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.
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. Since then, several hundred people with cognitive impairment have followed the protocol, and most have seen a reversal of cognitive impairment. Dr. Bredesen is currently partnering with the Cleveland Clinic to test the protocol in a larger trial.
Although Bredesen does not see private patients, he is in the process of making the protocol available to the wider public with the help of doctors certified in the protocol through MPI Cognition. His previous affiliation with Muses Labs has ended.
Bredesen’s protocol has not been tested as a preventative. That said, research has shown that amyloid-β is deposited in E4 carriers as early as their thirties, so addressing components early will likely lead to better health 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.
The following list links to summaries of why each strategy is important, what you can do, and a selection of research references.
Lab Tests to Track and Treat
Insulin sensitivity (insulin and blood glucose)
Inhalational Alzheimer's (editing note: update to types of AD)
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 Apo#4||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|
|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 Atc||≤ 4.5 (fasting insulin) 70-90 (fasting glucose) <5.6 (A1c)||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)|
|RBC thiamine pyrophosphate||100-150|
|Leaky gut, leaky bloodbrain barrier, gluten sensitivity, autoantibodies||Negative|
|Trophic support||Critical tests||Target values||Optional tests||Comments|
|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|
|Metals Excluding those listed above||Critical tests||Target values||Optional tests||Comments|
|Copper, zinc||90-110 (both)|
|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
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
- Videos are available on the MPI Cognition website www.mpicognition.com
- There is a long, but very good STEM Talk interview with Dr Bredesen available on YouTube, Published on Jun 1, 2016 Episode 12 Dale Bredesen discusses the metabolic factors underlying Alzheimer’s Disease
- Presentation given by Dr Bredesen at the Integrative Healthcare Symposium (IHS) Pre-Conference - Feb. 24, 2016 in Midtown, New York City IHS 2016 -Cognitive Health: Dawn of the Era of Treatable Alzheimer’s Disease
- 36 Holes in the Roof, comes with a very nice illustrative video, published Mar 25, 2015 36 ‘Holes in the Roof’ The Dawn of the Era of Treatable and Preventable Alzheimer’s Disease
- Dr Bredesen's presentation at the Ancestral Health Symposium in August 2016 (AHS16) AHS16 - Dale Bredesen - ApoE4 Mechanistics
- Dr Gundry's interview with Dr Bredesen, published on Aug 21, 2017 Dr. Steven Gundry interviews Dr Dale Bredesen about "The End of Alzheimer's"
- Dr Mercola's interview with Dr Bredesen, with a fair discussion of ApoE4, Published on Aug 25, 2017, Dr. Mercola Interviews Dr. Bredesen About ReCODE Protocol
- Dr Perlmutter, author of "The Grain Brain" interviewed Dr Bredesen on Dec 4, 2017. Dr Bredesen also took questions from the audience. Dr Perlmutter and Dr Bredesen
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:
- Metabolic profiling distinguishes three subtypes of Alzheimer's disease, published in August 2015, https://www.ncbi.nlm.nih.gov/pubmed/26343025
- Direct Transcriptional Effects of Apolipoprotein E published January 2016, Dr Bredesen is co-author. https://www.ncbi.nlm.nih.gov/pubmed/26791201
- Inhalational Alzheimer’s Disease: An unrecognized – and treatable epidemic, published February 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789584/
- Transcriptional Effects of ApoE4: Relevance to Alzheimer's Disease, published September 2017. https://www.ncbi.nlm.nih.gov/pubmed/28879423