Greetings from Los Angeles

[thoughtparticle]

Hi all,

I was very happy to learn of this site recently by way of Dale Bredesen’s book, and wanted to introduce myself and sketch out some of my own situation and experiences.

I’m a 64-year-old male with a father who passed away from Alzheimer’s at age 80 in 2005. My mother died a few years later with issues including non-Alzheimer’s dementia, which I gather was linked to circulatory issues that I didn’t inherit. Last winter my sister and I both had 23&Me DNA tests done, and were both told we had “slightly elevated” chance of Alzheimer’s. More recently I learned of Promethease, and uploaded my data to their site. There I learned I have an APOE4 gene from one parent, but not both, which I gather makes me APOE 3/4.

On the plus side, I began making health changes some years back. For more than 20 years I’ve avoided eating mammal meat, and saturated fat in general, concentrating on plants, fish and chicken. I’ve been fairly good at exercise -- usually walking more than the often-quoted 10,000 steps a day, high-intensity cardio and strength training three days a week, and a yoga weekly class plus daily asanas. High-intensity cardio in particular is the single item I’ve found to be most brain-sharpening (in my case this is sessions on an elliptical machine with intervals going up to 80% of my maximum heart rate). I also started taking curcumin and omega-3 oil daily some years back. My BMI is right around 22. I’ve been meditating daily for the past two years.

As far as cognitive issues go, I think I’m doing pretty well. I don’t have difficulty remembering names or more elaborate vocabulary, etc. The main thing I experience is an occasional “Now what did I come into this room to do, again?” moment. Generally I find this happens when I’m distracted, mentally wandering off, etc, so bringing back focus to the here-and-now helps. Of somewhat more concern, I’ve found that my balance in the past year or so has been worsening, and I’ve had three falls in which I haven’t yet broken anything but have scraped up shins pretty badly. Here again this seems to happen when I’m rushing, and not paying close attention to where I’m going.

Regarding other health issues, like other males in my family I drank quite heavily for some years as a young adult, but stopped completely 30 years ago. (Surely there is a gene or combination of genes involved in this.) As a result I have a middling amount of fibrous tissue in my liver which is loosely called fatty liver in my case. Because of this I always evaluate supplements carefully, as some can affect me more than they do people with normal livers. For example, Bredesen offers the frequent suggestion to take cinnamon for blood sugar control, but when I tried this a couple of years ago I had awful pain in my flank for a couple of days. This evidently was due to the significant amount of courmarin in the Saigon variety of cinnamon that I took.

While having my liver looked into, I also learned that I have a hiatal hernia (wonky valve between the stomach and esophagus), which encourages acid reflux. This is a shame, because I really get a big benefit from caffeine – but it definitely worsens reflux. My gastro doctor had me on proton pump inhibitors for a time, but more recently suggested Famotidine. I haven’t yet figured out how to balance Bredesen’s recommendation to get off acid reflux medications with my situation.

A couple of years ago, I found my hemoglobin A1c had drifted up to 5.7%, putting me on the edge between what are normally considered normal and prediabetic ranges. I’d thought my diet was pretty good, but obviously I was getting more high-glycemic carbs than I realized. I bought a cheap glucometer and started testing blood sugar before and after meals as well as first thing in the morning and late at night. This gave me a good sense of what really moved my blood sugar. Since then I’ve been on what I’d call a low-carb but not strictly keto diet. My A1c has gone down only modestly, but my triglycerides have plummeted (great!) and my HDL (which had been low) is up moderately. I’d like to move more toward a keto diet, but want to find a way to do this while still avoiding saturated fats, which seem to be the dietary mainstay for a lot of diabetics I know who do keto.

Finally, I have weak tooth enamel, which has prompted my dentist to recommend using fluoride gel in tooth trays as often as weekly. I don’t know if it’s psychosomatic or real, but I keep getting what feels like soreness near my liver after these treatments, even when I’m fastidiously careful not to swallow. Bredesen in his book doesn’t appear to flag fluoride as a problem per se, though he mentions it as something one patient avoids, and I see it spoken of negatively by various users on this site. So I need to find a way to preserve my teeth without fluoride, given my tendency to mild reflux.

So – apologies if I’ve rambled on a bit. Looking forward to getting to know others here and learning as much as possible.

[dcox]

Hi all,

I was very happy to learn of this site recently by way of Dale Bredesen’s book, and wanted to introduce myself and sketch out some of my own situation and experiences.

I’m a 64-year-old male with a father who passed away from Alzheimer’s at age 80 in 2005. My mother died a few years later with issues including non-Alzheimer’s dementia, which I gather was linked to circulatory issues that I didn’t inherit. Last winter my sister and I both had 23&Me DNA tests done, and were both told we had “slightly elevated” chance of Alzheimer’s. More recently I learned of Promethease, and uploaded my data to their site. There I learned I have an APOE4 gene from one parent, but not both, which I gather makes me APOE 3/4...
...So – apologies if I’ve rambled on a bit. Looking forward to getting to know others here and learning as much as possible.

Welcome thoughtparticle!
Wow, it sounds like you have been doing your homework and have taken many steps to prevent AD for yourself! The steps you have already taken have more than likely filled many of the "36 holes" that Dr. Bredesen speaks about. I like how you have been able to identify that when you are distracted or not fully focused is when you have experienced some of the moments that are concerning you. We live in a fast paced and all too often distracting world, and being mindful of times when we are in these moments goes a long way in helping our minds stay "on track" and strong.

Dr. Bredesen's ketoflex diet does not put the emphasis on large amounts of sat fats, as most strict keto diets do. He does use them to help increase/restore insulin sensitivity in the beginning then trades in the MCT oil for cold-pressed poly- and mono- unsaturated oils and fatty acids (olive oil, nuts, avocados...) as insulin sesitivity normalizes. You might also want to check out Dr. Gundry's protocol, which is followed by many on this site.

As it sounds like you have a pretty good handle on your diet, have you tried intermittent fasting? This is a big piece of the keto eating style and Dr. Bredesen's ketoflex plan. It involves shortening your "eating window" by fasting at least 12 hours, and up to 16hrs for E4 carriers, from the end of dinner to breakfast, and also fasting at least 3 hrs before going to bed, this fasting method is explained more here and here, this last link points to places in the Primer (link below) where fasting is discussed. Many on this site practice periods of longer fasts also. I practice intermittent fasting and have found it to be a powerful tool in my own life.

Here is a thread that might help you with alternatives to your fluoride treatments to improve your tooth enamel. One post up from where this link takes you circular talks about green tea and the rest of the posts on this page and beyond may give you some ideas to try.

We are all happy that you found this amazing community, here at ApoE4.info you are surrounded by like-minded, caring and courageous people who are determined to reverse, prevent and stop dementia, AD and cognitive decline in its tracks! As you will also find there is a huge amount of information in these amazing pages. Here are a few highly recommended pages that will give you great places to start taking a deeper dive into the site: the Wiki Page, where you will find some more in depth topics; "How-To" get the most out of the APoE4.info website page, is very easy to use and will allow you to spend your time on the site more efficiently. I also highly recommend the Primer it's a great place to start and to learn more about AD, it was written by Stavia, one of our most active members who is also a doctor, and is E4/E4 herself.

We are a great community full of energetic, encouraging, and extremely hopeful people who help each other navigate their paths through Alzheimer's, dementia and cognitive decline in general. You will find people from all walks of life here sharing their stories, what works for them and what doesn't. It's a great place to find new perspectives and reinforce the ones you may already have. We look forward to hearing more about you and your journey as you discover, learn and share with us.

Find your joy and hope in each new day and each new discovery along your path,
Deb

[SusanJ]

I haven’t yet figured out how to balance Bredesen’s recommendation to get off acid reflux medications with my situation.

Try looking at Norm Robillard's work for ideas. I used his book on IBS to get me to a point where I could understand why I didn't fit into the usual camps ("avoid these foods", "no avoid those", "use ferments", "eat resistant starch"), by looking at the fermentable potential of foods, instead of glycemic index. Tremendous help in getting my GI track to heal enough to take the next steps, like tolerating probiotics and ferments better. Yep, it was a shock to see that eating some things like jasmine rice and white potatoes could be healing (and I still eat both occasionally).

Here's his take on GERD. https://digestivehealthinstitute.org/20 ... flux-gerd/

Don't give up on healing your gut. For me, I'm pretty sure that healing my GI through diet and supplements targeted to my symptoms and not necessarily prevailing opinions (for instance using ox bile and phosphatidylcholine - both ideas from the book Dirty Genes) has brought my A1c from 5.7 to 5.2, and my current diet is not exactly very low carb.

[Plumster]

for instance using ox bile

Susan, I've been reading about ox bile and considering using it, but I am unclear about it's function. Does ox bile ease symptoms in the same way that digestive enzymes do or does it actually treat a bile/gut issue?

Thanks for your thoughts!

[seaweed]

I haven’t yet figured out how to balance Bredesen’s recommendation to get off acid reflux medications with my situation.

I found that all of my acid reflux issues went away once I cut out gluten/grains and stopped eating by 3 or 4pm. I know most doctors treating acid reflux say to stop eating about 3 hours before you go to bed, but that was nowhere near enough distance for me.

I'm an ApoE 4/4 so I try to fast for at least 16 hours a day, making my eating window 7am - 3pm.

[mike]

I had a stroke a few years back that effected my balance. I started seeing a physical therapist to work on it. It is the single best thing I've done to get back into shape. My core was weak, adding to my balance problems. We have been working on building my core and increasing my agility in addition to working on balance issues.

[SusanJ]

Does ox bile ease symptoms in the same way that digestive enzymes do or does it actually treat a bile/gut issue?

It's typically used to boost bile levels like enzymes, that can decrease for a myriad of reasons, but usually for those who have had their gall bladder removed.

But that boost, not only helps with digestion, but also helps eliminates bad gut bugs in the small intestine. (This insight came from the Dirty Genes book.)

I personally have PEMT variants, the enzyme that converts choline to phosphatidylcholine (PC), which helps insure your bile flows (among other things like sparing methyl groups). I also had gut problems, so I used ox bile for a couple months while trying to eliminate bad gut bugs (along with a set of other supplements). Because I added PC in my stack, and eventually felt my gut was functioning better, I quit taking ox bile after a few weeks. I think it's useful in gut healing, but it probably needs to be used just for a short time as a support, because of potential side effects (unless of course you're working with a doctor).

[Plumster]

Oh, interesting. Thanks for the info, Susan!

[thoughtparticle]

As it sounds like you have a pretty good handle on your diet, have you tried intermittent fasting? This is a big piece of the keto eating style and Dr. Bredesen's ketoflex plan. It involves shortening your "eating window" by fasting at least 12 hours, and up to 16hrs for E4 carriers, from the end of dinner to breakfast, and also fasting at least 3 hrs before going to bed, this fasting method is explained more here and here, this last link points to places in the Primer (link below) where fasting is discussed. Many on this site practice periods of longer fasts also. I practice intermittent fasting and have found it to be a powerful tool in my own life.

Thanks for the welcome and the suggestions. Yes, I currently fast for 12 hours (roughly 7 pm to 7 am) daily. Besides the fasting in and of itself, I find that stopping eating several hours before going to bed is helpful. But as noted I'm really on a low-carb rather than keto diet at this point. I'll go through Dr. Bredesen's plan to get a sense of what might be next steps for me.

Here is a thread that might help you with alternatives to your fluoride treatments to improve your tooth enamel. One post up from where this link takes you circular talks about green tea and the rest of the posts on this page and beyond may give you some ideas to try.

Thanks for the link. There are interesting ideas in that thread. For some years I've used a Waterpik irrigator (along with flossing and brushing), and this seems to have pretty much completely solved plaque and dental bacteria for me. My issue is more that I seem to have an acidic mouth, possibly due to ongoing mild reflux, which weakens the enamel. This has been going on a long time, and about 25 years ago around the time I hit 40 my teeth were worn to the point where I needed to have all of my teeth crowned. The crowns have been holding up nicely, but I guess my dentist is concerned about the state of the teeth bases that remain underneath the crowns. A couple of months ago I asked him if gargling several times a day with something alkaline like baking soda would help, but he seemed to be pretty fixated on wanting me to do fluoride gel applications with a tray.

Based on the thread you linked to, I ordered some Uncle Harry's toothpaste. Gargling with green tea also seems interesting -- will have to give that a try. I'll also have to go through that entire thread in greater detail -- thanks again for passing along the link.

[thoughtparticle]

Try looking at Norm Robillard's work for ideas. I used his book on IBS to get me to a point where I could understand why I didn't fit into the usual camps ("avoid these foods", "no avoid those", "use ferments", "eat resistant starch"), by looking at the fermentable potential of foods, instead of glycemic index. Tremendous help in getting my GI track to heal enough to take the next steps, like tolerating probiotics and ferments better. Yep, it was a shock to see that eating some things like jasmine rice and white potatoes could be healing (and I still eat both occasionally).

Here's his take on GERD. https://digestivehealthinstitute.org/20 ... flux-gerd/

Don't give up on healing your gut. For me, I'm pretty sure that healing my GI through diet and supplements targeted to my symptoms and not necessarily prevailing opinions (for instance using ox bile and phosphatidylcholine - both ideas from the book Dirty Genes) has brought my A1c from 5.7 to 5.2, and my current diet is not exactly very low carb.

Hi Susan, thanks for the comments and the link to Robillard's site. Interesting ideas, and different from how I've thought about my situation. My reflux is actually mild to what I'd think of as the low end of moderate -- mostly it manifests as a sour taste in my throat, and a soreness right under my sternum area -- but not the full-on heartburn that I hear others describe. My GI tract strikes me as being in pretty good shape -- no issues like IBS etc. I've been taking probiotics for a few years now, changing them around periodically (this was suggested to me by a dietitian at my HMO, which for the most part is a medically conservative organization. When I was pressing her about low-carb or keto diets for my borderline prediabetes, the dietitian seemingly reluctantly said it might be ok, but she saw the best results in people who (a) ate plant-based diets, and (b) got diversity in their GI tract bacteria through probiotics).

So I've mostly focused on the fact that I have a hiatal hernia. The reflux very clearly to me is precipitated by caffeine, which evidently has the effect of loosening the hiatal valve. If I have a cup of coffee, I definitely feel the difference in the symptoms mentioned above. I've gone through periods staying off caffeine entirely, and the reflux is negligible or absent -- but I'm mentally not anywhere near as together. Most days I try to strike a balance with modest amounts of green tea.

I'll take a closer look at Robillard's writings and see if there are ideas I can try, given that I'm already on a low-carb diet. I'm seeing the hiatal hernia as the biggest smoking gun, but increased pressure due to a gut issue might be a possibility. Beyond that, finding replacements for caffeine to boost mental clarity is something else I look at on a regular basis. In the past I've tried various things like ginkgo. The one thing that seems to help currently (though not to the degree that caffeine does) is sublingual B12. I have to keep my doses pretty low, though, as higher doses seem to cause flank soreness (liver?).