Low insulin pathway to dementia?

[MarcR]

Dale Bredesen's Type 3 Alzheimer's classification?

When I ask him about factors mentioned by Bredesen in Type 3 diabetes

Joe, I want to be sure that I communicated this point about Type 3 Alzheimer's effectively. Bredesen's schema includes four types of Alzheimer's:

• Type 1: Inflammatory. Chronic inflammation, often abetted by an overactive immune system, damages brain tissue faster than the body can repair it.
• Type 2: Atrophic. Insufficient thyroid, adrenal, and/or sex hormones, coupled with insulin resistance or insufficient insulin, impair brain tissue repair and renewal processes.
• Type 1.5: Glycotoxic. A combination of types 1 and 2 accelerate damage and decelerate repair simultaneously.
• Type 3: Toxic. Damage caused by exposure to mold, heavy metals, and/or toxic chemicals overwhelms repair processes.

In contrast, type 3 diabetes is a term used by others (not Bredesen) to suggest that the cellular dysfunction of type 2 diabetes may present independently behind the blood-brain barrier. It's more of a metaphor than a mainstream diagnosis. The idea overlaps most with Bredesen's definition of Type 2 Alzheimer's, but it lacks the detail of Bredesen's rubric.

That said, your mild PCA may well signify that what's happening to you is none of the above.

[joesmith]

Thanks Marc - sorry mine was a typo. I'm grateful for your clarification and original astute suggestion - when I first read it, I too thought Bredesen Type 3 Alzheimer's was the most plausible classification for my case , esp. since I'm Apoe4 negative, relatively young (48) and probably have been exposed to lots of toxins. Chemicals and metals have come back negative though (mycotoxin test on my desk) though, doc makes point that atrophy should be global (IIRC Bredesen says something similar in relation to Type 3 Alz). Still...

Once more Marc, I'm very grateful for your comments and thoughts.

Very best to you!

[Tincup]

Chemicals and metals have come back negative though (mycotoxin test on my desk) though, doc makes point that atrophy should be global (IIRC Bredesen says something similar in relation to Type 3 Alz). Still...

Couple of detox thoughts. Do you have access to a sauna?

I'm part of a FB group where a bunch of people take high dose melatonin - not for sleep but for other benefits. I take >300 mg/day. If
you want more info, let me know - detail post. Here is a paper on the topic The protective effects of melatonin on organisms against the environmental pollutants of heavy metal and non-metal toxins

[joesmith]

Thanks always Tincup for your kind suggestions

I do have access to a sauna (and, getting the austere-regimen-bit between my teeth, have started to almost like ice baths after), and I live and exercise outside in the tropics. It's all about sweat round here. (I wonder in this connection whether parasites local to the tropics (south east asia in my case) might be under-recognised causes of dementia)

I also take melatonin, though low doses. I had a look at the FB page and forum, thanks for the links. Sorry I must have missed this there, but doesn't taking such large doses make you very tired?

[Tincup]

I also take melatonin, though low doses. I had a look at the FB page and forum, thanks for the links. Sorry I must have missed this there, but doesn't taking such large doses make you very tired?

Interestingly, no. Also, sleep has been an issue for a long time for me and this hasn't solved it, but hasn't made it worse either. My understanding is 95% of body melatonin is made outside pineal gland. The dosing regimen is to have the big dose at night as a signal (along with dark). Melatonin is very interesting and old (evolutionarily speaking) . I think nearly every cell in the body makes it as well as bacteria, fish, plants & etc. The idea, is to help mitochondria. There have been some very interesting case reports in the FB group. Some have reported some "healing reactions" that clear after a while, including the reported digestion issues reported here. Most of the folks in the FB group take the powder, so no reactions from fillers to deal with (which may be the source of some digestive reports). The percentage reporting digestive issues in the group is very low, but not zero & again most of these resolve over time.

Basic dosing instruction is to start low and work up. Once an evening dose is settled on, then can dose during the day at 1/3 or less of the evening dose.

Next off the wall suggestion is breathing. Basics - always try to breathe through your nose. Work on CO2 tolerance, which drives urge to breathe (think free divers as an endpoint). Another mitochondrial hack. Because of the Bohr Effect (links in breathing link) the more CO2 in your serum, the more O2 gets into your cells. At least in the states, mouth breathing is rampant. If you look at the tachograms (heart rate vs time graphs) in this post, you can see the difference that taping your mouth at night can make. There are PowerPoint presentations online showing tachogram patterns and sleep apnea. The ugly patterns in the linked post match those in the PPT files. So taping can reduce/eliminate mild to moderate apnea in many cases. For a great overview of the importance of breathing, see James Nestor's book. as well as various exercises he links.. The other side of this is Wim Hof breathing - with hyperventilation followed by a long breath hold. Wim is also a fan of the cold. I do 3-4 rounds of his breathing daily and it really helped my lifelong nasal autoimmune issues. The other 23 hours and 45 or 50 minutes during the day, I try to do hypoventilation and work on CO2 tolerance. I'm 65 and one of my tests is to hike up a steep canyon wall approach trail with a 50-60# climbing pack on, nose breathing the whole time and being the fastest in my party, never stopping. I can ski hard off piste on the steeps at 12-13,000' nose breathing the whole time (I live at 5,550' elevation). Breathing is not talked about, but I think it is huge. More links if you have any interest - let me know. On the cold, I shoveled snow in Oct at 9 & 14 deg F in bare feet & shorts (but have to warm the feet after 15-20 minutes), No gloves or shirt. Monday, I climbed at 7,500' in only shorts all day. When I left the house, it was 28 deg F. It warmed up, but not very much and was windy. I will also take 20 minute baths in 46 deg F water in the winter.

[joesmith]

Tincup - please keep them coming!

Off the wall - not at all, making a lot of sense. I've spent the last fortnight with my mouth taped, amazed at the improvement. (And thinking, all these dollars spent on brain gadgets, and the biggest bang for my buck is….there’s a lesson here)

V. interested in breathing:

Was once a serious yoga practitioner and habituated to nose breathing before neck injury stupidly got me out of the habit. Been meaning to study Hof. Going to do that now

Talk of breathing, cold and altitude - God I miss those things - made me remember another phase where I lived in Japan Alps and meditated at a Zen monastery Came across Sekida's “bamboo method” - the premise being to exhale past your lungs' “reserve volume” (that is, hypoventilate) every fourth breath when you are as a matter of practical fact unable to be distracted by ruminative thought. This in contrast to standard vipassana advice to breath naturally. Just finally put this to the test with my Muse neurofeedback EEG meditation gizmo (those gadgets) and sure enough it thinks I’m 3x the meditator I was 10 minutes ago. I’m in meditation for the upper Alpha right now, maybe this is the way

So yes please give me anything else you think useful!

Apologies if this is poor forum discipline but, if I still have your attention:

My bruxism seems to be getting out of control - I see some scattered and suggestive information, but have you come across any persuasive literature about its possible relation to dementia? Annie Hopper mentioned in Bredesen 2020 relevant here?

Is there a plausible mechanism where a neck injury (herniated C5/6, 20 years ago) cause damage in specific cortical areas?

Very grateful for your advice! Thanks again!

[Julie G]

Joe, I want to be sure that I communicated this point about Type 3 Alzheimer's effectively. Bredesen's schema includes four types of Alzheimer's:

Type 1: Inflammatory. Chronic inflammation, often abetted by an overactive immune system, damages brain tissue faster than the body can repair it.
Type 2: Atrophic. Insufficient thyroid, adrenal, and/or sex hormones, coupled with insulin resistance or insufficient insulin, impair brain tissue repair and renewal processes.
Type 1.5: Glycotoxic. A combination of types 1 and 2 accelerate damage and decelerate repair simultaneously.
Type 3: Toxic. Damage caused by exposure to mold, heavy metals, and/or toxic chemicals overwhelms repair processes.
In contrast, type 3 diabetes is a term used by others (not Bredesen) to suggest that the cellular dysfunction of type 2 diabetes may present independently behind the blood-brain barrier. It's more of a metaphor than a mainstream diagnosis. The idea overlaps most with Bredesen's definition of Type 2 Alzheimer's, but it lacks the detail of Bredesen's rubric.

Just wanted to clarify a few points. The term type-3 diabetes overlaps with Dr. Bredesen's type 1.5 (Glycotoxic). Type 2 is Atrophic and refers to insufficient trophic support, such as nutrients, hormones, etc.

Is there a plausible mechanism where a neck injury (herniated C5/6, 20 years ago) cause damage in specific cortical areas?

Yes, adding to Marc's outline of Dr. Bredesen's Alzheimer's types is type 4 (Vascular) and type 5 (Traumatic) which can include injury to not only the head but other parts of the cerebrospinal column. ApoE4 carriers tend to respond worse than other APOE genotypes to any trauma in this region. I also experienced severe trauma in this area following a motor vehicle collision (28 years ago) and suspect that it has contributed to my risk. That said, by generally following the protocol, I feel confident that I've minimized the impact to the best of my ability. Kudos to you, Joe, for working to identify and address all of your risks!

[TheBrain]

MarcR kindly asked: "Do you meet the criteria for a positive dementia diagnosis today? If so I wonder if something else is going on" My diagnosis on basis of MRI and PET is of mild posterior cortical atrophy, especially in the parietal lobes (but not frontal or hippocampus), giving doctor to suspect early-onset atypical Alzheimers, but lumbar puncture came back negative. Neuropsychological test results still pending. Subjectively I feel I meet the DSM functional criteria for dementia, But in terms of cause we seem to have reached a dead end (Doc says, unhelpfullly,, that I "have a pathology whose cause we don't know and can't know with today's technology".) When I ask him about factors mentioned by Bredesen in Type 3 diabetes, he says (echoing Bredesen), but we'd expect your degeneration to be global. I've done almost all of the tests recommended by Bredesen 2020. So something else going on, seems plausible. But what?

Bredesen's Type 3 is the type of Alzheimer's caused by toxicity, not diabetes. This can cause atrophy in brain areas that aren't seen in typical Alzheimer's. Of course, there are different kinds of toxicity. A big one is mold toxicity. I believe heavy metals is another kind. I know of one person who suffers from toxicity from the silicone in breast implants. I recently bought Bredesen's second book but haven't delved into it yet. It probably covers Type 3, but I know his first book does. You could look at the index and read everything about Type 3 and see what you think.

I've been addressing mold toxicity for three years and am still struggling with it. (I have posted a lot about this stubborn issue on this forum.) I have two copies of a mold-susceptible haplotype that makes my body hold onto mycotoxins (the toxins from mold). My MRI with NeuroQuant showed brain atrophy in multiple places—but not in my hippocampus. I have mild atrophy of my total cerebral white matter and lower-than-ideal volume for my total cerebral white matter, along with atrophy in other areas. Of course, I'm hoping to ward off MCI and Alzheimer's altogether, but it doesn't help that I have yet to have great results from a Great Plains GPL-Mycotox test (I've had five of them so far).

All this is to say I'm wondering if you are dealing with some not-yet-identified toxicity.