Bredesen:  Yeah, so it’s thought that if you look at the, the production of corticotropin, so for example, just CRF one is one example.  CRF one is a receptor in the brain for corticotropin releasing factor. And it actually is basically part of stimulating your brain and saying you’re under attack. You need to switch from connection mode to protection mode. So you ramp up your amyloid, you ramp up your tau. You’re, again, you’re pulling back on your neural network.  You’re switching from this connection mode to protection mode. What’s been amazing to me is you see this at every level in the brain when you make this choice, when you, when you’re under assault, you change your likelihood of having thrombosis. So you change your endothelial lining, you change your renin levels.  Renin is part of what helps your neurites find the right place. You’re now pulling back. You have a low renin, you have less neuroplasticity. You’re changing your APOE signaling. You’re changing, literally changing your epigenetics. You’re changing the production of amyloid. You’re changing the phosphorylation of tau.  You’re changing something called hippo signaling, which is related to your, your lysosomes. It’s amazing. Your total body, you undergo this shift is literally like going from sleep sleep to wakefulness. You know, your whole systems change when you go from sleep to wakefulness. And the same idea, these systems change when you go from connection to protection.

Dr. Weitz:  Fascinating.  Last time we spoke, you have mentioned a nutrient called Homotaurine that prevents the oligeramization of A beta. Has there been any further progress on that compound?

Dr. Bredesen:  And I should finish responding to your, your issue of the diet first. And yes, when you look diet,

Dr. Weitz:  oh, okay.  Well, let’s, let’s finish with the diet first. Yeah, I’m sorry.

Dr. Bredesen:  It’s plant rich, mildly ketogenic. Doesn’t have to be only plants. Wild caught fish, great. Some grass fed beef, fine. You know, some pastured chicken, pastured eggs fine. Or if you don’t want those fine too. But, but it’s fine to have some, but it’s a plant rich.  Mildly ketogenic diet. And you know, you need either ketones or glucose to, to power your [00:22:00] brain. Your brain is much like a Prius that you’ve got two different things that will power it. And if you’re low on both, which, if you’ve got insulin resistance, you typically are low on both. You’re sputtering.  You don’t have that normal. So we want to bring these back for everybody, make them insulin sensitive and give them some ketogenesis. And so I just recommend at the beginning, just take some exogenous ketones. This is why people have had such good results with coconut oil, MCT, oil ketone salts, ketone esters, any way to get that up.  Then over time, you’ll be able to become insulin sensitive and generate them on your own, but your brain needs that energy. It needs the oxygenation. So if you’ve got some sleep apnea that’s undiagnosed, as so many people do, that needs to be addressed. This is again, where wearables is so helpful.

Dr. Weitz:  And we need the right fatty acids as well, right?  

Dr. Bredesen:  Absolutely. You want to have a good Omega-3 index ratio of about 10% or so. For sleep, you know, you wanna have at least [00:23:00] one hour of deep sleep every night, at least an hour and a half of REM sleep, and at least seven hours of total sleep with a an oxygen saturation. Of at least 94% during the night. So, again, the targets that you can do wearables can be very, very helpful.  You want to have this, you know, the high fiber in the diet, which helps with detox and with help helps improve your, your lipid status, helps improve your glycemic status. All these things. Very, very helpful. Now you mentioned Homo Toine which is an amino acid, but not one of the 20 building block amino acids.  But this thing has an interesting property, and this was shown several years ago by the ion group. That this actually prevents the oligo modernization of the amyloid. When the amyloid comes together to kill bacteria typically multiple ones stick together and it’s usually in like groups of three.  So for example, they’ll make a 12 me 3, 3, 3, 3. And these, these are much more potent against this. And so when that does that, they can also damage your mitochondria. They’re also involved with neurodegeneration. So we’re trying to prevent that, and especially for people who are APOE 4:4, that’s 7 million Americans, and unfortunately, most don’t know it, it’s a good idea for everyone to find out.  They then that will they actually do quite well with some hoori knives. Just heard within the last week from Dr. Christine Burke, one of the excellent physicians who’s practicing this approach up here, just outside Sacramento, that the group that was shipping the Homotaurine from Europe has stopped doing that.  So I don’t know how available it is today. Oh, interesting. Certainly, it’s, it, I think it’s, it is a promising approach. They’re looking at a drug trial with a precursor of it currently, and we’ll, you know, we’ll see where that goes.

Dr. Weitz: And then exercise is super important and as exercise is also super important for making sure we maintain our muscle and our bone density in a similar way to make sure we maintain our brain.

Dr. Bredesen: Absolutely. So it’s important to have aerobic and these are really synergistic. It’s important to have some strength training, which really does different things that really helps your insulin sensitivity, for example. And you know, people see again and again that’s associated with longevity. I. So it’s, it’s a very important piece of this.  Some people like to use katsu bands, which are these which are these resistance bands, which kind of gives you more bang for your buck. Some people like to use EWOT is one of my personal favorites because it gives you both the aerobic part, you get better blood flow, but you also get better oxygenation. 

Dr. Weitz: EWOT is Exercise without Oxygen?

Dr. Bredesen:  EWOT is exercise with oxygen. With oxygen. Okay. So it’s giving you extra oxygenation. So that, that’s all good. And then you know, sleeping, we just talked about [00:26:00] stress, a huge issue. Again I like to use my wearable and just look at heart rate variability. 

Dr. Weitz:   Do you, is that the oral ring? Is that what you use?

Dr. Bredesen:  I use an Apple watch, but Okay. People like Oura rings. Absolutely. Our daughters really like those and you know, others like Garmin or Fitbit or any of these things, whatever you like whatever you feel comfortable with they can be helpful to you.  Of course. Another wearable that’s so helpful is the CGMs, the continuous glucose monitors that so many people, you can now get ’em. Over the counter, which is fantastic. So you can look to see we are you spiking? Are you troughing? They’re both a problem. If you’re spiking your glucose that is a problem that’s gonna give you insulin resistance if you are going down in the trough, like a lot of people will wake up at three or 4:00 AM and they don’t know why they’re waking up until they do CGM, and it turns out their glucose is down to 45.  So they’re not kicking in that glucose when they need to. And that’s often associated with a high carb diet, so you want to smooth that out. 

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Dr. Weitz:  I was just talking to a patient and he says, well, I keep seeing my primary doctor and I’m pre-diabetic. I’m almost at diabetic, but he’s waiting until I’m diabetic, before he treats me.

Dr. Bredesen: That’s such old fashioned, just outdated, antiquated thinking. Unfortunately,

Dr. Weitz: right? All these things happen. These chronic diseases gradually happen. We need to catch these early [00:29:00] and not wait until you have frank disease as early as possible.

Dr. Bredesen: That’s the trick. 

Dr. Weitz: And when it comes to cognitive function we’ve gotta catch this as early as possible.  And even before mild cognitive impairment, which as you’ve pointed out, is actually an advanced state.

Dr. Bredesen: Yeah, that’s a really good point. Telling someone they have mild cognitive impairment is a little bit like telling ’em they have mildly metastatic cancer. It’s a relatively late stage, so when you develop dementia with Alzheimer’s, you go through four stages.  You have a stage that is asymptomatic. And the good news is we can now pick this up with PTA two 17. Then you go through a stage where you have SCI, subjective cognitive impairment. By definition, that means you know, something’s not quite right, but you’re still able to test normally on cognitive testing.

If we could just get people in those two stages to come in. Then there would be very little dementia. You don’t have to get further. We, we have pretty much a hundred percent improvement in [00:30:00] SCI. In the MCI. As you mentioned in our trial, 84% of people got better, but you had to work much harder with MCI than you do with SCI to get things to turn around.

That’s the third of four stages. SCI lasts on average about 10 years. Then you go to MCI, which lasts a few years, but each year with MCI, you have a five to 10% chance of converting to the fourth and final stage, which is dementia. Now we’ve had some people who’ve just been hearing some where they were all way down to significant dementia, and they’ve been better.

They haven’t come all the way back to perfect. You know, they come back from dementia to MCI or they come back from MCI to SCI. So we wanna get people to come in earlier to get much more complete turnarounds. So yes, MCI is the third of four stages. What? By definition, what that means is now you’re not testing normally on cognitive testing.  Now the tests are showing some abnormalities. However, you’re still able [00:31:00] to do your activities of daily living. You’re still able to care for yourself. That’s all part of MCI.

Dr. Weitz: And you’re using this approach and other practitioners are including myself for other neurological diseases like Parkinson’s, other forms of dementia and I understand you’re also experimenting with patients with a LS.

Dr. Bredesen: So, yeah. So if you just can go back to what drives these diseases, it’s this mismatch. It’s, it’s not enough supply, too much demand. Now you have to adapt it for each disease. So in Parkinson’s, the common things are not so much about what you see in Alzheimer’s, it’s really more about exposure to organic solvents, trichloroethylene ethylene dron P-C-E-D-D-T.  Paraquat, all these sorts of things are associated more with Parkinson’s, and so we wanna focus on those but we still want to obviously improve [00:32:00] health with it. In fact, one of the best things for Parkinson’s patients happens to be exercise. I. Huge. We know that in Parkinson’s, the rate limiting step, the problem with the nervous system is at the level of the mitochondria and specifically mitochondrial complex one.  So that gi we, we then want, it gives us a lot of understanding of what we wanna do. We wanna support the mitochondria. To get these people to be better. Now for others. So we have some people with macular degeneration who are doing better as well. That’s a different adaptation. They have different things.

So each of these has its own signature because each one has its own achilles heel. These all come because of the way we evolved. We evolved to select for performance. Over durability. So you keep doing that. And of course, if you don’t select for performance, the creatures that did select for performance kill you and they survive.

So because of the way evolution wor that works, always selecting for [00:33:00] performance at the expense of durability, we have these remarkable neural networks. You know, you can store as much information in one human brain. As over 2000 home computers. Wow. It’s equal to some of the largest supercomputers and this tiny little, you know, tiny little 1400 gram, three pound thing in your brain.

It’s incredible. But in so doing, in selecting for these amazing neural networks, you’re giving up some durability. If you look at a LS, again, what you’ve selected for is this incredible power amplification. You go from a thought to the maximal use of your muscles like that, and the amplification is huge.

In fact, there’s more amplification going from one thought to maximal muscle use, which a human can do than there is from take going into your car and stomping on the accelerator and getting up to. 300 or 400 horsepower, you actually get more amplification. It’s [00:34:00] incredible. You look at Parkinson’s, incredible motor modulation.

Look at what Simone Biles can do that shows you what a human brain is capable of with fine tuning of the motor of the motor modulation. And then look at macular degeneration. Humans, their macula. With support, appropriate vascular oxygenation, support, and not too much inflammation, they can distinguish about 1 million color variations.  Wow. So all of these things are these amazingly finely tuned networks. They are, it is just like taking out your super tuned Ferrari on the road. You can get into problems. It’s not, it’s, you’re not gonna drive that Ferrari at super high speed for 500,000 miles. It’s just not gonna work that long.

Dr. Weitz: Yeah.

Dr. Bredesen: You were talking about

Dr. Weitz: a LS with the a LS boy. You see that neurological collapse, that muscle atrophy, it just kicks in so severe, so quickly. It’s, it’s a [00:35:00] horrific disease.

Dr. Bredesen:  And again, if everybody could have a way to check that before it ever happens, wouldn’t it be great? Right. To my knowledge, there is, that’s the one area where there’s not a great, very early test.  We’ve got good ones for Alzheimer’s, fairly good ones for Parkinson’s, very good ones for macular degeneration. We don’t have a great prediagnostic test for a LS yet. Right.

Dr. Weitz: Ha. Has, is anybody using your approach with ALS right now and getting some success?

Dr. Bredesen:  Not to my knowledge. Okay. And this is just the beginning as, and as you indicated, I mean, this is a tough one because it tends to be faster than Alzheimer’s.  Alzheimer’s people, you know, have years of decline. A LS if you at present at presentation, if you have any symptoms above the neck, the average time of survival is one and a half years. Wow. If you, if you don’t have anything above the neck. The average is three years. So it’s a tough one. And [00:36:00] the good news is we understand a little bit about the, the Achilles heel in that neural sub network, which is the power amplification one, and it does seem to be about glutamate uptake.  You’re using this. This cytotoxic neurotransmitter glutamate, which stimulates and it helps you to have this dramatic burst of muscular power, et cetera but also can damage neurons over time. And so if you don’t take that stuff up, once you liberate it into the synapse, if you don’t take it up quickly and inactivate it, then it can be damaging.  So anything that damages your ability to take this stuff up and inactivate it. We’ll increase your risk for a LS unfortunately, do we have some ways to take up glutamate and inactivate it? So normally the astrocytes do that. So the, you know, your glial cells around will do that. So if you’ve got a mutation in a you know, in, in one of these transporters, that’s a problem.

If you’ve [00:37:00] got oxidative damage to the transporters if you overstimulate, as you know, this nice work from, from a group that’s that is looked at L-B-M-A-A beyl, methyl amino l alanine. So BMAA is one which is produced by things like cyanobacteria. And that also can be a problem because it acts like the glutamate and so it can continue to stimulate.

So there’s some studies now that they’re doing Dr. Paul Paul Allen Cox in his group. And they’re looking at l serin as a way to interfere with this glutamate toxicity. And we’ll see they have not reported their results yet. Then we’ll see where it goes, but I’m hopeful that that will be helpful.

Dr. Weitz: Interesting. Let’s talk about your study that’s currently underway right now at six different centers and. What a challenge it must be to conduct a study. You with so many different variables. The the model of what is considered a [00:38:00] scientific study that’s valid is the drug trial where half the patients get the drug and the other half of the patients get the placebo and everybody’s getting the exact same treatment.  Whereas a precision medicine, a functional medicine approach requires individualized care.

Dr. Bredesen:  Absolutely. So, the idea here was instead of just ahead of time saying everyone’s get the exact same thing, or they’re gonna get a placebo, the idea is we’re gonna look to see what’s driving it in each person.  So each person’s gonna get a personalized precision medicine approach. Addresses their various things, and they’re different for each person. Some people will have sleep apnea, some won’t. Some will have HSV one, some won’t. Some will have P. Gingivalis, some won’t, and so on and on. So these are all gonna be addressed and we are just actually finishing in a couple of days.  We are finishing enrollment and so the, the trial will be over by the end of October. We should have results to report shortly after that. So far things look very good. We did a kind of halfway analysis, you know, where do things stand? Things look good. And we are seeing differences. So the, the control group in this case is getting standard of care.

They get the standard drug treatment. If they you know, if they are. If they have dementia and we’re looking at people who, who have both MCI and early dementia. Those, that’s the group very similar to what’s been used in the drug trials. So that’s the idea. And as you indicated in the past, people have said, well, you can’t do a multi-variable trial.  But the argument is, but this is a multi-variable disease, so you’ve gotta look at these different things. And I’m really. Honored to be working with such outstanding physicians with Dr. Anne Hathaway here in Marin and Dr. Kat Toups, Dr. Christine Burke, Dr. Nate Bergman, David Haas, and Dr. Craig Tio down in Southern Florida. So we’re really fortunate to have some outstanding [00:40:00] physicians doing this trial.

Dr. Weitz: Yeah, I think we need a different paradigm to understand the type of medicine that I know I’m practicing with functional medicine because the, the trial, the double plan, placebo control trial that’s used to test drugs, it’s just not appropriate for this type of medicine.

Dr. Bredesen: Yeah, this is a, you know, this is a network insufficiency, so you’ve gotta look at all the different players in making that network work.

Dr. Weitz: Are there any new peptides or any other things that you’re finding might help a little bit in moving the needle?

Dr. Bredesen: Mean, there are all sorts of things that are helpful that are interesting.  I, I would say. But the, the most important thing we’re finding that the people who don’t do well aren’t doing the basics. They aren’t just Right. Doing the, so you really have to optimize the basics. Right. And that’s seven things. You know, you talked about it. Diet, exercise, sleep, stress, brain training, so brain [00:41:00] stimulation and training, things like photobiomodulation, very helpful.  Detox and some targeted supplements. Those are the basics. And then beyond that, the specifics. Are there any infections that you have that you have to treat? And are there any toxins that you have to detox from? Those are the critical pieces to do this. Now there are some new things, the armamentarium.

Is growing rapidly. And when you mentioned Homo Taurine there’s something interesting called, called Pentasol that a number of number of people have used. And one of the things that does is also to prevent the oligomer of the abbe that looks quite promising. Oh, really interesting. Yeah, both Dr. Is, I’ve talked to him a number of times.

Exactly. Yeah. So, so that, and then as he would, as he would note when they were doing their trial, they noticed that people were actually doing better with their cognition. Oh. I think that’s a, that’s a promising avenue as well. Of course, there’s some stem cells. Adipose derived regenerative cells, a DRCs that have had some good results in people.

There are there’s [00:42:00] uly and a, there’s been a lot of push on uly and a, which is, gives supports. Mitochondria. Of course PQQ also increases mitochondrial number. So those things can both be helpful. And then there’s an interesting new group called mi with Tom Benson and his group. And they are looking at what, what is essentially mitochondrial transfusions, so isolating mitochondria that are healthy and then giving you these, in these little.  Encapsulated what they call millets. Basically little encapsulated way to deliver large numbers of healthy mitochondria because so many of these diseases, energetics plays a role. 

Dr. Weitz: And so really, so it’s mitochondrial transplants or something.

Dr. Bredesen: Essentially like a transfusion of healthy mitochondria.  Wow. Exactly. I think that’s, it’s promising. And again, I think if you look at one advance, that’s the most important of all. It is earlier detection. ’cause if what we’re seeing it every day. The people who come in early, it’s, we now can do this pretty much every time. It’s pretty easy to make people who are in really early stages do well and stay well.

We just published a paper, the first example in history of people who stayed improved and stayed better, sustained their improvement for over a decade. And that’s free available online so anybody could read it.

Dr. Weitz:   And what is that paper called and where is it published? 

Dr. Bredesen:  Yes. It is sustained improvement.  It’s published in a journal if you look at biomedicine, so just look up under my name and biomedicines, you’ll see it. It’s again, freely available online. Most of our papers are so that you can see these. [Sustained Cognitive Improvement in Alzheimer’s Disease Patients Following a Precision Medicine Protocol: Case Series] 

Dr. Weitz:  So that’s great.

Dr. Bredesen:  You know, we’re seeing this sort of thing, so again, get in early. You can, it’s so easy.  The later it later you can still get some improvement, but. It’s harder, you’ve got to do more. And it’s, and it’s not as likely for for improvement. So and I, and again, coming back to, to, you [00:44:00] mentioned neuro code earlier, this is a. Very important advance. I think it’s the most important test that’s come out in years and I’ve just had my own done a few weeks ago.  So what, what we’ve done is we’ve worked with neuro code because they have the most sensitive approach and it combines three blood tests. So simple. You don’t have to have a PET scan, you don’t have to have an MRI. Get this blood test. It’s called Brain scan. And you can go, you can literally get do get a get a brain scan.com and I had it drawn at my house.  You can have it drawn by mobile phlebotomy, or you can go into a draw station either way. 

Dr. Weitz: And it looks now getting it through neuro code or brain scan, is that different than just ordering these three tests through LabCorp or Quest?

Dr. Bredesen: Yes, it’s different because this group, neuro code, they are pioneered this.  LabCorp has kind of copied it, but theirs is not as sensitive. Oh. Specifically the neuro code uses what’s called single molecule [00:45:00] assay, Samoa, S-I-M-O-A. And they use a special machine called Alts Path and they, so they have the most sensitive look and they’re actually coming out with an even more sensitive one in the next few months.  So very excited about that. Really. What is, what is gonna be different about that one? I. You know, I don’t know yet. They’re, they’ve been reporting this to us, so, okay. I’m excited to see, but they’re actually upping the sensitivity. So again, this would go back, imagine, you know, 50 years ago people would tell you, oh, Ben, you got diabetes.

I’m so sorry. And already you got diabetes. You’re already damaging your eyes, you’re damaging your kidneys, you’re damaging your blood vessels. Now they can tell you, oh. You’ve got a high fasting insulin. You’ve, you’re, you’re headed for diabetes. You don’t ever have to get it because we can detect it early, pre-diabetes and literally pre, pre-diabetes.  That’s where we are now. With this test, we can detect pre-Alzheimer’s and pre pre-Alzheimer’s. And so it looks at  PTau 217. This is what happens is really fascinating with tau. So tau is a molecule that stabilizes your microtubules. So when you’re sending out these neurons to make connections. You’re stabilizing these with tau it.

So it is part of connection mode. When your body senses uhoh, things are bad. There’s an insult I’ve gotta pull back. Now it phosphorylates the tau. So you have an enzyme called GSK three beta. So this thing phosphorylates the tau, it changes the shape and the charge. Because of the phosphorylation, it pops off the micro tubule.

And now this becomes a PreOn that goes and looks to kill bacteria. So you kind of go double duty this thing one day is working to stabilize your connections and now it says, no, no, you’re needed for protection. It now changes shape and it now starts to kill bacteria. It’s kind of amazing. Wow, what a system.

It’s, it’s [00:47:00] like, you know, go back to the Minutemen from the Revolutionary War where they were farmers and all of a sudden the British are coming. They give ’em a musket and now they’re out there as soldiers. It’s the same sort of thing. This changes. And so Isn’t that interesting? You started your career studying prence.  Yeah, exactly. So these things are, they are, prions and prions are involved in all the major neurodegenerative diseases. Now we believe, we understand why these things are anti infectious agents. They’re good ways to get, they’re antimicrobial proteins, they’re protecting you. So, what happens is you can measure the PTau 217 in your blood.

Dr. Weitz: Then the second thing is called gf and, and what does the PTau 217 is? It. This tells you whether or not you have Alzheimer’s, right?

Dr. Bredesen:  It tell, so it tells you are you on the side of pulling back where the, where you’ve got a lot of phospho tau or are you on the side of connection where your phosphol will be low?  So you want your phospho tau in this neuro code assay, the brain scan to be  0.0 0.34 or less. And if it’s high and especially if it’s 0.63 or higher that’s associated with amyloid in your brain and with some cognitive changes in between there, you’ve got an area that is indeterminate, which is 0.34 to 0.47, and then you’ve got the 0.47 to 0.63, which is a little bit high.  Not yet associated with cognitive decline. So you want to pick it up there early. And I tell you, we’ve got some amazing stories just in the first couple of months of these things, we’ve had a number of people who were APOE 4:4, so they’re in the worst genetic group. They already had symptoms several years ago.  They went on the program, the protocol we developed, they got better. Now they check their phospho and it’s normal now. Wow. I would, I wish we had it, you know, several years ago when they started. It would’ve been so helpful, but it just wasn’t available then, right? To, to have it be normal when they’ve already [00:49:00] had symptoms is unheard of.

So it really shows we’re on the right track here and I’m very excited about that. Then I should mention the third test is NFL, Neurofilament Light, and that gives you complimentary information. It says, are my neurons being damaged? And that can be from that can be from a car wreck, that can be from too much play in football and get hit in the head punching.  It could be from a vascular disease, Alzheimer’s, frontotemporal dementia. But for example, I’ll see people, so we have a report that we write up for each person. If you have high phosphol, but low NFL and low GFAP, the GFAP tells you about inflammation. You don’t have very active Alzheimer’s, but we’ll see ’em sometimes where we’ll not only have the high phosphol, but we’ll have high GFAP.  And high NFL, and that tells you this is active, very active, ongoing, and you really better jump in there and do everything possible. Then the good news, we can follow these as they come [00:50:00] back to normal, as people do the right thing. So this is gonna change I. And allows so many people to avoid Alzheimer related dementia because you can look at this early and prevent the continuation, prevent the progression.

Dr. Weitz: And GFAP is glial fibrillary. Acidic protein. Acidic protein, right?

Dr. Bredesen:  So GFAP, that is actually an intermediate filament protein. So what happens is. Your astrocytes are sitting there and they’re in a quiescent state. When you need help, when you’ve got an inflammation, when your neurons are damaged, they’re basically caretakers for the neurons.  You turn them on, you say, you know, the alarm goes off. Hey, we need you guys. They boom, they jump into action and they swell. They get bigger and they, you, they make more of this GFAP. As they’re getting to be larger and jumping into action. So that’s what you’re measuring in the blood. You’re measuring that GFAP.  Some of it will get into the blood and you can see it go up as [00:51:00] you have inflammatory things going on in your brain. Wow.

Dr. Weitz: Let’s see. Can other diseases degenerative diseases of other kinds related to kidneys or cardiovascular make these markers change, or these are purely related to neuroinflammation?

Dr. Bredesen: So the phospho Tau is specific for Alzheimer related processes. By the way. It is also teaching us something about what’s giving you more risk. One of the things that we’ll bump it up a little and tell you yeah, this is pushing you toward Alzheimer’s is COVID-19. So just having that inflammation from the Covid, we will bump it up a little bit.  Then the second thing is the GFAP is, so the PTO is specific. The, the GFAP is non-specific for inflammation, so anything that’s causing the inflammation and attempted repair bumps up that GFAP. And then the NFL is specific for neuronal damage, but not [00:52:00] just Alzheimer’s. So you’ll see it with Alzheimer’s.

Sometimes you’ll see it with frontotemporal dementia. So one of the classics is if someone comes in and they’re having problems with cognition. If their PTO is completely normal, but their NFL is high, you’ve gotta be suspicious of frontotemporal dementia. Another way to go. You also could be suspicious of Lewy body disease.  They are non Alzheimer conditions. And so it’s really helpful now to say, aha, this person, you need to focus on this, this person, you need to focus on that. So again, there’s so much that can be done. The armamentarium in these diseases is just expanding rapidly. I. Nobody should be getting Alzheimer’s anymore.  This, this is be rapidly becoming an optional condition. If everybody would just get checked and we recom recommend, just check your brain scan, check your, your, those, the neuro code numbers. These, this so-called brain scan when you turn 35 and then just every five years, [00:53:00] 40, 45 when you hit 60. Do it every two years.  That makes it easy. You don’t have to do it very often, but just like everyone should know their blood pressure, everyone should know their lipid status. Everybody should also know their PTA status because it is such an important determinant and will allow you to prevent problems in the future. I. That’s great.

Dr. Weitz: So where should listeners patients practitioners go to find out more about your programs that you offer?

Dr. Bredesen: Yeah, so the easiest thing to do, and I think the best is just do I. Go look at, so-called my CQ test. So CQ is your cognitive quotient. So if you just go to my CQ test that’s free. It’ll, it is a free way to look at where, what is your cognitive status.  And then we recommend again that everybody. Get the brain scan so that they can make sure not to have problems. And you can do that at Get a Brains scan at.com. You can follow what we’re doing on Facebook, [00:54:00] Dr. Dale Bredesen. You can follow it on X, you can follow it on Instagram. We just started recently.  You can also follow it on Blue Sky. So, any of those things all, and as you mentioned earlier several books out have a new one coming out March 25th which is called The Ageless Brain. And the whole idea of that was, we’ve talked a lot about what to do about Alzheimer’s. What about for all of us?  How do we get to make sure the whole goal of this is. Protection and performance. We wanna make it so that everybody’s brain span is as long as their lifespan. The big problem, of course, is people who live to 85 and they, their brain only only is working well until 65. That’s 20 I. Tough years. Yeah. When I talk to like the YPO group, I always say, you know, all these anti-aging guys, and I’m like, how many people wanna live to 140?  Everybody goes like, okay. And they say, and spend half of that time in a nursing home with dementia. Like, whoa. So, you know, we want to avoid that. We want to make sure that our brains function for as [00:55:00] long as our lifespan is, get that brain set up and that’s what the Ageless Brain is all about. So I have a couple examples I give of people.  Catching early in one case, catching Parkinson’s early in one case catching Alzheimer’s early. Neither one has any long-term problems. They do very well because looking at it early and doing the right thing makes all the difference.

Dr. Weitz:  That’s great. Thank you so much Dr. Bredesen, Great to talk to you. 

Dr. Bredesen:  Always. Thank you so much for the discussion and look forward to continued discussions in the future. This is an exciting time, you know? Oh, yes. It’s very exciting. All my career. Yeah, we had nothing, nothing. When I was training as a neurologist, we had nothing to offer people, and so just to be able to see people getting better, it just makes my day. 

Dr. Weitz: That’s great.

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star readings and review. As you may know, I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and want to promote longevity, please call my Santa Monica Weitz Sports chiropractic and nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.