Forum Survey: Will you microdose aducan?

[J11]

There is no survey software on forum; let's use this thread for the survey question.

aducan could be approved next Monday. Will those on forum then consider microdosing if they are even decades out for probable disease onset? Amyloid accumulates in the brain for decades before symptomatic onset of cognitive impairment. The current treatment strategy is to then mega dose with anti-amyoids (the label dose is proposed as 10 mg/kg or ~1 gram!).

Might be a better plan to micro-dose years or even decades ahead. The human research unfortunately has not been done, though starting at a thousand fold lower dose and watching amyloid response would not be a completely unreasonable suggestion. Regrettably even for a possible FDA approved drug this would be DIY medicine. Yet, at such microdosing side-effects likely would be minimal (so would out of pocket cost).

44s on forum who introduce themselves often are in a state of near panic upon learning of their heightened dementia risk; they are living their life, successful career, successful family and then bamoo- something unexpectedly arrives into their life from a far off dimension. The efforts of the leaders on this forum to "invent a cure" have been impressive, though an FDA approved medication that was proven to lower amyloid levels would seem to be a highly reasonable option for those with high dementia risk who wanted to proactively manage their risk.

Comments please!

[J11]

Amyloid.GIF

[J11]

As a helpful reminder to everyone, the above figure shows the stylized trajectory of AD progression. Roughly, wait decades and decades until the brain is nearly saturated with amyloid and then apply truly massive quantities of anti-amyloids with some genotypes then having (e.g., e44s) having ARIA like side-effects in up to ~50% of treated patients.

The survey question here for those on forum is instead of maximal dosing once reaching peak amyloid might some consider the somewhat less aggressive strategy of starting closer to the onset of amyloid accumulation and then micro-dose?

[SusanJ]

Interesting question, J11.

Personally, I probably would not, because I tend to not react well to most pharmaceuticals (and many supplements, too). I'd really have to see how others do on a micro dose before it would be on my list.

[J11]

@SusanJ, thank you for replying.
Do not want to pry; answer if you feel comfortable-- are you 44?

[Tincup]

I'm 3/4 and I concur with Susan. I think my 4/4 wife is in my camp. I think there are plenty of interventions before a pharma one would interest me.

[J11]

Tincup, thank you for your reply. I had not expected that response.

Many of those who find this forum arrive here in a state of panic.
Even the leaders of the forum admit that learning of a 44 genotype was disturbing to them.
I had thought that telling such people that there was something that they could proactively do to possibly reduce risk-- almost immediately and at minimal cost would be a great smoother of nerves. Amyloid is a known neurotoxin -- it is difficult to imagine that removing such a toxin could make things worse.

Entering into the research web of any medical topic is highly confusing and contradictory.
An FDA approved product would remove a great deal of such confusion for people.

I am somewhat critical that this possible off-label dose has not been given additional consideration and clinical investigation.
The whole point of regulated medicine is to avoid DIY medicine.
A harm reduction strategy would have seemed entirely reasonable.
Basically, micro-dose those who might be motivated to join a clinical trial and establish safety and the dose required for amyloid clearance. This would seem to be a reasonable effort at due diligence. From there basically say we don't really approve of off-label use and then just leave it at that.

[SusanJ]

Do not want to pry; answer if you feel comfortable-- are you 44?

I'm 3/4.

[J11]

Thank you SusanJ. My expectation is that 44s might be highly motivated to consider to micro-dosing.

We have had a 34 family member who was paid by a memory clinic for high performance memory exercises even into his mid-80s. For our family, a single 4 especially for males seems entirely compatible with sustained high mental performance. I am not as clear about any 44s in the extended family, though I expect that they would have more obvious cognitive impairments.

Pretty exciting! I am seeing if my R program will be able to create polygenic scores. I am now loading in a 1 Gb+ file and R has recognized 1.5 million + variants. This is fairly intense for a PC, though this might even all work out. It would be so much easier if the sequencer provided this software and more CPU. Yeah! Just finished the R load of all the full genome variants-- all 4.5 million of them.

[circular]

Yeah! Just finished the R load of all the full genome variants-- all 4.5 million of them.

Not to rain on your celebration, and I think your deep dives into your genes are so cool and I wish I had time to do that myself, but the scientists are a step ahead here in preprint What I don't know is what the new regions contain and whether its relevant to health (I haven't read the preprint):

The complete sequence of a human genome