COVID fog/BPH/Drug alternatives?

[Howard]

I am new to the forum and was recently tested and am APOE4/4. Not the best news to receive. My father and grandmother both had Alzheimer's. I have had Covid fog since April which is what led me to get tested as I feared it was Alzheimer's. I saw a functional medicine doctor and started on the new low carb diet, but in a couple weeks had constipation issues followed by Acute Urinary Retention due to BPH (enlarged prostate). I was put on a catheter and prescribed Tamsulosin (Flomax), Finasteride, and Cialis. After doing some research I see that cognitive impairment/dementia can be a side effect of the drugs I was prescribed which is not a risk I want to take. For now I must stay on them in order to get off the catheter, but don't want to do this long term. Does anyone have a similar experience and can share alternative treatments that have helped? I think alternative meds would be Saw Palmetto and Beta-Sitosterol. Are Saw Palmetto and Beta-Sitosterol effective, and are they safe, or do they have similar side effects? A last resort is surgery. I am concerned about the possible effect of anesthesia on my brain. This has been pretty stressful and I could use some help making the best decisions to treat this condition. Thank you for any advice you can share!

[NF52]

I am new to the forum and was recently tested and am APOE4/4. Not the best news to receive. My father and grandmother both had Alzheimer's. I have had Covid fog since April which is what led me to get tested as I feared it was Alzheimer's. I saw a functional medicine doctor and started on the new low carb diet, but in a couple weeks had constipation issues followed by Acute Urinary Retention due to BPH (enlarged prostate). I was put on a catheter and prescribed Tamsulosin (Flomax), Finasteride, and Cialis. After doing some research I see that cognitive impairment/dementia can be a side effect of the drugs I was prescribed which is not a risk I want to take. For now I must stay on them in order to get off the catheter, but don't want to do this long term. Does anyone have a similar experience and can share alternative treatments that have helped? I think alternative meds would be Saw Palmetto and Beta-Sitosterol. Are Saw Palmetto and Beta-Sitosterol effective, and are they safe, or do they have similar side effects? A last resort is surgery. I am concerned about the possible effect of anesthesia on my brain. This has been pretty stressful and I could use some help making the best decisions to treat this condition. Thank you for any advice you can share!

Welcome Howard, from another ApoE 4/4 ! You are so right that it's "not the best news"--but after some time to learn more and put our own health in perspective against those of our family that had very different environments and much less awareness of prevention, it doesn't look like the worst news either. At 69, I'm 7 years out from the news--and feeling more confident as I realize that my choices do make a difference for my future.

As for the BPH, my deep sympathy. I have a family member who experienced that and know of others, and there's probably not many issues more painful than Acute Urinary Retention. My guess is that your poor urinary tract is having fun stuff like bladder spasms and urgency and the catheter is giving everything a chance to calm down and heal. I wonder if your urologist has talked about a TURP (trans-urethral resection of the prostate)? While definitely "surgery", it can be done with a laser and take less than an hour, with little likelihood of cognitive effects since the anesthesia is "lighter", I believe. The goal of a TURP is to reduce the prostate's volume by enough to end the BPH and its symptoms. It's not the same as a prostatectomy, which is sometimes used as treatment for prostate cancer, and as a result spares all the nerves that you want to still work for all the right reasons!

My advice, based on experience, would be to talk with your urologist about options, and consider getting a second opinion. Not every urologist is trained on every procedure and you want someone who is open to answering your questions and explaining all the risks and benefits of each option. They might recommend a cystoscopy (scope of the urinary tract to the bladder) to be sure there are no additional factors besides the BPH that are causing your retention if that wasn't done. If for any reason you are looking at needing a catheter long term, you should know that a suprapubic catheter is an option, bypassing the ureter and connecting directly to your bladder through a small incision in the abdomen. It is less painful for long-term catheterization and allows for any systemic inflammation to calm down.

I don't know of any additional risks for you as an ApoE 4/4 to be on those drugs for the time needed to get better. My family member was on them for months, and had no cognitive issues. I imagine your pain and worry about COVID fog are to blame for not feeling like your brain is 100%.

It can be hard to see a future pain-free when things are bleak--but it is possible and I hope right around the corner for you. And in the meantime, the Meditteranean diet, with lots of healthy vegetables and fiber, also shows great research support for brain health and may be kinder to your GI system.

Hope this helps. Howard.

[nerdymel23]

I am new to the forum and was recently tested and am APOE4/4. Not the best news to receive. My father and grandmother both had Alzheimer's. I have had Covid fog since April which is what led me to get tested as I feared it was Alzheimer's. I saw a functional medicine doctor and started on the new low carb diet, but in a couple weeks had constipation issues followed by Acute Urinary Retention due to BPH (enlarged prostate). I was put on a catheter and prescribed Tamsulosin (Flomax), Finasteride, and Cialis. After doing some research I see that cognitive impairment/dementia can be a side effect of the drugs I was prescribed which is not a risk I want to take. For now I must stay on them in order to get off the catheter, but don't want to do this long term. Does anyone have a similar experience and can share alternative treatments that have helped? I think alternative meds would be Saw Palmetto and Beta-Sitosterol. Are Saw Palmetto and Beta-Sitosterol effective, and are they safe, or do they have similar side effects? A last resort is surgery. I am concerned about the possible effect of anesthesia on my brain. This has been pretty stressful and I could use some help making the best decisions to treat this condition. Thank you for any advice you can share!

Hi Howard,

I know all of this information coming in can be stressful, but you have found a thoughtful and caring community with us here. I hope you can be inspired by the stories that other members share. It empowers us to know that genetics are not our destiny. My heart goes out to you having to watch family members with Alzheimer's.

I'm glad to see other members chime in about BPH. My father didn't respond well to the medications so he opted for surgery. I was trying to dive into alternative care like Saw Palmetto or ways to break down hormones, but he wasn't interested so I didn't end up with research that I retained.

We're learning so much about brain repair these days. It's exciting to learn more about neuroplasticity. The brain health tools you are researching by joining the forum will help with the COVID fog. I understand it can feel like an irritating waiting process. Some medications can contribute to brain fog as well. One step at a time like you mentioned.

Did the doctor slowly walk you through a low carb diet? Dietary changes like that can contribute to gut changes and it's also really important to keep hydrated. In our comprehensive Wiki you'll find more information about various diets and protocols.

As a new member you may find our Primer an ideal starting place for your journey. It's authored by a member physician who carries two copies of the APOE-ε4 allele. The primer thread offers accessible science background and prioritized, sensible preventative measures. And for tips and tricks to get the most out of our discussion forums, visit our Handy Forum Guide.

I look forwarding to chatting with you more around the forum!

- Melissa

[Howard]

Thank you both for the encouragement. I will check into the TURP alternative. If I only need the drugs for a few months that wouldn't concern me as much as being on them for many years. I was hoping someone on here might have some experience with the Saw Palmetto/Beta-Sitosterol alternative. Thank you for the suggestion about the Mediterranean diet. Is that what you follow? My functional medicine doctor recommended the ReNew diet (which eliminated all dairy/sugar/grains etc.) but didn't walk me through the diet in detail, or warn me about possible gut issues (she recommended finding a nutritionist, but was aware that they may not be able to help me with this kind of diet). I will check out the Wiki for more diet information. I'm concerned that I might be losing weight too quickly or am losing muscle. I'm not really sure how many calories I should be getting, or if I'm getting enough protein. I have had a greatly decreased appetite, but before the diet I snacked a lot, and ate more sugar--sweets and bread, so that's not necessarily a bad thing. I was overweight and started losing when I had COVID, and after COVID I started the low carb diet and continued to lose. As far as hydration, I thought I was hydrating well but maybe I wasn't. I also exercise a lot, (rowing machine and treadmill, some weights), and usually in the evening. Because of the BPH I don't like to drink water in the late evening. Sleep has been difficult for quite a few years because I have constant ringing in the ears (from prior ear damage), as well as a need to urinate frequently at night (BPH related). If I could solve the BPH problem it would help my sleep. I tried to ask my functional medicine doctor about alternatives to the drugs but that may not be her area of expertise. She wanted to focus on the constipation issue, which will hopefully help prevent future AUR. Melissa, how did your father do after the surgery? Which surgery did he have? Right now I can't exercise, which is not helping the stress. And the stress is affecting my sleep. I feel like I'm falling apart at the age of 62. But I appreciate the encouragement and your suggestions.

[Julie G]

I am new to the forum and was recently tested and am APOE4/4. Not the best news to receive. My father and grandmother both had Alzheimer's. I have had Covid fog since April which is what led me to get tested as I feared it was Alzheimer's. I saw a functional medicine doctor and started on the new low carb diet, but in a couple weeks had constipation issues followed by Acute Urinary Retention due to BPH (enlarged prostate). I was put on a catheter and prescribed Tamsulosin (Flomax), Finasteride, and Cialis. After doing some research I see that cognitive impairment/dementia can be a side effect of the drugs I was prescribed which is not a risk I want to take. For now I must stay on them in order to get off the catheter, but don't want to do this long term. Does anyone have a similar experience and can share alternative treatments that have helped? I think alternative meds would be Saw Palmetto and Beta-Sitosterol. Are Saw Palmetto and Beta-Sitosterol effective, and are they safe, or do they have similar side effects? A last resort is surgery. I am concerned about the possible effect of anesthesia on my brain. This has been pretty stressful and I could use some help making the best decisions to treat this condition. Thank you for any advice you can share!

So sorry for all you're going through. Among your meds, the risky players seems to be Tamsulosin (Flomax) and Finasteride although I understand that they're absolutely necessary at the moment. Saw palmetto doesn't shrink the overall size of the prostate, but it seems to shrink the inner lining that puts pressure on the tubes that carry urine. Beta-sisterol, a plant sterol supplement, is not recommended for our population as we tend to hyperabsorb plant sterols leading to elevated ApoB. Dr. Thomas Dayspring (well known lipidologist) has warned against using them for E4s.

My guess is that diet and lifestyle factors are likely to provide significant benefit. A recent study in China looked at the effects of diet on BPH symptoms. Researchers found that men with diets high in fruits and vegetables — especially leafy, dark vegetables and tomatoes — had less BPH, less symptoms of BPH, and were less likely to have worsening of their BPH. Researchers believe it’s not just one nutrient, but rather the combinations found in a healthful diet and lifestyle, that are beneficial.

Are you familiar with Dr. Bredesen's work? He's found that many folks with COVID brain fog are finding help using his protocol, outlined in "The End of Alzheimer's Program." If you are struggling with diet, please consider adopting his KetoFLEX 12/3 Diet outlined in detail in the book and very consistent with the diet recommended by your provider and the dietary pattern in the study above. This approach also treats insulin resistance which can contribute to enlarged prostate. Best of luck, my friend. Please keep us posted on your progress.

[Tincup]

IBPH/Drug alternatives?

Dr. Gundry interviewed an ND on the topic recently. There is a transcript in the link and the guy has a book on the topic. One thing I recall from the interview is higher insulin can cause the prostate to enlarge.

[nerdymel23]

Melissa, how did your father do after the surgery? Which surgery did he have? Right now I can't exercise, which is not helping the stress. And the stress is affecting my sleep. I feel like I'm falling apart at the age of 62. But I appreciate the encouragement and your suggestions.

Great to see the replies! Lots of great information!

I always like to track any dietary changes. That may be helpful. There are various apps for tracking nutrients like cronometer that helps break down the proteins, fats, and carbs, or just pen and paper can work as well.

I'd also break down your top concerns for your functional medicine doctor so they stay on track with your needs and priorities.

My father had the TURP surgery and was doing pretty well with that. Let us know if you need additional assistance navigating the information through the forum, and we'll be happy to help!

[nerdymel23]

Are you familiar with Dr. Bredesen's work? He's found that many folks with COVID brain fog are finding help using his protocol, outlined in "The End of Alzheimer's Program." If you are struggling with diet, please consider adopting his KetoFLEX 12/3 Diet outlined in detail in the book and very consistent with the diet recommended by your provider and the dietary pattern in the study above. This approach also treats insulin resistance which can contribute to enlarged prostate. Best of luck, my friend. Please keep us posted on your progress.

Julie, I shared some information about the Bredesen Protocol with the Long COVID Alliance the other day. Patients seem to be spinning their wheels at the centers.