Bredesen Protocol

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Revision as of 11:05, 12 June 2019 by Theresab (talk | contribs) (chgd MPI to AHNP, added May 2019 interview & changes ID'd fm interview)
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Introduction

Dr. Dale Bredesen has created the ReCODE protocol that involves multiple strategies to address specific health issues that contribute to Alzheimer's Disease (AD). The results of each strategy are measured by using blood tests, cognitive evaluations, and other markers of overall health improvements. Actions are tweaked over time to aim for optimal lab and evaluation results. His analogy is to think of AD as a leaky roof - there are as many as 36 leaks in the AD roof that need to be addressed to stop the problem. Not every patient will have the same leaks, and the protocol is customized based on the patient’s genetics, current health, and lifestyle.

In 2014, his first published paper on the protocol, Reversal of Cognitive Decline, highlighted 10 case studies. Of those 10 people, nine showed enough improvement to return to normal life activities. Several hundred people with cognitive impairment have since followed the protocol, and most have seen a reversal of cognitive impairment. He published results of reversing various levels of cognitive decline in Reversal of Cognitive Decline: 100 patients, published October 2018. His book The End of Alzheimer's, published August 2017 discusses his protocol and explains many of the mechanisms of Alzheimer's.

Bredesen’s protocol has not been tested as a preventative, however in a May 2019 podcast interview, Dr Bredesen did say that he’s never had someone at risk come in for prevention and develop even mild cognitive impairment. Research has shown that amyloid-β is deposited in E4 carriers as early as their thirties, so addressing components prior to experiencing cognitive impairment symptoms will likely lead to better health and cognition in aging. Members on the APOE4.Info forum who follow the protocol report improvements not only in health but also in cognition, even if they do not have an SCI or MCI diagnosis.

Although Bredesen does not see private patients, he has made his protocol available to those seeking doctor assistance through AHNP: Precision Health. MPI Cognition, his previous affiliation, was acquired by AHNP and his prior affiliation with Muses Labs has ended.


The following list links to summaries of why each strategy is important, what you can do, and a selection of research references.

Diet Strategies

Optimize diet

Enhance autophagy and ketogenesis

Improve GI Health


Lifestyle Strategies

Reduce stress

Optimize sleep

Exercise

Rule out sleep apnea

Optimize mitochondrial function


Lab Tests to Track and Treat

Homocysteine

B vitamins

Inflammation

Insulin sensitivity (insulin and blood glucose)

Hormones

Zn:fCu ratio

Vitamin D

Rule out heavy metal toxicity

Optimize antioxidants  ??


Brain Strategies

Brain stimulation

Reduction of Aß

Cognitive enhancement

Increase NGF

Provide synaptic structural components

Increase focus

Increase SirT1 function


Inhalational Alzheimer's (editing note: update to types of AD)


Resources

Lab tests: Lab testing information


Supplements: Supplement ordering


Tracking results: Our member "optimize" made a Google spreadsheet using the recommended Cognoscopy test values in The End of Alzheimer's. This spreadsheet is a simple table to help you track your latest test results, with values flagged as "high", "low", or "in range". It's intended as a quick way to organize test results, and see at a glance where to make improvements.

The link to make your own copy of the spreadsheet for your private use is here: https://goo.gl/8t2dxi

Please note! The copied spreadsheet will let you type in the white areas, but this may cause errors in the formulas. If you accidentally type in a white area, hit "ctrl-Z" a few times to remove the typing, or download a fresh copy of the spreadsheet.


Summary of key tests for ReCode Protocol Taken from Dr Bredesen's book The End of Alzheimer's provided for quick reference, refer to the book for specific information

Genetics Critical tests Target values Optional tests Comments
ApoE Negative for ApoE4 Whole genome, exome, or SNPs Saliva or blood


Blood Tests Critical tests Target values Optional tests Comments
Inflammation vs. cellular protection Hs-CRP <0.9 IL-6, TNFalpha
Homocysteine <7
Vit. B6, B12, folate 60-100 (B6) 500-1500 (B12)10-25 (folate)
Vit. C, D, E 1.3-2.5 (C) 50-80 (D) 12-20 (E) Vit. D is measured as 25-hydroxy-cholecalciferol
Omega-6: omega-3 ratio 0.5-3.0
A/G ratio (albumin:globulin ratio) ≥ 1.8 > 4.5 (albumin)
Fasting insulin, glucose, hemoglobin A1c ≤ 4.5 (fasting insulin) 70-90 (fasting glucose) <5.6 (HbA1c.) Although in a 2019 interview Dr Bredesen updated to: fasting insulin < 5.0, and A1c of 4.5 to 5.2. Neural exosome studies (p-tau, AB42, REST, cathepsin D, and IRS-1 phos. Ratio)
Body mass index (BMI) 18-25
LDL-p or sdLDL or oxidized LDL 700-1000 (p) <20 (sd) <60 (ox)
Cholesterol, HDL, triglycerides >150 (cholesterol) >50 (HDL) <150 (TG)
Glutathione 5.0-5.5
RBC thiamine pyrophosphate 100-150
Leaky gut, leaky bloodbrain barrier, gluten sensitivity, autoantibodies Negative



Trophic support Critical tests Target values Optional tests Comments
Vit D. 50-80
Estradiol (E2), progesterone (p) 50-250 (E2) 1-20 (p)
Pregnenolone, cortisol, DHEA-sulfate 50-100 (preg) 10-18 (cort) 350-430 (DHEA, women) 400-500 (DHEA, men)
Testosterone, free testosterone 1500-1000 6.5-15 (free)
Free T3, free T4, reverse T3, TSH 3.2-4.2 (fT3) 1.3-1.8 (fT4) <20 (rT3) <2.0 (TSH) Ft3:rt3 ≥20


Toxin related Critical tests Target values Optional tests Comments
Mercury, lead, arsenic, cadmium <5, <2, <7, <2.5, respectively <50th percentile (Quicksilver)
Copper:zinc ratio 0.8-1.2 RBC zinc; ceruloplasmin
C4a, TGF-B1, MSH <2830 (C4a) <2380 (TGF-B1) 35-81 (MSH) MMP9, VEGF, leptin, VIP, ADH, osmolality If abnormal, add MARCoNS culture and VCS testing
HLA-DR/DQ Benign HLA-DR/DQ


Metals Excluding those listed above Critical tests Target values Optional tests Comments
RBC-magnesium 5.2-6.5
Copper, zinc 90-110 (both)
Selenium 110-150
Potassium 4.5-5.5
Calcium 8.5-10.5


Cognitive performance Critical tests Target values Optional tests Comments
CNS Vital Signs, BrainHQ, or equivalent >50th percentile for age, improving w/ practice Novel object recognition


Imaging Critical tests Target values Optional tests Comments
MRI w/ volumetrics Hippocampal, cortical valume percentiles steady (or increasing) for age, >25th percentile


Sleep Critical tests Target values Optional tests Comments
Sleep study AHI <5/h


Microbiomes Critical tests Target values Optional tests Comments
Gut, oral, nasal No pathogens

Dr Bredesen's research

Book

Dr Bredesen's book, The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline, published August 22, 2017. Amazon link to Dr Bredesen's book

Videos and interviews

  • He cites 6 types of Alzheimer's: (1) inflammatory (2) atrophic (1.5) glycotoxic (3) toxic (4) vascular and (5) traumatic. Vascular and traumatic are new since publication of his book
  • In his markers for glycotoxicity, he cites fasted insulin of 5.0 (his book cites 4.5) or lower and HbA1c 4.5 to 5.2 (the book cites less than 5.6)
  • Dr Bredesen said that the Big Four to avoid are: grains, simple carbs, dairy, and lectins. Pro-inflammatory lectins have been added since publication of his book.


Dr Bredesen's Papers

  • The first version of Dr Bredesen’s protocol (which is similar to the above) can be found in his paper: Reversal of cognitive decline: A novel therapeutic program, published September 2014, https://www.ncbi.nlm.nih.gov/pubmed/25324467

Subsequent papers of Dr Bredesen do not address his protocol, but further examine his findings. They include:

Of note, since publishing this paper, Dr Bredesen now identifies 5 bad molds: Stachybotrys, Penicillium, Aspergillus, Ketonium, and Wallemia. The last two, Ketonium and Wallemia, have since been added.

This paper addresses the common criticism that the original paper only covered a small number of patients. This paper documents improvement in cognition of 100 patients treated by several different physicians thus providing further support for a randomized, controlled clinical trial of the protocol and overall approach: